Aplasia of the flexor digitorum profundus tendon of the small finger.
Explore the source record for details and available documents.
Child↗
Biomedical subjects
A Schweizer
Publications and source records attributed to A Schweizer.
Vildagliptin therapy reduces postprandial intestinal triglyceride-rich lipoprotein particles in patients with type 2 diabetes.
AIMS/HYPOTHESIS: We assessed the effects of vildagliptin, a novel dipeptidyl peptidase IV inhibitor, on postprandial lipid and lipoprotein metabolism in patients with type 2 diabetes. SUBJECTS, MATERIALS AND METHODS: This was a single-centre, randomised, double-blind study in drug-naive patients with type 2 diabetes. Patients received vildagliptin (50 mg twice daily, n=15) or placebo (n=16) for 4 weeks. Triglyceride, cholesterol, lipoprotein, glucose, insulin, glucagon and glucagon-like peptide-1 (GLP-1) responses to a fat-rich mixed meal were determined for 8 h postprandially before and after 4 weeks of treatment. RESULTS: Relative to placebo, 4 weeks of treatment with vildagliptin decreased the AUC(0-8h) for total trigyceride by 22+/-11% (p=0.037), the incremental AUC(0-8h) (IAUC(0-8h)) for total triglyceride by 85+/-47% (p=0.065), the AUC(0-8h) for chylomicron triglyceride by 65+/-19% (p=0.001) and the IAUC(0-8h) for chylomicron triglyceride by 91+/-28% (p=0.002). This was associated with a decrease in chylomicron apolipoprotein B-48 (AUC(0-8h), -1.0+/-0.5 mg l(-1) h, p=0.037) and chylomicron cholesterol (AUC(0-8h), -0.14+/-0.07 mmol l(-1) h, p=0.046). Consistent with previous studies, 4 weeks of treatment with vildagliptin also increased intact GLP-1, suppressed inappropriate glucagon secretion, decreased fasting and postprandial glucose, and decreased HbA(1c) from a baseline of 6.7% (change, -0.4+/-0.1%, p<0.001), all relative to placebo. CONCLUSIONS/INTERPRETATION: Treatment with vildagliptin for 4 weeks improves postprandial plasma triglyceride and apolipoprotein B-48-containing triglyceride-rich lipoprotein particle metabolism after a fat-rich meal. The mechanisms underlying the effects of this dipeptidyl peptidase IV inhibitor on postprandial lipid metabolism remain to be explored.
Adamantane↗
[42-year-old man with painless swelling of the ring finger].
A 42 years old man presented with a painless increasing swelling in the region of the proximal phalanx and metacarpal bone of the ring finger persistent since five months. Plain X-rays revealed increased soft tissue density. The possibilities of differential diagnostic of tumors in the region were discussed because essential for the correct procedure. Histology revealed a bizarre periostal osteochromatic proliferation (Nora lesion). This rare lesion must be distinguished from an periostic osteosarcoma.
Adult↗
Five-year results of two cemented hip stem models each made of two different alloys.
INTRODUCTION: The aim of this study was to compare the influence of two different cemented hip stems each made of two different alloys concerning survival and outcome. MATERIALS AND METHODS: The 5-year results with 161 Mueller straight stems made of cobalt chromium (SS CoCr), 272 Mueller straight stems made of titanium (SS Ti), 233 Mueller SL stems made of titanium (SL Ti) and 255 SL stems made of cobalt chromium (SL CoCr) implanted consecutively in this order were compared. All patients were followed up prospectively during the first 5 years after implantation. The evaluation of the results was retrospective. RESULTS: The survival rates for aseptic loosening were 100% (SS CoCr), 92.8% (SS Ti), 81.6% (SL Ti) and 97.8% (SL CoCr). Clinical and radiological outcomes like pain occurrence, use of pain medication, ability to climb stairs, amount of stem subsidence and osteolysis correlated statistically significantly with the results of the survival rates. Concerning the two alloys, chromium cobalt showed better results, and concerning the two designs, the straight stem had a better outcome. For the four prostheses being compared, the results were influenced more by the alloy than by the design, and the small-sized titanium stems were more susceptible to undergoing revision than the large-sized prostheses. CONCLUSION: Stem design and even more alloy may influence the survival rate and clinical outcome. Evaluating the results, we recommend the use of the classic straight stem prosthesis made of cobalt chromium.
Adult↗
Functional ankle control of rock climbers.
OBJECTIVE: To evaluate whether rock climbing type exercise would be of value in rehabilitating ankle injuries to improve ankle stability and coordination. [figure: see text] METHODS: A group of 25 rock climbers was compared with a group of 26 soccer players. All were male, uninjured, and exercised three to four times a week. Active ankle stability was evaluated by one leg stand stabilometry (measurement of migration of the centre of gravity) and measurements of maximum strength of ankle isokinetic concentric flexion and extension (Cybex). RESULTS: The rock climbers showed significantly better results in the stabilometry and greater absolute and relative maximum strength of flexion in the ankle. The soccer players showed greater absolute but not relative strength in extension. CONCLUSION: Rock climbing, because of its slow and controlled near static movements, may be of value in the treatment of functional ankle instability. However, it has still to be confirmed whether it is superior to the usual rehabilitation exercises such as use of the wobble board.
Adolescent↗
Ten-year follow-up of primary straight-stem prosthesis (MEM) made of titanium or cobalt chromium alloy.
INTRODUCTION: An increased revision rate of cemented titanium stems compared with cobalt chromium stems has been described after a short follow-up. In this paper, the minimum 10-year outcome after the implantation of titanium (Ti) and cobalt chromium ME (CoCr) Mueller straight-stem prostheses is analyzed in order to estimate the prognosis of the patients who were not revised. MATERIALS AND METHODS: . A total of 272 (Ti) straight stems were implanted between 1987 and 1990, and 161 (CoCr) straight stems were implanted from 1984 to 1987. Clinical and radiological checks were carried out prospectively after 1, 2, 5, and 10 years. RESULTS: The survival rate concerning aseptic loosening of the stem after 5 years was 92.8% (Ti)/100% (CoCr) and after 10 years 80.9%/98.2%. Thirty-six (Ti)/2 (CoCr) patients required revision of the stem due to aseptic loosening. The revision rate per year of the Ti stems increased until 7 years postoperatively and decreased thereafter. At the 10-year follow-up, 107 Ti and 84 CoCr implants were checked, and the subjective and clinical parameters did not differ between the two groups. CONCLUSION: Except for an increased subsidence rate of the stems in the Ti (31%) versus the CoCr group (16%), there was no statistically significant difference in the clinical and radiological outcomes.
Aged↗
Friction between human finger flexor tendons and pulleys at high loads.
A method was developed to indirectly measure friction between the flexor tendons and pulleys of the middle and ring finger in vivo. An isokinetic movement device to determine maximum force of wrist flexion, interphalangeal joint flexion (rolling in and out) and isolated proximal interphalangeal (PIP) joint flexion was built. Eccentric and concentric maximum force of these three different movements where gliding of the flexor tendon sheath was involved differently (least in wrist flexion) was measured and compared. Fifty-one hands in 26 male subjects were evaluated. The greatest difference between eccentric and concentric maximum force (29.9%) was found in flexion of the PIP joint. Differences in the rolling in and out movement (26.8%) and in wrist flexion (14.5%) were significantly smaller. The force of friction between flexor tendons and pulleys can be determined by the greater difference between eccentric and concentric maximum force provided by the same muscles in overcoming an external force during flexion of the interphalangeal joints and suggests the presence of a non-muscular force, such as friction. It constitutes of 9% of the eccentric flexion force in the PIP joint and therefore questions the low friction hypothesis at high loads.
Adolescent↗
Surveillance of nosocomial transmission of Candida albicans in an intensive care unit by DNA fingerprinting.
The frequency of nosocomial transmission of the opportunistic fungal pathogen Candida albicans in an intensive care unit was tested by DNA fingerprinting of 91 isolates from 32 hospitalized patients with the mid-repetitive Ca3 DNA probe. This showed that serial isolates of C. albicans from individual patients belonged to genetically distinct strains. In comparison with nosocomial bacterial pathogens, the transmission of C. albicans in an intensive care unit occurred at a much lower frequency. In conclusion, the threat of C. albicans infection does not lie within the hospital, but in commensal isolates. These findings are relevant for infection control practices.
Candida albicans↗
Lumbrical tears in rock climbers.
Performance rock climbing places high demands on the hand and may lead to specific injuries. In a "one-finger-pocket" hold, the interphalangeal joints remain in 20-40 degrees flexion. To increase the maximum force of the holding finger by the quadriga effect, the interphalangeal joints of the adjacent fingers become almost maximally flexed. Holding a "one-finger-pocket" with the ring or small finger leads to a shift of the deep flexor tendons which increases the distance between the two adjacent origins of either the third or the fourth lumbrical. This may cause disruption and tear of that muscle. An organized haematoma in the third lumbrical was visible by ultrasonography in one of the three cases described.
Adult↗
Biomechanical properties of the crimp grip position in rock climbers.
Rock climbers are often using the unique crimp grip position to hold small ledges. Thereby the proximal interphalangeal (PIP) joints are flexed about 90 degrees and the distal interphalangeal joints are hyperextended maximally. During this position of the finger joints bowstringing of the flexor tendon is applying very high load to the flexor tendon pulleys and can cause injuries and overuse syndromes. The objective of this study was to investigate bowstringing and forces during crimp grip position. Two devices were built to measure the force and the distance of bowstringing and one device to measure forces at the fingertip. All measurements of 16 fingers of four subjects were made in vivo. The largest amount of bowstringing was caused by the flexor digitorum profundus tendon in the crimp grip position being less using slope grip position (PIP joint extended). During a warm-up, the distance of bowstringing over the distal edge of the A2 pulley increased by 0.6mm (30%) and was loaded about 3 times the force applied at the fingertip during crimp grip position. Load up to 116N was measured over the A2 pulley. Increase of force in one finger holds by the quadriga effect was shown using crimp and slope grip position.
Adult↗
A di-aromatic motif in the cytosolic tail of the mannose receptor mediates endosomal sorting.
The mannose receptor (MR), the prototype of a new family of multilectin receptor proteins important in innate immunity, undergoes rapid internalization and recycling from the endosomal system back to the cell surface. Sorting of the MR in endosomes prevents the receptor from entering lysosomes where it would be degraded. Here, we focused on a diaromatic sequence (Tyr(18)-Phe(19)) in the MR cytoplasmic tail as an endosomal sorting signal. The subcellular distribution of chimeric constructs between the MR and the cation-dependent mannose 6-phosphate receptor was assessed by Percoll density gradients and cell surface assays. Unlike the wild type constructs, mutant receptors with alanine substitutions of Tyr(18)-Phe(19) were highly missorted to lysosomes, indicating that the di-aromatic motif of the MR cytoplasmic tail mediates sorting in endosomes. Within this sequence Tyr(18) is the key residue with Phe(19) contributing to this function. Moreover, Tyr(18) was also found to be essential for internalization, consistent with the presence of overlapping signals for internalization and endosomal sorting in the cytosolic tail of the MR. A di-aromatic amino acid sequence in the cytosolic tail has now been shown to function in two receptors known to be internalized from the plasma membrane, the MR and the cation-dependent mannose 6-phosphate receptor. This feature therefore appears to be a general determinant for endosomal sorting.
Amino Acids↗
Organization and chromosomal localization of the human ECEL1 (XCE) gene encoding a zinc metallopeptidase involved in the nervous control of respiration.
ECEL1 (endothelin-converting enzyme-like 1; previously known as XCE) is a putative zinc metalloprotease that was identified recently on the basis of its strong identity with endothelin-converting enzyme. Although the physiological function of ECEL1 is unknown, inactivation of the corresponding gene in mice points to a critical role of this protein in the nervous control of respiration. In the present study we have characterized the human ECEL1 gene. It was located to region q36-q37 of chromosome 2 and shown to be composed of 18 exons spanning approx. 8 kb. The structure of the ECEL1 gene displays some striking similarities with those of genes of related metallopeptidases, supporting the hypothesis that they are all derived from a common ancestor. A short phylogenetic study describing the relationship between the various members of this gene family is also presented.
Animals↗
Cardiovascular responses to anesthetic induction in patients chronically treated with angiotensin-converting enzyme inhibitors.
PURPOSE: To investigate the effects of chronic ACE inhibition on cardiac neural function following induction of general anesthesia in patients with underlying coronary artery disease. METHOD: In a prospective case-control study, heart rate variability (HRV) and baroreflex control were compared preoperatively and 30 min after anesthesia induction in patients receiving, or not, ACEI (n=16, control group and n=16, ACEI group). All patients had normal cardiac function and anesthesia consisted of a fixed dose regimen of fentanyl and midazolam. Anesthesia-related hypotension was defined by systolic blood pressure < 90 mmHg. Spectral density of HRV was calculated for low frequency and high frequency bands (LF, from 0.05 to 0.15 Hz and HF, from > 0.15 to 0.6 Hz). Baroreflex sensitivity was estimated after blood pressure changes induced by injections of phenylephrine (PHE) and nitroglycerin (NTG). RESULTS: The HRV parameters and baroreflex sensitivity were not different between groups, during the awake and anesthesia periods. Anesthesia produced similar reduction in total HRV in the Control and ACEI groups (-93 +/- 28% vs -89 +/- 32%), and in baroreflex sensitivity during NTG (-64 +/- 21% vs -54 +/- 17%) or PHE tests (-74 +/- 25% vs -72 +/- 22%). Anesthesia-related hypotension occurred in nine patients in the ACEI group (vs two controls). Although the hypertensive response to phenylephrine was greater after anesthesia in both groups, the sensitivity to phenylephrine was attenuated in those patients experiencing hypotension in the ACEI group. CONCLUSIONS: Chronic preoperative treatment with ACEIs does not influence cardiac autonomic regulation and anesthetic-induced hypotensive episodes are mainly attributed to decreased alpha-adrenergic vasoconstrictive response.
Aged↗
Postoperative fatal intestinal necrosis after enalapril treatment in a patient with rheumatoid arthritis.
The inappropriate use of antihypertensive medications may cause hypotensive responses associated with organ failure. We describe a patient who developed nonocclusive splanchnic ischemia leading to death following the administration of enalapril to treat postoperative hypertension. The mechanisms and consequences of refractory hypotension induced by angiotensin-converting enzyme inhibitors are discussed.
Aged↗
The TEA/ATTS transcription factor CaTec1p regulates hyphal development and virulence in Candida albicans.
The temporal and spatial expression of stage-specific genes during morphological development of fungi and higher eukaryotes is controlled by transcription factors. In this study, we report the cloning and functional analysis of the Candida albicans TEC1 (CaTEC1) gene, a new member of the TEA/ATTS family of transcription factors that regulates C. albicans virulence. The promoters of the type 4, 5 and 6 proteinase isogenes (SAP4-6) contain repetitive TEA/ATTS consensus sequence motifs. This finding suggests a possible role for a homologue of Saccharomyces cerevisiae TEC1 during the activation of proteinase gene expression in C. albicans. CaTEC1 is predominantly expressed in the hyphal form of C. albicans. In vitro, serum-induced hyphal formation as well as evasion from MPhi after phagocytosis is suppressed in catec1/catec1 mutant cells. Furthermore, expression of the proteinase isogenes SAP4-6 is no longer inducible in these mutant cells. The deletion of the CaTEC1 gene attenuates virulence of C. albicans in a systemic model of murine candidiasis, although both mutant and revertant cells that were prepared from infected tissues or the vaginal mucosa grew in a hyphal morphology in vivo. CaTEC1 complements the pseudohyphal and invasive growth defect of haploid and diploid S. cerevisiae tec1/tec1 mutant cells and strongly activates the promoter of FLO11, a gene required for pseudohyphal growth. This study provides the first evidence pointing to an essential role for a member of the TEA/ATTS transcription factor family that had so far only been ascribed to function during development as a virulence regulator in microbial pathogenesis.
Animals↗
Biomechanical effectiveness of taping the A2 pulley in rock climbers.
Circular taping around the proximal phalanx is frequently used by rock climbers to treat tenosynovitis and to prevent injuries to the A2 pulley. The aim of this study was to determine the biomechanical effectiveness of such taping. Devices were built to measure physiological bowstringing in vivo, and to determine the force of bowstringing as well as the force applied to the pulley tape. Two kinds of taping on 16 fingers were measured during the typical crimp grip position. Taping over the A2 pulley decreased bowstringing by 2.8% and absorbed 11% of the force of bowstringing. Taping over the distal end of the proximal phalanx decreased bowstringing by 22% and absorbed 12% of the total force. Circular taping is minimally effective in relieving force on the A2 pulley. It is probably ineffective in preventing pulley ruptures.
Athletic Injuries↗
Aprotinin does not impair renal haemodynamics and function after cardiac surgery.
Patients undergoing cardiac surgery with moderate hypothermic cardiopulmonary bypass (CPB) were allocated randomly to receive either saline (control group, n = 29) or a high-dose regimen of aprotinin (aprotinin group, n = 28). In both groups, CPB was associated with similar and transient increases in effective renal plasma flow (+54% in controls and +48% in aprotinin-treated patients) and in fractional excretion of sodium and potassium, but glomerular filtration rate remained unchanged. Plasma and urinary ratios of 6-keto-PGF1 alpha to thromboxane B2 (TxB2) increased significantly, indicating systemic and renal release of vasodilatory prostaglandins. Osmolar clearance correlated with urinary excretion of cyclic GMP (r = 0.79 and 0.86 in the control and aprotinin groups, respectively) and 6-keto-PGF1 alpha (r = 0.63 and 0.69 in the control and aprotinin groups, respectively). Compared with preoperative values, plasma atrial natriuretic peptide increased after weaning from CPB (+71% and +93% in the control and aprotinin groups, respectively). Aprotinin had no apparent adverse effect on renal function and it did not alter mechanisms involving prostanoids and atrial natriuretic peptide during cardiac surgery.
6-Ketoprostaglandin F1 alpha↗
Endothelin-converting enzyme-like 1 (ECEL1; 'XCE'): a putative metallopeptidase crucially involved in the nervous control of respiration.
Endothelin-converting enzyme-like 1 (ECEL1) is a putative zinc metalloprotease that was recently identified on the basis of its strong similarity to endothelin-converting enzyme 1. The physiological function of ECEL1 remains unknown so far; the failure to identify a substrate for ECEL1 could be related to the endoplasmic reticulum subcellular localization found by immunofluorescence in recombinant systems. However, clues to the function of ECEL1 were provided by the inactivation of its gene in mice, which resulted in neonatal lethality. The phenotype of homozygous ECEL1(-/-) mice, together with the very specific expression profile of its mRNA in the central nervous system, suggests that ECEL1 is crucially involved in the nervous control of respiration.
Animals↗