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Biomedical subjects

J C Sterling

Publications and source records attributed to J C Sterling.

17 recordsLinked to original sources
PubMed1995

Erythrodermic mycosis fungoides treated with total body irradiation and autologous bone marrow transplantation.

We describe a middle-aged man with aggressive erythrodermic mycosis fungoides whose responses to several well-established therapies for the disease were either poor or short-lived. Infusion of antibodies engineered against cells expressing the CD4 molecule produced little response. Total body irradiation coupled with autologous bone marrow transplantation led to an encouraging but unfortunately unsustained improvement.

Adult↗
PubMed1995

Os acromiale in a baseball catcher.

Throwing injuries of the shoulder can result from an acute traumatic event or chronic overuse. Shoulder impingement has multiple etiologies; the most common being rotator cuff weakness/overuse and resultant glenohumeral instability. However, an uncommon cause of shoulder impingement syndrome is that of a nonfused os acromiale. There are three centers of ossification in the acromion which are usually completely fused by 18 yr of age. The most common site of nonunion is between the meso-acromion and meta-acromion. Os acromiale is reported at a rate of 14/1000 (1.4%) and is bilateral in approximately 62% of cases. The classic diagnosis is radiographically defined with both AP and axillary lateral views, and a contralateral comparison view may be helpful. Computerized axial tomography also aids in the diagnosis. Most os acromiale are asymptomatic. However, if recalcitrant impingement syndrome and/or rotator cuff tears are found in association with os acromiale, then surgical fusion or resection of the ossicle is recommended.

Acromion↗
PubMed1994

Mid-dermal elastolysis.

We report a case of mid-dermal elastolysis in which dermal inflammation was a mild but definite feature. The aetiology of this condition remains unknown, although inflammatory destruction of elastic fibres appears to be the final result. In this study, areas of inflammation exhibited features of a specific immune response, with induction of a number of immune accessory molecules.

Cell Adhesion Molecules↗
PubMed1993

Immunoelectron microscopical localization of human papillomavirus type 16 L1 and E4 proteins in cervical keratinocytes cultured in vivo.

The human papillomavirus (HPV) causes warts, but is also associated with the development of squamous cell dysplasia and carcinoma. The virus is host and tissue specific and the numerous HPV types show predilection for different body sites. Experimental production of HPV 16 particles is at present only possible using in vivo culture of keratinocytes containing episomal viral DNA. Using immunoelectron microscopy, we have investigated the localization of HPV 16 E4 and L1 proteins in a keratinized epithelium formed by grafting HPV 16-containing cervical keratinocytes onto the athymic mouse. New viral progeny are produced in this system, as confirmed by labeling of intranuclear particles with a mouse monoclonal antibody against the HPV 16 major capsid (L1) protein. The role of the E4 protein is not yet clear, although it is believed to be important for the later stages of the virus life cycle. Here we confirm its cytoplasmic localization in the cells of the spinous and granular layers and demonstrate co-localization with keratin tonofilaments.

Animals↗
PubMed1993

False negative bone scan in a female runner.

Stress fractures are more prevalent in today's fitness cognizant society. Stress fractures of the femoral neck are common and present with specific symptoms and findings. The diagnosis is based on clinical history, physical exam, radiography, bone scintigraphy, and computed tomography (C.T.) scans. The triple-phase bone scan is the most sensitive test for the diagnosis of stress fractures and is considered the gold standard for the diagnosis of the occult stress fracture. This case presents a 42-yr-old female marathon runner who presented with hip pain and clinical symptoms indicating a stress fracture of the femoral neck. Initial radiographs and a triple-phase bone scan were negative. When symptoms persisted, a repeat x-ray revealed a femoral neck fracture of the superior surface. In spite of a false negative bone scan, clinical suspicion allowed appropriate treatment of this femoral neck stress fracture. Nondiagnosed stress fractures of the femoral neck may lead to severe disability, including avascular necrosis of the femoral head. Therefore, clinical index of suspicion is very important even if ancillary tests are nondiagnostic.

Adult↗
PubMed1992

Stress fractures in the athlete. Diagnosis and management.

Stress fractures can be a troublesome injury for the sports medicine clinician. The first description was in military personnel, but recently there is an increasing awareness and diagnosis of stress fractures in the athletic population. Stress fractures have been described in all extremities. Some fractures appear to have a degree of sports specificity. Bone is a dynamic tissue which strengthens and remodels in response to stress. Maladaptation to stress causes osteoclastic activity to supersede osteoblastic activity, thereby allowing weakening of the bone. These areas of weakening may fracture and create prodromal symptoms and clinical findings. Localised pains of insidious onset which are activity related are the hallmarks in the clinical history. The physical examination can exhibit localised tenderness, redness and swelling. Radiographs can be negative for up to 4 months. The gold standard for diagnosis is the triple phase 99mtechnetium bone scan. The treatment of a stress fracture is usually conservative. Very few cases require surgical management. The algorithm of conservative management includes: rest, appropriate education for treatment and preventive care, analgesics, serial radiographs, icing and physical therapy modalities, appropriate exercise to prevent detraining, rehabilitation and a regimented return to participation and competition.

Age Factors↗
PubMed1992

Delayed treatment of a malreduced distal femoral epiphyseal plate fracture.

Fractures of the epiphyseal plate are considered rare when compared with the more prevalent injuries found in competitive sports, but the complications associated with this type of trauma are a major concern. The factors affecting the success or failure of healing include the severity of injury, patient age, and the type and expedience of treatment. This case study examines the clinical presentation and treatment of a 15-yr-old high school football player who sustained a displaced, distal femoral epiphyseal Salter II fracture. Primary treatment consisted of nonmanipulative, nonweight bearing knee immobilization. The treatment resulted in malunion, pain, decreased range of motion and physical deformity; therefore, the patient sought a second opinion. On physical exam, the displacement and rotational deformity of the fracture site were unacceptable. The fracture was treated 20 days post-injury via open reduction with internal fixation. On follow-up, the athlete demonstrated radiographic healing, normal physical exam, and no significant leg length discrepancy or deformity. The athlete successfully returned to full competitive sport activity.

Adolescent↗
PubMed1992

Postural responses to lateral perturbation in healthy subjects and ankle sprain patients.

The purpose of this study was to investigate postural responses of healthy subjects and patients with recent ankle sprains following a perturbation that created sway in the frontal plane. EMG data were taken from the posterior tibialis (PT) (not monitored in patients), peroneal longus (PL), and tibialis anterior muscles (TA). Subjects stood on a platform that provided a rotational perturbation (approximately 70 degrees.s-1) in the frontal plane. This perturbation had the effect of everting and loading one limb while inverting and unloading the contralateral limb. An initial response in the PT of the loaded limb and the PL of the unloaded limb was noted at approximately 50 ms following the perturbation. This was followed by a bilateral response in the TA at 60 ms. The amplitude of the TA muscle was significantly greater in the loaded limb. For ankle sprain patients a bilateral TA response and a PL response in the unloaded limb was noted at approximately 65 ms. TA response amplitude ratios between the loaded and unloaded limbs were similar to that of the healthy subjects. These data suggest that ankle sprain patients use a modified postural response following lateral perturbation as a compensation for the injury.

Adult↗
PubMed1991

A "public" T-helper epitope of the E7 transforming protein of human papillomavirus 16 provides cognate help for several E7 B-cell epitopes from cervical cancer-associated human papillomavirus genotypes.

We have identified a major T-cell epitope, amino acids 48-54 (DRAHYNI, in one-letter code) in the E7 open reading frame protein of human papillomavirus (HPV) type 16. Lymph node cells from mice immunized with synthetic peptides containing DRAHYNI proliferated and produced interleukin when challenged in vitro with peptide or whole HPV-16 E7 fusion protein. The T epitope was recognized in association with all five major histocompatibility complex class II I-A and I-E alleles tested. Synthetic peptides consisting of DRAHYNI linked to major B-cell epitopes on the E7 molecule formed immunogens capable of eliciting strong antibody responses to HPV-16 E7. The T epitope could provide help for the production of antibody to several B epitopes simultaneously, including a B epitope of HPV-18 E7 protein. Mice immunized with a peptide containing DRAHYNI and B epitope and, at a later date, infected with recombinant vaccinia E7 virus, displayed secondary antibody responses to E7. Because E7 has a role in cell transformation and is the most abundant viral protein in HPV-associated neoplastic cervical epithelial cells, the data have implications for vaccine strategies.

Amino Acid Sequence↗
PubMed1991

An unusual stress fracture in a multiple sport athlete.

Most overuse injuries are a direct result of repetitive stresses which may create a condition of maltraining. Young athletes are no exception to this rule. Swimming and baseball both create stresses to the humerus which may result in injuries to the shoulder and upper extremity. Stress fractures (fatigue fractures) are usually limited to the lower extremity (i.e., tibia or metatarsal). Upper extremity stress fractures, especially of the humerus, are very uncommon. Precipitating factors include repetitive stresses, low grade external forces, rapid application of muscular force to the bone, or an underlying disease or pathologic weakness of the bone. The majority of these fractures are primarily due to abnormal and repetitive stresses to bones. This case study examines the mechanism of injury, clinical presentation, and treatment of a clinically apparent stress fracture which ultimately converted to an overt humerus fracture in a 14-yr-old cross-trained athlete.

Adolescent↗
PubMed1990

Anabolic steroids in athletics.

Steroid abuse in athletics is one of the most pressing health problems in sports today. Many athletes believe that they must take steroids in order to compete, even though scientists are divided on the question of whether steroids increase strength. This paper reviews the history of anabolic drug use in sports, the types of steroids and amounts used, their intended effects, and the possible side effects.

Anabolic Agents↗
PubMed1984

In vitro migration of human mononuclear cells towards a psoriatic scale extract.

Extracts of psoriatic scales from patients with chronic plaque psoriasis and of normal human post-mortem skin were tested for their effects on the migration of healthy human mononuclear cells in a modified Boyden chamber. A preparation of cells containing 12-32% monocytes was obtained from whole blood by a density gradient technique. The cells were allowed to migrate through a polycarbonate filter towards various dilutions of the two types of extract, a known chemoattractant or towards buffer alone. There was enhancement of migration towards psoriasis scale extract, with significant differences only at the stronger concentrations tested. The results suggest that scales taken from stable plaque psoriasis contain an extractable water-soluble factor which stimulates the movement of peripheral blood mononuclear cells.

Chemotaxis, Leukocyte↗
PubMedDate not supplied

Injuries in intercollegiate rodeo athletes.

Collegiate rodeo athletes (N = 156) in the National Intercollegiate Rodeo Association (NIRA) Southern Region, were examined for injuries during a 7 month (10 rodeo) season from 1987 to 1988. Sixty-two athletes sustained a total of 138 acute injuries resulting from 3292 exposures. One hundred twenty-seven injuries (92% of total injuries) occurred in the roughstock and steer wrestling events, and 11 injuries (8%) occurred in the roping and female events. When calculating opportunity for injury, rodeo athletes face an 89% potential for injury per season. Ninety-one of the injuries incurred were upper body injuries; 47 were lower body injuries. A 6:1 exposure to injury ratio among roughstock events exemplifies the magnitude of injury potential in this sport, affecting 25% of roughstock competitors. Contusions, strains, and concussions comprised 42%, 16%, and 11% of the total injuries, respectively, whereas fractures and dislocations comprised only 5% of the total. Twenty-three percent of the injuries occurred during the completion of an athlete's ride, with 21% of injuries attributed to equipment mishaps. Frequency of injury by performance, relation of seasonal participation and exposure to injury, orthotic care, use of conditioning programs, medication history, and need for enhanced sports medicine education in this sport are discussed.

Adolescent↗
PubMedDate not supplied

Exercise performance of collegiate rodeo athletes.

In this study we examined the physical, hematologic, and exercise response of 20 male and 10 female athletes of the National Intercollegiate Rodeo Association, Central Rocky Mountain Region. Male subjects were grouped by roughstock, steer wrestling, and roping events. Female athletes were grouped separately. Maximal aerobic capacity, pulmonary ventilation, respiratory exchange ratio, energy expenditure, maximal heart rate, blood pressure, treadmill time, pre- and postexercise lactate, percent body fat, lean body mass, blood chemistry, serum lipids, and reaction/movement time were analyzed by event. No significant differences (P greater than 0.05) were found in any of these categories between male events. Mean resting blood chemistry parameters of rodeo athletes were within normal ranges. Steer wrestling athletes possessed greater body size and lean body mass than other groups. When analyzing body composition, blood pressure, and total cholesterol:high-density lipoprotein (HDL) cholesterol ratios, results indicate average to low risk for coronary heart disease. When compared to other intermittent-activity sport athletes, college rodeo athletes appear to have similar aerobic capacities, but possess lower lean body mass and greater percent body fat.

Adult↗
PubMedDate not supplied

Allograft failure in cruciate ligament reconstruction. Follow-up evaluation of eighteen patients.

Previous authors have reported the efficacy of cruciate ligament allograft reconstruction of the knee suggesting that allograft strength is not significantly different than that of autografts. The purpose of this study was to elicit the cause of a higher-than-expected failure rate in cruciate ligament allograft reconstructions. After clinical diagnoses, 12 male and 6 female patients with cruciate ligament instability underwent intraarticular allograft reconstruction followed by an aggressive rehabilitation program. Deep-frozen, freeze-dried, ethylene oxide-sterilized, bone-patellar tendon-bone allografts were rehydrated, prestressed, and implanted by an open or arthroscopically assisted technique. Results revealed 6 of 18 failures. Knee instability, postoperative complications, and roentgenographic changes were evident. Evaluation of procurement technique showed that graft failure was significantly correlated with time to implantation. A significant difference in mean time from procurement and deep freezing to freeze-drying and sterilization between failed-versus-successful grafts was 265.5 +/- 61.9 versus 66.8 +/- 43.8 days, respectively. Total mean time of failed grafts from procurement to implantation was significantly greater (528.3 +/- 75.1 versus 207.3 +/- 53.1 days) than for successful grafts. All graft failures came from the same batch number. These findings indicate that cruciate ligament allograft reconstruction can be successful; however, longer shelf life negatively affects graft integrity.

Adolescent↗