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At least 289 records · Page 16Linked to original sources
PubMed1995

Shoulder instability in the overhand or throwing athlete.

In the young throwing athlete with shoulder pain, it is essential to recognize that glenohumeral joint instability (occult subluxation, rather than impingement) is the primary underlying pathology. Fortunately, conservative management is effective in most chronic overuse injuries. For those athletes with continued symptoms, surgical intervention may become necessary. The anterior capsulolabral reconstruction addresses the problem of glenohumeral joint instability by correcting the capsular redundancy, labrum damage, or both. The authors believe this most recent surgical technique and postoperative rehabilitation program has resulted in a significant improvement in our ability to more predictably and successfully return these athletes to prior competitive levels.

Arm Injuries↗
PubMed1996

Elbow injuries to the throwing athlete.

Elbow injuries in the throwing athlete are common. Because of the tremendous medial tensile forces and lateral compressive forces borne by the elbow, there is a wide array of injuries that occur. A detailed history and physical examination are necessary for an accurate diagnosis. Many of the injuries discussed can be treated successfully with conservative measures followed by aggressive physical therapy. Prompt recognition and early treatment is mandatory. In those conditions in which conservative treatment tends to fail, the detailed surgical options have been discussed. It is important to select highly motivated patients for those procedures that require extensive rehabilitation postoperatively. The keys to success in elbow surgery are a compliant patient and a well-regimented rehabilitation program.

Athletic Injuries↗
PubMed2001

Primary oblique muscle overaction: the brain throws a wild pitch.

BACKGROUND: Sensorimotor and orbital anatomical mechanisms have been invoked to explain primary oblique muscle overaction. METHODS: Review of primitive visuo-vestibular reflexes and neuroanatomical pathways corresponding to vestibulo-ocular reflexes, and correlation with known clinical abnormalities in patients with primary oblique muscle overaction. RESULTS: Bilateral superior oblique muscle overaction, which corresponds to a backward pitch in lateral-eyed animals, can occur when structural lesions involving the brainstem or cerebellum increase central otolithic input to the extraocular muscle subnuclei that modulate downward extraocular muscle tonus. Bilateral inferior oblique overaction, which corresponds to a forward pitch in lateral-eyed animals, may result from visual disinhibition of central vestibular pathways to the extraocular muscle subnuclei that modulate upward extraocular muscle tonus. CONCLUSIONS: Primary oblique muscle overaction recapitulates the torsional eye movements that occur in lateral-eyed animals during body movements or directional luminance shifts in the pitch plane. These primitive ocular motor reflexes become manifest in humans when early-onset strabismus or structural lesions within the posterior fossa alter central vestibular tone in the pitch plane.

Animals↗
PubMed2005

Can a matrix make a training model?: "no." Let's not throw out the Boulder model.

In response to the call by C.R. Snyder and T.R. Elliott (this issue, pp. 1033-1054) for a new clinical training program, I propose the need to keep the Boulder model. I trace my involvement with the Boulder model from my clinical graduate training through my 30 years as a professor. One of the major tasks of clinical training is to teach graduate students to think in a critical rigorous fashion in order to avoid the fads in the mental health field.

Clinical Competence↗
PubMed1998

The crystal structure of Lactococcus lactis dihydroorotate dehydrogenase A complexed with the enzyme reaction product throws light on its enzymatic function.

Dihydroorotate dehydrogenases (DHODs) catalyze the oxidation of (S)-dihydroorotate to orotate, the fourth step and only redox reaction in the de novo biosynthesis of pyrimidine nucleotides. A description is given of the crystal structure of Lactococcus lactis dihydroorotate dehydrogenase A (DHODA) complexed with the product of the enzyme reaction orotate. The structure of the complex to 2.0 A resolution has been compared with the structure of the native enzyme. The active site of DHODA is known to contain a water filled cavity buried beneath a highly conserved and flexible loop. In the complex the orotate displaces the water molecules from the active site and stacks above the DHODA flavin isoalloxazine ring, causing only small movements of the surrounding protein residues. The orotate is completely buried beneath the protein surface, and the orotate binding causes a significant reduction in the mobility of the active site loop. The orotate is bound by four conserved asparagine side chains (Asn 67, Asn 127, Asn 132, and Asn 193), the side chains of Lys 43 and Ser 194, and the main chain NH groups of Met 69, Gly 70, and Leu 71. Of these the Lys 43 side chain makes hydrogen bonds to both the flavin isoalloxazine ring and the carboxylate group of the orotate. Potential interactions with bound dihydroorotate are considered using the orotate complex as a basis for molecular modeling. The role of Cys 130 as the active site base is discussed, and the sequence conservation of the active site residues across the different families of DHODs is reviewed, along with implications for differences in substrate binding and in the catalytic mechanisms between these families.

Binding Sites↗
PubMed1996

Throwing a spanner in the works: antibiotics and the translation apparatus.

The protein synthetic machinery is essential to all living cells and is one of the major targets for antibiotics. Knowledge of the structure and function of the ribosome and its associated factors is key to understanding the mechanism of drug action. Conversely, drugs have been used as tools to probe the translation cycle, thus providing a means to further our understanding of the steps that lead to protein synthesis. Our current understanding as to how antibiotics disrupt this process is reviewed here, with particular emphasis on the prokaryotic elongation cycle and those drugs that interact with ribosomal RNAs.

Anti-Bacterial Agents↗
PubMed1980

Disposable menstrual regulation kits in a non-throw-away economy.

The directions for use that are packaged with plastic menstrual regulation kits state that the kits are designed to be durable for approximately 50 procedures when used as directed. However, in much of the developing world, directions for use are ignored, equipment is not maintained properly and nothing (including disposable medical equipment) is discarded until it is unless. Therefore, it is of interest to know for how many procedures the disposable menstrual regulation kit can safely be used. This paper describes a study conducted in Singapore to determine the durability of three menstrual regulation kits manufactured by different companies and comments on how cleaning and sterilizing affects the durability of these kits.

Developing Countries↗
PubMed1995

The Ottawa Prenatal Prospective Study (OPPS): methodological issues and findings--it's easy to throw the baby out with the bath water.

In the OPPS we have been studying the effects of marihuana used during pregnancy since 1978. The subjects are primarily middle-class, low risk women who entered the study early in their pregnancy. Extensive demographic and life-style information was gathered several times during pregnancy and postnatally. The offspring have been assessed repeatedly during the neonatal period, at least annually until the age of 6 and less frequently thereafter. The outcome measures include a variety of age appropriate standardized global measures as well as a large battery of neuropsychological tests attempting to assess discrete functioning within particular domains including language development, memory, visual/perceptual functioning, components of reading and sustained attention. The results suggest that in the neonate, state alterations and altered visual responsiveness may be associated with in utero exposure to marihuana. Global measures, particularly between the ages of 1 and 3 years, did not reveal an association with prenatal marihuana exposure. However, this initial, apparent absence of effect during early childhood should not be interpreted as in utero marihuana exposure having only transient effects for, as the children became older, aspects of neuropsychological functioning did discriminate between marihuana and control children. Domains associated with prenatal marihuana exposure at four years of age and older included increased behavioral problems and decreased performance on visual perceptual tasks, language comprehension, sustained attention and memory. The nature and the timing of the appearance of these deficits is congruent with the notion of prenatal marihuana exposure affecting 'executive functioning'--goal directed behavior that includes planning, organized search, and impulse control. Such an interpretation would be consistent with the extant literature with animals and non-pregnant adult users suggesting that chronic marihuana use may impact upon prefrontal lobe functioning.

Child, Preschool↗