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PubMed1989

Differentiation between late potentials of right ventricular and of left ventricular origin.

The aim of this study was to determine whether late potentials of right and left ventricular origin could be differentiated with the use of a signal-averaging technique. Nineteen patients with both late potentials and recurrent sustained ventricular tachycardia were divided into 2 groups according to the origin of their late potentials. Group I consisted of 10 patients with late potentials that originated from the right ventricle. Group II consisted of 9 patients with late potentials originating from the left ventricle. Signal-averaged electrocardiograms (Marquette Electronics MAC I unit) were recorded using 3 bipolar and 3 augmented unipolar leads (the electrode positions were V1, V5 and V6R) with a band-pass filter of 100 to 300 Hz. The augmented unipolar V5 lead (aV5) was used for left-side recording and the augmented unipolar V1 lead (aV1) was used for right-side recording. In group I, the mean maximal late potential amplitude was larger in lead aV1 than in lead aV5 (5.1 +/- 2.5 vs 3.7 +/- 1.8 microV, p less than 0.005) and the maximal late potential amplitude was larger in lead aV1 in all except 1 patient. In group II, however, the mean maximal late potential amplitude was smaller in lead aV1 than in lead aV5 (4.0 +/- 3.0 vs 5.7 +/- 3.2 microV, p less than 0.005) and the maximal late potential amplitude was smaller in lead aV1 in all patients. Thus, the origin of late potentials (right ventricular vs left ventricular origin) can be determined by comparing the maximal amplitudes of late potentials in the right- and left-sided leads. This method might be useful in determining ventricular tachycardia origins.

Electrocardiography↗
PubMed1995

Aetiology of spider phobia: classificatory differences between two origins instruments.

The origins of fear of spiders was investigated in 33 spider phobic Ss entering a treatment study. All Ss completed Menzies and Clarke's (1993a) Origins Questionnaire (OQ) (Behaviour Research and Therapy, 31, 355-365) and Ost and Hugdahl's (1981) Phobic Origins Questionnaire (POQ) (Behaviour Research and Therapy, 19, 439-447). The results for the individual questionnaires were similar to those reported in previous studies. However a comparison of assignments of origin category for the two questionnaires showed widely discrepant results. The POQ returned 17 positive responses for classical conditioning, the OQ only 2. By contrast the OQ returned 10 origins as 'non-conditioning traumatic event', 9 of which returned positive responses for classical conditioning on the POQ. A further 15 Ss on the OQ were categorised as 'always been this way', the preponderance of these being classified as vicarious or informational in origin on the POQ. The POQ does not have a specific question or category for non-associative acquisition of phobias. The results of the origins assignments are detailed and their relation to the structure and questions of the questionnaires is outlined. Past studies using the POQ have produced results supporting acquisition of a substantial proportion of phobias by classical conditioning. The findings of this study suggest that such results mainly reflect inherent bias in that instrument.

Adult↗
PubMed1988

Origins of the short latency somatosensory evoked potentials in cat--with special reference to the sensory relay nuclei.

In order to identify the generators of short latency somatosensory evoked potential (SL-SEP) components, we studied, in cats, the relationship between the latencies of SL-SEP components and those of action potentials travelling along the somatosensory pathway. We also studied the changes of SL-SEPs after small lesions at various levels along the pathway. In the record with a noncephalic reference, four positive peaks (PI, PII, PIII, PIV) and three negative peaks (NI, NII, NIII) were identified. Two to three small negative waves (III-a, III-b, III-c) were superimposed on the waves from PIII to NIII. We concluded as follows: (i) NIII is a near-field component originating in the primary somatosensory cortex. (ii) III-a, III-b, and III-c originate between the decussation of the medial lemniscus and the thalamus. (iii) PIII probably originates from multiple structures rostral and caudal to the decussation of the medial lemniscus. PII, NII, and a part of PIII may originate in the region where C6 to T1 dorsal roots enter the spinal cord. (iv) The earliest components or PI and NI originate in the peripheral nerve at the axilla. (v) No components of SL-SEP originating at the dorsal root ganglia, dorsal column nuclei, thalamic VPL nucleus, or cerebellum were identified. (vi) Most of the SL-SEP components may originate where the volume conductor geometry or the impedance of the conducting medium changes suddenly.

Action Potentials↗
PubMed1992

Specificity of origin recognition by replication initiator protein in plasmids of the pT181 family is determined by a six amino acid residue element.

We have investigated the specificity of replication origin recognition by the initiator proteins of a set of six closely related Staphylococcus aureus plasmids, the pT181 family. These plasmids replicate by an asymmetric rolling-circle mechanism using plasmid-coded initiators that nick the replication origins and form a phosphotyrosine bond at the 5' nick terminus. Five of the plasmids are in different incompatibility groups and their initiator proteins do not cross-complement the cloned origins of any but their own plasmid. One pair is weakly incompatible and their initiator proteins and origins do cross-complement for replication in vivo. This pattern of cross-reactivity led to the prediction that the determinant of specificity would correspond to a homologously positioned set of six residues in the C-terminal domain of the protein, some 80 residues away from the active site tyrosine, that are divergent for all of the compatible plasmids and identical for the incompatible pair. Site-directed mutagenesis was used to exchange these six residues among three pairs of plasmids and these exchanges brought about the predicted switching of origin recognition specificity. Single substitution within this six residue set reduced or eliminated the activity of the protein but did not alter the origin recognition specificity. These six and flanking residues cannot form an amphipathic alpha-helix nor do they conform to the classical helix-turn-helix or other known DNA binding motifs. A novel type of interaction is suggested in which the protein binds to its recognition site, bends and melts the DNA, and causes or enhances the extrusion of an adjacent cruciform containing the nick site. This configuration would juxtapose the nicking target and the active site tyrosine residue and would unwind the highly G + C-rich replication origin.

Amino Acid Sequence↗
PubMed1991

Daughter origins can be held together by O protein in phage lambda replicative intermediates.

When lambda replicative intermediates are incubated with initiator protein O, complex molecules are observed in which O interacts with both daughter origin segments and with growing points. In the simplest of these molecules it appears that daughter origins and growing points may all be bound together at a single point. When replicative intermediates are sequentially incubated with single-stranded binding protein and O protein, simpler structures are observed. In this case, both daughter origins are bound together by O protein. This result mimics that found when plasmid containing two tandem lambda origin sequences is reacted with O protein. In this case double origin binding produces a DNA loop. Double origin binding, as demonstrated in this investigation, creates the potential for topological domains which will have important effects on the ability of daughter origins to initiate replication.

Bacteriophage lambda↗
PubMed1984

Random distribution of mammalian replication origins in matrix and total nuclear DNA.

Nuclear matrices from mouse and rat tumour cells were isolated and characterized by their microscopic appearance, protein profiles and DNA content. They presented well-defined structures containing 15-20% of the nuclear protein and 1-3% of the nuclear DNA. Matrix DNAs were immobilized on nitrocellulose filters and hybridized to nick-translation 32P-labelled homologous DNA fragments containing the corresponding replication origins. As control total nuclear DNAs were also immobilized on filters and hybridized to origin-containing DNAs. The origin-containing DNAs hybridized to the same extent to both matrix and total DNAs, which showed that they contained the same proportion of origin sequences. In an alternative series of experiments, plasmids containing either rat or mouse replication origins were immobilized on filters and were hybridized with in vitro 32P-labelled matrix and total nuclear DNAs. Here again both matrix and total nuclear DNAs hybridized to the same extent with the origin-carrying plasmids, which showed that neither rat nor mouse matrix DNAs were enriched in DNA replication origin sequences.

Animals↗
PubMed1994

Value of body surface mapping in localizing the site of origin of ventricular tachycardia in patients with previous myocardial infarction.

OBJECTIVES: This study examined the performance of the 62-lead body surface electrocardiogram (ECG) in identifying the site of origin of ventricular tachycardia in patients with a previous myocardial infarction. BACKGROUND: Because the accuracy of ECG localization of ventricular tachycardia using standard 12-lead recordings is restricted to the identification of rather large ventricular areas, application of multiple torso lead recordings may augment the resolving power of the surface ECG and result in more discrete localization of arrhythmogenic foci. METHODS: Thirty-two patients were selected for electrophysiologically guided ablative therapy for drug-resistant postinfarction ventricular tachycardia. In these patients, QRS integral maps of distinct monomorphic ventricular tachycardia configurations were correlated with a previously generated infarct-specific reference data base of paced QRS integral maps. Each paced pattern in the data base corresponded with ectopic endocardial impulse formation at 1 of 18 or 22 discrete segments of the left ventricle with a previous anterior or inferior myocardial infarction, respectively. Electrocardiographic localization was compared with the results obtained during intraoperative or catheter endocardial activation sequence mapping. RESULTS: Body surface mapping was performed during 101 distinct ventricular tachycardia configurations. Compared with the activation mapping data that were acquired in 64 of 101 ventricular tachycardias, body surface mapping identified the correct segment of origin in 40 (62%) of 64 tachycardias, a segment adjacent to the segment where the arrhythmia actually originated in 19 (30%) of 64 tachycardias and a segment disparate from the actual segment of origin in 5 (8%) of 64 tachycardias. With respect to infarct location, the segment of origin was correctly identified in 28 (60%) of 47 ventricular tachycardias in patients with anterior, 7 (70%) of 10 tachycardias in patients with inferior and 5 (71%) of 7 tachycardias in patients with combined anterior and inferior myocardial infarction. CONCLUSIONS: This study shows that body surface mapping enables precise localization of the origin of postinfarction ventricular tachycardia in 62% and regional approximation in 30% of tachycardias. The multiple-lead ECG may be used to guide and shorten catheter-based mapping procedures during ventricular tachycardia and to provide relevant information on the origin of tachycardias that cannot be mapped with conventional single-site mapping techniques because of unfavorable characteristics.

Body Surface Potential Mapping↗
PubMed2004

The role of family-of-origin violence in men's marital violence perpetration.

This paper presents overall transmission rates between family-of-origin violence and marital violence, as well as theoretical and empirical work on possible mechanisms of transmission. In identified samples, approximately 60% of the maritally violent men report family-of-origin violence, whereas slightly over 20% of the comparison group of maritally nonviolent men report family-of-origin violence. Modest associations between experiencing violence in the family of origin and marital violence are found in community samples and in studies with prospective and longitudinal designs. Variables that intervene in the association between family-of-origin violence and marital violence are reviewed, with a focus on personal characteristics such as antisocial personality, psychological distress, and attitudes condoning violence, as well as on contextual factors, such as marital problems and conflict resolution style. Variables associated with nonviolence in men who grew up in violent families also are identified, including strong interpersonal connections and the ability to create psychological distance from the family-of-origin violence. Continued empirical investigation of variables that potentiate or mitigate the association between family-of-origin violence and marital violence at different developmental stages is needed to identify explanatory mechanisms and, ultimately, to interrupt the intergenerational transmission of marital violence.

Adult↗
PubMed2004

Disparities in routine physical examinations among in-school adolescents of differing Latino origins.

PURPOSE: To estimate the prevalence of routine physical examination among in-school adolescents of differing national Latino origins and to assess associations with gender, age, immigrant generational status, language spoken at home, parental education, poverty level, family structure, and insurance status. METHODS: Cross-sectional analysis of Wave I of the National Longitudinal Study of Adolescent Health conducted during 1995. Our sample was limited to adolescents in grades 7 through 12 of Mexican (n = 1657), Cuban (n = 490), Puerto Rican (n = 555), and Central/South American or Dominican (C/S American or DR) (n = 427) origins. We used multivariate logistic regression for survey data to conduct the data analyses. RESULTS: Mexican-origin adolescents were less likely to report a routine physical examination in the previous year, compared with other Latino populations [prevalence (95% confidence interval)]: Mexicans, 47.7 % (42.0% -53.6%], Cubans 67.6% (57.4%-76.4%), Puerto Ricans 65.2% (58.4%-71.4%), and C/S American or DR (57.0% [47.3-66.2]). Among Mexican-origin adolescents, having a college-educated parent or insurance was associated with receiving care (adjusted prevalence odds ratio [95% confidence interval]), 2.12 (1.37-3.30) and 1.80 (1.31-2.47), respectively. For Cuban-origin adolescents, first-generation immigrants were less likely to receive care (0.31 [0.14-0.70]), and those living in a single-parent home were more likely to receive care (2.83 [1.52-5.25]). Having a routine physical examination among adolescents of C/S American or DR origins was associated with incomes above the poverty level (2.29 [1.10-4.77] and insurance (2.33 [1.10-4.91]). CONCLUSIONS: Reflecting the heterogeneity of Latino adolescents, the prevalence of routine physical examination and factors associated with it varied by national origin subgroup. These differences should be considered when developing strategies to better address the health needs of Latino youth.

Adolescent↗
PubMed2006

A simple algorithm for defining the mechanism and the chamber of origin in atrial tachycardias.

INTRODUCTION: Although macroreentrant atrial tachycardia (MRAT) and focal atrial tachycardia (FAT) can be successfully cured by catheter ablation, the proper diagnosis and treatment of these arrhythmias can still be challenging. AIM: The objective of this study is to develop an algorithm allowing rapid diagnosis of the mechanism and the chamber of origin of atrial tachycardia based on intracardiac catheter recordings from the right atrium and the coronary sinus (CS). METHODS: A 2-stepped algorithm was designed: (1) The time of biatrial activation expressed as a percentage of the tachycardia cycle length served to discriminate FAT from MRAT. (2) In FAT, the direction of activation of the CS catheter and the earliest atrial activation were used to define the chamber of origin. In MRAT, the time of right atrium activation was determined or entrainment was used at different sites. Thirty-two intracardiac recordings were reviewed off-line after the algorithm by 4 electrophysiologists blinded to the mechanism and the chamber of origin. The results of their analysis were compared with the intraoperative diagnosis. RESULTS: The algorithm correctly identified 11 (100%) of 11 FATs and 19 (90.4%) of 21 MRATs. The site of origin was correctly identified in 8 (72.7%) of 11 FATs and in 20 of 21 (95.2%) MRATs. The site of origin was misidentified in 3 FATs, all arising from the CS ostium. CONCLUSIONS: This algorithm allows rapid discrimination between FAT and MRAT. The chamber of origin is detected with a high accuracy in MRAT. However, the earliest atrial activation taken as an isolated event is not a good predictor for the chamber of origin in FAT arising from the ostium of the CS.

Algorithms↗
PubMed2002

Splenic marginal zone lymphomas appear to originate from different B cell types.

Splenic marginal zone lymphomas (SMZLs) have been proposed to originate from postgerminal center memory B cells that usually have mutated immunoglobulin heavy-chain variable (VH) genes. However, the majority of SMZLs are thought to express both IgD and IgM, which is more typical of naïve B cells that have unmutated VH genes. To better define the SMZL cell of origin and pathogenesis, we studied the histological and immunophenotypic features of eight cases and also sequenced their rearranged VH genes. Half of the cases had unmutated VH genes consistent with a naïve B-cell origin and half had mutated VH genes consistent with a memory B-cell origin. Most of the unmutated cases (three of four) were positive for IgD, which further supports a naïve B-cell origin, whereas the others were negative. In addition, VH gene segment use seems to be nonrandom because seven of eight cases used genes from the VH1 or VH4 families and repetitive use of the V1-2, V1-69, and V4-34 gene segments was observed. Our results suggest there are two types of SMZLs, one that originates from naïve marginal zone B cells in addition to one that originates from memory marginal zone B cells, and that antigen selection may be occurring during lymphomagenesis.

Aged↗
PubMed1999

Identification and cloning of TWIK-originated similarity sequence (TOSS): a novel human 2-pore K+ channel principal subunit.

We have identified and cloned a new member of the mammalian tandem pore domain K+ channel subunit family, TWIK-originated similarity sequence, from a human testis cDNA library. The 939 bp open reading frame encodes a 313 amino acid polypeptide with a calculated Mr of 33.7 kDa. Despite the same predicted topology, there is a relatively low sequence homology between TWIK-originated similarity sequence and other members of the mammalian tandem pore domain K+ channel subunit family group. TWIK-originated similarity sequence shares a low (< 30%) identity with the other mammalian tandem pore domain K+ channel subunit family group members and the highest identity (34%) with TWIK-1 at the amino acid level. Similar low levels of sequence homology exist between all members of the mammalian tandem pore domain K+ channel subunit family. Potential glycosylation and consensus PKC sites are present. Northern analysis revealed species and tissue-specific expression patterns. Expression of TWIK-originated similarity sequence is restricted to human pancreas, placenta and heart, while in the mouse, TWIK-originated similarity sequence is expressed in the liver. No functional currents were observed in Xenopus laevis oocytes or HEK293T cells, suggesting that TWIK-originated similarity sequence may be targeted to locations other than the plasma membrane or that TWIK-originated similarity sequence may represent a novel regulatory mammalian tandem pore domain K+ channel subunit family subunit.

Amino Acid Sequence↗
PubMed1997

The anatomic origin of the posterior cruciate ligament: where is it? Reference landmarks for PCL reconstruction.

There is a lack of defined reference points for reproducible femoral tunnel placement during posterior cruciate ligament (PCL) reconstruction. The PCL, consisting of two major bands, anterolateral (AL) and posteromedial (PM), has a femoral origin that spans 3 cm, which cannot be covered by a substitute graft positioned in one femoral tunnel to reconstruct the PCL. The purpose of this study was to define the location of the anatomic origin of both bands of the PCL in reference to local anatomy to develop landmarks that can be used to reproducibly position two femoral tunnels (one to each band's origin) during PCL reconstruction. The anatomy of the PCL origin was dissected and studied in 20 knees at the time of total knee replacement. The central origin point for each band was marked, and its distance was measured in reference to three axes. The AL band centrally originated 13 +/- 0.5 mm posterior to the medial articular cartilage-intercondylar wall interface and 13 +/- 0.5 mm inferior to the articular cartilage-intercondylar roof interface. The PM band centrally originated 8 +/- 0.5 mm posterior to the medial articular cartilage-intercondylar wall interface and 20 +/- 0.5 mm inferior to the articular cartilage-intercondylar roof interface. These distances were noted to be relatively constant despite varying knee morphologies and size. For this reason, referencing the articular cartilage-intercondylar roof, and wall interfaces may be used as a method to facilitate more reproducible anatomic femoral tunnel placements during PCL reconstruction.

Femur↗
PubMed2003

Subarachnoid hemorrhage of unknown origin and the basilar artery configuration.

It is unclear whether the configuration of the basilar artery (BA) in patients with subarachnoid hemorrhage (SAH) of unknown origin is comparable to that in normal subjects or whether there are differences which may help to identify the origin. We studied the BA configuration in 57 patients with SAH of unknown origin (10%), who were identified in a prospectively collected series of 549 SAH patients consecutively admitted to our service over a 9-year period. There were 30 patients (53%) with non-perimesencephalic SAH and 27 with perimesencephalic SAH (47%). According to a standardized algorithm we determined, on straight anteroposterior digital subtraction angiography (DSA), the width of the proximal BA segment at the origin of the anterior inferior cerebellar artery and the width of the most distal BA segment between the superior cerebellar arteries and the posterior cerebral arteries. Based on these measurements we calculated the distal-proximal BA ratios and compared them to the ratios obtained in a control group of 31 patients who had DSA for reasons other than aneurysmal SAH. The mean ratio in patients with non-perimesencephalic SAH of unknown origin was 1.150 (range: 1.080-1.230). In patients with perimesencephalic SAH of unknown origin it was 1.156 (range: 1.120-1.250). In the control group the mean ratio was 1.163 (range: 1.125-1.200). There are no variations in the configurations of the BA which could possibly explain the cause of this type of SAH or clarify the origin of hemorrhage.

Adult↗
PubMed1998

Stoichiometry and mechanism of assembly of SV40 T antigen complexes with the viral origin of DNA replication and DNA polymerase alpha-primase.

The interactions of simian virus 40 (SV40) large T antigen with DNA carrying the viral origin of DNA replication, as well as its interactions with cellular replication proteins, have been investigated by using fluorescent ATP analogues as specific probes. The enhanced fluorescence of 3'(2')-O-(2,4, 6-trinitrophenyl)adenosine diphosphate (TNP-ADP) induced by T antigen binding to the nucleotide was decreased upon binding of T antigen to origin DNA. Similarly, the enhanced fluorescence induced by T antigen binding to TNP-ADP or TNP-ATP was decreased upon binding to human DNA polymerase alpha-primase (pol alpha), but not to replication protein A (RPA). Fluorescence titrations revealed noncompetitive inhibition of TNP-ADP binding by origin DNA, and noncompetitive inhibition of TNP-ADP and TNP-ATP binding by pol alpha, suggesting that T antigen complexed with either origin DNA or pol alpha was not able to bind the TNP nucleotide. From these titrations, we have measured a binding stoichiometry of 11.5 +/- 0.8 T antigen monomers per viral origin DNA, in agreement with the double hexamer assembly of T antigen on the origin as reported earlier. The stoichiometry of pol alpha binding to T antigen was measured to be 5.5 +/- 0.6 mol of T antigen per mole of pol alpha. While monomeric T antigen-nucleotide complex was a preferred ligand over free T antigen in the double hexamer assembly reaction, preformed T antigen hexamers were incapable of forming double hexamers on the DNA. The results support a model in which double hexamer assembly on the viral origin occurs by successive binding of 12 free T antigen or monomeric T-nucleotide complexes to the DNA. In contrast with this stepwise assembly of T antigen monomers on DNA, hexameric T antigen was able to bind directly to pol alpha with concomitant release of the bound TNP nucleotide. The possible implications of these results for the mechanism of initiation of SV40 DNA replication are discussed.

Antigens, Polyomavirus Transforming↗
PubMed1982

New drug development by United States pharmaceutical firms with analyses of trends in the acquisition and origin of drug candidates, 1963-1979.

The average number of self-originated new chemical entities (NCEs) first tested in man by 39 United States-owned pharmaceutical firms in the 3-year period from 1977 to 1979 was 26 a year, approximately half the number investigated annually in the previous decade. Investigational New Drug (IND) Exemption filings on self-originated NCEs, but not those on acquired NCEs, were also comparatively low. Consequently, the contribution of self-originated NCEs to total IND filings fell from 81% in 1963 through 1975 to 68% in 1976 through 1979. (There was a similar decline, from 78% to 61%, in the proportion of compounds synthesized in the United States.) The relative increase in IND filings on acquired NCEs was greatest for smaller firms. By the late 1970s acquired NCEs accounted for almost 50% of the INDs filed by smaller firms, but only 10% to 25% of those filed by large and medium-sized firms. The importance of NCEs acquired from abroad has increased since the mid-1970s. The number of INDs filed on Japanese-originated NCEs rose from approximately one a year in 1963 through 1975 to an average of 3.5 a year in 1976 through 1979. Initial clinical testing of self-originated drugs abroad, which increased sharply in the early 1970s to reach a peak of 36% in 1976, declined to approximately 21% in 1977 through 1979. Self-originated drugs approved in 1977-1979 spent an average of 6 years in United States clinical testing and 2 in regulatory review, a total of 8 years from IND filing to NDA approval. The percentage of IND filings on self-originated NCEs that received New Drug Application (NDA) approval after 8 years or more was 9% overall, although ultimate success rates will be higher. There was a higher success rate for anti-infective drugs (17%) than for other pharmacologic categories (7%). For acquired NCEs, the overall approval rate was much larger (28%).

Drug Industry↗
PubMed2002

Vulvar Paget disease of urothelial origin: a report of three cases and a proposed classification of vulvar Paget disease.

Extramammary Paget disease is generally considered a distinct entity that can involve the genital tract skin and may be associated with underlying adenocarcinoma. Evidence is presented that vulvar Paget disease represents a heterogeneous group of epithelial neoplasms that can be similar both clinically and histopathologically. Three cases of vulvar Paget-like disease that were manifestations of urothelial carcinoma are investigated. Vulvar Paget disease can be classified based on the origin of the neoplastic Paget cells as either primary (of cutaneous origin) or secondary (of noncutaneous origin). Each classification has 3 subtypes: primary, intraepithelial cutaneous Paget disease of the usual type; intraepithelial cutaneous Paget disease with invasion, and intraepithelial cutaneous Paget disease as a manifestation of underlying skin appendage adenocarcinoma; secondary, Paget disease of anorectal origin, Paget disease of urothelial origin, and Paget disease of other origin. This subclassification is based on a review of the literature and the current study of 3 patients with Paget-like disease of urothelial neoplastic origin. The 3 subtypes of vulvar Paget disease studied here can present similarly as eczematoid skin or vulvar mucosal lesions and may appear similar on routine hematoxylin and eosin-stained slides. Immunohistochemical studies can be used to help differentiate them. The distinction between these 3 types of Paget-like lesions is essential in that the specific diagnosis has a significant influence on current treatment. The difference in surgical approach to the subtypes of vulvar Paget disease justifies classifying them into distinct lesions to avoid potential confusion and unnecessary surgery.

Aged↗
PubMed2001

Biomechanical evaluation of the origin of the long head of the biceps tendon.

PURPOSE: Lesions of the superior glenoid labrum extending anterior and posterior (SLAP) have recently been recognized as important sources of shoulder pain and dysfunction. Among the 4 described types of SLAP lesions, the type II SLAP involves detachment of the superior labrum from the bony glenoid and destabilization of the origin of the long head of the biceps tendon (LHBT). The purpose of this cadaveric biomechanical study was to evaluate the relative contribution regarding linear stiffness and displacement under load of the 2 origins of the LHBT: the superior glenoid labrum and the supraglenoid tubercle (the biceps anchor). TYPE OF STUDY: Cadaveric biomechanical study. METHODS: Seven pairs of fresh-frozen cadaveric shoulders were dissected free of all soft tissue except for the glenoid labrum and LHBT. Tension from 0 to 55 N was applied to the LHBT while keeping the tendon perpendicular to the face of the glenoid. Each specimen was tested for linear stiffness and biceps tendon displacement in the intact state, after releasing 1 of the LHBT origins, and after releasing the remaining origin. RESULTS: The average stiffness of the LHBT origin was 103 N/mm. Sectioning the anchor alone resulted in a 52% reduction in linear stiffness, whereas only detaching the superior glenoid labrum from the 10 o'clock to the 2 o'clock position resulted in a 15% reduction in linear stiffness. Maximum displacement of the biceps tendon origin in the intact state at the 55 N load averaged 0.99 mm. With a minimum load applied, displacement changed less than 1 mm unless both origins were released. CONCLUSIONS: The results indicate that the biceps anchor is the primary restraint of the LHBT and that the superior labrum is a secondary restraint in regard to linear stiffness. However, disruption of both restraints is required to produce the laxity typically seen in a type II SLAP lesion.

Adult↗