Fluorescence spectra of single chlorosomes isolated from a green filamentous bacterium (Chloroflexus (Cfl.) aurantiacus) and a green sulfur bacterium (Chlorobium (Cb.) tepidum) were measured by using a confocal laser microscope at 13 K. Chlorosomes were frozen either in a liquid solution (floating chlorosome) or on a quartz plate after being adsorbed (adsorbed chlorosome). Fluorescence peak wavelengths were shorter for the adsorbed single chlorosomes than for the floating ones. Single floating Cfl. chlorosomes showed a distribution of fluorescence peak positions having a center at 759.0 nm with a full width at half maximum of 6.3 nm. Single floating Cb. chlorosomes showed a 782.7 nm center with a full width at half-maximum of 3.4 nm. The distribution shifted to the blue and became wider with increasing temperature, especially in Cb. chlorosomes, suggesting a large excitonic density of states just above the lowest level. Energy transfer from BChl-c aggregates to BChl-a molecules in the baseplate proteins was observed in the floating chlorosomes but not in the adsorbed ones. A positive correlation was found between the peak wavelength of BChl-c fluorescence and the intensity of BChl-a fluorescence in single Cfl. chlorosomes. The results suggest that the BChl-c aggregates with longer wavelengths of the fluorescence peaks have a more efficient Förster-type energy transfer to the baseplate BChl-a.

OBJECTIVE

Reading speed of patients with central field loss (CFL) correlates with the size of saccades (measured in letters per forward saccade [L/FS]). We assessed whether this effect is mediated by the total number of fixations, by the average fixation duration, or by a mixture of both.

METHODS

We measured eye movements (with a video eye tracker) of 35 AMD and 4 Stargardt patients (better eye decimal acuity from 0.08-0.3) while they monocularly read single-line French sentences continuously displayed on a screen. All patients had a dense scotoma covering the fovea, as assessed with MP1 microperimetry, and therefore used eccentric viewing. Results were analyzed with regression-based mediation analysis, a modeling framework that informs on the underlying factors by which an independent variable affects a dependent variable.

RESULTS

Reading speed and average fixation duration are negatively correlated, a result that was not observed in prior studies with CFL patients. This effect of fixation duration on reading speed is still significant when partialling out the effect of the total number of fixations (slope: -0.75, P < 0.001). Despite this large effect of fixation duration, mediation analysis shows that the effect of L/FS on reading speed is fully mediated by the total number of fixations (effect size: 0.96; CI [0.82, 1.12]) and not by fixation duration (effect size: 0.02; CI [-0.11, 0.14]).

CONCLUSIONS

Results are consistent with the shrinking perceptual span hypothesis: reading speed decreases with the average number of letters traversed on each forward saccade, an effect fully mediated by the total number of fixations.

The objective was to carry out a clinical assessment of different cervical mobility measurements in ankylosing spondylitis (AS), including two new tape methods for measuring cervical rotation and lateral bending. A range of cervical movements was measured in 52 consecutive male AS patients and the results correlated with detailed radiological changes in the whole spine and sacroiliac joints. Occiput- and tragus-to-wall distance (OWD/TWD), cervical rotation (CR) and lateral flexion (CLF) using a Myrin inclinometer (My) and a tape method (t), cervical flexion-extension (CFl-CExt/My) motion and chin chest distance (CCD) measurements were taken and repeated (test-retest). The results showed a highly significant correlation of all measurements with cervical radiological changes, except for CCD, and also those of OWD/TWD with lumbar changes. CLF and CExt also correlated significantly with lumbar changes, other measurements did not, and only TWD and CExt correlated with thoracic changes. All measurements showed good reliability, intra-class correlation coefficients (ICC) ranging from 0.89 to 0.98. Occiput- or tragus-to-wall distance, cervical extension and lateral flexion proved to be valid and reliable measurements in AS, but cervical rotation also appeared to be a clinically relevant method. Cervical lateral flexion is a recommendable measurement for clinical trials in AS. The two new tape methods for measuring cervical rotation and lateral bending were as valid and reliable as the inclinometer method (Myrin), but also quick and easy. Chin-to-chest distance was not among the most valid tests in AS.

BACKGROUND

In the assessment of lateral ankle instability, the anterior drawer test has been found to be inaccurate and the focus on pure anterior translation cannot properly perceive the anterolateral rotatory nature of the talar displacement. In order to address this, the anterolateral drawer test can be done with digital palpation of the talar displacement anterolaterally with a controlled angle of plantarflexion as well as application of the translational force.

METHODS

We evaluated the anterolateral drawer test and the original anterior drawer test in 10 fresh below-the-knee specimens using a direct anatomic measurement (DAM) loaded by a Telos stress device as a reference. Specimens were assigned into three groups: intact ligaments, ATFL-cut, and ATFL&CFL-cut. The examiners were blinded with one performing the anterolateral drawer test (E1) while the other performed the original anterior drawer test (E2).

RESULTS

Pearson's correlation coefficient indicated a statistically significant linear relationship between DAM/E1 r = 0.931, p < 0.001 but not between DAM/E2 r = 0.519, p = 0.124. Intraclass correlation coefficient show correlation between DAM/E1 and DAM/E2 to be 0.945 (p < 0.001) and 0.683 (p = 0.051). When 3 mm or more was used as the threshold to diagnose a lateral ligament rupture, sensitivity and specificity were E1(100%, 100%) and E2(75%, 50%).

CONCLUSIONS

The anterolateral drawer test showed high accuracy in the determination of lateral ankle instability and in the diagnosis of a ligament rupture.

CONCLUSIONS

Further investigation regarding the accuracy and reliability of this test in comparison with the original anterior drawer test is warranted in a patient population with ankle instability.

BACKGROUND

Despite the numerous in-vitro studies on the mechanical properties and simulated injury mechanisms of the anterior talofibular ligament (ATFL) and calcaneofibular ligament (CFL), the in-vivo biomechanical behavior of these two ligaments has not yet been described.

METHODS

Apparent length of the ATFL and CFL was measured in four ankles in healthy male subjects between 32 and 45 years of age (two left and two right) during a dorsiflexion-plantarflexion and supination-pronation arc of motion using a combined dual-orthogonal fluoroscopic and magnetic resonance imaging technique.

RESULTS

The ATFL elongated from the neutral position at 16.3 +/- 3.0 mm to 20.8 +/- 2.7 mm at maximal plantarflexion and shortened significantly from the neutral position to 13.9 +/- 2.9 mm at maximal dorsiflexion (p = 0.01). The CFL shortened from the neutral position at 28.0 +/- 2.9 mm to 26.6 +/- 2.2 mm at maximal plantarflexion (p = 0.08) and elongated significantly from the neutral position to 29.9 +/- 3.0 mm at maximal dorsiflexion (p = 0.003). The ATFL elongated significantly from 14.8 +/- 2.5 mm at maximal pronation to 17.4 +/- 3.0 mm at maximal supination (p = 0.08). At the same time, the CFL shortened from 31.0 +/- 3.8 mm at maximal pronation to 26.9 +/- 3.6 mm at maximal supination (p = 0.02).

CONCLUSIONS

The results showed that the ATFL elongates more during plantarflexion and supination whereas the CFL increases in length with dorsiflexion and pronation. Concurrently, these data also demonstrated the reciprocal function between the two ligaments. While one shortens, the other one elongates. The different elongation of the ATFL and CFL during the same motion arc suggests that under excessive loading conditions the ATFL might be more vulnerable in plantarflexion and supination while the CFL might be more susceptible to injury in dorsiflexion and pronation. Furthermore, in the case of surgical reconstruction the grafts used to reconstruct the two ligaments may need to be tensioned at different positions of the ankle in order to reproduce their natural in vivo function.

Streptomyces scabies is an important causative agent of common scab disease of potato tubers and other root crops. The primary virulence factor produced by this pathogen is a phytotoxic secondary metabolite called thaxtomin A, which is essential for disease development. In addition, the genome of S. scabies harbors a virulence-associated biosynthetic gene cluster called the coronafacic acid (CFA)-like gene cluster, which was previously predicted to produce metabolites that resemble the Pseudomonas syringae coronatine (COR) phytotoxin. COR consists of CFA linked to an ethylcyclopropyl amino acid called coronamic acid, which is derived from L-allo-isoleucine. Using a combination of genetic and chemical analyses, we show that the S. scabies CFA-like gene cluster is responsible for producing CFA-L-isoleucine as the major product as well as other minor COR-like metabolites. Production of the metabolites was shown to require the cfl gene, which is located within the CFA-like gene cluster and encodes an enzyme involved in ligating CFA to its amino acid partner. CFA-L-isoleucine purified from S. scabies cultures was shown to exhibit bioactivity similar to that of COR, though it was found to be less toxic than COR. This is the first report demonstrating the production of coronafacoyl phytotoxins by S. scabies, which is the most prevalent scab-causing pathogen in North America.

The hippocampus has become the focus of research in several neurodegenerative disorders. Automatic segmentation of this structure from magnetic resonance (MR) imaging scans of the brain facilitates this work. Segmentation techniques must be evaluated using a dataset of MR images with accurate hippocampal outlines generated manually. Manual segmentation is not a trivial task. Lack of a unique segmentation protocol and poor image quality are only two factors that have confounded the consistency required for comparative study. We have developed a publicly available dataset of T1-weighted (T1W) MR images of epileptic and nonepileptic subjects along with their hippocampal outlines to provide a means of evaluation of segmentation techniques. This dataset contains 50 T1W MR images, 40 epileptic and ten nonepileptic. All images were manually segmented by a widely used protocol. Twenty five images were selected for training and were provided with hippocampal labels. Twenty five other images were provided without labels for testing algorithms. The users are allowed to evaluate their generated labels for the test images using 11 segmentation similarity metrics. Using this dataset, we evaluated two segmentation algorithms, Brain Parser and Classifier Fusion and Labeling (CFL), trained by the training set. For Brain Parser, an average Dice coefficient of 0.64 was obtained with the testing set. For CFL, this value was 0.75. Such findings indicate a need for further improvement of segmentation algorithms in order to enhance reliability.

OBJECTIVE

The purpose of this study was to compare the modified Broström and Evans procedures for simulated lateral ankle instability in cadaveric lower extremities.

METHODS

Six normal cadaveric ankles were loaded with inversion and internal rotation stress through the range of ankle flexion, and three-dimensional motion of the calcaneus and talus relative to the tibia were measured. An ankle stability testing device and a magnetic tracking system were used. Testing was performed in the intact condition, unstable condition after sectioning both the anterior talofibular (ATFL) and calcaneofibular ligaments (CFL), after the Gould modification of the Broström procedure, and after the Evans procedure.

RESULTS

With inversion loading, both operations resulted in a significantly more stable ankle-hindfoot complex (calcaneal-tibial) than the unstable condition, but there was restricted motion after the Evans operation from neutral to plantarflexion. Tibiotalar inversion motion approximated normal after both operations, but subtalar motion was markedly restricted in the Evans procedure throughout the range of ankle flexion. With internal rotation loading, the Broström operation stabilized the ankle-hindfoot joint complex in plantarflexion. The Evans operation improved internal rotation stability, but restricted motion in all positions. Both operations improved tibiotalar internal rotation stability, but not to normal. The subtalar internal rotation was the same as the intact condition after the Broström operation, but markedly restricted after the Evans operation through the range of ankle flexion.

CONCLUSIONS

Both operations improved ankle-hindfoot stability, but neither was successful in restoring it to normal as determined with the ankle stability testing device. The Evans procedure improved stability at the expense of creating abnormal subtalar function. The Broström operation improved stability without excessively restricting subtalar movement, but was not effective in addressing the internal rotation laxity.

In this study, a transparent and stretchable thin-film capacitive strain sensor based on patterned Ag nanowire networks (AgNWs) was successfully fabricated. The AgNWs were patterned using a capillary force lithography (CFL) method and were embedded onto the surface of the polydimethylsiloxane substrate. The strain (ε) sensitivity of the capacitive strain sensor was controlled and enhanced by patterning the AgNWs into electrodes with an interdigitated shape. The interdigitated capacitive strain sensor (ICSS) is expected to have -1.57 gauge factor (GF) at 30% ε by calculation, which is much higher than the sensitivity of typical parallel-plate-type capacitive strain sensors. Because of the interdigitated pattern of the electrodes, the GF of the ICSS was increased up to -2.0. The ICSS had no hysteresis behavior up to ε values of 15% and showed stable ε sensing performance during the repeated stretching test at ε values of 10% for 1000 cycles. Furthermore, there was no cross talk between ε and pressure sensing in the AgNW-based ICSS, which was found to be insensitive to externally applied pressure. The ICSS was then used to detect the finger and wrist muscle motions of the human body to simulate its application to large and small ε sensing.

BACKGROUND

This study was part of a Phase 3 program treating crow's feet lines (CFL) with onabotulinumtoxinA.

OBJECTIVE

To evaluate the efficacy and safety of onabotulinumtoxinA treatment of CFL.

METHODS

This multicenter, double-blind, placebo-controlled, 5-month study randomized subjects with moderate-to-severe CFL (maximum smile) to onabotulinumtoxinA (24 U; n = 222) or placebo (n = 223). Investigators and subjects assessed CFL severity (maximum smile and rest) using the 4-grade Facial Wrinkle Scale (FWS). Co-primary end points were investigator- and subject-assessed proportion of subjects achieving a CFL FWS grade of 0 (none) or 1 (mild) at maximum smile (Day 30). Additional efficacy end points, patient-reported outcomes, and safety/adverse events (AEs) were evaluated.

RESULTS

All primary and secondary end points were achieved; statistically significant differences favored onabotulinumtoxinA (p < .001, all comparisons vs placebo). Co-primary responder rates were 66.7% compared with 6.7% for investigator-assessed and 58.1% compared with 5.4% for subject-assessed response (onabotulinumtoxinA group and placebo, respectively; p < .001). A significantly greater proportion of the onabotulinumtoxinA group than placebo group achieved a 1 grade or greater improvement on the FWS (maximum smile and rest assessed by both the investigator and subject; all time points; p < .001). Most AEs were mild or moderate and did not result in discontinuations.

CONCLUSIONS

Treatment of moderate-to-severe CFL with onabotulinumtoxinA was effective and well tolerated.

The differentiation processes of excystation and encystation of Entamoeba are essential for infection and completion of their life-cycle, and the processes need cell motility and its control by actin cytoskeletal reorganization. This study investigated actin depolymerizing factor (ADF)/cofilin (Cfl) family proteins, which are important molecules in actin cytoskeletal reorganization, in Entamoeba invadens in relation to the encystation and excystation. Axenic culture systems were used to induce encystation and excystation. A homology search of the E. invadens genome database and molecular cloning identified three ADF/Cfl family proteins of the parasite (named for short as EiCfl-1, EiCfl-2, and EiCfl-3). This is different from other Entamoeba species, i.e. Entamoeba histolytica and Entamoeba dispar, each of which has only one ADF/Cfl family protein. These ADF/Cfl of E. invadens do not have Ser3 (serine locates third from first methionine), similar to E. histolytica, E. dispar, Saccharomyces cerevisiae and Schizosaccharomyces pombe, although the activity of ADF/Cfl is negatively regulated by phosphorylation of the Ser3 in metazoans. Phylogenetic analysis revealed that Entamoeba Cfl formed a distinctive clade that is separate from other organisms, and the branches of the tree were separated in two consistent with the presence and absence of Ser3. Rabbit anti-EiCfl-2 serum reacted with all recombinant EiCfls and EiCfl in lysates of cysts, trophozoites and metacystic amoebae. Immunofluorescence staining with this antiserum showed co-localization of EiCfl with actin beneath the cell membrane through the life stages. Both proteins proved to be rich in pseudopodia of trophozoites and metacystic amoebae. Real-time RT-PCR showed that mRNAs of EiCfl-2 and actins were highly expressed, but there were few mRNA of EiCfl-1 and EiCfl-3. Remarkably decreased mRNA levels were observed in EiCfl-2 and actins during encystation. All three EiCfls and actins became transcribed after the induction of excystation. The mRNAs of only EiCfl-1 and EiCfl-3 increased remarkably when the excystation was induced in the presence of cytochalasin D. These findings demonstrate that EiCfl-2 and actins co-localize beneath the cell membrane in trophozoites and cysts as well as metacystic amoebae being rich in pseudopodia, that EiCfl-1 and EiCfl-3 are expressed only after the induction of excystation, and that enhanced excystation by cytochalasin D is associated with high expression of EiCfl-1 and EiCfl-3.

BACKGROUND

Operative treatment of mechanical ankle instability is indicated for patients who have had multiple sprains and have continued episodes of instability despite bracing and rehabilitation. Anatomic reconstruction has been shown to have improved outcomes and return to sport as compared with nonanatomic reconstruction.

OBJECTIVE

The use of 2 suture anchors and a push-lock anchor is equal to 2 bone tunnels in strength to failure for anatomic Broström repair.

METHODS

Controlled laboratory study.

METHODS

In 7 matched pairs of human cadaver ankles, the calcaneofibular ligament (CFL) and anterior talofibular ligament (ATFL) were incised from their origin on the fibula. A No. 2 Fiberwire suture was placed into the CFL and a separate suture into the ATFL in a running Krackow fashion with a total of 4 locking loops. In 1 ankle of the matched pair, the ligaments were repaired to their anatomic insertion with bone tunnels. In the other, 2 suture anchors were used to reattach the ligaments to their anatomic origins, and a push-lock was used proximally to reinforce these suture anchors. The ligaments were cyclically loaded 20 times and then tested to failure. Torque to failure, degrees to failure, and stiffness were measured. The authors performed a matched pair analysis. An a priori power analysis of 0.8 demonstrated 6 pairs were needed to show a difference of 30% with a 15% standard error at a significance level of .05.

RESULTS

There was no difference in the degrees to failure, torque to failure, and stiffness. A post hoc power analysis of torque to failure showed a power of .89 with 7 samples. Power for initial stiffness was .97 with 7 samples. Eleven of 14 specimens failed at either the suture anchor or the bone tunnel.

CONCLUSIONS

There is no statistical difference in strength or stiffness for a suture anchor and push-lock construct as compared with a bone tunnel construct for an anatomic repair of the lateral ligaments of the ankle.

CONCLUSIONS

The use of suture anchors in lateral ligament stabilization allows for a smaller incision, less surgical dissection, and improved surgical efficiency. It is up to the discretion of the performing surgeon based on preference, ease of use, operative time, and cost profile to choose either of these constructs for anatomic repair of the lateral ligaments of the ankle. The suture repair at the ligament was significantly strong enough such that the majority of ankles failed at the bone interface.

OBJECTIVE

Routine use of intraoperative pathologic examination (IOPE), including frozen section (FS) and scrape preparation cytology (SPC), during diagnostic thyroid lobectomy continues to be a source of controversy. We sought to better delineate the usefulness and cost-benefit ratio of IOPE in the context of cytologically diagnosed cellular follicular lesion (CFL) or follicular neoplasm (FN).

METHODS

Records of 205 patients who underwent thyroidectomy for cytologically diagnosed FN or CFL between 1997 and 2005 were retrospectively reviewed. IOPE results, patient demographics, and tumor characteristics were correlated to final histopathologic diagnoses. Sensitivity, specificity, predictive values, accuracy, and costs of IOPE were calculated.

RESULTS

IOPE correctly identified 3 of 16 follicular carcinomas and 9 of 36 papillary carcinomas. Sensitivity, specificity, and accuracy were 23%, 99%, and 78%, respectively. On univariate analysis, malignancy risk among follicular nodules did not correlate with age, gender, or nodule size. On multivariate analysis, nodule size was predictive of malignancy (p < 0.05). Over the entire patient series, routine IOPE resulted in a net cost savings of $74,304.33.

CONCLUSIONS

IOPE reduced costs and limited the number of completion thyroidectomies necessary. IOPE is specific, cost effective, and of minimal additional risk when performed routinely for patients with CFL or FN.

YACs from the region containing the spinal muscular atrophy (SMA) locus at 5q12 have been used as probes in a direct screening of cDNA libraries to isolate 8 cDNAs, mapped to different YAC fragments. Three clones showed complete identity to the genes for cyclin B1 (CCNB1), the p44 subunit of the transcription factor BTF2 (BTF2p44), and cofilin (CFL). Two clones showed partial identity to the beta-glucuronidase gene (GLCB) and a rat integral membrane glycoprotein gene (RNINMEGLA). CFL turned out to have been identified by a pseudogene sequence. Related sequences occurred on other chromosomes. CCNB1 and BTF2p44 were given an exact location. The GLCB-like gene and the RNINMEGLA-like gene detected loci on both 5q and 5p. The remaining three cDNA clones were localized to the SMA region only. Their sequences did not show identity to any gene for which a function is already known. Two of them have now turned out to be identical to recently reported candidate genes for SMA.

The strain changes of the central part of the anterior talofibular ligament (ATFL), the posterior talofibular ligament (PTFL), the calcaneofibular ligament (CFL), and the tibiocalcaneal ligament (TCL) were measured simultaneously for a full range of ankle motion. Twelve fresh frozen amputated ankles were used. To measure the strain changes of the ligaments, a Galium-Indium-filled silastic strain transducer was implanted in the center of each ligament. The zero strain reference was determined immediately after the measurement of strain changes in five of the 12 ankles by tensile testing of each bone-ligament-bone preparation. The maximum strain change of the ATFL, the PTFL, the CFL and the TFL were 7.9%, 5.9%, 5.3% and 5.2%, respectively. The ATFL was elongated in plantar flexion and shortened in dorsiflexion. The PTFL and the CFL were shortened in plantar flexion and elongated in dorsiflexion. The TCL was the longest around the neutral position and became shorter in planter flexion and dorsiflexion. The results showed that the ATFL was taut in plantar flexion over 16.2 degrees, the PTFL and the CFL were taut in dorsiflexion over 18 degrees and 17.8 degrees respectively, and the TCL was taut between 9.5 degrees of dorsiflexion and 9.5 degrees of plantar flexion. The length change pattern was different among the ankle ligaments, although there was only a slight difference between that of the PTFL and the CFL. This study provides fundamental data useful in studying ankle ligament reconstruction.

OBJECTIVE

To evaluate the accuracy of magnetic resonance imaging (MRI) findings in chronic lateral ankle ligament injury in comparison with that of surgical findings.

METHODS

Forty-eight cases (25 men, 23 women, mean age 36 years) of clinically suspected chronic ankle ligament injury underwent MRI studies and surgery. Sagittal, coronal, and axial, T1-weighted, spin-echo, proton density and T2-weighted, fast spin-echo images with fat saturation were obtained in all patients. MRI examinations were read in consensus by two fellowship-trained academic musculoskeletal radiologists who evaluated the lateral ankle ligaments, including the anterior talofibular ligament (ATFL) and calcaneofibular ligament (CFL) without clinical information. The results of the MRI studies were then compared with the surgical findings.

RESULTS

The MRI findings of ATFL injury showed a sensitivity of detection of complete tears of 75% and specificity of 86%. The sensitivity of detection of partial tears was 75% and the specificity was 78%. The sensitivity of detection of sprains was 44% and the specificity was 88%. Regarding the MRI findings of CFL injury, the sensitivity of detection of complete tears was 50% and the specificity was 98%. The sensitivity of detection of partial tear was 83% and the specificity was 93%. The sensitivity of detection of sprains was 100% and the specificity was 90%. Regarding the ATFL, the accuracies of detection were 88, 58, 77, and 85% for no injury, sprain, partial tear, and complete tear, respectively, and for the CFL the accuracies of detection were 90, 90, 92, and 96% for no injury, sprain, partial tear, and complete tear, respectively.

CONCLUSIONS

The diagnosis of a complete tear of the ATFL on MRI is more sensitive than the diagnosis of a complete tear of the CFL. MRI findings of CFL injury are diagnostically specific but are not sensitive. However, only normal findings and complete tears were statistically significant between ATFL and CFL (p < 0.001).

BACKGROUND

Chronic ankle instability (CAI) is the main complication of ankle sprains and requires surgery if non-operative treatment fails. Surgical ankle stabilisation techniques can be roughly classified into two groups, namely, repair involving retensioning and suturing of the anterior talofibular ligament (ATFL) and calcaneofibular ligament (CFL) and reconstruction using a tendon graft. Arthroscopic repair and reconstruction techniques for CAI have been introduced recently. The objective of this prospective multicentre study was to assess the feasibility, morbidity, and short-term outcomes of these arthroscopic ankle-stabilisation techniques.

METHODS

Consecutive patients scheduled for arthroscopic treatment of CAI were included prospectively. Of the 286 included patients, 115 underwent ligament repair and 171 ligament reconstruction. Mean follow-up was 9.6 months (range, 6-43 months). We recorded the AOFAS and Karlsson scores, patient satisfaction, complications, and time to return to sports.

RESULTS

The overall patient satisfaction score was 8.5/10. The AOFAS and Karlsson scores improved significantly between the pre- and postoperative assessments, from 62.1 to 89.2 and from 55 to 87.1, respectively. These scores were not significantly different between the groups treated by repair and by reconstruction. Neurological complications occurred in 10% of patients and consisted chiefly in transient dysesthesia (with neuroma in 3.5% of patients). Cutaneous or infectious complications requiring surgical revision developed in 4.2% of patients.

CONCLUSIONS

Arthroscopic treatment is becoming a method of choice for patients with CAI, as it allows a comprehensive assessment of the ligament lesions, the detection and treatment of associated lesions, and repair or reconstruction of the damaged ligaments. These simple, reliable, and reproducible arthroscopic techniques seem as effective as conventional surgical techniques. The rate of cutaneous complications is at least halved compared to open surgery.

CONCLUSIONS

Arthroscopic ankle stabilisation repair and reconstruction techniques hold considerable promise but require further evaluation to better determine the indications of repair versus reconstruction and to obtain information on long-term outcomes.

OBJECTIVE

Peroneal tendons are known as active stabilizer in acute ankle sprain while an intact ankle mortise and intact lateral ligaments are required for passive stability of the ankle joint. The goal of this study is to determine the peroneal tendons as passive stabilizer in case of lateral ligament instability.

METHODS

Twelve (12) human lower leg cadaver specimens underwent a torsion simulation in the testing system, 858 Mini Bionix(®) (MTS(®) Systems Corporation, Eden Prairie, MN, USA) and a specially designed mounting platform for the specimens. The preset torsion between tibia and calcaneus was primarily set at 30° of internal rotation during plantar flexion and hindfoot inversion. The resisting torque around mechanical tibial axis was recorded which ensures stability in ankle sprain trauma. The first series of measurements were performed on healthy specimens and the following after transecting structures in following order: ATFL (anterior talofibular ligament) in combination with CFL (calcaneofibular ligament), followed by peroneus longus tendon and finally peroneus brevis tendon.

RESULTS

The combined lateral ATFL and CFL instability shows a decrease of the resisting torque which ensures stability in ankle sprain trauma. Only a transection of PLT with existing lateral dual-ligament instability results in a significant decrease in torque (p < 0.0001).

CONCLUSIONS

The PLT has a substantial effect on passive stability at a present lateral ligament lesion in ankle sprain trauma. A deficiency in viscoelastic properties of the peroneus longus tendon must be considered in diagnostic and treatment for ankle instability.

The aim of this study was to determine the effect of central visual field loss (CFL) on fixation patterns of a person walking towards a target. Subjects were four visually normal persons and 10 persons with CFL. Eye position on scene was recorded and classified into 20 scene categories. The distributions of fixations among scene categories were compared across the two subject groups. For all but two CFL subjects, who fixated primarily at the floor, the distributions of fixations for the CFL subjects ranged from being moderately to strongly correlated with that of the visually normal mean. An analysis of the similarity in the sequence of fixations (or gaze pattern) of the CFL subjects to the visually normal subjects showed a range of 7-66%. Excluding the one CFL subject who had a functioning fovea, sequence similarity was strongly correlated with the logarithm of the minimum angle of resolution (logMAR). The better a person's logMAR, the more closely his or her gaze pattern matched that of the visually normal subjects. Finally, the CFL data were tested against two current models of oculomotor strategy, visual salience and guided search. Similar to what was found with visually normal subjects, CFL subjects appear to use the expected features and general location of the target to guide their fixations, the guided-search strategy.

The fluorescence emission properties of single chlorosomes from the green sulfur photosynthetic bacterium Chlorobium (Chl.) tepidum are studied for the first time, using a total internal reflection fluorescence microscope. The fluorescence peak positions of bacteriochlorophyll (BChl)-c self-aggregates in a single chlorosome of Chl. tepidum were widely distributed in the wavelength region between 750 and 768 nm, and the standard deviation (s.d. = 4.1 nm, n = 51) was larger than that of single chlorosomes of Chloroflexus (Cfl.) (s.d. = 1.9 nm, n = 50). The spectral heterogeneity among single chlorosomes from Chl. tepidum was in sharp contrast to those from Cfl. aurantiacus. The difference of chlorosomal spectral properties between Chl. tepidum and Cfl. aurantiacus at the single-unit level would be ascribed to the homolog composition of BChl-c--chlorosomes of Chl. tepidum have BChl substituted with various alkyl groups at both the 8- and 12-positions, whereas light-harvesting BChl-c molecules in Cfl. chlorosomes have the same substituents at the 8- (ethyl group) and 12- (methyl group) positions.

It has been shown that if a recurrent neural network (RNN) learns to process a regular language, one can extract a finite-state machine (FSM) by treating regions of phase-space as FSM states. However, it has also been shown that one can construct an RNN to implement Turing machines by using RNN dynamics as counters. But how does a network learn languages that require counting? Rodriguez, Wiles, and Elman (1999) showed that a simple recurrent network (SRN) can learn to process a simple context-free language (CFL) by counting up and down. This article extends that to show a range of language tasks in which an SRN develops solutions that not only count but also copy and store counting information. In one case, the network stores information like an explicit storage mechanism. In other cases, the network stores information more indirectly in trajectories that are sensitive to slight displacements that depend on context. In this sense, an SRN can learn analog computation as a set of interdependent counters. This demonstrates how SRNs may be an alternative psychological model of language or sequence processing.

BACKGROUND

Individuals typically self-identify symptoms of facial aging that lead them to seek facial aesthetic treatments. No systematic data exist to describe preferences for facial areas requiring treatment.

OBJECTIVE

To determine (1) the facial areas most likely to be treated first, (2) the relationship between the most bothersome facial area and the area first planned for treatment, and (3) differences between younger and older women.

METHODS

A total of 603 women aged 30 to 65 years considering aesthetic treatments participated in an online research survey using Maximum Difference scaling.

RESULTS

Maximum Difference analysis revealed that crow's feet lines (CFLs) were most likely to be treated first (82% of the first preferences), followed by oral commissures (74%) and tear troughs (72%). There was a strong correlation between the most bothersome facial area and the area first planned for treatment. In women younger than 45 years, features of the upper face were more likely to be treated first, whereas women aged 50 years or older had an increased preference for treating features of the lower face, with a reduction in preference for upper face treatment.

CONCLUSIONS

This cross-sectional survey suggests that aesthetically oriented women have changing facial treatment preferences with age; however, CFLs are of most concern.

Photolysis of alpha-diazo-N-methoxy-N-methyl (Weinreb) beta-ketoamides derived from enantiomerically pure (EP) alpha-amino acids affords the corresponding EP beta-lactams via an intramolecular Wolff rearrangement. The photochemistry is promoted with either standard UV irradiation or through the use of a 100 W compact fluorescent light; the latter affords a safe and environmentally friendly alternative to standard photolysis conditions. A continuous-flow photochemical reactor made from inexpensive laboratory equipment reduced reaction times and was amenable to scale-up. The diastereoselectivity (cis or trans) of the product beta-lactams has been shown to vary from modest to nearly complete. An extremely facile, atom-economical method for the epimerization of the product mixture to the trans isomer, which is generally highly crystalline, has been developed. Evidence for C3 epimerization of Weinreb amide structures via a nonbasic, purely thermal route is presented. Subsequent transformations of both the Weinreb amide at C3 (beta-lactam numbering) and the amino acid side chain at C4 are well-tolerated, allowing for a versatile approach to diverse beta-lactam structures. The technology is showcased in the synthesis of a common intermediate used toward several carbapenem-derived structures starting from unfunctionalized aspartic acid.

BACKGROUND

In rats, quinpirole, a dopaminergic D2/D3 receptor agonist, elicits both hyperdipsia and water "contrafreeloading" (CFL), a putative model of compulsivity. The role of D3 receptors in this effect remains unclear. Clomipramine (CIM) was found to contrast both hyperdipsia and CFL, but the role of serotonin in this effect requires further investigation.

OBJECTIVE

We studied the effects of the preferential D3 agonist pramipexole (PPX) in both models. Furthermore, we tested the sensitivity of PPX-induced CFL to CIM and to the 5HT2c antagonist SB242084.

METHODS

In experiment 1, drinking was measured at 2 and 5 h after eight daily injections of PPX (0 to 1.0 mg/kg intraperitoneally). In the CFL study, every other third lever press, the rat was reinforced by the delivery of water. On days 1-6, water was only available upon lever pressing. On days 7-15, choice between response-contingent and free access was provided. PPX doses as in the experiment 1 were given. In two further experiments, PPX (0.5 mg/kg) was administered alone or in combination with CIM (5 or 10 mg/kg) or SB242084 (0.3 or 1.0 mg/kg).

RESULTS

PPX did not produce hyperdipsia but enhanced spontaneous CFL. SB242084 attenuated PPX-induced CFL more effectively than CIM, restoring the preference for free access to water.

CONCLUSIONS

CFL, but not polydipsia, was induced by preferential D3 activation, an effect prevented by 5HT2c receptor blockade. Since PPX interferes with decision making and 5HT2c receptor supersensitivity is involved in the expression of compulsive behaviors, this study supports the compulsive nature of dopaminergic-induced CFL.