Anthropometric risk factors for patellar tendon injury among volleyball players.

OBJECTIVE: Abnormal imaging in the patellar tendon reveals pathology that is often associated with knee pain. Anthropometric measures of body size and mass, such as height, weight and waist-to-hip ratio (WHR), have been individually associated with abnormal imaging. The aim of this study was to investigate the anthropometric factors that have the strongest relationship with abnormal imaging in volleyball players. METHODS: Height, weight, body mass index (BMI), waist girth, hip girth and WHR were measured in a cohort of 113 competitive volleyball players (73 men, 40 women). The univariate (ANOVA) and multivariable (discriminant function analysis) association between abnormal imaging and these anthropometric factors were investigated. RESULTS: No significant association was found in the female volleyball players. A significant univariate association was observed between abnormal imaging and heavier weight, greater BMI, larger waist and hip girth and larger WHR in the male volleyball players. Waist girth was the only factor that retained this association in a multivariable model (p<0.05). CONCLUSIONS: Men with a waist girth greater than 83 cm seem to be at greater risk of developing patellar tendon pathology. There may be both mechanical and biochemical reasons for this increased risk.

Treatment and outcome of 83 children with intraspinal neuroblastoma: the Pediatric Oncology Group experience.

PURPOSE: To investigate whether the rate of neurologic recovery or the incidence of long-term sequelae differed for children with neuroblastoma (NB) initially treated with chemotherapy versus surgical decompression with laminectomy, we reviewed the Pediatric Oncology Group (POG) experience. PATIENTS AND METHODS: A retrospective review of children diagnosed with intraspinal NB registered on POG NB Biology Protocol 9047 was performed. Survival, neurologic outcome, and orthopedic sequelae were evaluated according to age of the patient at diagnosis, stage of disease, duration and severity of neurologic symptoms, and therapeutic intervention. RESULTS: Between May 1990 and January 1998, 83 children with intraspinal NB were entered onto the study. Five-year survival for this cohort of patients was 71% +/- 9%. Forty-three (52%) of the patients had neurologic symptoms at diagnosis. After treatment, six of 15 severely affected patients, who presented with paralysis, completely recovered neurologic function. Two of five patients with moderate deficits, consisting of paresis and bowel/bladder dysfunction, completely recovered neurologic function. Seventeen of 22 assessable children, who had mild symptoms comprised of paresis alone, fully recovered. Seven of 24 assessable patients who had undergone laminectomy developed scoliosis, whereas spinal deformities were only detected in one of 49 assessable patients managed without laminectomy (P =.001). CONCLUSION: The frequency of complete neurologic recovery in children with intraspinal NB inversely correlated with the severity of the presenting neurologic deficits. The rate of neurologic recovery was similar for patients treated with chemotherapy compared to those managed with laminectomy. Fewer orthopedic sequelae were observed in the children managed with chemotherapy than were seen in children managed with laminectomy.

Development and evaluation of pulsatile roller pump and tubing for cardiac assistance.

In our laboratories we have developed a roller pump for cardiopulmonary bypass and circulatory assistance that has the ability to produce steady or pulsatile flow. The pulsatile mode can also be used for counterpulsation. The roller pump has been tested both experimentally and clinically. Studies have also been performed in vitro and in vivo to evaluate and select the best medical-grade roller pump tubing to be used in the pump for short- and long-term support. In vitro tests included rebounding of tubing volume versus revolutions per minute, rebounding over time with continuous pumping, flex life, and spallation. In vivo testing was performed in mongrel dogs using heparinless left heart bypass pumping for 6 h. Hematologic studies were performed during the procedure. Postmortem examination was performed, looking especially for thromboembolism. The tubing and connectors were also inspected. The results of the in vivo and in vitro tests of all tubings were then compared.