Recombinant human fibroblast growth factor and autogenous bone for periodontal regeneration: Alone or in combination? A randomized clinical trial.

AIM: To compare the outcomes of therapy using recombinant human fibroblast growth factor (rhFGF)-2 combined with autologous bone grafting (ABG) therapy with those of rhFGF-2 alone and ABG alone in the treatment of periodontal intraosseous defects. METHODS: Periodontal intraosseous defects were randomized to receive rhFGF-2 therapy + ABG, rhFGF-2 therapy alone, or ABG alone. Periodontal examination and periapical radiography were performed preoperatively and at 3, 6, and 12 months postoperatively. RESULTS: At the 12 months follow-up, all three groups showed significant improvement in the clinical attachment level (CAL): 5.6 ± 1.6, 5.8 ± 1.7, and 5.2 ± 1.6 mm in the rhFGF-2 + ABG, rhFGF-2 alone, and ABG alone groups, respectively, with no significant inter-group differences (p < .05). rhFGF-2 therapy (alone or in combination) resulted in greater bone defect filling (BDF) (2.3 ± 1.2 mm and 2.6 ± 1.9 mm, respectively) than ABG therapy alone (1.2 ± 1.2 mm). Gingival recession was lesser in the ABG alone (1.2 ± 1.1 mm) and rhFGF-2 + ABG groups (1.4 ± 0.8 mm) than in the rhFGF-2 alone group (2.2 ± 1.2 mm). CONCLUSION: The results of this study showed that at 12 months postoperatively, all treatments resulted in statistically significant clinical improvements compared to the baseline. From these results, it can be concluded that rhFGF-2 promotes hard tissue regeneration in intraosseous defects.

In-Water Resisted Swim Training for Age-Group Swimmers: An Evaluation of Training Effects.

PURPOSE: The purpose of this study is to compare the efficacy of resisted sprint swim training with that of nonresisted sprint swim training on 50-m freestyle competition time (Vmax50) in age-group swimmers. METHODS: Twenty-four age-group swimmers (age 10.6-14.9 y) were divided into resisted or nonresisted sprint swim training groups and completed a sprint swim training intervention 2 times per week for 10 weeks. Repeated 10-m sprints with progressively increasing resistance were used to determine measures of swim power. Skeletal muscle mass was estimated using B-mode ultrasound. Maturity status was estimated using predicted adult height (%Htadult) and maturity offset. RESULTS: A 2-way repeated-measures analysis of variance revealed no group × time interaction for measured variables. Vmax50 was correlated with skeletal muscle mass and swim power variables, but no significant relationship was found between relative changes in these variables. Estimated maturity status (%Htadult) appeared to be associated with initial measures of swim power and performance variables. CONCLUSIONS: Ten weeks of resisted sprint swim training was not any more effective than nonresisted sprint swim training at improving sprint swim performance in age-group swimmers.

Duodenal Diverticular Bleeding Treated with Endoscopy or Transcatheter Arterial Embolization: A Report of Two Cases and a Literature Review.

Duodenal diverticular bleeding (DDB) is extremely rare. We herein report 2 life-threatening cases of DDB successfully treated with endoscopy or transcatheter arterial embolization (TAE) and review 13 cases of DDB reported from Japan. When upper gastrointestinal bleeding of unknown origin is encountered in middle-aged or older adults, DDB should be included in the differential diagnosis. DDB often causes massive bleeding. It is therefore important to judge which is safer and more effective, endoscopy or TAE, based on the general condition of the patient. In addition, it is critical to attempt hemostasis via various strategies, including different gastroscopes and hemostatic devices.

Multi-age-grouping paradigm for young swimmers.

The purpose of this study was to examine the adequacy of "multi-age" classification systems in youth sports with a specific focus on the unisex multi-age-groupings used by USA Swimming. In addition, we offer an analytical rationale for the multi-age-groupings and potential alternatives. We examined the top 100 US swim performances for three years (2005, 2006, and 2007) for girls and boys in 15 age-groups (7 to 20 years and a singular group of 21 years and older). Data for each age and sex were pooled over the three years and means were calculated for each of seven competitive swim events. Swim times differed among each age up to the 14-year age-group in girls (F (14,30885) = 183.9, P < 0.01, Cohen's d = 1.19-3.72, large effect) and 16-year age-group in boys (F (14,30885) = 308.7, P < 0.01, Cohen's d = 0.81-3.64, large effect) for all events. Age-related differences in swim times continued later in boys than girls likely due to differences between the sexes in timing of growth and maturation. Because of the differences in swim performance in contemporary multi-age-groups, stratifying swimmers by a single age is the best means to ensure competitive fairness and equality, although there is no rationale for swimmers under the age of 8 years to compete in separate unisex competitive groups.

Variation in Heart-Rate Profile During a Prolonged, Submaximal Swim Bout.

PURPOSE: To describe the heart-rate (HR) response during a prolonged, submaximal, multirepetition swimming bout (ie, typical early-season swimming training), as there is currently little or no literature on this topic. METHODS: A total of 12 collegiate swimmers were instructed to complete sixty 91.4-m (100-yd) freestyle repetitions at their fastest sustainable pace, allowing between 5 and 10 seconds of rest between repetitions. Each swimmer was outfitted with a cardiotachometer, which monitored HR throughout the trial. Completion time (CT) was also recorded for each repetition. Individual means of HR and CT were calculated, and linear mixed models were used to determine the trend across repetitions and between- and within-subject SD for HR and CT. RESULTS: The mean (SD) value for HR was 167.8 (10.8) beats per minute (bpm), for CT was 68.7 (4.1) seconds, and for percentage of best time was 71.2% (4.5%). There was no change (Δ rep 55-6) in HR (-0.1 bpm; 95% confidence interval, -6.8 to 6.6 bpm; P = .97), whereas CT increased (3.0 s; 95% confidence interval, 1.5-4.4 s; P = .001). The between-subjects SD (95% confidence interval) for HR was 12.6 (8.4-19.3 bpm) and for CT was 4.6 (3.1-7.0 s). The within-subject SDs for HR and CT were 4.0 (3.8-4.3 bpm) and 0.9 (0.8-0.95 s), respectively. CONCLUSIONS: The inherent individual variability between swimmers in HR during training suggests that coaches carefully consider the common practice of prescribing workout intensity using rigid HR zones.

Influence of the stimulus parameters of galvanic vestibular stimulation on unilateral spatial neglect.

Galvanic vestibular stimulation (GVS) stimulates the vestibular system electrically with low-amplitude direct current through surface electrodes applied to the left and right mastoids. The effects of GVS on unilateral spatial neglect (USN) in poststroke patients were recently reported, but the influence of the current intensity and application duration of GVS on USN has not been sufficiently investigated. Here we explored the influence of these stimulus parameters on USN. We recruited seven patients with right-hemisphere stroke and left-sided USN (four female) for this single-blind, sham-controlled cross-over trial. Their scores on the line cancellation test were measured under three stimulation conditions [left-cathodal/right-anodal GVS (L-GVS), right-cathodal/left-anodal GVS, and sham] at three time points (before the start of GVS, 10 min after the start of GVS, and 20 min after the start of GVS). The GVS intensity was set below the sensory threshold and differed among the patients (0.4-2.0 mA). The cancellation scores were significantly increased after 10 and 20 min L-GVS, with a greater increase observed after the latter (P<0.0001). The other stimulus conditions had no significant effect. There was a significant positive correlation between the change in the increase in the cancellation score with L-GVS and the total charge (r=0.81, P=0.0004). The effect of GVS on USN may depend on its application duration, current intensity, and polarity.

Skeletal muscle mass and muscular function in master swimmers is related to training distance.

It is unknown whether or not the daily swim training distances of master swimmers (MS) affect the observed changes in skeletal muscle mass (SM) and physical function commonly associated with the aging process. Twenty-two male MS aged 52-82 years were divided into two groups based upon training distance: High MS (>3000 meters swim/session and 4.1 times/week; n=11) and moderate MS (1500-2800 meters swim/session and 3.4 times/week; n=11). Eleven age- and body mass index-matched older (aged 56-80 years) men served as controls (AMC). Subjects who performed resistance training were excluded in this study. Muscle thickness (MTH) was measured by ultrasound at nine sites on the anterior/posterior aspects of the body (forearm, upper arm, trunk, thigh, and lower leg), and from this, total and segmental SM mass values were estimated. Thigh MTH (anterior:posterior mid-thigh, A50:P50) ratio was calculated to assess the site-specific thigh muscle loss. Straight and zigzag walking performance and maximum knee extension/flexion strength were also measured. Arm SM was greater for high MS and moderate MS than for AMC. Total SM index was higher for high MS than for moderate MS and AMC. A50:P50 ratio was greater for high MS than for AMC. Absolute and relative knee extension strength, but not flexion strength, was greater in high MS than in AMC. The A50:P50 ratio inversely correlated (p<0.05) with zigzag walking time, whereas relative knee extension strength positively correlated (p<0.05) with both straight and zigzag walking performance. Training distance in older MS may be an important factor for maintaining muscle mass and function in the aging process.

Feasibility study of a combined treatment of electromyography-triggered neuromuscular stimulation and mirror therapy in stroke patients: a randomized crossover trial.

BACKGROUND: Mirror therapy (MT) and electromyography-triggered neuromuscular stimulation (ETMS) are both effective treatments for impaired upper limbs following stroke. A combination of these two treatments (ETMS-MT) may result in greater gain than either treatment alone. OBJECTIVES: The feasibility and possible effects of ETMS-MT upon upper extremity function were investigated in stroke patients. METHODS: Thirteen post-acute stroke patients were randomly assigned to an immediate ETMS-MT group or a delayed ETMS-MT group and then underwent an 8-week training program. The immediate ETMS-MT group received ETMS-MT in addition to physical and occupational therapy (PT+OT) for 4 weeks. They then received only PT+OT for the next 4 weeks. In the delayed ETMS-MT group, interventions were provided in the reverse order. The main outcome measure was the Fugl-Meyer Assessment (FMA). RESULTS: The immediate ETMS-MT group showed significantly greater gain in FMA in the first 4 weeks. The delayed ETMS-MT group showed significantly greater gain in active range of motion during the latter 4 weeks. No adverse effects were reported following ETMS-MT. CONCLUSION: ETMS-MT might be as effective as independent MT or ETMS without causing any side effects. Future research should focus upon the direct comparisons between independent and combined interventions.

Peak oxygen uptake during running and arm cranking normalized to total and regional skeletal muscle mass measured by magnetic resonance imaging.

The purposes of our study were to determine the peak oxygen uptake (V(.) >O(2peak)) per total or regional skeletal muscle (SM) mass using magnetic resonance imaging (MRI) and to investigate the relationships between SM mass and V(.) >O(2peak) during running and arm cranking. Eight male college swimmers aged 18-22 years [mean (SD) age 20.0 (1.3) years] were recruited to participate in this study. V(.) >O(2) during running and arm cranking were measured using an automated breath-by-breath mass spectrometry system. Contiguous MRI slices were obtained from the first vertebra cervicale to the malleolus lateralis (1.0-cm slice thickness, 0-cm inter-slice gap), resulting in a total of approximately 156 images for each subject. The absolute V(.) O(2peak) and the V(.) O(2peak) per body mass during running and arm cranking were 3.6 (0.6) l.min(-1), 54.4 (5.9) ml.min(-1).kg(-1) and 2.5 (0.5) l.min(-1), 36.9 (5.3) ml.min(-1).kg(-1), respectively. The absolute V(.) O(2peak) was higher ( P <0.05) during running than during arm cranking, but not the V(.) O(2peak) per regional area SM mass. The lower body SM mass was correlated to the V(.) O(2peak) during running ( r =0.95, P <0.001). All measurements and calculated values were expressed as the mean (SD) for the eight subjects. To eliminate the influence of body mass and fat-free mass (FFM), a regression analysis was performed on the mass-residuals of the V(.) O(2peak) during running and the lower body SM mass. The residuals of lower body SM mass were correlated to the residuals of V(.) O(2peak) during running, with respect to body mass ( r =0.90, P <0.001) and FFM ( r =0.82, P <0.05). These results suggest that the MRI-measured lower body SM mass was closely associated to the absolute V(.) O(2peak) during running, independently of body mass or FFM, and that the V(.) O(2peak) per regional SM mass corresponded, regardless of the type of exercise (upper or lower body).