Influence of population size, density, and proximity to talent clubs on the likelihood of becoming elite youth athlete.

Previous studies have found significant differences in the likelihood of becoming an elite athlete depending on community population sizes and densities, an effect known as the place of early development, or birthplace effect. However, the results have not been consistent between sports or European countries. As both professional and voluntary clubs are vital to the talent development systems in Europe, the proximity of an athlete's place of early development to the location of talent clubs may be an important predictor of the likelihood of becoming an elite athlete. Therefore, the primary purpose of this study was to investigate the place of early development effect and the effect of proximity to talent clubs. The samples included elite youth league athletes (579 football and 311 handball) and national youth athletes (85 football and 80 handball) and a comparison group of 147 221 football and 26 290 handball youth athletes. Odds ratios showed variations in the optimal community size and density across sports. Geospatial analyses of proximity to talent clubs highlighted a trend indicating that most national and elite youth league athletes in both sports had their place of early development in their sport near a talent club. The results suggest that proximity is an important predictor in the development of expertise across sports, but future studies need to clarify if proximity is important in other countries and sports.

Kinetics of human connecting peptide in normal and diabetic subjects.

The metabolic clearance rate (MCR) of synthetic human connecting peptide (C-peptide) was measured with a single-dose injection technique in six normal and seven diabetic subjects and with a constant infusion technique in one normal subject. The MCR of C-peptide did not differ in normal subjects (4.4 ml/min per kg; range, 3.7-4.9) and in diabetic subjects (4.7 ml/min per kg; range, 3.7-5.8). Employment of both techniques in one subject gave similar MCR. The average half-life of C-peptide in plasma calculated from the last 1-h period of the single-dose injection studies was longer in the insulin-dependent diabetics (42.5 min; range, 39.4-48.5) than in the normal subjects (33.5 min; range, 24.9-45.3). These results indicate that the beta-cell secretory capacity of normal and insulin-dependent diabetic subjects can be compared by measuring the C-peptide concentration in peripheral venous plasma. The difference in the half-life of C-peptide in plasma between diabetics and normals suggests an altered kinetics of the disappearance of the peptide, while the overall metabolism, as expressed by the MCR, is similar.

The role of community in the development of elite handball and football players in Denmark.

The primary purpose of this study was to investigate the effect of the place of early development in a sample of Danish male elite and youth handball and football players. The sample included 366 handball and football players from the elite Danish league in the season 2011-2012 and a comparison sample of youth players under the age of 12 from 2003, including 147,221 football and 26,290 handball players. Odds ratio analysis showed that both population size and density significantly affected the proportional number of youth players per community and the odds of athletes reaching an elite level in football and handball. The odds for youth player registrations in both handball and football increased in rural in contrast to urban communities. However, elite football players primarily came from communities of high density (>1000 pop./km(2)), whereas elite handball players primarily came from less densely populated communities (100 to <250 pop./km(2)). Furthermore, there seems to be a relation between representation of elite and talent clubs in different communities and the probability of becoming an elite player in both sports. The limited number of elite players in both sports from rural communities may be due to national talent development strategies that do not incorporate development support for clubs in rural areas. Additionally, the results of the study clearly suggest the need to include the youth player population to advance research findings in birthplace effect studies.

Long-term effects on renal function and blood pressure of treatment with cisplatin, vinblastine, and bleomycin in patients with germ cell cancer.

Long-term effects of cisplatin on renal function were investigated in 34 patients with germ cell cancer observed for a median of 65 months (range, 43 to 97 months). All patients achieved a complete remission after treatment with cisplatin (median dose 583 mg/m2), vinblastine, and bleomycin. None of the patients relapsed during follow-up. During treatment the glomerular filtration rate (GFR) decreased by 18% (P less than .05). During follow-up kidney function recovered in ten patients and partly improved in eight patients. Changes in plasma creatinine did not consistently correspond to alterations in GFR. The mean increase in systolic blood pressure during follow-up did not differ from the increase seen in a group of age-matched healthy men. The mean increase in diastolic pressure, however, was significant (P less than .05), but was entirely due to hypertension observed in six patients. Renography of these patients was normal. We conclude that the decrease in GFR observed during treatment with cisplatin is partly reversible. Cisplatin-treated patients have an increased risk of developing hypertension years after treatment.

Microvascular protein leakage in extensive skin diseases: aspects of the transport mechanisms.

The transcapillary escape rates of albumin (TERalb) and IgG (TERIgG) (i.e. fractions of intravascular masses of albumin and IgG passing to the extravascular spaces per unit time) can be used as parameters of the microvascular leakiness to macromolecules. These parameters were examined simultaneously in 12 patients with extensive skin disease. Six of the patients were reexamined after treatment with systemic steroid. The significantly increased (p less than 0.001) pretreatment values of both TERalb and TERIgG were normalized after treatment with systemic steroid to mean values comparable to those of the control group (p greater than 0.1). The patients mean ratio of TERIgG/TERalb did not differ from that of controls, neither before nor after treatment (p greater than 0.1). The microvascular leakage to differently sized macromolecules in the patients examined seems to be independent of the underlying skin disease. On the background of the structural microvascular changes often described in inflammatory reactions developed experimentally, and the similar changes present in the microvasculature of the psoriatic skin, it is suggested, that the increased microvascular leakage as found in this study, is confined to the postcapillary venules. The functional mechanisms dominating the transport of macromolecules across the vessel wall in this study are compatible with free diffusion as well as with filtration.

Microvascular leakage of plasma proteins after PUVA and UVA.

The transcapillary escape rate of albumin (TERalb), i.e., the fraction of intravascular albumin mass passing to the extravascular space per unit time, is a parameter of the leakage of macromolecules from the total microvasculature. In patients with psoriasis short-term PUVA treatment induces an increase in TERalb. In this study TERalb was measured in 3 groups of normal humans treated with PUVA, UVA and 8-methoxypsoralen. Treatment with PUVA and UVA caused a statistically significant increase in TERalb, whereas treatment with 8-methoxypsoralen did not induce any measurable changes. It is concluded that the UVA irradiation causes the abnormal leakage of macromolecules, whereas psoralen is not the responsible component. Furthermore the phenomenon can be elicited in normals and is not based on a preexisting psoriasis.

Direct and indirect effects of UVA on skin vessel leakiness.

By using the suction blister technique we have investigated the leakiness of skin vessels in healthy volunteers after whole-body suberythemogenic doses of UVA radiation (a quadrant on one side of the abdominal skin was shielded with lead-rubber). The accumulation of intravenously injected labeled albumin in blister fluid was slightly elevated 1 day after irradiation and increased significantly 2 days later. The blister concentrations of 4 endogenous plasma proteins (albumin, transferrin, IgG, and alpha 2-macroglobulin) were elevated 1 day after radiation exposure and normalized 2 days later. All changes were equal on irradiated and nonirradiated skin. It is concluded that UVA radiation can induce a continued or biphasic increased leakage of plasma proteins in the skin vessels, due to a humoral rather than to a direct physical effect of the radiation on the vessel walls. It is suggested that an increased microvascular leakiness in organs other than the skin might be present.

Comparing the performance of two gamma cameras under high counting rates: principles and practice.

The performance of two large Anger cameras at high counting rates was compared, and the principles for measuring the relevant parameters, especially deadtime loss and coincidence artifacts, are discussed. The results demonstrate the importance of the following factors: modern pulse-shaping circuitry with short paralyzable deadtime, and anti-pileup circuit, and uniform energy information within the field of view, which requires separate summing matrices for energy and position. Elaborate testing of the specifications should be carried out before purchase of a gamma camera.

Pulmonary permeability in never-smokers between 21 and 67 yr of age.

During the last 5-10 years, measurements of pulmonary clearance (PCl) of aerosolized 99mTc-labeled diethylenetriamine pentaacetic acid (99mTC-DTPA) have become increasingly used as an index of pulmonary epithelial injury. The aim of this study was to apply a carefully defined procedure for measurements of PCl in healthy nonsmoking individuals and analyze whether sex, age, and height are clinically relevant confounders contributing to the range of interindividual variation. Measurements of regional ventilation (V) and perfusion (Q) were included to analyze whether these indexes are influenced by the same confounders. We studied 39 males and females between 21 and 67 yr of age. Average PCl of the lungs was 0.85 +/- 0.25%.min-1. There was a significant difference between PCl of the central and peripheral parts of the lungs (P less than 0.01). Regional V and Q were greater in the lower than in the upper halves of the lungs (P less than 0.01). There was no relation between PCl, V, or Q and the sex, age, and height of the individuals. It is concluded that when measuring PCl in adult individuals anthropometric measurements need not be considered.

Effect of change in particle number on pulmonary clearance of aerosolized 99mTc-DTPA.

Pulmonary clearance (PCl) of inhaled aerosolized 99mTc-diethylenetriamine pentaacetic acid (DTPA) across the alveolocapillary membrane is diffusion limited. Therefore, if the mixing of the 99mTc-DTPA in the aqueous hypophase underlying surfactant is slow or incomplete or if there were no hypophase, an increase in the alveolar surface area occupied by 99mTc-DTPA particles would increase the absorption rate. The aim of this study was to examine whether there is an effect on PCl of changing the number of inhaled particles. The change in particle number was accomplished by a setup of four parallel jet nebulizers feeding a central delivery chamber of 400 cm3. We performed two kinds of experiments in eight healthy nonsmokers between 28 and 52 yr of age. In the first experiment, 99mTc-DTPA in saline was nebulized in one nebulizer, while saline was nebulized in the other three. In the second experiment the number of inhaled particles containing 99mTc-DTPA was increased by a factor of four by nebulizing 99mTc-DTPA in saline in all four nebulizers simultaneously. Increasing the number of inhaled 99mTc-DTPA particles caused an increase in PCl of 24.2% (P less than 0.01). We conclude that there is a slight but significant effect of changing the number of DTPA particles on PCl and that this is probably due to an uneven mixing of the 99mTc-DTPA in the aqueous hypophase underlying the surfactant lining and the alveoli.

Effects of cisplatin on different measures of glomerular function in the human kidney with special emphasis on high-dose.

To investigate the effect of high-dose cisplatin (40 mg/m2 daily for 5 days), 51Cr-EDTA clearance was used as a measure of glomerular filtration rate (GFR). 51Cr-EDTA clearance decreased significantly from 109 +/- 3 ml/min * 1.73 m2 to 68 +/- 3 ml/min * 1.73 m2 after three cycles of cisplatin and remained at this decreased level during the observation period (24 months). To determine the reliability of creatinine as a measure of GFR, we compared the simultaneous clearance of creatinine to that of 51Cr-EDTA. A good correlation between 51Cr-EDTA clearance and creatinine clearance was observed before and 3 months after termination of treatment, but no correlation was found during treatment. S-creatinine decreased significantly during treatment, probably due to muscle wasting. We conclude that s-creatinine and creatinine clearance are unsuitable measures of glomerular function during high-dose cisplatin treatment. All patients developed proteinuria during treatment. The changes in clearance ratios of beta-2-microglobulin/albumin and IgG/albumin show that the proteinuria observed during cisplatin infusion is predominantly of tubular origin, whereas the proteinuria between the treatment periods is mainly of glomerular origin.

Regional lung function impairment following post-operative radiotherapy for breast cancer using direct or tangential field techniques.

We have compared the effect of tangential and direct irradiation on regional lung function in 22 consecutive patients with breast cancer, who had been treated by post-operative irradiation 3 months prior to the examination. The tangential technique (total dose 32-36 Gy, less than 5 Gy of the lung) was employed in eight of the patients, while the direct technique (total dose 40 Gy, 5-20 Gy to the lung) was used in the other 14. In the group that had been treated by the tangential technique, there was no impairment of the ventilation or perfusion of the irradiated lung compared with the contralateral lung. The radiographs of the thorax were all normal. In the group that had been treated by the direct technique, there was a reduction in both the ventilation and the perfusion in 12 of the patients (p less than 0.01). The radiographs of the thorax were abnormal in only seven of these 12 patients. In both groups the regional leakiness of the lungs was evaluated as the pulmonary clearance of inhaled nebulised 99Tcm-DTPA. Due to differences in smoking habits between and within the groups, the results were not conclusive. It is concluded that the regional lung function was not significantly affected by the tangential technique, in contrast to a pronounced and harmful effect of the direct technique.

Intra- and extravascular distribution of albumin and immunoglobulin in man.

The plasma proteins are constantly shuttling between intravascular and extravascular mass of a specific plasma protein is determined by its individual rate of synthesis and the mean total time it spends in plasma. The ratio of intravascular to total mass (distribution ratio) is determined by the relative rate, at which it passes from plasma to interstitial spaces (transcapillary escape rate: TER) and the relative return rate via lymph. TER in a specific organ depends on the local leakiness of the microvasculature. The overall value in normal man varies with the molecular weight of the protein being about 5%/h of the intravascular albumin mass, 3%/h for IgG and less than 1%/h for IgM. The higher the TER, the lower is the intravascular fraction. Hypertension, diabetes mellitus, burns, myxedema and certain types of liver cirrhosis will increase TER. In hypertension and diabetes this may be compensated for by an increased lymphatic return rate. Hypoproteinemia due to malnutrition or urinary or gastrointestinal loss is accompanied by a shift from the extravascular to the intravascular space.

[Bone scintigraphy in patients with hip joint prostheses. Use of bone scintigraphy in hip pain after total hip replacement]. / Knogleskintigrafi ved hofteledsprotese. Anvendelse af knogleskintigrafi ved hoftesmerter efter proteseindsaettelse.

A retrospective investigation was undertaken to assess the value of bone scintigraphy with 99mtechnetium methylene-diphosphonate in patients referred with hip pain after total hip replacement. The material comprized 68 patients with a total of 68 prostheses. This review revealed that 10/25 of the patients with pathological scintigrams and 6/28 of the patients with normal scintigrams were submitted to replacement of the prostheses. In the way in which it was carried out and interpreted in this department, scintigraphy was of limited value in selection of the patients who required replacement of the prostheses.