Ablation of frequent premature ventricular complex in an athlete.

Premature ventricular complex are common findings in the exam of many athletes. There is no extensive scientific evidence in the management of this situation particularly when associated with borderline contractile function of the left ventricle. In this case report, we present a 35-year-old asymptomatic healthy athlete with high incidence (over 10,000 beats in 24 h) of premature ventricular complex and left ventricular dilatation with dysfunction, which persisted after a resting period of 6 months without training. We performed radiofrequency ablation of the premature ventricular complex focus. After 1-year follow-up, he was asymptomatic without arrhythmia and the left ventricle normalized its size and function as shown by echocardiogram and cardiac magnetic resonance.

Characteristics of French users of child pornography: description of a cohort subjected to forensic evaluation.

Child pornography is a form of sexual exploitation of children. The virtual aspect of this offence appears to be encouraged by the internet. It is important to know the profiles of the people downloading these images. The aim of our study was to identify the characteristics of people who are drawn to child pornography. Our study was based on psychiatric assessments carried out at the request of the law courts. The feeling of loneliness and poor social integration are evoked by a lot of users of child pornography. Generally, they have no criminal record.

Complex distal femoral fractures in the fragile elderly patient treated by distal femoral replacement: A report of 3cases. / [Artículo traducido] Fractura de fémur distal compleja en el paciente frágil y anciano tratada mediante reemplazo femoral distal: reporte de 3 casos.

Complex distal femoral fracture (DFF) in the elderly patient is an infrequent but challenging scenario. In these fragile patients, DFF is associated with a high rate of medical complications and mortality. The optimum treatment remains controversial. Our aim is to propose our standard treatment, describe our results and discuss its clinical relevance. We describe 3cases of elderly and fragile patients with multiple comorbidities who suffered a complex DFF after low energy trauma. They were successfully treated through a primary arthroplasty with distal femoral replacement. All the 3patients presented early full weight-bearing mobilization (average time to first ambulation was 5days), good functional outcome (mean knee range of motion was 103°) and short hospital length of stay (mean of 10days). According to our experience, primary arthroplasty with distal femoral replacement could be a good therapeutic option for complex DFF in elderly patients.

Complex distal femoral fractures in the fragile elderly patient treated by distal femoral replacement: A report of three cases.

Complex distal femoral fracture (DFF) in the elderly patient is an infrequent but challenging scenario. In these fragile patients, DFF is associated with a high rate of medical complications and mortality. The optimum treatment remains controversial. Our aim is to propose our standard treatment, describe our results and discuss its clinical relevance. We describe three cases of elderly and fragile patients with multiple comorbidities who suffered a complex DFF after low energy trauma. They were successfully treated through a primary arthroplasty with distal femoral replacement (DFR). All the three patients presented early full weight-bearing mobilization (average time to first ambulation was five days), good functional outcome (mean knee range of motion was 103°) and short hospital length of stay (mean of ten days). According to our experience, primary arthroplasty with DFR could be a good therapeutic option for complex DFF in elderly patients.

Validación de un cuestionario de conocimientos adquiridos por los pacientes tras un taller educativo de artroplastia de rodilla.

INTRODUCTION: Total knee arthroplasty (TKA) is a surgery that aims to restore function and relieve pain in advanced osteoarthritis. The Educational Workshop (EW) for TKA is given to patients in the pre-surgery period to inform them and facilitating their participation in their health process (empowerment). The aim of this study was developing and validating a self-administered questionnaire to evaluate the acquired knowledge after the EW by the patients who will undergo the TKA procedure. MATERIAL AND METHODS: It was a longitudinal and prospective observational study with a sample of TKA candidate patients. The phases for the construction and validation of this ad hoc questionnaire were: Phase 1: A panel of experts who agreed on a final questionnaire of 20 items; Phase 2: Pilot test administered to 47 patients; Phase 3: Final test of 11 items administered to 50 patients, before and after the EW; Phase 4: Re-test, after the EW and 2 weeks after, administered to 58 patients. RESULTS: One hundred and fifty five patients were included. The Cronbach's alpha coefficient for the item's internal consistency of the final questionnaire, 11 items, was 0.78. To reach the criterion validity, in pre-EW the mean number of hits was: 4.92 (SD=1.78) and in post-EW 10.68 (SD=0.55), a difference that had a statistical significance p<.0001, with no overlap in the 95% CI of the mean: 4.46-5.38/10.54-10.82. The test for stability and reliability, re-test, obtained a mean of right answers 10.87 (SD=0.33) and for the re-test of 10.70 (SD=0.59). The correlation of the interclass coefficient for the re-test was 0.99, which corresponds almost to a maximum concordance. CONCLUSIONS: The questionnaire developed in this study is a reliable and easy tool to evaluate the acquired knowledge in the EW for patients who will be TKA operated.

Biomechanical demands of percussive techniques in the context of early stone toolmaking.

Recent discoveries in archaeology and palaeoanthropology highlight that stone tool knapping could have emerged first within the genera Australopithecus or Kenyanthropus rather than Homo. To explore the implications of this hypothesis determining the physical demands and motor control needed for performing the percussive movements during the oldest stone toolmaking technology (i.e. Lomekwian) would help. We analysed the joint angle patterns and muscle activity of a knapping expert using three stone tool replication techniques: unipolar flaking on the passive hammer (PH), bipolar (BP) flaking on the anvil, and multidirectional and multifacial flaking with free hand (FH). PH presents high levels of activity for Biceps brachii and wrist extensors and flexors. By contrast, BP and FH are characterized by high solicitation of forearm pronation. The synergy analyses depict a high muscular and kinematic coordination. Whereas the muscle pattern is very close between the techniques, the kinematic pattern is more variable, especially for PH. FH displays better muscle coordination and conversely lesser joint angle coordination. These observations suggest that the transition from anvil and hammer to freehand knapping techniques in early hominins would have been made possible by the acquisition of a behavioural repertoire producing an evolutionary advantage that gradually would have been beneficial for stone tool production.

Complex distal femoral fractures in the fragile elderly patient treated by distal femoral replacement: A report of three cases / Fractura de fémur distal compleja en el paciente frágil y anciano tratada mediante reemplazo femoral distal: reporte de 3 casos

Complex distal femoral fracture (DFF) in the elderly patient is an infrequent but challenging scenario. In these fragile patients, DFF is associated with a high rate of medical complications and mortality. The optimum treatment remains controversial. Our aim is to propose our standard treatment, describe our results and discuss its clinical relevance. We describe three cases of elderly and fragile patients with multiple comorbidities who suffered a complex DFF after low energy trauma. They were successfully treated through a primary arthroplasty with distal femoral replacement (DFR). All the three patients presented early full weight-bearing mobilization (average time to first ambulation was five days), good functional outcome (mean knee range of motion was 103°) and short hospital length of stay (mean of ten days). According to our experience, primary arthroplasty with DFR could be a good therapeutic option for complex DFF in elderly patients.(AU)

La fractura femoral distal (FFD) compleja en el paciente anciano es infrecuente, pero su manejo es un desafío. En estos pacientes frágiles, la FFD se asocia a un elevado riesgo de complicaciones médicas y mortalidad. Su tratamiento óptimo sigue siendo controvertido. El objetivo del estudio es proponer nuestro tratamiento estándar, describir nuestros resultados y discutir su relevancia clínica. Reportamos 3 casos de pacientes ancianos y frágiles con múltiples comorbilidades que sufrieron una FFD compleja a causa de un traumatismo de baja energía. Fueron tratados con éxito mediante un reemplazo femoral distal (RFD). Los 3 pacientes presentaron una movilización precoz con carga completa (la media hasta la primera deambulación fue 5 días), buenos resultados funcionales (la media de rango de movimiento de la rodilla fue 103̊) y una estancia hospitalaria breve (media de 10 días). Según nuestra experiencia, la artroplastia primaria podría ser una buena elección terapéutica para las FFD complejas en los pacientes ancianos.(AU)

Fractura de fémur distal compleja en el paciente frágil y anciano tratada mediante reemplazo femoral distal: reporte de 3 casos / Complex distal femoral fractures in the fragile elderly patient treated by distal femoral replacement: A report of 3cases

La fractura femoral distal (FFD) compleja en el paciente anciano es infrecuente, pero su manejo es un desafío. En estos pacientes frágiles, la FFD se asocia a un elevado riesgo de complicaciones médicas y mortalidad. Su tratamiento óptimo sigue siendo controvertido. El objetivo del estudio es proponer nuestro tratamiento estándar, describir nuestros resultados y discutir su relevancia clínica. Reportamos 3 casos de pacientes ancianos y frágiles con múltiples comorbilidades que sufrieron una FFD compleja a causa de un traumatismo de baja energía. Fueron tratados con éxito mediante un reemplazo femoral distal (RFD). Los 3 pacientes presentaron una movilización precoz con carga completa (la media hasta la primera deambulación fue 5 días), buenos resultados funcionales (la media de rango de movimiento de la rodilla fue 103̊) y una estancia hospitalaria breve (media de 10 días). Según nuestra experiencia, la artroplastia primaria podría ser una buena elección terapéutica para las FFD complejas en los pacientes ancianos.(AU)

Complex distal femoral fracture (DFF) in the elderly patient is an infrequent but challenging scenario. In these fragile patients, DFF is associated with a high rate of medical complications and mortality. The optimum treatment remains controversial. Our aim is to propose our standard treatment, describe our results and discuss its clinical relevance. We describe three cases of elderly and fragile patients with multiple comorbidities who suffered a complex DFF after low energy trauma. They were successfully treated through a primary arthroplasty with distal femoral replacement (DFR). All the three patients presented early full weight-bearing mobilization (average time to first ambulation was five days), good functional outcome (mean knee range of motion was 103°) and short hospital length of stay (mean of ten days). According to our experience, primary arthroplasty with DFR could be a good therapeutic option for complex DFF in elderly patients.(AU)

Phytochrome B affects the levels of a graft-transmissible signal involved in tuberization

Grafting experiments between phytochrome B antisense and wild-type potato (Solanum tuberosum L. subsp. andigena [line 7540]) plants provide evidence that phytochrome B is involved in the production of a graft-transmissible inhibitor of tuberization, the level of which is reduced in the antisense plants, allowing them to tuberize in noninducing photoperiods.

Multiple variability in the sequence of a family of maize endosperm proteins.

A collection of cDNA clones, corresponding to a group of maize endosperm proteins classified in the glutelin-2 (or reduced soluble proteins) and in the zein-2 subfractions, has been identified and characterized. The nucleotide sequence of three of these clones has been obtained and the amino acid sequence deduced. They appear to correspond to a small family of genes that are specifically expressed in immature endosperm simultaneously to zeins, the best characterized proteins from this tissue. Unlike zeins, the proteins of the glutelin-2 and zein-2 family contain sequences homologous to storage proteins from other cereals such as gliadins or hordeins. The cDNA clones encoding for the two types of proteins have been compared, and a high degree of homology has been observed for both the nucleotide and amino acid sequences. The differences existing in both the coding and non-coding regions allow the definition of multiple types of variability in their sequence. An hypothesis is proposed on how sequence diversity may have been generated in this particular class of plant proteins.

Highly heterogeneous families of Ty1/copia retrotransposons in the Lycopersicon chilense genome.

We have used the degenerated oligonucleotide primers-PCR (DOP-PCR) technique to determine the presence of Ty1/copia-related retrotransposons in the wild species of tomato, Lycopersicon chilense. Using degenerated oligonucleotides corresponding to highly conserved domains in the Ty1/copia retrotransposons, fragments of roughly 300 bp were obtained by PCR amplification. These were cloned in a plasmid vector and the nucleotide sequence determined for 20 clones, 19 of which showed sequence homology to retrotransposon-related sequences. Comparison of the deduced amino-acid sequence of these clones with those reported for other retrotransposons has allowed their classification into four distinct families: TLC1-TLC4. The level of amino-acid sequence similarity between these elements extends from 66.7% (between TLC1 and TLC2) to 42.6% (between TLC2 and TLC3). Altogether, the four families comprise about 0.17% of the L. chilense genome. RT-PCR analysis shows that the four TLC families are transcriptionally active, suggesting a mechanism for the generation of the observed diversity between the L. chilense retrotransposons.

Repression of the CaMV 35S promoter by the octopine synthase enhancer element.

A 16 base-pair palindrome upstream of the Agrobacterium tumefaciens octopine synthase (ocs) gene functions as a positive regulatory element in plant cells (Ellis et al. (1987) EMBO J. 6, 3203-3208; Fromm et al. (1989) Plant Cell 1, 977-984). We have converted it into a negative element by locating two copies flanking the TATA-box of the constitutively expressed CaMV 35S promoter. The reduced promoter activity is very likely due to sterical hindrance of the ocs binding protein (OCSTF) x ocs complex with the transcription initiation complex. We propose that this type of constructs can be used for the identification of recognition sites for DNA-binding proteins which are labile in vitro as well as for determining the DNA-binding activity of a trans-acting factor in vivo.

Characterization of the wound-induced metallocarboxypeptidase inhibitor from potato. cDNA sequence, induction of gene expression, subcellular immunolocalization and potential roles of the C-terminal propeptide.

A partial cDNA clone for the potato wound-inducible metallocarboxypeptidase inhibitor (PCI) was isolated from a cDNA library constructed from mRNA of abscisic acid (ABA)-treated potato leaves. The full 5' region of the cDNA was obtained through a RACE-PCR protocol. PCI mRNA encodes a precursor polypeptide which comprises a 29 residue N-terminal signal peptide, a 27 residue N-terminal pro-region, the 39 residue mature PCI protein, and a 7 residue C-terminal extension. Northern blot analysis demonstrates that the PCI gene is transcriptionally activated by wounding, and wound signaling can be induced by ABA and jasmonic acid. Subcellular localization of the protein was investigated by immunocytochemistry and electron microscopy, showing that PCI accumulates within the vacuole. A partial PCI precursor form, comprising the mature protein and the C-terminal extension, has been expressed in Escherichia coli and characterized. Its inability to inhibit carboxypeptidases, and stability to carboxypeptidase digestion, suggest that the C-terminal pro-domain may have, besides a probable vacuolar sorting function, a role in modulation of the inhibitory activity of PCI.

Gene expression during tuber development in potato plants.

Potato tubers are modified stems that have differentiated into storage organs. Factors such as day-length, nitrogen supply, and levels of the phytohormones cytokinin and gibberellic acid, are known to control tuberization. Morphological changes during tuber initiation are accompanied by the accumulation of a characteristic set of proteins, thought to be involved in N-storage (i.e. patatin) or defense against microbial or insect attack (i.e. proteinase inhibitor II). Additionally, deposition of large amounts of starch occurs during tuber formation, which is paralleled by an increase in sucrose synthase and other enzymes involved in starch biosynthesis (i.e. ADP-glucose pyrophosphorylase, starch synthases, and branching enzyme). Potential controlling mechanisms for genes expressed during tuberization are discussed.

A rapeseed-specific gene, acetyl-CoA carboxylase, can be used as a reference for qualitative and real-time quantitative PCR detection of transgenes from mixed food samples.

Polymerase chain reaction (PCR) methods are very useful techniques for the detection and quantification of genetically modified organisms (GMOs) in food samples. These methods rely on the amplification of transgenic sequences and quantification of the transgenic DNA by comparison to an amplified reference gene. Reported here is the development of specific primers for the rapeseed (Brassica napus) BnACCg8 gene and PCR cycling conditions suitable for the use of this sequence as an endogenous reference gene in both qualitative and quantitative PCR assays. Both methods were assayed with 20 different rapeseed varieties, and identical amplification products were obtained with all of them. No amplification products were observed when DNA samples from other Brassica species, Arabidopsis thaliana, maize, and soybean were used as templates, which demonstrates that this system is specific for rapeseed. In real-time quantitative PCR analysis, the detection limit was as low as 1.25 pg of DNA, which indicates that this method is suitable for use in processed food samples which contain very low copies of target DNA.

[Spinal tuberculosis: early surgical treatment combined with medical treatment]. / Tuberculosis espinal: tratamiento quirúrgico temprano coadyuvante al tratamiento médico.

BACKGROUND: Spinal tuberculosis can produce kyphosis with neurologicaldeficit, despite antibiotic treatment. When there is no response to medical treatment, the recommended procedure is debridementand interbody fusion with bone autograft. The biological characteristicsof Mycobacterium tuberculosis do not prevent osteosynthesisof the infected bone from being performed. PATIENTS AND METHOD: Five patients with spinal tuberculosis and neurological deficitunderwent debridement, interbody fusion and anterior osteosynthesisin addition to medical treatment. In order to ensure stability, posterior fusion was also performed in three patients. All 5 patientsdisplayed weakness and paralysis of their lower extremities, two patients suffered an L4 radiculopathy, one developed paraparesiaand one was excluded due to a short follow-up. Mean value of vertebralkyphosis was 22,8 degrees and mean follow-up was 3,1 years. RESULTS: No patient had septic loosening or progression of the disease. Correction of kyphosis was 104,5% postoperatively and 80,5% atthe end of follow-up. All patients, apart from one with an L4radiculopathy, exhibited neurological recovery. CONCLUSIONS: Anterior instrumentation allows spinal decompression, septic focusdebridement, deformity correction and autologous bone grafting. In severe kyphotic flattening, it is advisable to associate alimited posterior arthrodesis. When pathological fractures appearor there is no response to antibiotic treatment, the combinationof medical and surgical treatment improves patients' outcome.

Aseptic necrosis of the sternal end of the clavicle Friedrich's disease.

A case of aseptic necrosis of the medial segment of the clavicle with X-ray images of fragmentation and few clinical symptoms is presented. This condition develops spontaneously and leads to early sternoclavicular osteoarthritis. The benign nature of the disease and the absence of treatment make it important to establish the correct diagnosis, differentiating it from other disorders in this area.

[Microsporidian spores in the stool specimens of toddlers, with or without diarrhea, from Tucumán, Argentina]. / Esporas de microsporidios en las heces de niños de corta edad, con y sin diarrea, de Tucumán, Argentina.

An investigation has been carried out from September 1995 to December 1997 to search for microsporidian spores in the stool specimens of 344 toddlers aged 1 to 24 months, hospitalized at a pediatric institution in Tucumán. They were classified in two groups: I, made up of 222 children suffering from severe diarrheas, and II by 122 affected by different pathologies, except gastroenteritis. The detection of microsporidia was done by light microscopy in smears of stained stool specimens by using the Weber modified Kokoskin method. Copro-parasitological and coprobacteriological studies were also carried out and the nutritional status of each child was determined. In group I, microsporidia were found in 12/122 cases (7.2%), 4/68 belong to eutrophic children (5.9%), and 12/137 to undernourished children (8.8%); 8/16 positives were found to be related with other enteropatogenics. In group II, microsporidia were detected in 10/122 (8.2%), 4/47 in eutrophic children (8.5%), 4/54 in undernourished children (7.4%) and without data in two cases. They were related with other enteropatogenics in 5/10 positives. Tucumán can be estimated as an area with a low rate of HIV infection in toddlers, then it can be estimated that the studied sample was essentially HIV negative. The occurrence of microsporidia was important and did not show significant differences between toddlers with or without diarrhea, eutrophic or undernourished children.

[Vascular injuries of the lower extremity]. / Traumatismos vasculares del miembro inferior.

Authors present their experience (32 patients affected by a traumatic femoropopliteal injury) with vascular traumatisms at the lower limb. Causes, treatment and successful results with the new technics and the early clinical management to the patients are commented.