ISOKINETIC MUSCLE STRENGTH IN NORMAL ADULTS: REVISITED

PURPOSE In evaluating patients it is necessary to have understanding of the normal population. Although many authors have reported isokinetic normal strength values, several questions regarding testing protocol and data interpretation remain unanswered. This study was conducted to address the difference between preferred and stronger sides, determine a clinically relevant muscle imbalance threshold for various muscle groups, and to study the correlation of strength between various muscle groups. METHODS Fifteen subjects (8 female, 7 male) were evaluated. Average age was 29.9 (24 - 43 years). Isokinetic muscle strength was measured for Hip ext/flex, Hip abd/add, and Ankle pf/df at 30,60, and 120 degree/sec. Knee ext/ flex was collected at 60, 120 and 180 degree/sec. Data were collected on a Cybex II and analyzed using the CSMI-Humac 600. One evaluator encouraged subjects to familiarize themselves with the machine by a warm up session and then give a maximal effort for each movement, and not to stop until instructed to do so. If the repetitions were not within 15% of one another, the test was repeated for validity. Limb preference was recorded. Peak torque/body weight (PEAK) for all speeds, average of the 3 maximal repetitions1 body weight (AVG) for slow and medium speeds, and fatigue index for the high speed were computed for all speeds and all motions. Preferred vs stronger and stronger vs weaker comparisons were made using a paired t-test. Pearson correlations for all motions were computed. RESULTS - Limb preference is not a good indicator of stronger side in isokinetic muscle strength testing. Strongest to preferred side was compared in all variables by computing the percentage of reversals (stronger side was not the preferred side). For most joints 50 - 60% of the time the strongest side was not the preferred side, with the exception on ankle pf at 39%. Looking at all speeds and motions, the greatest incidence of reversals were in PEAK with 60% at high speed, 54% at medium, and 5 1 % at slow. The AVG was comparable with 5 1 % at medium, 58% at slow speeds and fatigue index was the lowest at 36%. Significant muscle imbalance, the percentage difference in PEAK from side to side, was noted. Muscle imbalance varied between sexes for hip ext (9%M vs 14%F), ankle pf (9%M vs 18%F) and ankle df (1 l%M vs 208F). The mean difference in PEAK was 13% for hip flex, 19% for hip abdladd, and 11% for knee flexlext. Analysis was done to determine whether particular muscle groups correlated in strength. All opposing muscle groups (hip ext 1 flex, knee ext / flex, hip flex knee flex and knee flex / ankle pf) were positively correlated (R = .8, pc.001). CONCLUSIONS Approximately 50% of the time, the strongest side was not the preferred side. Ankle pf, primary power genator during running and gait, had the lowest number of reversals. Clinical significant imbalance in muscle strength thresholds have previously been reported to be a difference > 20% is probably abnormal, 10-20% possibly abnormal, and up to 10% normal (Sapaga, 1990). In contrast, our results indicate that a greater imbalance (20%) can be expected for hip abd/add in the normal population. It was noted imbalance was greater in females as compared to males. A side to side difference of 20% in ankle pf/df is normal for females. There was a strong correlation between opposing muscle groups at all speeds. REFERENCES Sapaga, A.A. 1990 "Muscle performance evaluation in orthopaedic practice", Journal of Bone and Joint Surgery 72A:1562-1574

Colistin as A Good Monotherapy to Restrain the Pathogenicity of Acinetobacter baumannii In vivo and In vitro

  تعد بكتيريا Acinetobacter baumannii من احد مسببات الأمراض الانتهازية الرئيسية التي تقاوم العديد من المضادات الحيوية. الكوليستين هو مضاد حيوي يستخدم في الوقت الحاضر كطريقة  لمعالجة أخيرة للعزلات ذات المقاومة الشديدة. الغرض من هذه الدراسة هو التعرف على أهمية  جين LptD في الطبقه الدهنية LPS  من بكتريا A. baumannii ومعرفة دورها  الاساسي كعامل ضراوة.في الدراسة الحالية،  تم استخدام عزلتين من بكترياA.baumannii ، االعزلة المحلية HHR1 والعزلة العالمية ATCC 17904 ، وتم استخدام ثلاث انواع من المضادات الحياتية  (الكوليستين ،الريفامبيسين و  الفوسفوميسين كعلاج احادي او مزدوج خارج وداخل الجسم الحي.اظهرت النتائج أن A. baumannii HHR1 هي أكثر مقاومة لـ AMPs (Antimicrobial peptides) من السلالات العالمية ، تم ملاحظة ازدياد تأثير AMPs على A. baumannii بزيادة التركيز ووقت الحضانة ، كما تبين أيضًا أن AMPs تعتبر قاتله على بكتريا A. baumannii عند التركيز العالي (µg ml-12 ) في العلاج الأحادي و (1.5 ، 2 ) µg ml-1  في الدمج. علاوة على ذلك ، كانت حساسية العزلات متغايرة ، حيث اظهر الكولستين فعالية متميزة في تثبيط النمو البكتيري كعلاج احادي او عند المزج مع مضاد اخر.أظهرت النتائج أن التعبير الجيني لجينات lptD ، lptA للعزله المحلية أقل من العزلة القياسية بتركيز  2 µg ml-1 من الكوليستين ، بينما جين lptE كانت العزله القياسية  ذات  نمط تنظيم أعلى مما كان عليه في العزلة المحلية. علاوة على ذلك ، يؤثر الكوليستين على التصاق  A. baumannii على الخلايا الظهارية (A-549 خلية سرطان الرئة) ، وأظهر الكولستين تأثيرًا كبيرًا على نمو البكتيريا ، وتكاثر الخلايا ، عن طريق تقليل اعداد البكتيريا.        Acinetobacter baumannii  (A. baumannii) is a major opportunistic nosocomial pathogen, mostly resistant to several groups of antibiotics. Colistin is now used as a last-line treatment for isolates that are highly resistant. The purpose of this study is to identify the importance of LptD; which is involved in the translocation of LPS from the inner membrane to the outer membrane in compartment with LptA and LptC of A. baumannii and its indispensable role as a virulence factor, and the efficiency of colistin as a monotherapy. In the current research, two isolates of A.baumannii were used, the local isolate HHR1 isolated from urine sample and the global strain ATCC 17904, and three antibiotics (colistin, rifampicin and Fosfomycin) were used as a monotherapy and synergic therapy in vivo and ex vivo. The results demonstrated that A. baumannii HHR1 was more resistant to Antimicrobial peptides (AMPs) than the standard strains. The effect of AMPs  on A. baumannii was increased by increasing the concentration and the time of incubation, and also AMPs were shown to be lethal on A. baumannii growth spatially at high concentration (2 µg ml-1) in  monotherapy and (1.5, 2 µg ml-1) in synergic. The susceptibility of isolates towards antibiotics was variable, where colistin exerts significant growth had defect as a monotherapy and in combination with others. The results showed that the expression of lptD, lptA genes of A.baumannii HHR1 were  higher than of  the same genes in A.baumannii ATCC 17904 in the presence of 2 µg ml-1  colistin, while lptE gene of the A.baumannii ATCC 17904 showed an upregulation pattern  than in A.baumannii HHR1. Furthermore, colistin influences the adhesion ability of A. baumannii on epithelial cells (A-549 lung cancer cell) by reducing the number of cells, and thus could colistin be a good candidate for A. baunmannii treatment

Extramedullary progression of multiple myeloma despite concomitant medullary response to multiple combination therapies and autologous transplant: a case report

A grant from the One-University Open Access Fund at the University of Kansas was used to defray the author’s publication fees in this Open Access journal. The Open Access Fund, administered by librarians from the KU, KU Law, and KUMC libraries, is made possible by contributions from the offices of KU Provost, KU Vice Chancellor for Research & Graduate Studies, and KUMC Vice Chancellor for Research. For more information about the Open Access Fund, please see http://library.kumc.edu/authors-fund.xml.Introduction Extramedullary myeloma that occurs during the clinical course of multiple myeloma is rare but is an independent poor prognostic factor with mortality of 73% and median survival of 12 months despite aggressive therapies including novel agents. The clinicopathological aspects, biology and management of extramedullary myelomas are poorly understood. Our case highlights the pathobiological aspects of this important but rare entity, and the repercussions of modern therapies. Case presentation A 60-year-old Caucasian man initially presented with an anterior rib fracture. Subsequent workup revealed stage IIIB immunoglobulin G lambda multiple myeloma. A bone marrow biopsy showed sheets of plasma cells, harboring unfavorable cytogenetics including deletion of 17p and t(4;14). He achieved near complete remission and resolution of karyotypic abnormalities with three cycles of induction doxorubicin, thalidomide, and dexamethasone (clinical trial). This was followed by high-dose melphalan and autologous stem cell transplant. He relapsed 1 year later. His bone marrow at that time showed only a few scattered polyclonal plasma cells. He received three cycles of bortezomib and tanespimycin (clinical trial) and achieved very good partial response. He again relapsed 1 year later with multiple large peripheral soft tissue masses and lymph nodes. Biopsies of the peripheral lesions were consistent with extramedullary myeloma, but repeat bone marrow biopsy continued to show no evidence of intramedullary disease. Conclusions This is one of the few cases reported that illustrates the differential response of extramedullary compared to intramedullary myeloma to multiple standard combination therapies including novel therapeutics and transplant, resulting in a very short survival. Several mechanisms for intra-to-extra medullary migration and hence the differential treatment response have been hypothesized. Physicians should be aware of this problem during treatment with immunomodulatory drugs and proteasome inhibitors not only in relapsed but also in front-line setting. In such cases, there is a potential role for evolving targeted therapeutics as we continue to better understand the tumor biology

Differentiated Stem Cells Derived from Rabbit Adipose Tissue Exhibited in ‎Vitro Adipogenesis and Osteogenesis

The multipotent characteristic of rabbit adipose-derived stem cells makes them available and ‎convenient sources for isolating mesenchymal stem cells. The aim of this study was to assess ‎the differentiation in rabbit adipose-derived stem cells pre-committed to produce several ‎mesenchymal lineages in response to inductive extracellular cues to multipotent stromal cells. ‎Three grams of adipose tissue was taken from a subcutaneous region of the nape of the neck ‎and was carefully isolated to obtain mesenchymal stem cells for expanded by fourth passage. In ‎the 4th passage, active growth of mesenchymal stem cells was observed. Furthermore, the ‎research demonstrated the inherent ability of rabbit MSCs to induce differentiation in ‎osteogenic and adipogenic lineages. These mesenchymal stem cells were successfully isolated ‎from adipose tissue which differentiated into either osteocytes or adipocyte-like cells after 21 ‎and 14 days of culturing in specific osteogenic and adipogenic media, respectively. The ‎remarkable differentiation potential of rabbit mesenchymal stem cells is indicated by ‎mineralized deposition to the osteocytes and lipid droplets accumulated in the cytoplasm lipid ‎vacuoles in the adipocytes‎

Evaluating the Activity of Ultrasound on Biofilm Formation by Acinetobacter baumannii isolated from clinical Specimens

Acinetobacter baumannii received attention for its multi-drug resistant associated with many severe infections and outbreaks in clinical environment. The aims of the study are to investigate the antibiotic susceptibility profile of clinically isolated A. baumannii, biofilm production, and the efficiency of Low Frequency Ultrasound (LFU) and honey to attenuate biofilm production. A total of 100 samples were taken from different sources from Baghdad hospitals. The susceptibility patterns revealed the percentage of pan drug resistant (PDR) isolates were 1.5 %, 72.7 % were extended drug resistant (XDR), 16.7 % were multidrug resistant (MDR), and 9.1 % were non MDR and sensitive to most antibiotics used. The ability to form biofilm was detected by crystal violet staining, and the results showed that 20% were strong biofilm, and 31.8% were moderate biofilm. The biofilm formation percentage was decreased using Low frequency ultrasound LFU and honey. Moreover, PCR results revealed that not all of them harbouring biofilm-related genes or integrons (bap, csuE, IntI-1, IntI-2), although, they are strong biofilm producers. These results conclude that low frequency ultrasound and chemical components of honey might be a good choice to restrain A. baumannii biofilm formation, and negative correlation between antibiotic resistance and biofilm ability. Running title: Antimicrobial drug resistance, Acinetobacter baumannii, biofilm inhibitio

Production, Characterization, and Antimicrobial Activity of Mycocin Produced by Debaryomyces hansenii

The present study was conducted to estimate the antimicrobial activity and the potential biological control of the killer toxin produced by D. hansenii DSMZ70238 against several pathogenic microorganisms. In this study, the effects of NaCl, pH, and temperature, killer toxin production, and antimicrobial activity were studied. The results showed that the optimum inhibitory effect of killer toxin was at 8% NaCl, and the diameters of clear zones were 20, 22, 22, 21, 14, and 13 mm for Staphylococcus aureus, Escherichia coli, Klebsiella pneumoniae, Streptococcus pyogenes, Candida albicans, and Candida neoformans, respectively. The largest inhibition zones were observed at pH 4.5 with inhibition zone of 16, 18, 17, 18, 11, and 12 mm for the same microorganisms. The results also showed that 25°C is the optimal temperature for toxin killing activity against all targeted microorganisms. In addition, the activity of killer toxin significantly inhibited the growth of fungal mycelia for all target pathogenic fungi and the percentages of inhibition were 47.77, 48.88, 52.22, and 61.11% for Trichophyton rubrum, Alternaria alternata, Trichophyton concentricum, and Curvularia lunata, respectively. The results showed the highest growth rate of D. hansenii DSMZ70238 under condition of 8% NaCl concentration, pH 4.5, and 25°C for 72 h

Superoxide dismutase SodB is a protective antigen against Campylobacter jejuni colonisation in chickens

Campylobacter is the leading cause of foodborne diarrhoeal illness in the developed world and consumption or handling of contaminated poultry meat is the principal source of infection. Strategies to control Campylobacter in broilers prior to slaughter are urgently required and are predicted to limit the incidence of human campylobacteriosis. Towards this aim, a purified recombinant subunit vaccine based on the superoxide dismutase (SodB) protein of C. jejuni M1 was developed and tested in White Leghorn birds. Birds were vaccinated on the day of hatch and 14 days later with SodB fused to glutathione S-transferase (GST) or purified GST alone. Birds were challenged with C. jejuni M1 at 28 days of age and caecal Campylobacter counts determined at weekly intervals. Across three independent trials, the vaccine induced a statistically significant 1 log10 reduction in caecal Campylobacter numbers in vaccinated birds compared to age-matched GST-vaccinated controls. Significant induction of antigen-specific serum IgY was detected in all vaccinated birds, however the magnitude and timing of SodB-specific IgY did not correlate with lower numbers of C. jejuni. Antibodies from SodB-vaccinated chickens detected the protein in the periplasm and not membrane fractions or on the bacterial surface, suggesting that the protection observed may not be strictly antibody-mediated. SodB may be useful as a constituent of vaccines for control of C. jejuni infection in broiler birds, however modest protection was observed late relative to the life of broiler birds and further studies are required to potentiate the magnitude and timing of protection

Transcriptome and proteome dynamics in chemostat culture reveal how Campylobacter jejuni modulates metabolism, stress responses and virulence factors upon changes in oxygen availability

Campylobacter jejuni, the most frequent cause of food-borne bacterial gastroenteritis worldwide, is a microaerophile that has to survive high environmental oxygen tensions, adapt to oxygen limitation in the intestine and resist host oxidative attack. Here, oxygen-dependent changes in C. jejuni physiology were studied at constant growth rate using carbon (serine)-limited continuous chemostat cultures. We show that a perceived aerobiosis scale can be calibrated by the acetate excretion flux, which becomes zero when metabolism is fully aerobic (100% aerobiosis). Transcriptome changes in a downshift experiment from 150% to 40% aerobiosis revealed many novel oxygen-regulated genes and highlighted re-modelling of the electron transport chains. A label-free proteomic analysis showed that at 40% aerobiosis, many proteins involved in host colonisation (e.g. PorA, CadF, FlpA, CjkT) became more abundant. PorA abundance increased steeply below 100% aerobiosis. In contrast, several citric-acid cycle enzymes, the peptide transporter CstA, PEB1 aspartate/glutamate transporter, LutABC lactate dehydrogenase and PutA proline dehydrogenase became more abundant with increasing aerobiosis. We also observed a co-ordinated response of oxidative stress protection enzymes and Fe-S cluster biogenesis proteins above 100% aerobiosis. Our approaches reveal key virulence factors that respond to restricted oxygen availability and specific transporters and catabolic pathways activated with increasing aerobiosis. This article is protected by copyright. All rights reserved

Characterisation of aerotolerant forms of a robust chicken colonizing Campylobacter coli

Campylobacter contaminated poultry meat is a major source of human foodborne illness. Campylobacter coli strain OR12 is a robust colonizer of chickens that was previously shown to outcompete and displace other Campylobacter strains from the chicken’s gastrointestinal tract. This strain is capable of aerobic growth on blood agar. Serial aerobic passage increased this aerotolerance as assessed by quantitative assays for growth and survival on solid media. Aerotolerance was also associated with increased peroxide stress resistance. Aerobic passage did not alter cellular morphology or motility or hinder the microaerobic growth rate. Colonization of broiler chickens by aerotolerant C. coli OR12 was significantly lower than the wild-type strain at 3 days after challenge but not by 7 days, suggesting adaptation had occurred. Bacteria recovered from chickens had retained their aerotolerance, indicating this trait is stable. Whole genome sequencing enabled comparison with the wild-type sequence. Twenty-three point mutations were present, none of which were in genes known to affect oxidative stress resistance. Insertions or deletions caused frame shifts in several genes including, phosphoglycerate kinase and the b subunit of pyruvate carboxylase that suggest modification of central and carbohydrate metabolism in response to aerobic growth. Other genes affected include those encoding putative carbonic anhydrase, motility accessory factor, filamentous haemagglutinin, and aminoacyl dipeptidase proteins. Aerotolerance has the potential to affect environmental success and survival. Increased environmental survival outside of the host intestinal tract may allow opportunities for transmission between hosts. Resistance to oxidative stress may equate to increased virulence by virtue of reduced susceptibility to oxidative free radicals produced by host immune responses. Finally, resistance to ambient atmospheric oxygen may allow increased survival on chicken skin, and therefore constitutes an increased risk to public health