AIP inactivation leads to pituitary tumorigenesis through defective Gαi-cAMP signaling.

The aryl hydrocarbon receptor interacting protein (AIP) is a tumor-suppressor gene underlying the pituitary adenoma predisposition. Thus far, the exact molecular mechanisms by which inactivated AIP exerts its tumor-promoting action have been unclear. To better understand the role of AIP in pituitary tumorigenesis, we performed gene expression microarray analysis to examine changes between Aip wild-type and knockout mouse embryonic fibroblast (MEF) cell lines. Transcriptional analyses implied that Aip deficiency causes a dysfunction in cyclic adenosine monophosphate (cAMP) signaling, as well as impairments in signaling cascades associated with developmental and immune-inflammatory responses. In vitro experiments showed that AIP deficiency increases intracellular cAMP concentrations in both MEF and murine pituitary adenoma cell lines. Based on knockdown of various G protein α subunits, we concluded that AIP deficiency leads to elevated cAMP concentrations through defective Gαi-2 and Gαi-3 proteins that normally inhibit cAMP synthesis. Furthermore, immunostaining of Gαi-2 revealed that AIP deficiency is associated with a clear reduction in Gαi-2 protein expression levels in human and mouse growth hormone (GH)-secreting pituitary adenomas, thus indicating defective Gαi signaling in these tumors. By contrast, all prolactin-secreting tumors showed prominent Gαi-2 protein levels, irrespective of Aip mutation status. We additionally observed reduced expression of phosphorylated extracellular signal-regulated kinases 1/2 and cAMP response element-binding protein levels in mouse and human AIP-deficient somatotropinomas. This study implies for the first time that a failure to inhibit cAMP synthesis through dysfunctional Gαi signaling underlies the development of GH-secreting pituitary adenomas in AIP mutation carriers.

Feeding efficiency of planktivores under disturbance, the effect of water colour, predation threat and shoal composition.

The consumption of phantom midge Chaoborus flavicans larvae by Perca fluviatilis showed clear response to water colour, predation threat and shoal composition with the most significant negative effect for water colour. In the case of Rutilus rutilus, no similar combined response was observed and the total prey consumption was significantly negatively affected by predation threat of Esox lucius. The results suggest that differences in life-history traits may result in disparity in species-specific responses to disturbance.

Sex-specific distribution and diet of Platichthys flesus at the end of spawning in the northern Baltic Sea.

This study examined the relationship of seascape structure, prey availability and sex on the post-spawning distribution and diet of European flounder Platichthys flesus in the northern Baltic Sea. The objectives were to determine whether: (1) wave exposure and substratum affect abundance and distribution of P. flesus, (2) diet reflects the benthic prey composition and (3) sex affects the distribution or diet of P. flesus. The results showed that P. flesus was evenly spread in the archipelago with no correlation to wave exposure. The distribution was, however, sex specific; reproductive males dominated the exposed zone and mainly post-reproductive females dominated the intermediate and sheltered zones. Platichthys flesus fed mainly on two bivalve prey species: blue mussels Mytilus edulis and Baltic tellins Macoma balthica. Hard substratum invertebrates dominated the diet in all habitats and apart from some typical soft substratum species, there was no clear link between fish feeding and the dominance structure of benthic prey. Diet was further sex specific, with females showing a broader range of diet than males. Results suggest that P. flesus is a specialist molluscivore found commonly and equally in soft- and hard-substratum habitats throughout the archipelago area. Previous studies on P. flesus in the Baltic Sea have yielded inconsistent results regarding diet and it has commonly been believed that the distribution of Baltic Sea P. flesus is linked to sand and soft substrata. The present findings emphasize the importance of including the entire range of habitats when diet and regional species distributions are assessed.

Somatic MED12 mutations in uterine leiomyosarcoma and colorectal cancer.

BACKGROUND: Mediator complex participates in transcriptional regulation by connecting regulatory DNA sequences to the RNA polymerase II initiation complex. Recently, we discovered through exome sequencing that as many as 70% of uterine leiomyomas harbour specific mutations in exon 2 of mediator complex subunit 12 (MED12). In this work, we examined the role of MED12 exon 2 mutations in other tumour types. METHODS: The frequency of MED12 exon 2 mutations was analysed in altogether 1158 tumours by direct sequencing. The tumour spectrum included mesenchymal tumours (extrauterine leiomyomas, endometrial polyps, lipomas, uterine leiomyosarcomas, other sarcomas, gastro-intestinal stromal tumours), hormone-dependent tumours (breast and ovarian cancers), haematological malignancies (acute myeloid leukaemias, acute lymphoid leukaemias, myeloproliferative neoplasms), and tumours associated with abnormal Wnt-signalling (colorectal cancers (CRC)). RESULTS: Five somatic alterations were observed: three in uterine leiomyosarcomas (3/41, 7%; Gly44Ser, Ala38_Leu39ins7, Glu35_Leu36delinsVal), and two in CRC (2/392, 0.5%; Gly44Cys, Ala67Val). CONCLUSION: Somatic MED12 exon 2 mutations were observed in uterine leiomyosarcomas, suggesting that a subgroup of these malignant tumours may develop from a leiomyoma precursor. Mutations in CRC samples indicate that MED12 may, albeit rarely, contribute to CRC tumorigenesis.

Different berries and berry fractions have various but slightly positive effects on the associated variables of metabolic diseases on overweight and obese women.

BACKGROUND/OBJECTIVES: Dietary habits have a major role in obesity, type 2 diabetes and atherosclerotic cardiovascular diseases. In this study, we compared the effects of sea buckthorn (SB) and its fractions, and bilberries (BBs) on associated variables of metabolic diseases on overweight and obese women. SUBJECTS/METHODS: In total, 110 female volunteers were recruited, and they followed four different berry diets (BB, SB, SB phenolic extract (SBe) and SB oil (SBo)) in a randomized order for 33-35 days. Each intervention was followed by a wash-out period of 30-39 days. Blood samples were drawn and physical measurements were performed after each period. Eighty volunteers completed the study. RESULTS: There was statistically significant decrease in waist circumference after BB (Δ, -1.2 cm; P = 0.041) and SB (Δ, -1.1 cm; P = 0.008) periods and also a small decrease in weight after BB diet (Δ, -0.2 kg; P = 0.028). Vascular cell adhesion molecule decreased after BB (Δ, -49.8 ng/ml; P = 0.002) and SBo (Δ, -66.1 ng/ml; P = 0.001) periods, and in intercellular adhesion molecule (ICAM) after SBe diet (Δ, -6.1 ng/ml; P = 0.028). CONCLUSIONS: Based on the results, it can be stated that different berries and berry fractions have various but slightly positive effects on the associated variables of metabolic diseases.

Postprandial hyperglycemia and insulin response are affected by sea buckthorn (Hippophaë rhamnoides ssp. turkestanica) berry and its ethanol-soluble metabolites.

BACKGROUND/OBJECTIVES: Repeated postprandial hyperglycemia and subsequent mild, late hypoglycemia as well as high postprandial insulin response lead to metabolic events that may eventually develop into type 2 diabetes. The aim of this study was to assess how sea buckthorn berries as well as two sea buckthorn extraction residues modulate the postprandial metabolism after a high-glucose meal. SUBJECTS/METHODS: Ten healthy normal-weight male volunteers consumed four study breakfasts, one control (A) and three sea buckthorn meals on four distinct study days. All the meals contained yoghurt and glucose (50 g). The sea buckthorn ingredients used were dried and crushed whole berries (meal B1), supercritical fluid (SF)-carbon dioxide (CO(2))-extracted oil-free berries (meal B2) or ethanol-extracted SF-CO(2)-extraction residue (meal B3). Blood samples for glucose, insulin and tumor necrosis factor-α analyses were collected before and during the 6-h study period. RESULTS: Meal B1 suppressed the postprandial peak insulin response when compared with meal A (Δconcentration of 30-min peak value--21.8 mU/l, P=0.039), and stabilized postprandial hyperglycemia and subsequent hypoglycemia (Δconcentration of 30-min peak value--120-min value -30.4 mU/l, P=0.036). Furthermore, meal B2 resulted in a more stable insulin response than the control meal (Δconcentration of 30-min peak value--120-min value -25.9 mU/l, P=0.037). CONCLUSIONS: Removal of the CO(2)-soluble oil component from the berries did not show a significant change in the studied postprandial effects of the berries. The EtOH soluble components, again showed advantageous properties in both insulin and glucose responses.

Diet shifts and food selection of perch Perca fluviatilis and roach Rutilus rutilus in humic lakes of varying water colour.

The field data from four humic lakes suggested that water colour may have both direct and indirect effects on inter- and intra-specific interactions of perch Perca fluviatilis and roach Rutilus rutilus. The results agree with suggestions that, compared with R. rutilus, P. fluviatilis may be an inferior forager on zooplankton in highly coloured water. As an indirect effect, water colour decreases the coverage of macrophytes and limits suitable littoral habitats, benefiting R. rutilus over P. fluviatilis. Perca fluviatilis benefiting from complex habitats does not have the advantage in macrophyte-poor highly coloured water.

Environmental factors regulate the effects of roach Rutilus rutilus and pike Esox lucius on perch Perca fluviatilis populations in small boreal forest lakes.

In this study of 18 small boreal forest lakes, the effects of abiotic and biotic factors (roach Rutilus rutilus and pike Esox lucius) on various population variables of perch Perca fluviatilis were examined. As a single variable, the gillnet catch per unit effort (CPUE) of R. rutilus was negatively related to the mean mass of small (< 200 mm) and the growth rate of young (1-2 years) P. fluviatilis. The mean mass of large (> or = 200 mm) P. fluviatilis was the highest at intermediate CPUE of R. rutilus. Redundancy analysis including environmental factors and P. fluviatilis population variables suggested that 'predation-productivity-humus' gradient affected P. fluviatilis populations by decreasing the CPUE and mean mass of small individuals but increasing these variables of large individuals. The CPUE of R. rutilus and lake area had a negative effect on small and a positive effect on large P. fluviatilis growth rate. In small boreal forest lakes, P. fluviatilis populations are affected by the partially opposite forces of competition by R. rutilus and predation by E. lucius, and the intensity of these interactions is regulated by several environmental factors.

Berry meals and risk factors associated with metabolic syndrome.

BACKGROUND/OBJECTIVES: Nonalcoholic fatty liver disease is commonly associated with obesity, insulin resistance, dyslipidemia and type 2 diabetes, and can thus be regarded as the hepatic manifestation of metabolic syndrome. In this study we compared the effects of lifestyle intervention with and without industrial berry products, on risk factors associated with metabolic syndrome on slightly overweight women. SUBJECTS/METHODS: Sixty-one female volunteers (average age 42.9 years) were recruited and randomized for a 20-week dietary intervention trial with two parallel treatment groups, one lifestyle intervention group with berry products equaling with an average daily dose of 163 g of northern berries (berry group, diet 1, N=31, of which 28 completed the study) and the other group with lifestyle intervention only (control group, diet 2, N=30, of which 22 completed the study). RESULTS: Increased berry consumption as part of the normal daily diet was the only lifestyle difference between the two intervention groups. The major effects achieved by diet 1 were changes in the levels of alanine aminotransferase (ALAT) and adiponectin (at P-values <0.001 and 0.002, respectively). A statistically significant difference between the two intervention groups was the higher decrease in the ALAT value in the berry group (P=0.003). CONCLUSIONS: The 23% decrease in the ALAT value, from 20.29 to 15.66 U/l in the berry group may be regarded as nutritionally significant by enhancing the liver function. This may contribute positively to the low-grade systemic inflammation in body and decrease the risk of cardiovascular diseases.

Stunted growth of pikeperch Sander lucioperca in Lake Sahajärvi, Finland.

Growth of pikeperch Sander lucioperca in the eutrophic and clay-turbid Lake Sahajärvi, Southern Finland, was extremely slow in comparison with other lakes at similar latitudes. The most important food item in July was phantom midge larvae Chaoborus flavicans for all sizes of S. lucioperca (239-423 mm total length L(T)), while later, in August and September, the diet of S. lucioperca (149-407 mm L(T)) consisted of small (30-100 mm L(T)) perch Perca fluviatilis, ruffe Gymnocephalus cernuus and roach Rutilus rutilus.

Simulated financial losses of classical swine fever epidemics in the Finnish pig production sector.

Rapid structural change and concentration of pig production in regions with most intensive production has raised concerns about whether the risk of large-scale disease losses has increased in Finland. This paper examines the pig industry's losses due to classical swine fever (CSF) epidemics. The work is based on economic and epidemiological models providing insights to the consequences of epidemics to infected and uninfected farms, government and meat processing. The economic analysis was carried out by use of a sector model, which simulated the recovery of pig production, starting from the recognition of the disease in the country and ending at a steady-state market equilibrium about 12 years later. The model explicitly took into account profit-maximising behaviour of producers and the effects of decrease in export demand. Epidemiological evidence suggests that under the current spatially diversified structure of Finnish pig farming and related industries, the probability of a severe disease epidemic counting dozens of infected farms is small. Even for epidemics considered large in Finland (5-33 infected farms) combined with a major reduction in export demand, the median loss was simulated to be only euro19.2 million. The majority of these losses were due to loss of exports corresponding almost 20% of pig meat production in Finland. While the current structure of pig farming in Finland incurs higher production costs than the most intensive structures in Europe, it also seems to decrease the probability of 'catastrophic' economic losses. The results suggest that the response of export markets and the number of uninfected farms affected by preventive measures are critical to the magnitude of losses, as they can amplify losses even if only few farms become infected.

Increased risk of cancer in patients with fumarate hydratase germline mutation.

Hereditary leiomyomatosis and renal cell cancer (HLRCC) is a tumour predisposition syndrome caused by heterozygous germline mutations in the fumarate hydratase (FH) gene. The condition is characterised by predisposition to benign leiomyomas of the skin and the uterus, renal cell carcinoma (RCC), and uterine leiomyosarcoma (ULMS). To comprehensively examine the cancer risk and tumour spectrum in Finnish FH mutation positive families, genealogical and cancer data were obtained from 868 individuals. The cohort analysis of the standardised incidence ratios (SIR) was analysed from 256 individuals. FH mutation status was analysed from all available individuals (n = 98). To study tumour spectrum in FH mutation carriers, loss of the wild type allele was analysed from all available tumours (n = 22). The SIR was 6.5 for RCC and 71 for ULMS. The overall cancer risk was statistically significantly increased in the age group of 15-29 years, consistent with features of cancer predisposition families in general. FH germline mutation was found in 55% of studied individuals. Most RCC and ULMS tumours displayed biallelic inactivation of FH, as did breast and bladder cancers. In addition, several benign tumours including atypical uterine leiomyomas, kidney cysts, and adrenal gland adenomas were observed. The present study confirms with calculated risk ratios the association of early onset RCC and ULMS with FH germline mutations in Finns. Some evidence for association of breast and bladder carcinoma with HLRCC was obtained. The data enlighten the organ specific malignant potential of HLRCC.

Assessment of environmental impacts following alternative agricultural policy scenarios.

Abstract Finnish agriculture is likely to undergo major changes in the near and intermediate future. The ifuture policy context can be examined at a general level by strategic scenario building. Computer-based modelling in combination with agricultural policy scenarios can in turn create a basis for the assessments of changes in environmental quality following possible changes in Finnish agriculture. The analysis of economic consequences is based on the DREMFIA model, which is applied to study effects of various agricultural policies on land use, animal production, and farmers' income. The model is suitable for an impact analysis covering an extended time span--here up to the year 2015. The changes in land use, obtained with the DREMFIA model assuming rational economic behaviour, form the basis when evaluating environmental impacts of different agricultural policies. The environmental impact assessment is performed using the field scale nutrient transport model ICECREAM. The modelled variables are nitrogen and phosphorus losses in surface runoff and percolation. In this paper the modelling strategy will be presented and highlighted using two case study catchments with varying environmental conditions and land use as an example. In addition, the paper identifies issues arising when connecting policy scenarios with impact modelling.

Fish stocks in the Baltic Sea: finite or infinite resource?

Human-induced environmental changes, especially eutrophication, and fluctuations of natural environmental conditions under the changes in climate and solar activity affect the reproduction and growth of various fish species and communities in the Baltic Sea. The importance of human impacts has increased considerably during the last decades, overshadowing in many cases natural factors. High exploitation rates have depressed some valuable fish species and affected the species dominance hierarchy. Oxygen depletion in deeper layers progressively deteriorates the living conditions of certain marine species. Mass immigration of nonindigenous species with ballast waters can seriously affect ecosystems and fish stocks. The summary effect of these variables upon marine, relict and freshwater species can yield unexpected results. Fish resources should be properly assessed and managed by their natural units (populations). Based on cyclic fluctuations of global climatic processes, composition of long-term forecasts on changes in the structure and abundance of fish fauna should be started.

The effect of esophageal pressure monitoring on nasal airway resistance.

OBJECTIVE: Artificial obstruction of nasal airflow has been shown to increase the amount of apneas and arousals. An esophageal catheter inserted through the nasal cavity is used in sleep studies to show intrathoracic pressure variations as sign of obstructive apneas and increased respiratory resistance. This study evaluates the effect of transnasal esophageal catheter on nasal airflow. STUDY DESIGN AND SETTING: Fifty patients with problem snoring referred to our ENT clinic underwent overnight limited sleep study with an esophageal catheter. Nasal airway resistance was measured the following morning with active anterior rhinomanometry. After exclusion of 17 measurements, the results of 33 patients were compared with same parameters obtained earlier without nasal manipulation. RESULTS AND CONCLUSION: The ipsilateral nasal resistance was clearly elevated when measured with a catheter used overnight compared with the control measurement (P < 0.05). However, the combined nasal resistance was not significantly increased in this material with patent nasal airways. In patients with already compromised nasal airflow, the possibility of clinically relevant changes in nasal airflow during catheter use should be taken in account.

Detachment of trophozoites of Acanthamoeba species from soft contact lenses with BEN22 detergent, BioSoak, and Renu multi-purpose solutions.

PURPOSE: BEN22 detergent was studied for its ability to detach Acanthamoeba from soft contact lenses without mechanical cleaning or separate cleaning agents. METHODS: Trophozoites of Acanthamoeba castellanii and A. polyphaga were adhered onto nonionic, high water content soft contact lenses. The lenses were immersed for 2 hours in contact lens care solutions and the remaining trophozoites were counted microscopically. The counts were compared to the counts on the same lens before treatment. RESULTS: BEN22 (50:50 mixture of L-alpha-L-rhamnopyranosyl-beta-hydroxydecanoyl-beta-hydroxydecanoate and 2-O-alpha-L-rhamnopyranosyl-alpha-L-rhamnopyranosyl-beta-hydroxydecanoyl-beta-hydroxydecanoate) (Kassell Industries, Inc., Wisconsin Dells, WI) in a concentration of 0.05% detached the trophozoites to a statistically significant greater extent than saline, but commercial ReNu Multi-Purpose Solution (Bausch & Lomb, Italy) and BioSoak (Finnsusp Ltd., Finland) did so as well. ReNu Multi-Purpose Solution was more effective than 0.005% BEN22 in detaching the trophozoites of both of the Acanthamoeba strains. After the 2 hour immersion period, a maximum of 97% of the initial trophozoites were detached. The variation between individual lenses was significantly greater than that within the different areas of one lens. CONCLUSIONS: BEN22 had no reliable detaching effect on Acanthamoeba. The variation between lenses was great, and the rate of detachment was low with all the agents tested indicating that immersion and rinsing in the solutions tested cannot be considered as a safe substitute for proper disinfection against Acanthamoeba in contact lens care.

Free flap reconstructions in the management of oral and pharyngeal cancer.

Fifty patients who had undergone microvascular free flap reconstruction of the oral cavity or pharynx for malignancy between 1989 and 1995 were retrospectively analysed to find factors predicting postoperative complications and outcomes. The mean follow-up time was 2.6 years. More than half (26/50) of the patients had a stage IV malignancy and 10 patients had a recurrent tumour. The overall flap success rate, with 2 flap losses, was 96%. Postoperative medical complications occurred in 29/50 (58%) cases. The recipient site of 10/50 (20%) flaps required re-exploration. Mortality was 2%, with 1 death occurring within 30 days. The mean survival rate after the microvascular operation was 1.6 years, and the 3- and 5-year survival rates were 42% and 23%, respectively. Patients with an oropharyngeal tumour seemed to have the best prognosis and those with a hypopharyngeal tumour the poorest. Men had a threefold greater risk of dying within < 1 year postoperatively compared with women. Tumour stage was the strongest attribute influencing survival. The risk of death after the microvascular procedure increased 2.8-fold when the stage advanced from II to III or from II to IV. None of the tested variables alone could predict complications.

Long-term outcome of anatomical reconstruction versus tenodesis for the treatment of chronic anterolateral instability of the ankle joint: a multicenter study.

The long-term clinical outcome after anatomical reconstruction and tenodesis in the treatment of chronic anterolateral ankle instability was assessed in a retrospective multicentre study. The first group (AR) consisted of 25 patients (mean age at operation 22 yrs +/- 5.7) who underwent anatomical reconstruction and the second group (TE) of 29 patients (mean age 23 yrs +/- 6.6) who underwent tenodesis. For both groups, the mean follow-up period was 12.3 yrs (AR +/- 2.5 yrs, TE +/- 2.7 yrs). At physical examination, there were significantly more patients in the TE group (n=18) with a positive anterior drawer sign as compared with the AR group (n=7) (p=0.02). Medially located degenerative changes in the ankle joint as seen on standard radiographs were seen more often in the TE group (n=7) than in the AR group (n=1) (p=0.03). The mean talar tilt, 4.7 degrees in the AR group vs 6.9 degrees in the TE group, (p=0.02) and anterior talar translation, 2.9 mm in the AR group vs 4.3 mm in the TE group, (p=0.04) were significantly higher in the TE group at radiographic stress examination. According to the rating system developed by Good et al. (1975), significantly fewer patients in the TE group (n=8) had an excellent result as compared with the AR group (n=15) (p=0.03) and more patients in the TE group (n=9) had a fair or poor result (p=0.04) as compared with the AR group (n=2). We conclude that a tenodesis procedure does not restore the normal anatomy of the lateral ankle ligaments. When compared with anatomical reconstruction, a tenodesis leads to inferior results in terms of functional and mechanical stability, as well as overall satisfaction at long-term follow-up.

Tetravalent meningococcal polysaccharide vaccine is immunogenic in adult allogeneic BMT recipients.

Forty-four adult BMT recipients transplanted from an HLA-identical sibling donor were randomized to receive meningococcal polysaccharide (Men PS) vaccine either 8 (early group; 22 patients) or 20 (late group; 22 patients) months after BMT. The geometric mean concentrations (GMC) of antibodies to serogroup A Neisseria meningitidis (Men A) and serogroup C Neisseria meningitidis (Men C), determined by an EIA method, decreased during the first 6 months after BMT but remained at a stable level thereafter. Before vaccination the GMCs of anti-Men A were 1.53 microg/ml and 1.61 microg/ml, but 1 month after vaccination they were significantly higher, 3.46 microg/ml and 6.39 microg/ml, in the early and late groups. The GMCs of anti-Men C increased from 0.37 microg/ml and 0.44 microg/ml before vaccination to 3.31 microg/ml and 4.62 microg/ml at 1 month after vaccination in the early and late groups, respectively. By 6 months after vaccination the GMCs of Men antibodies had decreased to levels of about 50% of those measured at 1 month after vaccination. Two-fold responses to Men A PS were seen in 52% and 74% and to Men C PS in 76% and 89% of the BMT recipients in the early and late groups, respectively. Chronic GVHD had no influence on the vaccination response. In the present study, Men PS vaccine induced good and equal antibody responses to Men A and Men C PSs in allogeneic BMT recipients regardless of timing after BMT. Vaccination against Neisseria meningitidis should be considered, especially in the event of travelling or military service > or = 8 months after BMT.

Anatomical reconstruction versus tenodesis for the treatment of chronic anterolateral instability of the ankle joint: a 2- to 10-year follow-up, multicenter study.

The clinical outcome of anatomical reconstruction or tenodesis in the treatment of chronic anterolateral ankle instability was assessed in a retrospective multicenter study. The anatomical reconstruction group (group A) consisted of 106 patients (mean age at operation 24 +/- 8.4 years) and the tenodesis group (group B) of 110 patients (mean age at operation 26 +/- 11.4 years). Patients were evaluated at a mean follow-up of 5.5 +/- 2.8 years in group A and 5.2 +/- 2.9 years in group B. The review protocol included patient characteristics, physical examination, two ankle scoring scales to evaluate the functional results, and standard anteroposterior and lateral radiographs to evaluate degenerative changes. Mechanical stability was evaluated using standardized stress radiographs. A larger number of reoperations was performed in group B (P = 0.008). At physical examination, more patients in group B had a smaller range of ankle motion than those in group A (P = 0.009). A larger proportion of patients in group B had medially located osteophytes, as seen on standard radiographs (P = 0.04). On stress radiographic examination, the mean talar tilt (P = 0.001) and mean anterior talar translation (P < 0.001) were seen to be significantly greater in group B than in group A. There were no differences in mean Karlsson score between the groups, but more patients in group A had an excellent result on the Good score (P = 0.011). Unlike anatomical reconstructions, tenodeses do not restore the normal anatomy of the lateral ankle ligaments. This results in restricted range of ankle motion, reduced long-term stability, an increased risk of medially located degenerative changes, a larger number of reoperations, and less satisfactory overall results.