Cross-cultural adaptation and validation of the Kerlan-Jobe orthopedic clinic shoulder and elbow score for German-speaking overhead athletes.

BACKGROUND: The Kerlan-Jobe Orthopedic Clinic Shoulder and Elbow Score (KJOC) originally developed in English, assesses the functional status of the shoulder and elbow in overhead athletes. To date, no German version of the questionnaire exists. OBJECTIVE: The aim of the study was to translate and to culturally adapt the KJOC into German (KJOC-G) and to test its psychometric properties. METHODS: The first part of the study consisted of a translation and cross-cultural adaptation process which was performed in six stages according to international recommendations: Initial translations, synthesis, back translations, expert committee review, pretesting of the prefinal version, and final adaptations. Secondly, reliability, validity, and feasibility of the KJOC-G were assessed in German overhead athletes. RESULTS: The translation and adaptation process led to minor alterations due to cultural differences while maintaining the general structure and content of the original score. A total of 152 overhead athletes (age 25.0 ± 6.6 years; 87 men/65 women) were included in the main analyses. The internal consistency (Cronbach's alpha = 0.93) and test-retest reliability (ICC2.1 = 0.94) of the overall questionnaire were excellent. Moderate correlations with the German version of the Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire (r = -0.51, p < .05) as well as the DASH-sports module (r = -0.54, p < .05) suggest moderate construct validity. Known-group method analysis showed the ability of the KJOC-G to discriminate between actively playing symptomatic (score: 71.2 ± 16.0) and asymptomatic (score: 93.1 ± 8.7) athletes. CONCLUSION: The KJOC-G score is valid, reliable, and suitable for assessing the functional shoulder and elbow status in German-speaking overhead athletes.

A Retrospective Head-to-head Comparison Between TiLoop Bra/TiMesh® and Seragyn® in 320 Cases of Reconstructive Breast Surgery.

BACKGROUND/AIM: Clinical data concerning synthetic meshes in comparison to acellular dermal matrices (ADMs) in breast reconstruction are limited. Also, direct comparisons between titanium-coated polypropylene mesh and partially absorbable polypropylene mesh have not yet been reported. MATERIALS AND METHODS: This analysis represents a retrospective, single-surgeon, multi-center study of 320 cases using either TiLoop Bra/TiMesh® (n=192) or Seragyn® (n=128) in breast reconstruction. Results were compared with ADM-based reconstructions (Epiflex® and SurgiMend®). RESULTS: Major complication rates (i.e. revision surgery) occurred in 3.9% (Seragyn®) and 8.3% (TiLoop Bra/TiMesh®) of all cases. Minor complications occurred in 18% (Seragyn®) and 8.9% (TiLoop Bra/TiMesh®). Subgroup analysis showed red breast syndrome to occur more often in the Seragyn group (3.9% Seragyn® vs. 0.5% TiLoop Bra/TiMesh®, p<0.05). CONCLUSION: TiLoop Bra/TiMesh® and Seragyn® do not differ significantly in complication rates. There was no difference in performance when compared to ADMs.

Quantification of co-, n-, and ad-lupulone in hop-based dietary supplements and phytopharmaceuticals and modulation of their contents by the extraction method.

Hop ß-bitter acids (lupulones) are health-beneficial components of Humulus lupulus L. showing, for example, antidepressant-like effects in vitro. Despite of the widespread use of hops for medicinal purposes, the concentrations of lupulones in hop-based drugs have not been reported yet. The present study developed, validated, and applied a method with external calibration, which allows for the first time separate quantification of co-, n-, and ad-lupulone in hop-based drugs by UHPLC‒DAD. Concentrations between 'not detectable' and 2.7 mg/mL co-lupulone, 2.2 mg/mL nlupulone, or 0.7 mg/mL ad-lupulone were measured in nine different commercial dietary supplements and phytopharmaceuticals. Only one hop tincture contained sufficient lupulone to possibly exert potential antidepressant effects. Aiming for products with increased lupulone content, the extraction efficiency of different solvents was investigated. Complete extraction of lupulones from raw hops was achieved by organic solvents including methanol and ethanol, whereas aqueous mixtures resulted in low recovery. These results indicate that adapted extraction conditions may result in more effective hops products.

Activation of membrane-located Ca2+ channels by hop beta acids and their tricyclic transformation products.

Beta-bitter acids of hops (lupulones) revealed sedative and antidepressant-like effects in animal studies. Transformation of ß-acids during beer brewing leads to the formation of tricyclic transformation products, which have a close structural analogy to hyperforin. The latter compound is responsible for the antidepressant activity of St. John's wort by activation of TRPC6 cation channels in neuronal-like cells leading to Ca2+ influx. In this study, nortricyclolupones, dehydrotricyclolupones, and tricyclolupones were isolated from a wort-boiling model and their structures were elucidated by UHPLC-DAD, UHPLC-ESI--MS/MS and 1D/2D-NMR spectroscopy. Beta-bitter acids and their transformation products induced Ca2+ influx in PC12 cells to the same extent as hyperforin. Application of a Ca2+-free environment abolished the Ca2+ elevation, indicating that the increase is mediated by influx across the plasma membrane. Thus, activation of neuronal-like Ca2+-channels by lupulones and tricyclolupones represent a novel mechanism contributing to the antidepressant activity of hops.

The Use of Acellular Dermal Matrices (ADM) in Breast Reconstruction: A Review.

The use of acellular dermal matrices (ADM), sometimes referred to as extracellular matrix (ECM), has become an interesting aspect of breast reconstruction. A great deal of literature is available, totaling over 7000 ADM-based reconstructions. Most often, ADMs are used in a skin sparing mastectomy (SSM) scenario, although heterologous breast augmentation with a sub-pectoral fixation may also require an ADM application. Their use has become an attractive, but expensive option. Available data shows head to head comparisons between individual ADMs to be mostly retrospective in nature with only a few prospective trials available. Points of interest include postoperative hematoma, postoperative skin irritation, infection, red breast syndrome, and revision surgery. This work will, therefore, highlight the individual properties of ADMs used in breast reconstruction and compare the available data on complication rates and costs for these devices.

Combination of Pyrosequencing® and Sanger sequencing reveals alleged novel mutation in exon 18 of EGFR.

BACKGROUND: EGFR sequencing is crucial for therapeutic decisions in treatment regimens of lung cancer patients. Several mutations have been identified in the past, of which some were confirmed as activating or resistance mutations by in vitro phenotyping. In this study, novel mutations of so far unknown relevance were identified by a combination of Sanger and Pyrosequencing®. MATERIALS & METHODS: Formalin-fixed paraffin-embedded lung biopsies from 20 randomly selected patients suffering from non-small-cell lung cancer with previous external EGFR mutation analyses were reanalyzed by Sanger sequencing according to a previous study, and Pyrosequencing with the EGFR Pyro Kit (Qiagen, Hilden, Germany). Sensitivity and specificity were determined in comparison with the results of an external supplier for all relevant mutations in exons 18, 19, 20 and 21. RESULTS: Our analyses revealed that Pyrosequencing is faster and more sensitive for the common mutations compared with Sanger sequencing and the results of the external supplier. A new mutation, c.2160delC, in exon 18 in 40% of patients leading to a frameshift was identified. Another two frameshift mutations were detected in exon 18 in 10% of patients; c.2168delT in combination with c.2160delC, and c.2163insG alone. CONCLUSION: Divergences regarding the detection of the common mutations could be traced back to inhomogeneous or insufficient tumor material. Surprisingly, none of the newly identified mutations have been previously described, although they occurred in total in up to 40% of randomly selected cases. A possible explanation may be that commercial assays did not cover these deletions that are located nearby but not in the known mutation hotspot of exon 18, or that Sanger sequencing produced serious artifacts.