[Criteria for socket type prescription: indications and contraindications of a liner system]. / Verordnungskriterien für Oberschenkelschaftsysteme: Indikationen und Kontraindikationen der Linerversorgung.

BACKGROUND: The prescription of socket type for above-knee-amputees is based on clinical experience. There are no official guidelines. On the basis of treatment statistics and a patient survey, this study shows the indications and contraindications of a liner system. PATIENTS AND METHODS: Treatment statistics including data from the medical reports of 183 above-knee-amputees, who were treated in our clinic from 2003 to 2007 were analysed. 32 patients had a system change between liner- and contact-shaft accommodation and were contacted by telephone. The aim was to evaluate satisfaction with the current socket type and thus be able to compare types. RESULTS: A statistically significant relation in the treatment statistics between the quality of the stump and the socket type can be shown. A mesh graft to cover the stump, extreme volume fluctuation, low activity class and co-morbidities are the main reasons for the use of a liner system. Main reasons for a change to a liner system were the preservation of individual independence, better adhesion and skin problems. CONCLUSION: The developed clinical criteria can help physicians decide which socket type is most beneficial for each individual patient.

[Determination of skeletal age : comparison of the methods of Greulich and Pyle and Tanner and Whitehouse]. / Bestimmung des Skelettalters : Vergleich der Methoden nach Greulich und Pyle sowie Tanner und Whitehouse.

PURPOSE: The main purpose of this study was to evaluate the accuracy and the time required to determine skeletal age (SA) in healthy children by the methods of Greulich and Pyle (GP) and of Tanner and Whitehouse (TW). Based on these results recommendations for routine clinical practice is to be established. MATERIALS AND METHODS: In this study a total of 63 children between the ages of 5 and 18 years were included. Each conventional radiographic image of the left hand was assessed under blinded conditions by 5 or 6 examiners and the time needed was recorded. The assessments were repeated after 2 months. RESULTS: The average chronological age was estimated slightly too low by the GP method and clearly too high by TW. The mean deviation between the results of two examiners tended to be higher with the TW method than with GP. Repeated assessments of SA by the same examiner deviated only slightly for both methods. The time taken to assess the SA by GP was less than half as long as for TW. An improvement in accuracy of SA estimation after repeated use was only observed for GP. CONCLUSION: Of the two methods tested neither proved to be superior. Determination of SA by the GP method was found to be more suitable for routine clinical practice.

Associations of HDL phospholipids and paraoxonase activity with coronary heart disease in postmenopausal women.

A low high-density lipoprotein-cholesterol (HDL-C) is an established indicator for increased risk of coronary heart disease (CHD). Multiple functional relationships between HDL and CHD have been discussed. We tested the clinical relevance of some of these relationships in a cross-sectional coronary angiography (CA) study of 87 post-menopausal women between 48 and 73 years. In addition to established cardiovascular risk factors we measured concentrations of phosphatidylcholine (PC) and sphingomyelin (SPM) in HDL as indirect markers of cholesterol efflux capacity, the serum activity of the paraoxonase (PON) as a measure of the antioxidative capacity and serum concentrations of insulin/C-peptide and C-reactive protein (CRP) as indirect markers of insulin sensitivity and inflammation, respectively. Upon multivariate analysis of data from 55 women with angiographically assessed CHD differed from 32 women with angiographically excluded CHD, HDL-SPM had the strongest association with the presence of CHD among all HDL-related parameters. It was also the only HDL-related parameter which had a significant and independent correlation with the number of coronary stenoses. As HDL-SPM was previously shown to correlate with cholesterol efflux capacity of plasma, we conclude that reduced cholesterol efflux capacity is an important factor accounting for the inverse association between HDL-cholesterol and CHD.