Extracorporeal shock wave therapy in situ - novel approach to obtain an activated fat graft.

One of the mainstays of facial rejuvenation strategies is volume restoration, which can be achieved by autologous fat grafting. In our novel approach, we treated the adipose tissue harvest site with extracorporeal shock wave therapy (ESWT) in order to improve the quality of the regenerative cells in situ. The latter was demonstrated by characterizing the cells of the stromal vascular fraction (SVF) in the harvested liposuction material regarding cell yield, adenosine triphosphate (ATP) content, proliferative capacity, surface marker profile, differentiation potential and secretory protein profile. Although the SVF cell yield was only slightly enhanced, viability and ATP concentration of freshly isolated cells as well as proliferation doublings after 3 weeks in culture were significantly increased in the ESWT compared with the untreated group. Likewise, cells expressing mesenchymal and endothelial/pericytic markers were significantly elevated concomitant with an improved differentiation capacity towards the adipogenic lineage and enhancement in specific angiogenic proteins. Hence, in situ ESWT might be applied in the future to promote cell fitness, adipogenesis and angiogenesis within the fat graft for successful facial rejuvenation strategies with potential long-term graft survival.

Electron-phonon coupling in quantum-well states of the Pb/Si(1 1 1) system.

The electron-phonon coupling parameters in the vicinity of the Γ point, λ(Γ), for electronic quantum well states in epitaxial lead films on a Si(1 1 1) substrate are measured using 5, 7 and 12 ML films and femtosecond laser photoemission spectroscopy. The λ (Γ) values in the range of 0.6-0.9 were obtained by temperature-dependent line width analysis of occupied quantum well states and found to be considerably smaller than the momentum averaged electron-phonon coupling at the Fermi level of bulk lead, (λ = 1.1-1.7). The results are compared to density functional theory calculations of the lead films with and without interfacial stress. It is shown that the discrepancy can not be explained by means of confinement effects or simple structural modifications of the Pb films and, thus, is attributed to the influence of the substrate on the Pb electronic and vibrational structures.

Differences in the vaginal lactobacilli of postmenopausal women and influence of rectal lactobacilli.

OBJECTIVE: This study was undertaken to characterize the Lactobacillus spp. dominating the vaginal microbiota of healthy postmenopausal women and to determine the possible influence of rectal lactobacilli. METHODS: Sixty postmenopausal women aged 55-65 years without clinical signs of vaginal infection not receiving hormone replacement therapy were included in this cross-sectional observational study. Based on Gram-stained smears, 30 women with a normal vaginal flora (Nugent score 0) were included in Group 1, and 30 women with an intermediate vaginal flora characterized by an absence of vaginal lactobacilli (Nugent score 4) were included in Group 2. Vaginal and rectal smears were taken for molecular lactobacillus profiling using polymerase chain reaction and denaturing gradient gel electrophoresis. Diversity of vaginal and rectal lactobacilli in postmenopausal women was the main outcome measure. RESULTS: We noticed a minor interference of gut lactic acid bacteria on a normal vaginal microflora dominated by lactobacilli strains of the L. delbrueckii group. When the normal vaginal microflora is disturbed by depletion of lactobacilli, the gut may function as a reservoir for lactobacilli of the L. casei group, which then colonize the vagina. CONCLUSION: Our data indicate that rectal lactobacilli may affect the vaginal flora of postmenopausal women in the case of lactobacillary absence and help to maintain a normal vaginal microbiota.

Thermal damage of the inner vein wall during endovenous laser treatment: key role of energy absorption by intravascular blood.

BACKGROUND: Despite the clinical efficacy of endovenous laser treatment (EVLT), its mode of action is incompletely understood. OBJECTIVE: To evaluate the role of intravascular blood for the effective transfer of thermal damage to the vein wall through absorption of laser energy. METHODS: Laser energy (15 J/pulse, 940 nm) was endovenously administered to explanted greater saphenous vein (GSV) segments filled with blood (n = 5) or normal saline (n = 5) in addition to GSVs under in vivo conditions immediately prior to stripping. Histopathology was performed on serial sections to examine specific patterns of damage. Furthermore, in vitro generation of steam bubbles by different diode lasers (810, 940, and 980 nm) was examined in saline, plasma, and hemolytic blood. RESULTS: In saline-filled veins, EVLT-induced vessel wall injury was confined to the site of direct laser impact. In contrast, blood-filled veins exhibited thermal damage in more remote areas including the vein wall opposite to the laser impact. Steam bubbles were generated in hemolytic blood by all three lasers, while no bubbles could be produced in normal saline or plasma. CONCLUSION: Intravascular blood plays a key role for homogeneously distributed thermal damage of the inner vein wall during EVLT.

[Scleroderma, an ageing process? I. Clinical and immunological aspects (author's transl)]. / Hinweise auf Alterungsprozesse bei der Sklerodermie. I. Klinische und immunologische Aspekte.

Scleroderma with its different manifestations is mainly a disease of connective tissue and of vascular system. Next the alteration to collagen, which is demonstrable in lesions by decrease of embryonale collagen type III, there are also humoral and cellular phenomens of autoimmunity. In more than 70% of our patients we found antinuclear antibodies, and in most of them, we found with the leukocytemigration--inhibition-test cellular immunphenomenons to RNA, collagen and muscle. There is a small connection between ageing and immunological defense and repair, accordingly of immunocytes and fibroblasts. Further more precise characterization of this cell-compartments under the aspect of a premature ageing could bring a new understanding in the largely unknown etiopathogenese of scleroderma.

[Leukocyte migration inhibition test in lupus erythematosus and dermatomyositis]. / Leukocytenmigrationshemmung bei Lupus erythematodes und Dermatomyositis.

The Leucocyte-Migration-Inhibition-Test was performed to examine 10 patients with Systemic Lupus Erythematosus (SLE), 10 patients with Discoid Lupus Erythematosus (DLE) and 4 patients with Dermatomyositis for evidence of cell-mediated immunity to RNA, DNA, human muscle antigen and collagen human type I. Our results support, that cell-mediated immunity plays a pathogenic role in both diseases. Patients with SLE show a correlation between activity of disease, Leucocyte-Migration-Inhibition to DNA and DNA-binding-activity of serum. Muscle-antigen is an obvious relevant partner of reaction of cellular immunity in patients with Dermatomyositis.

Immunological studies in childhood scleroderma.

The results of immunological studies on 13 children suffering from scleroderma are reported. Antinuclear antibodies with speckled pattern of fluorescence could be found in systemic sclerosis and in 3 patients with scleroderma en bandes. The same patients (except but one with PSS) demonstrated high levels of DNA antibodies. The 2 patients with PSS were found to have a very low percentage of T cells, whereas the percentage of B cells was increased. The results demonstrate the significance of autoimmunity not only in systemic sclerosis but also in focal scleroderma. Beyond this it can be presumed that immune deficiency (with a defect in cellular immunity) may be the predisposing cause of at least progressive systemic sclerosis.

[Cellular immune phenomenon in scleroderma]. / Zelluläre Immunphänomene bei der Sklerodermie

The leucocyte-migration-inhibition test was performed to examine 10 patients with progressive systemic sclerosis and 6 patients with linear scleroderma for evidence of cell-mediated immunity to RNA, DNA, human muscle antigen and collagen human type I. An inhibition of cell migration was detected in 6 patients with progressive systemic sclerosis (PSS) and in 3 patients with linear scleroderma in presence of RNA. No cellular reactivity in presence of DNA was observed. Seven cases with PSS, and all 6 cases with linear scleroderma showed a migration inhibition when human muscle antigen was tested. Cell-mediated immunity to collagen human type I was discovered 7 times in PSS and 2 times in linear scleroderma.

[Xeroderma pigmentosum with normal excision-repair capacity and decreased U-V tolerance (author's transl)]. / Xeroderma Pigmentosum mit intaktem Exzisionsrepair-Mechanismus und herabgesetzter UV-Toleranz

Unscheduled DNA synthesis was investigated in the peripheral lymphocytes of a 31-year-old woman suffering from Xeroderma pigmentosum, clinically manifest since early childhood. The present data indicate a normal level of excision repair capacity, though U-V sensitivity was increased. The present case is considered to be a new variant of the syndrome Xeroderma pigmentosum, demonstrating once more its genetic heterogeneity. The question of a relationship between the observed data and the known occurrence of carcinoma in the light-exposed skin areas remains to be answered.

[Leucocyte migration-inhibition test in syphilis (author's transl)]. / Leukozytenmigrationsinhibitionstest bei der Syphilis

The leucocyte migration-inhibition test was performed on blood from 57 patients with syphilis. Even in the early stages of the disease with lymph-node involvement there were signs of cellular antitreponemic reactivity. But there was an absence of cellular immune response in some patients with secondary syphilis and CNS involvement in the course of tertiary syphilis.

[The presence of scleroderma and chronic lymphadenosis concurrently in a patient (author's transl)]. / Gemeinsames Vorkommen von progressiver Sklerodermie und chronischer Lymphadenose

This report deals with the case of a 50 year-old woman with long-standing scleroderma of the acral-asphyxial type with a relatively slight tendency to progression. Chronic lymphadenosis has been an additional feature of this case over the past few years. The following findings appear of particular interest: autoimmune phenomena in the form of antinuclear antibodies, a virtually monoclonal proliferation of B-lymphocytes and a relative T-lymphocyte deficiency. It is suggested that both conditions may be pathogenetically connected with an immunologically defined insufficiency of the lymphocytic system. Hence, in view of this observation, it may not be correct to consider scleroderma a "paraneoplastic phenomenon".