Breast cancer patient-reported outcomes on level 1 and level 2 oncoplastic procedures using BREAST-Q®.

PURPOSE: In breast cancer management not only mortality and surgical morbidity measurements are important but also patient satisfaction indexes. The authors evaluated the satisfaction and health-related quality of life (HRQOL) using the breast-conserving therapy (BCT) and breast reduction (BR) modules of BREAST-Q®. METHODS: This is a cross-sectional study that analyzed breast cancer patients consecutively submitted to breast surgery between January 2011 and April 2018 using two modules of BREAST-Q®. 968 patients were contacted and 232 answers were gathered: 171 patients submitted to oncoplastic level 1 surgery answered the BCT module and 61 submitted to oncoplastic level 2 surgery answered the BR module. Clinical data were retrieved from patients' medical records. RESULTS: Among the 232 questionnaires received, the median scores for psychosocial well-being, sexual well-being and (postoperative) satisfaction with breasts for BCT and BR modules were, respectively, 77.0 and 73.5 (p = 0.17); 62.0 and 53.0 (p = 0.14); 72.0 and 66.0 (p = 0.66). The median of adverse effects of radiation in the BCT module was 87.0. The median satisfaction with outcome in the BR module was 86.0. Both groups of patients revealed high scores of satisfaction with care. For the BCT patients, satisfaction with breasts strongly correlated with sexual well-being and was moderately correlated with psychosocial and physical well-being. For the BR patients, the satisfaction with outcome strongly correlated with satisfaction with medical team and moderately correlated with the remaining scales. CONCLUSION: Both oncoplastic surgery levels yielded similar satisfaction outcomes when assessed using BCT and BR modules of BREAST-Q®.

Conceptual design of a heavy ion beam probe diagnostic for the Wendelstein 7-X Stellarator.

This article describes the current state of the design of the heavy ion beam probe (HIBP) for Wendelstein 7-X (W7-X). It will be the first HIBP diagnostic on an optimized stellarator and is designed to study electric fields and ion scale turbulence in all W7-X reference magnetic configurations. The use of an existing 2 MV accelerator, located outside of the torus hall, results in the need for a circuitous primary beamline. This increases the complexity of the ion optics design to deliver a focused beam to the plasma. To access most of the magnetic configuration space of W7-X, the secondary beamline and an energy analyzer are designed to pivot, thereby redirecting a wider range of secondary beam trajectories. Signal level estimates indicate that the equilibrium potential can be measured at all radii and that the radial coverage for potential and density fluctuations measurements depends on the plasma density.

Bio-distribution and longevity of mesenchymal stromal cell derived membrane particles.

Vesicle-based medicines hold great promise for therapy development but essential knowledge on the bio-distribution and longevity of vesicles after administration is lacking. We generated vesicles from the membranes of human mesenchymal stromal cells (MSC) and we demonstrated earlier that these so-called membrane particles (MP) mediate immunomodulatory and regenerative responses in target cells. In the present study we examined the bio-distribution and longevity of MP after intravenous administration in mice. While most vesicle tracking methods are based on imaging techniques, which require labeling of vesicles and can only detect dense accumulations of vesicles, we used proteomics analysis to detect the presence of MP-derived proteins in multiple organs and tissues. MP proteins were mainly present in plasma and leukocytes at 1 h after injection, indicating that MP - in contrast to whole MSC - do not accumulate in the lungs upon first passage but remain in circulation. After 24 h, MP proteins were still present in plasma but were most abundant in the liver. RNA sequencing of livers demonstrated that MP impact liver function and in particular induce metabolic pathways. These data provide a clear view of the bio-distribution and longevity of MP, which is likely extrapolatable to other types of vesicles, and demonstrate that MP circulate for up to 24 h and may be a tool for targeting the liver.

Initial experience with targeted axillary dissection after neoadjuvant therapy in breast cancer patients.

BACKGROUND: Targeted axillary dissection (TAD) combines sentinel node biopsy (SNB) with the removal of the previously marked metastatic node. TAD is a promising concept for axillary restaging in node-positive breast cancer patients with pathological complete response (pCR) to neoadjuvant therapy (NAT). We aimed to evaluate TAD feasibility in this context. METHODS: A prospective observational study was conducted in biopsy-confirmed cN1 patients. The removal of the clipped node (CN) was guided by intraoperative ultrasound. SNB used indocyanine green and patent blue V dye. If the CN or sentinel lymph nodes (SLN) had any metastatic foci, or the TAD procedure was unsuccessful, the patient underwent axillary lymph node dissection (ALND). RESULTS: Thirty-seven patients were included. TAD and SNB identification rates were 97.3%. Every retrieved CN was also a SLN. At the individual level, SNB identification rate was 89.2% with indocyanine green and 85.5% with patent blue V dye. The CN identification rate was 81.1%, being higher when the CN was localized on the intraoperative ultrasound (84.4% vs 60.0%). Nodal pCR was achieved by 54.1% of our patients and was more frequent in HER2-positive and triple-negative tumors (p = 0.039). Nineteen patients were spared from ALND. CONCLUSION: TAD with intraoperative ultrasound-guided excision of the CN and SNB with indocyanine green and patent blue V dye is a feasible concept to identify patients without axillary residual disease after NAT, that can be spared from ALND, although the need for marking the biopsied node should be further investigated.

[Prevalence of injury of the medial collateral ligament of the knee assessed by magnetic resonance]. / Prevalencia de lesión del ligamento colateral medial de la rodilla valorada por resonancia magnética.

INTRODUCTION: The medial collateral ligament (MCL) is one of the main stabilizers of the knee, but its injury occurs in conjunction with other ligaments. OBJECTIVE: To determine the prevalence of MCL lesions by magnetic resonance imaging, their degrees and associated lesions in our institution. MATERIAL AND METHODS: Retrospective study from January to April 2018 where KNEE MRIs were evaluated where the MCL lesion was presented to evaluate the degree and type of associated injuries. RESULTS: We included 368 studies, prevalence of isolated MCL lesion of 3.07%, grade I and grade II, prevalence of concomitant MCL lesions was 17.66% grade I (75%), grade II (15%) and grade III (3%). Associated injuries were medial meniscus injury (46.15%), anterior cruciate ligament injury (30.7%), isolated bone contusion (18.46%), chodral injuries (37.58%), medial vastus injury (14.51%), patellar medial retinacular injury (14.51%), vastus lateral injury (9.23%), posterior cruciate ligament injury (6.15%), lateral meniscus injury (4.61%), iliotibial band tenosynovitis (4.61%), medial facet avulsion fracture (3.07%), Pes Anserine tenosynovitis (3.07%). CONCLUSION: Prevalence of 17.66% of the MCL injuries in our hospital by magnetic resonance, the first 2 degrees predominate, with a wide spectrum of associated knee injuries.

INTRODUCCIÓN: El ligamento colateral medial (LCM) es uno de los principales estabilizadores de la rodilla, pero su lesión se presenta en conjunto con otras lesiones ligamentarias. OBJETIVO: Determinar la prevalencia de lesiones del LCM por resonancia magnética, sus grados y lesiones asociadas en nuestra institución. MATERIAL Y MÉTODOS: Estudio retrospectivo de Enero a Abril de 2018, se evaluaron resonancias magnéticas de rodilla donde se presentó lesión del LCM para evaluar grado y tipo de lesiones asociadas. RESULTADOS: Se incluyeron 368 estudios, prevalencia de lesión aislada del LCM de 3.07%, una grado I y una grado II, la prevalencia de lesiones de LCM concomitantes fue de 17.66%, grado I (75%), grado II (15%) y grado III (3%). Las lesiones asociadas fueron lesión del menisco medial (46.15%), lesión del ligamento cruzado anterior (30.7%), contusión ósea aislada (18.46%), lesiones condrales (37.58%), lesión de vasto medial (14.51%), lesión del retináculo medial patelar (14.51%), lesión del vasto lateral (9.23%), lesión del ligamento cruzado posterior (6.15%), lesión del menisco lateral (4.61%), tenosinovitis banda iliotibial (4.61%), fractura de avulsión de la faceta medial (3.07%), tenosinovitis de la Pes Anserinus (3.07%). CONCLUSIÓN: Prevalencia de 17.66% de lesiones del LCM en nuestro hospital por resonancia magnética, predominan los dos primeros grados con un espectro amplio de lesiones asociadas de la rodilla.

Circulating endothelial cells transiently increase in peripheral blood after kidney transplantation.

The diagnosis of kidney allograft rejection is based on late histological and clinical markers. Early, specific and minimally-invasive biomarkers may improve rejection diagnosis. Endothelial cells (EC) are one of the earliest targets in kidney transplant rejection. We investigated whether circulating EC (cEC) could serve as an earlier and less invasive biomarker for allograft rejection. Blood was collected from a cohort of 51 kidney transplant recipients before and at multiple timepoints after transplantation, including during a for cause biopsy. The number and phenotype of EC was assessed by flow-cytometric analysis. Unbiased selection of EC was done using principal component (PCA) analysis. Paired analysis revealed a transient cEC increase of 2.1-fold on the third day post-transplant, recovering to preoperative levels at seventh day post-transplant and onwards. Analysis of HLA subtype demonstrated that cEC mainly originate from the recipient. cEC levels were not associated with allograft rejection, allograft function or other allograft pathologies. However, cEC in patients with allograft rejection and increased levels of cEC showed elevated levels of KIM-1 (kidney injury marker-1). These findings indicate that cEC numbers and phenotype are affected after kidney transplantation but may not improve rejection diagnosis.

Highly Sensitive Piezoresistive Graphene-Based Stretchable Composites for Sensing Applications.

Nanocarbonaceous materials with specific geometries and physicochemical properties allow the development of high-performance polymer-based smart composite materials. Among them, chemical treatments of graphene allow tailoring its electrical conductivity and, therefore, tuning functional response of materials for sensing applications. Polymer-based nanocomposites have been developed from styrene-ethylene-butylene-styrene (SEBS), a high deformation thermoplastic elastomer, and different graphene-based fillers, including graphene oxide (GO), reduced graphene oxide (rGO), and graphene nanoplatelets (G-NPLs). It is shown that the electrical conductivity shows a percolation threshold around 2 wt % for GO and rGO, remaining nearly independent of the filler content for G-NPL filler contents up to 6 wt %. Furthermore, GO/SEBS and rGO/SEBS composites show high piezoresistive sensibility with gauge factors ranging from 15 up to 120 for strains up to 10%. Thus, GO/SEBS and rGO/SEBS composites can represent a new generation of materials for strain sensor applications, as demonstrated in their implementation in a hand glove prototype with finger movement monitoring.

Multiscale design of a dairy beverage model composed of Candida utilis single cell protein supplemented with oleic acid.

One of the main challenges in the food industry is to design strategies for the successful incorporation of natural sources of bioactive compounds. Recently, yogurts and other fermented dairy beverages have been proposed as ideal carriers of such bioactive compounds such as fatty acids and antioxidants that could improve consumers' health. However, the incorporation of new ingredients causes functional and structural modifications that may affect the consumers' preferences. In this work, a dairy beverage model supplemented with oleic acid has been designed by partial substitution of milk by Candida utilis single-cell protein extract. The changes in the structural properties of this new beverage were evaluated by following the fermentation process, pH, aggregate size, microstructure, and changes in rheological properties. Furthermore, molecular dynamics simulations were carried out to analyze the interaction between its main components. Our data revealed that samples with a percentage of milk substitution of 30% showed a higher viscosity as compared with the other percentages and less viscosity than the control (no substitution). These samples were then selected for fortification by incorporating oleic acid microcapsules. A concentration of 1.5 g/100 g was shown to be the optimal quantity of microcapsules for oleic acid supplementation. Molecular dynamic simulations revealed glutathione as an important component of the micro-gel structure. The present study forms the basis for novel studies where Candida utilis single-cell protein and microencapsulated essential oils could be used to design innovative bioproducts.

Gastrointestinal stromal tumor of the stomach and hepatocellular carcinoma: An unusual association.

INTRODUCTION: Gastrointestinal stromal tumors (GIST) are uncommon, potentially malignant tumors, that arise in the wall of the gastrointestinal tract. Up to 50% can develop metastasis, mainly in the liver, but the occurrence of synchronous primary liver tumors is a rare event in these patients. PRESENTATION OF CASE: The authors report a case of the association of gastric GIST and hepatocellular carcinoma (HCC) in a non-cirrhotic liver in a 76 year-old patient. DISCUSSION: The appearance of an hepatic lesion in a GIST patient does not necessarily imply its secondary nature. CONCLUSION: In diagnosed GIST patients, all efforts should be pursued to characterize synchronous hepatic lesions, in order to plan a correct and tailored treatment of the patients.

Adolescent understanding of DOHaD concepts: a school-based intervention to support knowledge translation and behaviour change.

A life-course approach to reduction of risk of non-communicable diseases (NCD) suggests that early-life interventions may be more effective than lifestyle modifications in middle age. Knowledge translation to develop understanding of the Developmental Origins of Health and Disease (DOHaD) within the community offers the potential to encourage informed diet and lifestyle choices supporting reduction of NCD risk in current and future generations. Many women do not make sustained dietary change before or during pregnancy, therefore appropriate nutritional behaviours need to be established prior to adulthood. This makes adolescence an appropriate stage for interventions to establish suitable dietary and lifestyle behaviours. Therefore, we engaged adolescents in a school-based educational intervention, and assessed the value of this in development of understanding of DOHaD concepts to support behaviour change that could lead to NCD risk reduction in the next generation. Modules of course work were written for 11-14 year olds and trialled in nine schools. Matched pre- and post-intervention questionnaire responses from 238 students and 99 parents, and post-intervention interviews evaluated the intervention. Understanding of a link between maternal diet during pregnancy and the health of the foetus in adulthood increased from 46% to 76% following intervention. Post-intervention evidence suggests the programme facilitated discussion of diet, lifestyle and DOHaD concepts in most families. The intervention was effective in improving understanding of DOHaD concepts and in some cases led to appropriate behaviour change. However, the sustainability of these changes remains to be determined through on-going evaluation of attitudes and behaviour within this cohort.

Caracterización del estrés oxidativo en ratas Wistar diabéticas por estreptozotocina / Oxidative stresss caracterization in streptozotocin-diabetic Wistar rats

La diabetes es un trastorno metabólico crónico de gran alcance epidemiológico. Numerosos estudios han demostrado que la diabetes mellitus se encuentra asociada al incremento de la formación de radicales libres derivados del oxígeno y a la disminución del potencial antioxidante del organismo, generando el daño oxidativo de algunos componentes de la célula tales como las proteínas, carbohidratos, lípidos y ácidos nucleicos. Este trabajo pretente establecer, en ratas Wistar, la relación dosis-respuesta de estreptozotocina frente a los niveles de glucosa y a diferentes parámetros del estatus antioxidante. Como marcadores del daño asociado a las especies de oxígeno reactivas se evaluó la actividad enzimática de catalasa y de superóxido dismutasa, la capacidad antioxidante total del plasma y la peroxidación lipídica. Los resultados obtenidos evidencian una clara relación de la dosis de estreptozotocina con los niveles de glucosa y los parámetros de estrés oxidativo evaluados luego de 20 días de la inducción de la diabetes experimental.

El Carácter de Producción y la síntesis del conductismo, el psicoanálisis, la psicología humanista-existencial y cognitiva / Tittle

El presente artículo emplea la teoría del Carácter de Producción: una orientación psicológica involuntaria e inconsciente que sirve para trabajar y que determina las particularidades de la existencia social del individuo; es decir, sus manifestaciones artísticas, éticas, religiosas, morales, jurídicas, filosóficas y sus estructuras de carácter, costumbres y actitudes, para llegar a la síntesis de la psicología moderna, la síntesis del conductismo, el psicoanálisis, la psicología humanista-existencial y cognitiva. El estímulo-sentido, la orientación -energía dirigida- implica principio, fin, afirmación, dirección y unidad. Es decir, el Carácter de Producción implica a todas y a cada una de las principales corrientes de la psicología actual

The present article takes the theory of Production Character, a psychological orientation and unconscious which is serves to work and determines the particularities of the social existence of the individual; it means, its ways to show artistical, ethics, religious, morals, juridicals, philosophical and character structures, habits and attitudes, to get to the synthesis of the modern psychology, the synthesis of the conductivism, the psychoanalysis, the congnitive and existence humanist. The idea of orientation -directed energy- implies beginning, end, affirmation, direction and unit. It means, the Production Character to implicate to all and each one of the principal currents of the present psychology

[Effect of low glycemic index diets in hyperlipidemia]. / Efecto de dietas con bajo índice glucémico en hiperlipidémicos.

INTRODUCTION: After consuming a low-glycemic-index (GI) diet, patients with diabetes and hyperlipidemia showed reduced biochemical markers of dyslipidemia. Despite Mexican food habits include low-GI foods; there have not been published results on the effect of low-GI diet on hyperlipidemia. The aim of this study was to compare the effects of a low and high glycemic index (GI), using cultural based foods to Mexicans on LDL, HDL, total cholesterol, and triacylglycerol. METHODS: Eight volunter's individuals with hyperlipidemia participated in the study. Six diets were designed, three with low-GI and three with High-GI. The study design included 2 times 3-week treatment periods with a 4-week washout period between treatments. Biochemical data was obtained at the start and finish of each dietary period. Subjects completed 1-day dietary diaries during the first and third weeks of each of the treatment periods. Paired t-test was used to compare biochemical data at the baseline and after the dietary treatment periods. RESULTS: At the end of the study periods, total cholesterol (P < 0.05) and LDL (< 0.02) were improved significantly by 10 and 13% respectively. A low GI diet containing Mexican foods during three week period may help to improve LDL and total cholesterol in individuals with hyperlipidemia.

Efecto de dietas con bajo índice glucémico en hiperlipidémicos / Effect of low glycemic index diet in hyperlipidemia

Introducción: Se ha descrito que con las dietas de bajo índice glucémico (IG) se mejora el control metabólico de los diabéticos y el perfil metabólico de los hiperlipidémicos. A pesar de que los hábitos alimentarios de los mexicanos incluyen alimentos de bajo IG no se han descrito el efecto de comidas de bajo IG en hiperlipidémicos mexicanos. El objetivo de este estudio es comparar los efectos de dos dietas con diferente IG en pacientes hiperlipidémicos utilizando alimentos de consumo frecuente en México y valorar su efecto sobre marcadores bioquímicos. Métodos: Se diseñaron seis menús, tres con dieta de IG alto y tres con IG bajo. Participaron en el estudio ocho voluntarios hiperlipidémicos. Al inicio y al final de cada dieta se valoró el peso, la glucosa, el colesterol, los triglicéridos, LDL y HDL. Cada dieta se valoró durante tres semanas y entre el final de una prueba y el principio de la segunda los participantes consumieron la dieta usual. Durante los períodos de las dietas experimentales, los participantes realizaron registro de la dieta durante un día. Para comparar los datos bioquímicos basal y al finalizar cada período de tratamiento se realizó el t-test para muestras pareadas. Resultados: Con la dieta de IG bajo se observó una reducción de 10 por ciento en los niveles de colesterol (P < 0,05) y de 13,0 por ciento de LDL (P < 0,02). Con la dieta de bajo IG, incluyendo alimentos de consumo usual en México, se observó una mejora en colesterol y LDL (AU)

Introduction: After consuming a low-glycemic-index (GI) diet, patients with diabetes and hyperlipidemia showed reduced biochemical markers of dyslipidemia. Despite Mexican food habits include low-GI foods; there have not been published results on the effect of low-GI diet on hyperlipidemia. The aim of this study was to compare the effects of a low and high glycemic index (GI), using cultural based foods to Mexicans on LDL, HDL, total cholesterol, and triacylglycerol. Methods: Eight volunteer’s individuals with hyperlipidemia participated in the study. Six diets were designed, three with low-GI and three with High-GI. The study design included 2 times 3-week treatment periods with a 4-week washout period between treatments. Biochemical data was obtained at the start and finish of each dietary period. Subjects completed 1-day dietary diaries during the first and third weeks of each of the treatment periods. Paired t-test was used to compare biochemical data at the baseline and after the dietary treatment periods. Results: At the end of the study periods, total cholesterol (P < 0.05) and LDL (< 0.02) were improved significantly by 10 and 13% respectively. A low GI diet containing Mexican foods during three week period may help to improve LDL and total cholesterol in individuals with hyperlipidemia (AU)

Human spermatozoa motility analysis in a Ringer's solution containing cupric ions.

The ability of cupric ions to immobilize human spermatozoa was assessed in vitro using an optical microscope. A Ringer's solution containing human spermatozoa and three cupric ion concentrations of 8 x 10(-8) mol/L, 8 x 10(-6) mol/L and 8 x 10(-5) mol/L were tested. The higher cupric ion concentrations (8 x 10(-5) mol/L and 8 x 10(-6) mol/L) significantly reduced spermatozoa motility after about 20 min. However, with the lower cupric ion concentration tested (8 x 10(-8) mol/L), also for 20-min experimentation, the reduction in motility was more limited.

Plasmodium falciparum: red blood cell binding studies of peptides derived from histidine-rich KAHRP-I, HRP-II and HRP-III proteins.

Histidine-rich proteins have been associated with Plasmodium falciparum infected red blood cells (RBC) cytoadherence, and RBC rosetting; these phenomena may cause clogging of the post-capillary venules, this being one of the main causes of severe cerebral malaria. They may also participate in parasite mature stages' evasion of the immune system and their subsequent destruction in the spleen. Non-overlapping synthetic peptides, corresponding to entire amino acid sequences reported for the KAHRP-I, HRP-II and HRP-III proteins, were used in RBC binding assays. Peptides with high and low binding activity were recognized. The KAHRP-I protein shows 3 peptides with high binding affinity to RBCs, two of them variable (peptide 6783, sequence 321QNYVHPWSGYSAPYGVPHGA(340) and peptide 6789, sequence 441KKREKSIMEKNHAAKKLTKK(460)) and the other conserved (peptide 6786, sequence 381KSKKHKDHDGEKKKSKKHKD(400)) having affinity constant of around 190 nM and 1000 binding sites per cell. Interestingly, this peptide shares aminoacid sequences with one reported as being recognized by malaria exposed human antibodies. The HRP-I protein also presents one conserved peptide (peptide 6800, sequence 24NNSAFNNNLCSKNAKGLNLN(43)) with high affinity, located in the amino terminal region of the native protein, having 210 nM affinity constant and 6000 receptor sites. The HRP-III protein only contains peptides with low binding activity. Treatment of red blood cells with neuraminidase reduces the binding of the conserved high binding 6786 and 6800 peptides. Anti-glycophorins A, B and C antibodies inhibit the binding of the conserved high binding 6786 and 6800 peptides. Furthermore, the specific determination of glycoproteins by chemioluminescenoe, in SDS/PAGE western blot, suggests that these glycophorins could be the receptor for these high binding peptides. High binding peptides' critical amino acids, involved in RBC binding were determined by means of competition binding assays.

[Assisted ventilation via nasal mask in patients hospitalized in a pneumology ward for decompensation of their chronic air-flow obstruction]. / Ventilación asistida vía máscara nasal en pacientes hospitalizados en una sala de neumología por descompensación de su obstrucción crónica al flujo aéreo.

Our aim was to evaluate the efficacy of assisted ventilation through a nasal mask (AVN) in treating chronic obstructive pulmonary disease (COPD) patients who were admitted to a pneumology ward due to decompensation, with PaCO2 > 60 mmHg and pH < 7.35. We studied 13 COPD patients who were first observed for 1-2 days until adaptation and then given 2 daily sessions of AVN lasting 4 hours with double positive pressure (DP90) devices through Sullivan mask with a cannula for hyperoxia. Gasometric readings were recorded, along with subjective assessment of condition and problems with the mask. Gasometric readings were taken as follows: the first upon admission to the ward (AW), the second with AVN 2 days after adaptation and the third 3 hours after the second (POST). Statistical analysis was with a Student t-test for paired series. Mean age was 64 +/- 3 years and FEV1 was 0.69 +/- 0.14 l. Interruptions were due to the need for mouth opening even at minimum pressures, and the inability to adapt to the consequent tachypnea. No other problems were reported by the remaining patients and all perceived improvement subjectively. The pH of 7.29 +/- 0.03 at AW increased to 7.41 +/- 0.03 with AVN (p < 0.001) and held steady at 7.39 +/- 0.01 at POST (p < 0.001 POST-AW and p = NS POST-AVN). PaO2/FiO2 was 223 +/- 49 mmHg at AW and 267 +/- 41 mmHg at the POST reading (p = 0.06). PaO2 with AVN was 67 +/- 8 mmHg.(ABSTRACT TRUNCATED AT 250 WORDS)

[Calculation of optimized and individualized hip prosthesis. A study of feasibility]. / Calcul d'une prothèse de hanche optimisée et individualisée. Etude de faisabilité.

As logical consequence of a series of basic research studies on human femoral bones with unipodal support and under static stress, performed with physicomathematic modelling methods (finite-elements method) then confirmed by direct visualization of deformations resulting from such stress using holographic interferometry, the authors have worked on the definition of an optimized and individualized hip prosthesis. Thick CT sections digitized with a table and entered into a specially programmed computer allowed three-dimensional modelling of the femur as a volume, i.e. with its external contour and its medullary canal, and therefore of the implantable space. The prosthesis was then defined taking a number of hypotheses into account: necessity to regularize cortical bone spicules inside spongious bone, which are so often present opposite the rough line, partial machining at the level of the calcar, reduced tail length, presence or absence of collar. Thus an optimized and individualized prosthesis was defined. A prototype corresponding to a given femoral bone could then have been produced. However, the authors found it preferable to use simulation with computer synthetic images to check easy insertion and removal.