The effects of sex, nation, ethnicity, age and self-reported pubertal development on participant-measured right-left 2D:4D (Dr-l) in the BBC internet study.

Digit ratio (2D:4D) - a proxy for prenatal sex steroids - shows sex, nationality and ethnic differences and is linked to pubertal onset. It is unclear whether right-left 2D:4D (Dr-l) also correlates with prenatal sex steroids, as evidence of these differences has been less conclusive. The present study examined the effects of sex, nation, ethnicity, age and self-reported pubertal development (i.e. the rate of physical development and age at menarche [females] or first shave [males]) on Dr-l in a large online study (the BBC internet study). Digit lengths were self-measured in 201,865 adults (110,955 males) and the sample of nations included 41 countries. Participants reported the self-perceived rate of physical pubertal development on a five-point scale (from very slow to very fast) and provided information on the age at menarche or first shave. Adult (>17 years) males had lower Dr-l than females with weak effect size across 41 nations (males-females; d = -.065, p < .0001). There were sex and ethnicity effects on Dr-l across seven ethnic groups with males < females and lower Dr-l in Whites and Middle/Near Eastern participants compared to Asian, Black and Chinese respondents. Considering age effects, the authors focused on participants >12 years; there were stable sex differences and a weak positive effect of age on Dr-l. Dr-l showed a positive relationship with the rate of physical development and a negative relationship with age at menarche or first shave. Relationships were present in males and females with stronger effects in the latter. It is concluded that Dr-l shows a weak sex difference (males < females) independent of nation, ethnicity and age, and suggest that Dr-l is a proxy for prenatal sex steroids.

Digit ratio (2D:4D) and body mass index in the BBC Internet Study: prenatal sex steroids and a Trivers-Willard effect on body composition.

Digit ratio - a putative measure of prenatal sex steroids - may be related to body mass index (BMI). However, reports of correlations between 2D:4D and BMI have yielded mixed results with some studies showing no relationship while others have reported positive associations in men or women only. This study considers associations between self-reported 2D:4D and BMI in a large online survey (i.e. the BBC Internet Study). At the individual level, there was a weak positive association between 2D:4D and BMI in both sexes with greater effect sizes in women. Body mass index was positively related to age and negatively related to parental income; however, the relationship between 2D:4D and BMI was independent of both variables. At the national level, mean 2D:4D per country showed positive associations with mean national BMI but those correlations were restricted to females. It is concluded that BMI is positively related to low prenatal testosterone and high prenatal oestrogen. Parental income inequality may influence both prenatal sex steroids (through a 'Trivers-Willard' effect) and BMI such that increases in inequality result in reductions in prenatal testosterone and increases in BMI at the individual and national level.

Parental income inequality and children's digit ratio (2D:4D): a 'Trivers-Willard' effect on prenatal androgenization?

Income inequality is associated positively with disease prevalence and mortality. Digit ratio (2D:4D) - a negative proxy for prenatal testosterone and a positive correlate of prenatal oestrogen - is related to several diseases. This study examined the association of income inequality (operationalized as relative parental income) and children's 2D:4D. Participants self-measured finger lengths (2D=index finger, and 4D=ring finger) in a large online survey conducted in July 2005 (the BBC Internet Study) and reported their parents' income. Children of parents of above-average income had low 2D:4D (high prenatal testosterone, low prenatal oestrogen) while the children of parents of below-average income had high 2D:4D (low prenatal testosterone, high prenatal oestrogen). The effects were significant in the total sample, present among Whites (the largest group in the sample), in the two largest national samples (UK and USA) and were greater for males than females. The findings suggest a Trivers-Willard effect, such that high-income women may prenatally masculinize their sons at the expense of the fitness of their daughters. Women with low income may prenatally feminize their daughters at the fitness expense of their sons. The effect could, in part, explain associations between low income, high 2D:4D (low prenatal testosterone) and some major causes of mortality such as cardiovascular disease.

The effect of skin surface topography and skin colouration cues on perception of male facial age, health and attractiveness.

OBJECTIVE: Previous studies investigating the effects of skin surface topography and colouration cues on the perception of female faces reported a differential weighting for the perception of skin topography and colour evenness, where topography was a stronger visual cue for the perception of age, whereas skin colour evenness was a stronger visual cue for the perception of health. We extend these findings in a study of the effect of skin surface topography and colour evenness cues on the perceptions of facial age, health and attractiveness in males. METHODS: Facial images of six men (aged 40 to 70 years), selected for co-expression of lines/wrinkles and discolouration, were manipulated digitally to create eight stimuli, namely, separate removal of these two features (a) on the forehead, (b) in the periorbital area, (c) on the cheeks and (d) across the entire face. Omnibus (within-face) pairwise combinations, including the original (unmodified) face, were presented to a total of 240 male and female judges, who selected the face they considered younger, healthier and more attractive. RESULTS: Significant effects were detected for facial image choice, in response to skin feature manipulation. The combined removal of skin surface topography resulted in younger age perception compared with that seen with the removal of skin colouration cues, whereas the opposite pattern was found for health preference. No difference was detected for the perception of attractiveness. These perceptual effects were seen particularly on the forehead and cheeks. Removing skin topography cues (but not discolouration) in the periorbital area resulted in higher preferences for all three attributes. CONCLUSION: Skin surface topography and colouration cues affect the perception of age, health and attractiveness in men's faces. The combined removal of these features on the forehead, cheeks and in the periorbital area results in the most positive assessments.

Peri-conceptional obesogenic exposure induces sex-specific programming of disease susceptibilities in adult mouse offspring.

Vulnerability of the fetus upon maternal obesity can potentially occur during all developmental phases. We aimed at elaborating longer-term health outcomes of fetal overnutrition during the earliest stages of development. We utilized Naval Medical Research Institute (NMRI) mice to induce pre-conceptional and gestational obesity and followed offspring outcomes in the absence of any postnatal obesogenic influences. Male adult offspring developed overweight, insulin resistance, hyperleptinemia, hyperuricemia and hepatic steatosis; all these features were not observed in females. Instead, they showed impaired fasting glucose and a reduced fat mass and adipocyte size. Influences of the interaction of maternal diet∗sex concerned offspring genes involved in fatty liver disease, lipid droplet size regulation and fat mass expansion. These data suggest that a peri-conceptional obesogenic exposure is sufficient to shape offspring gene expression patterns and health outcomes in a sex- and organ-specific manner, indicating varying developmental vulnerabilities between sexes towards metabolic disease in response to maternal overnutrition.

[Resurfacing of the humeral head : sensible indications]. / Oberflächenersatz des Humeruskopfs : Sinnvolle Indikationen.

Cup resurfacing of the humeral head is one of the possible prosthetic solutions for severe destruction of the glenohumeral joint. Because neurological complications are not uncommon after total shoulder arthroplasty using surface replacement, these cups are indicated when hemiarthroplasty is possible. The advantages of humeral head resurfacing are bone preservation and the technically easy exchange if revision is necessary; therefore, young patients are candidates for this type of endoprosthesis. At present humeral head resurfacing is indicated for osteoarthritic destruction of Walch types A1 and C, for rheumatic destruction with deficient cuff in younger patients, cuff arthropathy in younger patients with Seebauer types 1A and 1B, humeral head necrosis with normal glenoid and necrotic bone in less than one third of the humeral head and dislocation arthropathy in younger patients.

Digit ratio (2D:4D) and its relationship to foetal and maternal sex steroids: A mini-review.

The challenges of terrestrial existence may mean that the early development of tetrapod limb traits is linked to the development of the urogenital system and sex steroids. One such limb trait is the sex-dependent ratio of the lengths of the 2nd and 4th digits (2D:4D). Direct evidence for the association between early sex steroids and offspring 2D:4D can be obtained by manipulating foetal sex hormones. However, this is not ethically permissible in humans. It is widely accepted that 2D:4D is a biomarker for early foetal sex hormones in tetrapods but the link in humans remains controversial. Here we review the evidence that (i) manipulation of sex steroids in early development leads to sex-dependent changes in 2D:4D throughout the tetrapods, and (ii) maternal sex steroids cross the placenta and thus are associated with offspring 2D:4D in both non-human and human animals. We suggest a research focus on associations between human maternal sex steroids and offspring 2D:4D to clarify the link between 2D:4D and early sex steroids. A protocol is proposed to examine the correlation between 1st-trimester maternal sex steroids and offspring 2D:4D. Such an association may explain the existence and medium effect size of the human sex difference in 2D:4D.

Colour homogeneity and visual perception of age, health and attractiveness of male facial skin.

BACKGROUND: Visible facial skin condition in females is known to affect perception of age, health and attractiveness. Skin colour distribution in shape- and topography-standardized female faces, driven by localized melanin and haemoglobin, can account for up to twenty years of apparent age perception. Although this is corroborated by an ability to discern female age even in isolated, non-contextual skin images, a similar effect in the perception of male skin is yet to be demonstrated. OBJECTIVES: To investigate the effect of skin colour homogeneity and chromophore distribution on the visual perception of age, health and attractiveness of male facial skin. METHODS: Cropped images from the cheeks of facial images of 160 Caucasian British men aged 10-70 years were blind-rated for age, health and attractiveness by a total of 308 participants. In addition, the homogeneity of skin images and corresponding eumelanin/oxyhaemoglobin concentration maps were analysed objectively using Haralick's image segmentation algorithm. RESULTS: Isolated skin images taken from the cheeks of younger males were judged as healthier and more attractive. Perception of age, health and attractiveness was strongly related to melanin and haemoglobin distribution, whereby more even distributions led to perception of younger age and greater health and attractiveness. The evenness of melanized features was a stronger cue for age perception, whereas haemoglobin distribution was associated more strongly with health and attractiveness perception. CONCLUSIONS: Male skin colour homogeneity, driven by melanin and haemoglobin distribution, influences perception of age, health and attractiveness.

Visible skin colouration predicts perception of male facial age, health and attractiveness.

Although there is evidence that perception of facial age, health and attractiveness is informed by shape characteristics as well as by visible skin condition, studies on the latter have focused almost exclusively on female skin. Recent research, however, suggests that a decrease in skin colour homogeneity leads to older, less healthy and less attractive ratings of facial skin in both women and men. Here, we elaborate on the significance of the homogeneity of visible skin colouration in men by testing the hypothesis that perception of age, health and attractiveness of (non-contextual) digitally isolated fields of cheek skin only can predict that of whole facial images. Facial digital images of 160 British men (all Caucasian) aged between 10 and 70 were blind-rated for age, health and attractiveness by a total of 147 men and 154 women (mean age = 22.95, SD = 4.26), and these ratings were related to those of corresponding images of cheek skin reported by Fink et al. (J. Eur. Acad. Dermatol. Venereol. in press). Linear regression analysis showed that age, health and attractiveness perception of men's faces could be predicted by the ratings of cheek skin only, such that older men were viewed as older, less healthy and less attractive. This result underlines once again the potent signalling role of skin in its own right, independent of shape or other factors and suggests strongly that visible skin condition, and skin colour homogeneity in particular, plays a significant role in the perception of men's faces.

[Minimally invasive posterior approach for total hip arthroplasty]. / Minimal-invasiver posteriorer Zugang für die Hüfttotalendoprothesenimplantation.

The mini-posterior approach for total hip arthroplasty (THA) belongs to the mini-incision approaches. In comparison to standard approaches, less muscle trauma resulting in less pain, less blood loss and faster rehabilitation in the early postoperative period are attributed to this approach, as known for all other minimally invasive approaches. In a prospective study of 100 cases of THA it could be shown that this is true when comparing the mini-posterior approach with the posterolateral approach. Lower levels of muscle enzymes as a parameter for muscle trauma, could not be seen.

[Logistic requirements and biopsy of periprosthetic infections: what should be taken into consideration?]. / Logistische Voraussetzungen und Probenentnahme bei periprothetischen Infektionen: Was muss beachtet werden?

Preoperative diagnosis of periprosthetic infections is particularly important before revision of knee and hip arthroplasties because of the therapeutic consequences. Therefore, periprosthetic infections should be ruled out before any revision surgery is performed. Of the different diagnostic methods direct techniques which allow the direct detection of microorganisms with testing of antibiotic sensitivity are recommended. This allows microorganism-specific systemic and local antibiotic therapies and helps to reduce the risk of development of resistance. In our studies it could be shown that the time for incubation to detect microorganisms should be 14 days and that biopsy of periprosthetic tissues is superior to aspiration alone because it combines several diagnostic methods (microbiological and histological). It is preferable to repeating an aspiration when data are unclear, i.e. in cases of potentially false positives or negatives results of aspiration.

Differences in visual perception of age and attractiveness of female facial and body skin.

Perception of age and health is critical in the judgement of attractiveness. The few studies conducted on the significance of apparent skin condition on human physical appearance have studied faces alone or isolated fields of images facial skin. Little is known about whether perception of the face matches that of other body parts or if body skin affects overall age and attractiveness perception when presented in combination with facial skin. We hypothesized that independent presentation of female faces, chests and arms (including hands) - cropped from a full face and upper body image - would result in significant differences in perception of age and attractiveness compared to the corresponding composite. Furthermore, we sought to investigate whether relatively young and attractive looking skin on selected, individual parts of the body affects overall perception. Digital photographs of 52 women aged 45-65 years were collected and processed to yield four derivative sets of images: One set showed the composite of all features, i.e. the face, the chest and the arms, whereas the other three were cropped carefully to show each part of the upper body described above independently. A total of 240 participants judged these faces for perceived age and attractiveness. Our results showed significant differences in perception with the chest and the arms being judged significantly younger than the face or composite image of the same women. Moreover, arms and chest images were perceived as more attractive than face and composite images. Finally, regression analysis indicated that differences between the perceived and chronological values of overall age perception could be predicted by age perception of the face and arms. These results continue to support the significance of facial age perception in assessment of a woman's age, but highlight that body skin also plays a role in overall age impression.

Visible skin condition and perception of human facial appearance.

Evolutionary psychology suggests that certain human beauty standards have evolved to provide reliable cues of fertility and health. Hence, preferences for some physical characteristics of the face and body are thought to reflect adaptations for the promotion of mate choice. Studies that have investigated facial attractiveness have concentrated mainly on features such as symmetry, averageness and sex-typical traits, which are developed under the influence of sex steroids. Few studies, however, have addressed the effect of human skin condition on perception of facial appearance in this context, and possible implications for sexual selection. There is now accumulating evidence that skin pigmentation and skin surface topography cues, particularly in women, have a significant influence on attractiveness judgements, as they seem primarily to signal aspects of age and health. This article (i) reviews briefly some of the main determinants of visible skin condition, (ii) presents recent evidence on its signalling value in face perception and (iii) suggests areas for future research with reference to an evolutionary psychology framework.

Three-step technique for implantation of rotating hinge knee prostheses : Demonstration using the Enduro prosthesis.

OBJECTIVE: Implantation of an axis-guided knee prosthesis with consideration of the joint line and balanced flexion and extension gap to reduce the mechanical load on the prosthesis axis and to improve the movement of the prosthesis. INDICATIONS: Distinct unilateral instability due to ligament insufficiency in association with knee prostheses. Primary implantation of axis-guided knee prostheses with pronounced axial malalignment (>20-25° valgus or varus malalignment) or/and severe flexion contracture > 40°. Replacement of prosthesis with nonsignificant imbalance between flexion and extension gap. CONTRAINDICATIONS: Clearly unstable flexion gap such that the extension gap cannot be adjusted appropriately. Significant femoral bone defects requiring distal femoral replacement prostheses. SURGICAL TECHNIQUE: Reconstruction of the tibial platform with the trial prosthesis with regard to height in relation to the tip of the fibula. Determination of the femoral prosthesis size. Adjustment of the anteroposterior (AP) cutting block of the selected size, referenced anteriorly and in correct rotation. Determination of the flexion gap with spacers using the stable side of the collateral ligaments. Positioning the distal cutting block and determination of the height of the extension gap. Moving the distal cutting block until the same height of spacer as used in the flexion gap fits into the extension gap, taking into account the stable side of the collateral ligaments. The extent of the displacement D1 is noted. Reverse displacement of the distal cutting block by the distance D2 until a satisfactory bony contact surface for the femoral component in the distal femur can be created. The thickness of the required distal augments on the following chamfer-cutting guide (4-in­1 cutting block) and thus on the femoral prosthetic component is the sum of D1 + D2. The chamfer-cutting guide (4-in­1 block) with distal augments of the calculated height (D = D1 + D2) is placed in position. Definition and preparation of the posterior contact surface with positioning of any necessary posterior augments. Completion of the femoral preparation taking into account the distal and posterior augments. Assembly of the trial prostheses with a trial inlay having the height of the spacers used. Implantation of the selected prosthesis components. POSTOPERATIVE MANAGEMENT: Thrombosis prophylaxis, physiotherapy under full weight-bearing and mobility exercises. RESULTS: After implantation of 104 axis-guided Enduro™ knee prostheses (Aesculap AG, Tuttlingen, Germany) (73 knee prosthesis revisions and 31 primary implantations), the Knee Society Score increased from 42.8 ± 18.8 preoperatively to 84.8 ± 13.9 after 24 months. Complications comprised one deep vein thrombosis and one periprosthetic infection.

Improving the improvisational pelvic circumferential compression technique for open-book pelvic fractures using a simulation model and a sphygmomanometer.

BACKGROUND: Open-book pelvic fractures are associated with significant mortality. Emergency management may require a commercial pelvic circumferential compression device to reduce the fracture and compress haemorrhaging pelvic vasculature. Standard, commercial, twin-sized bedsheets are acceptable should commercial devices be unavailable. However, obese victims or personnel with insufficient body strength may impede successful reduction. OBJECTIVE: To demonstrate the value of an improvisational windlass (intravenous pole) in improving the ability to reduce an open-book pelvic fracture. METHODS: The Institutional Review Board-approved study involved 28 diverse healthcare students and emergency medicine residents. Each participant's demographic information and physical characteristics were recorded. A METIman was prepared with knee and ankle binding and a sphygmomanometer set at 40 mm Hg placed over the symphysis pubis. Two-person teams were randomly selected to place a bedsheet at greater trochanter level and atop the sphygmomanometer. The bedsheet was secured with maximum effort by the pairs and the pressure recorded. Following this, the pairs inserted an intravenous pole in the knot and torqued the pole to maximum effort and a repeat pressure recorded. RESULTS: The mean increase in pressure using only the bedsheet was 106.43 mm Hg per team. With bedsheet and intravenous pole, the mean pressure increase was 351.79 mm Hg per team. The difference was statistically significant (independent samples t-test: t = 17.177, p < 0.001, 95% CI (216.65 to 274.07 mm Hg). There was no correlation between pressure increases and the individual physical characteristics of the subjects (r = - 0.183, p = 0.352). CONCLUSIONS: Regardless of personnel's physical attributes, the addition of an improvisational windlass to a pelvic circumferential compression bedsheet can improve the ability to reduce an open-book fracture, especially in obese victims.

Interaction of human thrombospondin with types I-V collagen: direct binding and electron microscopy.

Binding of thrombospondin (TSP) to types I-V collagen was examined by direct binding assays using 125I-TSP and by visualization of rotary-shadowed intermolecular complexes in the electron microscope. The binding of TSP was highest to type V collagen in the absence of Ca, while lower but significant levels of binding were observed to all other collagen types in the presence or absence of Ca. Unlike intact TSP, the trimeric collagen-binding domain of TSP composed of 70-kD chains showed no Ca dependence in its binding to type V collagen. Further evidence for binding of TSP to types I and III collagen was obtained by competition studies in which these soluble collagens effectively inhibited binding of 125I-TSP to immobilized type V collagen. The binding of TSP to type V collagen was inhibited by heparin and fucoidin, both high-affinity ligands of TSP's heparin-binding domain. mAb A6.1, which binds to the 70-kD domain of TSP, is also the best of a panel of anti-TSP mAbs at inhibiting the TSP-collagen interaction. Electron microscopy of rotary-shadowed replicas of TSP-collagen complexes revealed that all five types of collagen examined had a binding site for TSP at one end of the pepsinized, triple helical molecule. The specificity of this site was tested by examining the ability of BSA to form a complex with the end of the pepsinized collagens. Rotary-shadowed replicas revealed a low frequency of apparent BSA-collagen complexes, and histograms of these data showed no evidence for the preferential association of BSA with the end of the collagen molecules. In addition to the specific end site, type V collagen had an internal binding site for TSP located about two-thirds of the distance along the length of the collagen molecule from the end site. The internal binding site for TSP on type V collagen is apparently the site responsible for the higher affinity binding of TSP to that protein observed in direct binding assays. The trimeric 70-kD collagen-binding domain of TSP bound to the same sites on the collagens as did intact TSP.

The effects of skin colour distribution and topography cues on the perception of female facial age and health.

According to evolutionary psychology, the preference for some facial characteristics reflects adaptations for mate choice because they signal aspects of mate quality. Although morphological features such as facial symmetry and sexually dimorphic traits have been studied extensively in recent years, little is known about skin condition in this context. The preferences for young and healthy looking skin could offer an explanation as to why women place such an importance on the condition of their skin and its refinement through e.g., cosmetic products. Recent research showed that facial skin colour distribution significantly influences the perception of age and attractiveness of female faces, independent of skin surface topography cues. However, the relative effect of skin colour distribution and topography cues on age and health perception remains to be investigated. We present data showing that both skin colour distribution and skin surface topography cues not only significantly influence the perception of female facial age and health but also convey differential information with regard to the strength of these effects. Our data indicate that skin surface topography cues account for a large proportion of variation in facial age perception, whereas skin colour distribution seems to be a stronger health cue.

Dietary supplement with vitamin C prevents nitrate tolerance.

Enhanced formation of superoxide radicals has been proposed to play a major role in the development of nitrate tolerance in humans. We tested the effects of vitamin C (Vit-C) supplementation on glyceroltrinitrate (GTN)-induced hemodynamic effects during 3-d nonintermittent transdermal administration of GTN (0.4 mg/h) in nine healthy subjects. Tolerance development was monitored by changes in arterial pressure, dicrotic digital pulse pressure, and heart rate. Studies with GTN, Vit-C, or GTN/Vit-C were successively carried out at random in three different series in the same subjects. GTN treatment caused an immediate rise in arterial conductivity (a/b ratio of dicrotic pulse), but within 2 d of initiating GTN, the a/b ratio progressively decreased and reached basal levels. In addition, there was a progressive loss of the orthostatic decrease in blood pressure. However, coadministration of Vit-C and GTN fully maintained the GTN-induced changes in the orthostatic blood pressure, and the rise of a/b ratio was augmented by 310% for the duration of the test period. Changes in vascular tolerance in GTN-treated subjects were paralleled by upregulation of the activity of isolated platelets, which was also reversed by Vit-C administration. These findings demonstrate that dietary supplementation with Vit-C eliminates vascular tolerance and concomitant upregulation of ex vivo-washed platelet activity during long-term nonintermittent administration of GTN in humans.

Cryopreservation of human adipose tissues.

Scientific studies on cryopreservation of adipose tissues have seldom been performed. The purpose of our present study is conducted both in vitro and in vivo to develop a novel cryopreservation method that can be used successfully for long-term preservation of human adipose tissues for possible future clinical application. In this study, samples of adipose aspirates were obtained from 36 adult white female patients after liposuction and collected from the middle layer after centrifugation. In the in vitro study, suitable cryoprotectant agents (CPAs) and their concentrations and possible combinations were selected from our preliminary experiment. A combination of dimethyl sulfoxide (Me(2)SO) and trehalose as CPA with the optimal concentration (0.5M Me(2)SO and 0.2M trehalose) was chosen and then used throughout the study. In addition, maximal recovery of adipose tissues was achieved after cryopreservation using slow cooling without seeding (1-2 degrees C/min to -30 degrees C, followed by plunging to -196 degrees C for storage) and fast warming (in 40 degrees C water bath, averaging 35 degrees C/min). Fresh adipose aspirates (Group 1), cryopreserved adipose aspirates without CPAs (Group 2), or cryopreserved adipose aspirates with CPAs (Group 3) were evaluated by integrated adipocyte counts and histology. In the in vivo study, fresh adipose aspirates (Group 1), cryopreserved adipose aspirates without CPAs (Group 2), or cryopreserved adipose aspirates with CPAs (Group 3) were injected into a nude mouse. The retained adipose aspirates (fat grafts) were harvested in each animal at 4 months and their weight, volume, and histology was assessed. In the in vitro study, significantly higher integrated viable adipocyte count (2.06+/-0.54 x 10(6)mL(-1) vs. 1.07+/-0.41 x 10(6)mL(-1), p<0.0011) of adipose aspirates was found in Group 3 compared with Group 2. Group 3 had only a marginally lower integrated viable adipocyte count compared with Group 1 (2.06+/-0.54 x 10(6)mL(-1) vs. 2.57+/-0.56 x 10(6)mL(-1), p=0.083). Histologically, more tissue shrinkage was evident in Group 2 compared with Group 3. In the in vivo study, various degrees of absorption of injected fat grafts were seen in all 3 groups. However, Group 3 had significantly more retained weight and volume of the injected fat grafts than Group 2 (both p<0.0001) but had significantly less retained weight and volume than Group 3 (weight, p=0.009178; volume, p=0.007836). Histologically, a large amount of tissue fibrosis was seen in Group 2, and reasonably well maintained fatty tissue with only a small amount of tissue fibrosis was seen in Group 3. The results from the present in vitro and in vivo studies, for the first time, demonstrate that our preferred cryopreservation method, the combination of 0.5M Me(2)SO and 0.2M trehalose as CPA in addition to the controlled slow cooling and fast rewarming protocol, appears to provide the maximum recovered results in cryopreservation of human adipose tissues and may become a real option after further refinements for cryopreservation of human adipose aspirates in a clinical setting.

[Modern three-piece total ankle replacement. Frequency and causes of luxation and premature wear of the polyethylene bearing]. / Moderne 3-Komponenten-Sprunggelenkprothesen. Häufigkeit und Ursachen von Luxation und vorzeitigem Verschleiss des Polyethylengleitkerns.

Luxation and excessive wear of the mobile bearing in modern three-piece total ankle replacement (TAR) is reported. We conducted a systematic review of studies to explore and discuss the rate and causes of these complications.A systematic review of studies since 2000 showed 26 studies with altogether 1,318 followed up TARs which we analyzed. Of these 1,318 TARs, 188 (14.3%) were revised and 56 (4.2%) complications with the mobile bearing were reported. A total of 39 cases (3%), i.e., 20.7% of all revisions, were revised due to failure of the mobile bearing, including 17 cases with subluxation (1.3%), 15 with asymmetric load of the bearing (1.1%), 10 with fracture of the polyethylene (PE) inlay (0.76%), 7 with massive PE wear (0.53%), and 7 with luxation of the meniscal bearing (0.53%).Complications due to the meniscal mobile bearing in TARs such as luxation, subluxation, massive wear, and fracture of the PE inlay are rare complications. The cause of these complications is regularly not found in the design of this three-piece total ankle replacement. Causes of failure of the mobile bearing are mostly found in incorrect indication, incorrect soft tissue balancing, incorrect positioning of components, implantation in ankles with hindfoot malalignment and ankle instability.