[Body experience and self-esteem after minimally invasive skin rejuvenation : Study of female patients using botulinum toxin A and/or dermal fillers]. / Körper- und Selbsterleben nach minimalinvasiver Hautverjüngung : Studie mit Nutzerinnen von Botulinumtoxin-A und/oder Dermafillern.

BACKGROUND: More and more people worldwide and also in Germany are using botulinum toxin type A (BoNT-A) and hyaluronic acid injections for skin rejuvenation. OBJECTIVE: Study on body image and self-esteem of women with BoNT-A and/or hyaluronic acid filler treatment. MATERIAL AND METHODS: A total of 145 women who requested BoNT-A and/or hyaluronic acid injections completed a survey comprised of the body dysmorphic disorder questionnaire, the Rosenberg self-esteem scale and questionnaires on the attitudes and motives on measures for optimization of the body and demographic features. Using this instrument data on the body image and self-esteem as well as attitudes and motives for utilization of minimally invasive skin rejuvenation were collated. RESULTS: Female users of minimally invasive skin rejuvenation showed an overall higher socioeconomic status and an above average high monthly income. They lived in a partnership more often in comparison to women of equal age living in Berlin. The users of BoNT-A and/or hyaluronic acid fillers showed no conspicuous differences in body image and self-esteem. They showed a moderately positive attitude to body optimization procedures and 91% achieved their standard weight with a body mass index (BMI) of ≤25 kg/m2 in comparison to 56% of German women in the same age range (25 to ≥75 years old). CONCLUSION: In the first study of body image and self-esteem in users of BoNT­A and/or dermal fillers in German women, the users showed no signs of body dysmorphic patterns or disorders of self-esteem.

Characteristics and treatment outcomes of 69 cases with early prosthetic joint infections of the hip and knee.

PURPOSE: Early prosthetic joint infection (PJI) can be treated with an intensive surgical debridement and implant retention (DAIR) of the prosthesis if (1) the prosthesis is stable, (2) the pathogen is not a difficult-to-treat microorganism, (3) symptoms have lasted for <3 weeks and (4) a sinus tract is absent. METHODS: We retrospectively evaluated the treatment outcome of early PJI in the hip and knee in a single orthopaedic centre. An early PJI was defined as a prosthesis infection within 3 months after primary implantation or revision surgery for a non-infectious cause. RESULTS: We identified 69 patients with confirmed early PJI, with a median age of 71 (range 33-84) years. Only 64 % presented with ≥2 acute signs of infection. The most commonly isolated bacteria were coagulase-negative staphylococci (38 %) and Staphylococcus aureus (25 %). Surgical procedures included DAIR (50 cases, 69 %) and two-stage exchange (19 cases, 31 %). At last follow-up, five of remaining living 67 patients (7.5 %) had a relapse of infection. The overall relapse-free survival of the prosthesis after 2 years was 92.3 % (95 % confidence interval 82-97 %) with no significant difference between DAIR and exchange of prosthesis. CONCLUSION: Our data suggest that an early PJI should be treated with DAIR as a less invasive procedure whenever possible according to the established treatment algorithm.

Can tibio-femoral kinematic and kinetic parameters reveal poor functionality and underlying deficits after total knee replacement? A systematic review.

BACKGROUND: Extensive efforts have been made to understand joint kinematics and kinetics in total knee arthroplasty (TKA) in subjects with satisfactory outcomes during daily functional activities and clinical tests, but it remains unclear whether such movement characteristics hold the potential to indicate the underlying aetiology of unsatisfactory or bad TKA outcomes. PURPOSE: To investigate which kinematic and kinetic parameters assessed during passive clinical tests and functional activities of daily living are associated with poor functionality and underlying deficits after total knee replacement. METHODS: We focused on studies characterizing the kinematic or kinetic parameters of the knee joint that are associated with poor clinical outcome after TKA. Seventeen articles were included for the review, and kinematic and kinetic data from 719 patients with minimal follow up of 6 months were extracted and analyzed. RESULTS: Passive posterior translation at 90°flexionexhibited good potential for differentiating stable and unstable TKAs. Anterior-posterior (A-P) translation of the medial condyle at 0-30° and 30-60° flexion, A-P translation of the lateral condyle at 60-90°during closed chain exercises, as well asknee extension moment during stair ascent and descent, knee abduction moment during stair descent, knee internal rotation moment and plantar flexion moment during walking, 2ndpeak ground reaction force during stair ascent and walkingshowed the greatest promise as functional biomarkers for a dissatisfied/poor outcome knee after TKA. CONCLUSION: In this study, we systematically reviewed the state-of-the-art knowledge of kinematics and kinetics associated with functional deficits, and found 11 biomechanical parameters that showed promise for supportingdecision making in TKA.

Hepatic TLR2 & TLR4 expression correlates with hepatic inflammation and TNF-α in HCV & HCV/HIV infection.

Signalling activated by Toll-like receptors (TLRs) can result in the production of tumour necrosis factor alpha (TNF-α) which is implicated in hepatitis C virus (HCV) and human immunodeficiency virus (HIV) infection. No study has examined or compared hepatic expression of TLRs in both HCV and HCV/HIV. Liver and peripheral blood mononuclear cells (PBMCs) were obtained from HCV & HCV/HIV-infected patients and PBMCs from HIV-infected patients. Liver RNA was analysed by microarray and reverse transcription quantitative PCR (RT-qPCR). PBMCs were analysed by flow cytometry. Associations with hepatic histology and infection type were sought. Forty-six HCV, 20 HIV and 27 HCV/HIV-infected patients were recruited. Increasing Metavir inflammatory activity score was associated with increased hepatic TLR mRNA by RT-qPCR: TLR2 (P ≤ 0.001), TLR4 (P = 0.008) and TNF-α (P ≤ 0.001). A high degree of correlation was seen between hepatic mRNA expression of TNF-αvs TLR2 (r(2) = 0.66, P < 0.0001) and TLR4 (r(2) = 0.60, P < 0.0001). No differences in TLR gene or protein expression was observed between HCV, HCV/HIV- or HIV-infected groups. Hepatic TLR2, TLR4 and TNF-α mRNA are associated with hepatic inflammation in both HCV and HCV/HIV infection. High correlation between TNF-α and TLR2/TLR4 suggests a role for the innate immune response in TNF-α production. Activation of the innate immune response appears to be independent of infection type.

Patellofemoral kinematics in mobile-bearing and fixed-bearing posterior stabilised total knee replacements: a cadaveric study.

PURPOSE: The aim was to compare the patellar kinematics in the normal knee, fixed-bearing (FB) and mobile-bearing total knee replacement (MB-TKR). The hypothesis that a mobile-bearing TKR has a more natural patellar movement was tested. METHODS: Computer navigation was used to track the patella in nine whole lower extremities in the natural knee and in the same knee with a posterior stabilised FB-TKR and a posterior stabilised MB-TKR from 0° to 90° flexion. The form and position of the trochlea in the natural knee and the patellar groove of the TKR femoral component was also analysed. RESULTS: There were no differences between the FB and MB-TKRs. But the patella in the TKRs at flexion angles of more than 50° had a more medial tilt compared to the natural knee. The patella of the natural knee tended to rotate externally with flexion, this was not seen in both TKR types. There were no significant differences in absolute mediolateral translation nor in translation relative to the patellar groove. During flexion, the patella lost contact with its groove earlier in the TKRs. The radius of the patellar groove of the femoral component was larger. The groove extended more superiorly and less far posteriorly, it was also positioned further laterally compared to the natural knee. CONCLUSIONS: There are subtle kinematic differences in patellar tracking between the natural knee and a TKR presumably due to differences in the shape and position of the patellar groove. There are no kinematic differences in patellar movement between the FB- and MB-TKR.

Tumor rejection by disturbing tumor stroma cell interactions.

The stroma of solid tumors is a complex network of different cell types. We analyzed stroma cell interactions in two tumor models during cyclophosphamide (Cy)-induced tumor rejection. In growing tumors, tumor infiltrating macrophages (TIMs) produced interleukin (IL)-10. Beginning 6 h after Cy-treatment T cells in the tumor were inactivated and TIMs switched to interferon (IFN)-gamma production. Both, IL-10 production before and IFN-gamma production after Cy-treatment by TIMs required T cells. With the same kinetics as TIMs started to produce IFN-gamma the tumor vasculature was destroyed which required IFN-gamma receptor expression on host but not tumor cells. These events preceded hemorrhagic necrosis and residual tumor cell elimination by T cells. Together, T cells regulate the function of TIMs and tumor rejection can be induced by disturbing the stroma network.

Generation of tumor-associated cytotoxic T lymphocytes requires interleukin 4 from CD8(+) T cells.

Activation of tumor-associated CD8(+) cytotoxic T lymphocytes (CTLs) often requires antigen representation, e.g., by dendritic cells (DCs), and CD4(+) T cell help. Previously, we showed that CTL-mediated tumor immunity required interleukin 4 (IL-4) during the immunization but not effector phase. To determine the source and target cells of IL-4, we performed adoptive T cell transfers using CD4(+) and CD8(+) T cells from IL-4(-/-) and IL-4R(-/-) mice and analyzed CTL generation. Even though necessary for CTL generation, CD4(+) T cells did not need to express IL-4 or IL-4R. Surprisingly, CTL generation required IL-4 but not IL-4R expression by CD8(+) T cells. As IL-4 (a) was expressed by naive CD8(+) T cells within 24 h after antigen encounter, (b) IL-4 induced DC maturation, and (c) CTL development was impaired in T cell-reconstituted IL-4R(-/-) mice, CD8(+) T cell-derived IL-4 appears to act on DCs. We conclude that CD4(+) and CD8(+) T cells provide different signals for DC activation during CTL generation.

An aquaporin-like gene required for the Brassica self-incompatibility response.

Self-incompatibility in Brassica refers to the rejection of self-related pollen and is mediated by a receptor protein kinase localized to the plasma membrane of the stigma epidermis in the flower. The recessive mutation mod eliminates self-incompatibility in the stigma. In mod mutants, self-compatibility was shown to be associated with the absence of transcripts encoded by an aquaporin-related gene. This observation suggests that a water channel is required for the self-incompatibility response of Brassica, which is consistent with the concept that regulation of water transfer from the stigma to pollen is a checkpoint in the early events of pollination in the crucifer family.

Tooth brushing habits in uninstructed adults--frequency, technique, duration and force.

Professional recommendations for individual oral hygiene mostly include tooth brushing at least twice daily for 2-3 min with gentle force using the Bass technique or modifications of it. This study evaluated whether habitual tooth brushing actually meets these standards. Uninstructed adults (n = 103; mean age 31 +/- 6 years; 61 female, 42 male) with habitual manual tooth brushing were given a self-administered questionnaire about the frequency of brushing and a computer system recorded their brushing technique, duration and force. The majority (79.6%) of participants brushed twice daily. The mean brushing duration was 96.6 +/- 36.0 s, the mean brushing force was 2.3 +/- 0.7 N (max. 4.1 N), and no significant differences were found for quadrants. Most subjects (73.8%) brushed with circling, 8.7% with horizontal/scrubbing, 13.6% with horizontal/circling and 3.9% with vertical/sweeping movements. Modified Bass technique was not observed. When appropriate brushing habits were defined as brushing at least twice daily for 120 s with a brushing force of less than 3 N and with circling or vertical sweeping movements, only 25.2% of the participants fulfilled all criteria, emphasising the ongoing need for oral hygiene education.

Characterization of the innate immune signalling pathways in hepatocyte cell lines.

Hepatitis B virus (HBV) infection is a major cause of liver-related morbidity and mortality. Toll-like receptors (TLRs) have recently been recognized to play an important role in the pathogenesis of chronic hepatitis B (CH-B). Furthermore, manipulation of TLR signalling pathways shows potential as an antiviral therapeutic strategy. Whether hepatocytes themselves possess intact TLR signalling pathways remains controversial. It is critical that cell culture models be developed to allow investigation of the interaction between HBV and the TLR signalling pathways. We have screened three hepatocyte cell lines for the integrity of pro-inflammatory responses and antiviral cytokines following stimulation with interleukin-1 (IL-1) and different TLR ligands. We observed that Huh-7, HepG2 and PH5CH8 cells selectively responded to IL-1 and TLR2 ligands, leading to the activation of NF-kappaB. In addition, the PH5CH8 cell lines were able to induce type 1 interferon (IFN) via both TLR3 and RIG-I following stimulation with poly I:C, HepG2 cells mounted an IFN response via RIG-I only, whereas Huh-7 cells were unresponsive. We conclude that the hepatocyte cell lines investigated display a repertoire of TLR signalling, albeit limited, suggesting that hepatocytes may themselves play an active role in innate immune responses to viruses such as HBV. Furthermore, particular hepatoma cell lines are suitable for investigating the interaction between HBV and hepatocyte-expressed pattern recognition receptors.

Spontaneous Minced Cartilage Procedure for Unexpectedly Large Femoral Condyle Surface Defect.

Articular cartilage defects at the knee joint are being identified and treated with increasing frequency. Chondrocytes may have strongest potential to generate high-quality repair tissue within the defective region, in particular when large diameter defects are present. Autologous chondrocyte implantation is not available in every country. We present a case where we spontaneously covered an acute cartilage defect, which was significantly larger than expected and loose during initial arthroscopic inspection after reading preoperative MRI, by mincing the separated fragment and directly implanting the autologous cartilage chips into the defective region.

Intrinsic superoxide dismutase activity of MnO nanoparticles enhances the magnetic resonance imaging contrast.

Superoxide radicals are associated with the development of many severe diseases, such as cancer. Under nonpathogenic conditions, the natural enzyme superoxide dismutase (SOD) regulates the intracellular superoxide concentrations, but nearly all tumor tissues show reduced SOD levels. Selective imaging in early progression stages remains a key requirement for efficient cancer diagnosis and treatment. Magnetic resonance imaging (MRI) as a noninvasive tool with high spatial resolution may offer advantages here, but MRI contrast agents exhibiting a redox-triggered change in the image contrast towards superoxide radicals have not been reported so far. Here we show that manganese oxide (MnO) nanoparticles (NPs) exhibit an intrinsic SOD-like activity, which is higher than that of the native Mn-dependent SOD. In addition, MnO NPs significantly enhance the MRI contrast when exposed to superoxide radicals, making them responsive MRI contrast agents for the treatment and imaging of cancer cells with reduced SOD levels.

Stability of the Apoproteins of Light-Harvesting Complex I and II during Biogenesis of Thylakoids in the Chlorophyll b-less Barley Mutant Chlorina f2.

Transcription and translation of Lhc (cab) genes have been compared in the chlorina f2 mutant of barley (Hordeum vulgare) and its wild type to study the effect of chlorophyll b's absence on the regulation of assembly of the light-harvesting complexes (LHC). All tested genes were transcribed and the amount of their respective mRNAs increased rhythmically upon illumination of etiolated mutant plants. The synthesis of individual LHC apoproteins also had a rhythmic pattern when total leaf protein extracts were examined, whereas they increased gradually in the thylakoid. Only some LHC pigment-proteins present in wild-type thylakoids were found in mature mutant membranes. Thus, only the 25-kD (type 3) apoprotein of the three apoproteins of the major LHC IIb complex survived. The amount of the minor LHC II pigment-proteins was considerably reduced but not to zero. Photosystem I had some of the two LHC la apoproteins but had little of those of LHC lb. This was reflected in a shift of the 77-K emission maximum of whole leaves from 741 to 732 nm. It is concluded that the two largest LHC IIb and the LHC Ib apoproteins need chlorophyll b for stable integration into the membrane and that posttranslational regulation plays a major role in LHC assembly.

Cervical joint position sense in neck pain. Immediate effects of muscle vibration versus mental training interventions: a RCT.

BACKGROUND: Impaired cervical joint position sense is a feature of chronic neck pain and is commonly argued to rely on abnormal cervical input. If true, muscle vibration, altering afferent input, but not mental interventions, should have an effect on head repositioning acuity and neck pain perception. AIM: The aim of the present study was to determine the short-term effects of neck muscle vibration, motor imagery, and action observation on cervical joint position sense and pressure pain threshold in people with chronic neck pain. DESIGN: Forty-five blinded participants with neck pain received concealed allocation and were randomized in three treatment groups. A blinded assessor performed pre- and post-test measurement. SETTING: Patients were recruited from secondary outpatient clinics in the southwest of Germany. POPULATION: Chronic, non specific neck pain patients without arm pain were recruited for this study. METHODS: A single intervention session of 5 minutes was delivered to each blinded participant. Patients were either allocated to one of the following three interventions: (1) neck muscle vibration; (2) motor imagery; (3) action observation. Primary outcomes were cervical joint position sense acuity and pressure pain threshold. Repeated measures ANOVAs were used to evaluate differences between groups and subjects. RESULTS: Repositioning acuity displayed significant time effects for vibration, motor imagery, and action observation (all P<0.05), but revealed no time*group effect. Pressure pain threshold demonstrated a time*group effect (P=0.042) as only vibration significantly increased pressure pain threshold (P=0.01). CONCLUSION: Although motor imagery and action observation did not modulate proprioceptive, afferent input, they nevertheless improved cervical joint position sense acuity. This indicates that, against the common opinion, changes in proprioceptive input are not prerequisite to improve joint repositioning performance. However, the short-term applications of these cognitive treatments had no effect on pressure pain thresholds, whereas vibration reduced pressure pain thresholds. This implies different underlying mechanisms after vibration and mental training. CLINICAL REHABILITATION IMPACT: Mental interventions were effective in improving cervical joint position sense and are easy to integrate in rehabilitation regimes. Neck muscle vibration is effective in improving cervical joint position sense and pressure pain thresholds within 5 minutes of application.

Co-inoculation of human and murine carcinoma cells induces reciprocal suppression of metastasis by both cell lines.

The interactions of two cell lines having different metastatic properties, and the subsequent effects on dissemination were investigated using the chicken embryo metastasis assay. The highly aggressive human epidermoid cell line HEp-3 was tested alone or mixed with the mouse colon carcinoma cell line CL26 in this assay. When inoculated individually, each cell line forms experimental metastases in the chicken embryo, but only the HEp-3 cells give rise to spontaneous metastases. In embryos co-inoculated with both cell lines there was an overall reduction in metastatic burden in both the spontaneous and experimental metastasis assays. Furthers studies revealed that CL26 cells, when co-inoculated with HEp-3 cells did not acquire the ability to spontaneously metastasize. However, in the presence of CL26 cells, spontaneous HEp-3 metastasis was reduced. Intravenous co-inoculation of HEp-3 and CL26 cells also resulted in a reciprocal suppression of experimental metastasis by both cell lines. These studies demonstrate that the interactions of adjacent, phenotypically different tumor cells can have a suppressive effect on dissemination of one or both cell types.

Age-dependent changes in magnetization transfer contrast of white matter in the pediatric brain.

BACKGROUND AND PURPOSE: It is unknown to what extent magnetization transfer contrast (MTC) in white matter of the brain changes during myelination. The goal of this study was to measure the age-dependent changes of MTC in different regions of the pediatric brain and to evaluate their relation to T2 relaxation times. METHODS: Seventy children aged 1 week to 80 months without evidence of organic brain disease underwent MR imaging of the brain. A double-echo spin-echo (SE) sequence and an SE sequence with and without an off-resonance pulse were performed in the axial orientation. Using paired images, we calculated MTC ratios in 13 predefined regions of the brain and compared them with the T2 relaxation times measured in the same areas. Regression analysis was performed for both parameters to evaluate age dependency. RESULTS: MTC in white matter increased during myelination from a range of 13% to 19% to a range of 34% to 37%. At the same time, T2 relaxation times decreased from a range of 115 to 160 milliseconds to a range of 60 to 70 milliseconds after myelination. For both MTC and T2 relaxation times, age dependency could be expressed by a monoexponential function. CONCLUSION: A strong positive correlation exists between MTC ratios and the degree of myelination in the pediatric brain, and an inverse correlation exists between MTC and T2 relaxation times. Fast proton relaxation within macromolecules in the myelinated white matter and subsequent MT may be the most important reason for the decreasing T2 relaxation time of white matter during brain myelination.

[Supracondylar traction of a pertrochanteric femur fracture in a patient amputated below the knee]. / Suprakondyläre Extension einer pertrochantären Femurfraktur bei einem Patienten mit Unterschenkelamputation.

Pertrochanteric femur fracture is rare in patients with lower leg amputation. Using supracondylar traction takes full advantage of the extension table. Intraoperative insertion of a Steinmann pin for traction is a well-known low-risk procedure. In our opinion, this kind of extension is a simple procedure that carries no risks for postoperative prosthetic management in patients with lower leg amputation.