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Cartilage tissue has a limited capacity for healing with the consequence that patients are often treated symptomatically until they become candidates for osteotomy or total joint replacement. Alternative biological therapies, for example, application of platelet-rich plasma and implantation of chondrocytes and mesenchymal stem cells, have emerged as a new treatment modality to repair articular cartilage. In addition, autologous fat transfer is performed for treatment of cartilage defects, example given, in osteoarthrosis, but several questions regarding basic biochemical properties of the transplant remain unanswered. Bone morphogenetic protein 4 (BMP4), matrix metalloproteinase (MMP)-8, cartilage oligomeric matrix protein (COMP), and chitinase-3-like protein 1 (CHI3L1) have been shown to be involved in chondrogenic regeneration and represent potential therapeutic agents for cartilage repair. However, no study regarding naturally occurring levels of these soluble factors in transplanted adipose tissue has yet been performed.To investigate the influence of age, body mass index, donor site, and sex on the concentration of BMP4, MMP-8, COMP, and CHI3L1 in freshly aspirated adipose tissue, their content was measured by means of enzyme-linked immunosorbent assay readings.There were significant quantities of BMP4, MMP-8, COMP, and CHI3L1 (23.6, 249.9, 298.0, and 540.6 pg/mg, respectively) in the lipoaspirate harvested for transplantation. There was no correlation between the content of soluble factors and the patients' age or body mass index. Furthermore, the sex did not affect the amount of the investigated factors. However, there were significantly lower contents of BMP4, COMP, and CHI3L1 found in lipoaspirates harvested from the abdomen compared with nonabdominal donor sites.Naturally occurring differences in the concentrations of the investigated soluble factors will favor certain donor sites for autologous fat transfer in the field of cartilage repair. Thus, increasing knowledge will enable researchers and clinicians to make autologous fat transfer procedures more reliable and efficient for treatment of articular cartilage defects.

Background: Although chemical antiseptics are the most basic measure to control wound infection and frequently come into contact with subcutaneous adipose tissue, no studies have evaluated their toxicity on adipose tissue and its cell fractions. In the present study, the effects of five different antiseptics on adipose-derived stem cells were evaluated. Methods: Human adipose-derived stem cells were harvested from healthy donors. Adipose-derived stem cell viability was measured after treatment with different concentrations of antiseptics over 5 days. Furthermore, the effect on the proliferation, adipogenic differentiation, and apoptosis/necrosis of adipose-derived stem cells was analyzed. Finally, the mRNA expression of the stem cell markers CD29, CD34, CD73, CD90, and CD105 was detected. Results: Octenisept and Betaisodona significantly reduced cell proliferation and differentiation and led to considerable adipose-derived stem cell necrosis. Octenisept decreased stem cell viability at the lowest concentrations tested, and all stem cell markers were down-regulated by Octeniseptr and Betaisodona. Lavasept and Prontosan both led to reduced stem cell viability, proliferation, and differentiation, and increased apoptosis/necrosis, although the effects were less pronounced compared with Octenisept and Betaisodona. Adipose-derived stem cells survived treatment with mafenide acetate even at high concentrations, and mafenide acetate showed minimal negative effects on their proliferation, adipogenic differentiation, cell death, and stem cell marker expression. Conclusions: Mafenide acetate may be regarded as a feasible antiseptic for the treatment of wounds with exposed adipose tissue because of its low adipose-derived stem cell toxicity. Lavasept and Prontosan are possible alternatives to mafenide acetate. Octenisept and Betaisodona, by contrast, may be used only in highly diluted solutions.

Background The aim of this study was to assess the impact of two teaching interventions (ultrasound and arthroscopy) in a peer teaching (PT) environment on anatomy examination scores and also to examine the influence of gender and learning style on these scores. Methods We randomly assigned 484 second year medical students to one of three groups: musculoskeletal ultrasound (MSUS), arthroscopy (ASC) and control (CON). The MSUS- and the ASC-group attended two additional training sessions in ultrasound or arthroscopy; the CON-group received no additional lessons. Students were asked to complete Kolb's Learning Style Inventory test. We assessed differences in anatomical knowledge (multiple choice (MC) exam) and subjective evaluation with respect to gender and learning style. Results There were no relevant differences between the three groups regarding the MC exam. Acceptance of the peer teaching concept was good. All students preferred ultrasound to arthroscopy and thought that they learned more from ultrasound despite the fact that they rated the instructors as less competent and needed more time to gain in-depth knowledge. There was no significant effect of gender on evaluation results. Arthroscopy was best enjoyed by accommodators according to Kolb's Inventory and least by divergers, who found that they had learned a lot through ultrasound. The improvement in spatial conceptualization was greatest for accommodators and worst for assimilators. Conclusion Gender and learning style had no impact on quantitative parameters. Qualitative analysis, however, revealed differences for learning style and further evaluation is warranted to assess the impact on medical education.

Hintergrund: Der Fachbereich der Plastischen Chirurgie weist eine deutlich zunehmende Bandbreite der Forschungsaktivitat in den vergangenen Jahrzenten auf. Im Vergleich zu anderen Fachdisziplinen scheint es gleichzeitig an zentraler Koordination in den unterschiedlichen Forschungsbereichen zu fehlen. Bis dato fehlt es hier auch an einer umfangreichen, regelmasigen Auswertung der Forschungsaktivitat. Diese Studie dient einer Ubersicht der deutschen, universitaren Forschungsaktivitat im Bereich der Plastischen Chirurgie. Material und Methoden: Wir fuhrten eine retrospektive Analyse im 5-Jahresintervall (01/2010–12/2014) von PubMed gelisteten Publikationen deutscher, universitarer Kliniken fur Plastische Chirurgie durch. Es erfolgte fur jede Universitat (n=11) eine statistische Auswertung der folgenden Parameter: Verteilung des Forschungsschwerpunktes, Anzahl der Publikationen, jahrliche kumulative Impact-Summe (IS) und Impact-Factor (IF). Ergebnisse: Fur den o. g. Zeitraum wurden insgesamt n=904 Publikationen ausgewertet. Ein Ranking der akademischen Kliniken ergab sich wie folgt: Anzahl an Publikationen: 1. MH-Hannover 178 (jahrlicher Durchschnitt x=36/Median x=34); 2. Universitat Erlangen 115 (x=23/x=23); 3. Bergmannsheil Bochum 90 (x=18/x=19). Die durchschnittliche IS ergab: 33,51 (SD 11,088, p Schlussfolgerung: Basierend auf dieser umfangreichen Auswertung scheint eine zentrierte, periodische Auswertung der aktuellen Forschungsaktivitat in Zukunft nutzlich. Datenauswertungen sollten sowohl auf europaischer als auch auf internationaler Ebene begonnen und auf andere chirurgische und medizinische Disziplinen ubertragen werden.

BACKGROUND A variety of therapeutic procedures for treating keloids have been previously reported, with varying success and recurrence rates. As a monotherapy, intralesional cryosurgery has yielded convincing clinical results. OBJECTIVE We combined intralesional cryosurgery with the application of topical silicone gel sheeting. MATERIALS AND METHODS In this retrospective study, which was conducted between 2008 and 2012, 21 patients with 32 keloids were enrolled. Twenty-five lesions were treated with intralesional cryotherapy combined with postoperative silicone gel sheeting (the cryotherapy + silicone group), and 7 keloids were treated with intralesional cryotherapy alone (the cryotherapy group). The scar volume reduction was assessed, and the patients' subjective and objective parameters were evaluated. Additionally, patient satisfaction was estimated using a modified Gorney Gram scale (0-3). RESULTS In all cases (n = 32 for both groups), a significant keloid volume reduction was observed. The patients' subjective complaints were significantly improved, whereas the combined therapy showed slightly better results in hardness (p < .0012), pain (p < .0233), and discomfort (p < .0029), whereas monotherapy achieved higher satisfaction scores in redness (p < .0220) and pruritus (p < .0206), although these differences were not significant between the treatment modalities. CONCLUSION The results of this study support the use of combined intralesional cryosurgery followed by the application of silicone gel sheeting to treat refractory keloids.

Summary Fordyce spots are ectopic sebaceous glands, ranging between 2 and 3 mm in diameter. These benign lesions are most frequently located in the oral mucosa and the genital skin. Especially in the male genital region they can cause itching, discomfort during sexual activities and are aesthetically unpleasant. So far, a variety of therapeutic procedures have been reported with varying success and recurrence rates. In the present retrospective study ( n = 23 patients between 2003 and 2011), we present our surgical approach by means of the micro-punch technique. Using this effective method, we achieved very satisfactory functional and cosmetic results. There were no signs of recurrence during postoperative observations from 12 up to 84 months (median = 51.3 months).

International journal of surgery case reports 4(1), 23-25 (2013). doi:10.1016/j.ijscr.2012.09.008, Published by Elsevier B.V., [Amsterdam]

Cornstarch is a white, taste- and odorless powder widely used for food processing, papermaking, production of industrial adhesives, and is also a component of many cosmetic products. We herein report a case of severe cornstarch inhalation in a 49-year-old male who was exposed to high amounts of cornstarch powder while unloading a cornstarch transporter system. To our knowledge this is the first report on a high-pressure cornstarch inhalation during occupational activities. This report demonstrates the initial clinical situation, the patient's symptoms, and the severe clinical course. Finally the problems during the management of this rare but life-threatening accident are discussed.

The reconstruction of zygoma is a challenge with regard to aesthetic and reconstructive demands.Pre-operative CT data were imported into specific surgical planning software. The mirror-imaging technique was used. A surgical guide transferred the virtual surgery plan to the operation site, whereby it fitted uniquely to the iliac donor site. A postoperative CT scan was obtained for comparing the actual postoperative graft position and shape with the pre-operative virtual simulation.A mean difference of 0.71 mm (SD ± 1.42) for the shape analysis and 3.53 mm (SD ± 3.14) for the graft position was determined. The calculation of the closest point distance showed a surface deviation of 2 mm for the shape analysis with 83.6% of values and for the graft position with 35.7% of values.Virtual surgical planning is a suitable method for zygoma reconstruction with vascularized iliac crest bone graft, with good accuracy for restoring the three-dimensional anatomy.

European journal of medical research 22(1), 10 (2017). doi:10.1186/s40001-017-0251-3, Published by BioMed Central, London