Belastbarkeit und Verformung instabiler pertrochanterer Osteotomien nach 145°-Winkelplattenosteosynthese und Endernagelung

In 24 femora an unstable intertrochanteric osteotomy was performed. In twelve an endernail osteosynthesis and in the other twelve a 145°-plate osteosynthesis was performed. Eight femora were tested as control. The loading capacity was 500 N higher in the endernail group. In four cases after 145°-plate osteosynthesis but only in one case after endernailing the osteosynthesis becomes unstable under an alternating load of 2000 N. In femora with pronounced osteoporosis the maximal loading capacity is higher in the endernail osteosynthesis group. The loading capacity increase with the CCD-angle. The deformation after alternating load of 500 N is significant lower in the 145°-plate osteosynthesis group. At higher alternating load the deformation of the 145°-plate osteosynthesis exceeds that of the endernail osteosynthesis.     

Emotion Recognition in Children and Adolescents with Autism Spectrum Disorders

We examined upper facial basic emotion recognition in 57 subjects with autism spectrum disorders (ASD) (M = 13.5 years) and 33 typically developing controls (M = 14.3 years) by using a standardized computer-aided measure (The Frankfurt Test and Training of Facial Affect Recognition, FEFA). The ASD group scored lower than controls on the total scores of FEFA and perceived ambiguous stimuli more often as a negative emotion. The older ASD group (≥12 years) performed better than the younger ASD group (<12 years) on the blended emotions of FEFA. The results support the findings that individuals with ASD have difficulties in emotion recognition. However, older subjects with ASD seem to have better skills than younger subjects with ASD.     

Childhood Bullying Behaviors as a Risk for Suicide Attempts and Completed Suicides: A Population-Based Birth Cohort Study

ObjectiveThere are no previous studies about the association of childhood bullying behavior with later suicide attempts and completed suicides among both sexes. The aim was to study associations between childhood bullying behaviors at age 8 years and suicide attempts and completed suicides up to age 25 years in a large representative population-based birth cohort.MethodThe sample includes 5,302 Finnish children born in 1981. Information about bullying was gathered at age 8 years from self-report, as well as parent and teacher reports. Information about suicide attempts requiring hospital admission and completed suicides was gathered from three different Finnish registries until the study participants were 25 years old. Regression analyses were conducted to determine whether children who experience childhood bullying behaviors are at risk for later suicide attempts and completed suicides after controlling for baseline conduct and depression symptoms.ResultsThe association between bullying behavior at age 8 years and later suicide attempts and completed suicides varies by sex. Among boys, frequent bullying and victimization are associated with later suicide attempts and completed suicides but not after controlling for conduct and depression symptoms; frequent victimization among girls is associated with later suicide attempts and completed suicides, even after controlling for conduct and depression symptoms.ConclusionsWhen examining childhood bullying behavior as a risk factor for later suicide attempts and completed suicides, each sex has a different risk profile.     

Psychometric evaluation of social phobia and anxiety inventory for children (SPAI-C) and social anxiety scale for children-revised (SASC-R)

The study evaluated the psychometric properties of Finnish versions of the Social Phobia and Anxiety Inventory for Children (SPAI-C) and the Social Anxiety Scale for Children-Revised (SASC-R). 352 students (M = 12.2 years) participated in the study and completed the SPAI-C and SASC-R. In addition, 68 participants (M = 12.2 years) and their parents were interviewed with the Schedule for Affective Disorders and Schizophrenia for School Aged Children (K-SADS-PL). The SPAI-C was more sensitive for identifying youth meeting criteria for social phobia (SP), whereas the SASC-R demonstrated greater specificity. The youth in this sample had lower mean total scores on the self-report questionnaires than did those in the original validitation studies of the SPAI-C and SASC-R conducted in America. These findings question whether cross-cultural differences in the expression of SP influence the clinical cut-off scores used in translated versions of social anxiety questionnaires.     

Physical ill health and risk of psychosis

Patients with psychosis have been found to suffer from physical illnesses more commonly than the general population. In this report, self-reported physical ill health and its correlates among subjects with and without vulnerability to psychosis in a sample of first-degree relatives, help-seekers and controls were investigated. Perceived physical health was statistically significantly poorer among subjects with minor symptoms on the Structured Interview for Prodromal Symptoms and those vulnerable to psychosis than among those without symptoms measured by 13 somatoform symptom sum scores of the Symptom Checklist-90. Those at current risk of psychosis had a significantly higher mean sum score on the 13 somatic items (mean=21.1) than others (mean=9.6). Having physical symptoms or a self-reported physician-diagnosed illness was significantly associated with vulnerability to psychosis (odds ratio=3.05). The subjects with a mood disorder (odds ratio=4.33) had significantly more commonly physician-diagnosed illnesses than those who had no diagnosis or any other diagnosis. Physical ill health seems to be common among those vulnerable to psychosis.     

Intraneuronal Aβ immunoreactivity is not a predictor of brain amyloidosis-β or neurofibrillary degeneration

Amyloid β (Aβ) immunoreactivity in neurons was examined in brains of 32 control subjects, 31 people with Down syndrome, and 36 patients with sporadic Alzheimer’s disease to determine if intraneuronal Aβ immunoreactivity is an early manifestation of Alzheimer-type pathology leading to fibrillar plaque formation and/or neurofibrillary degeneration. The appearance of Aβ immunoreactivity in neurons in infants and stable neuron-type specific Aβ immunoreactivity in a majority of brain structures during late childhood, adulthood, and normal aging does not support this hypothesis. The absence or detection of only traces of reaction with antibodies against 4–13 aa and 8–17 aa of Aβ in neurons indicated that intraneuronal Aβ was mainly a product of α- and γ-secretases (Aβ_17–40/42). The presence of N-terminally truncated Aβ_17–40 and Aβ_17–42 in the control brains was confirmed by Western blotting and the identity of Aβ_17–40 was confirmed by mass spectrometry. The prevalence of products of α- and γ -secretases in neurons and β- and γ-secretases in plaques argues against major contribution of Aβ-immunopositive material detected in neuronal soma to amyloid deposit in plaques. The strongest intraneuronal Aβ_17–42 immunoreactivity was observed in structures with low susceptibility to fibrillar Aβ deposition, neurofibrillary degeneration, and neuronal loss compared to areas more vulnerable to Alzheimer-type pathology. These observations indicate that the intraneuronal Aβ immunoreactivity detected in this study is not a predictor of brain amyloidosis or neurofibrillary degeneration. The constant level of Aβ immunoreactivity in structures free from neuronal pathology during essentially the entire life span suggests that intraneuronal amino-terminally truncated Aβ represents a product of normal neuronal metabolism. This study was supported in part by funds from the New York State Office of Mental Retardation and Developmental Disabilities and grants from the National Institutes of Health (The National Institute of Child Health and Human Development R01 HD43960 and PO1 HD35897; and the National Institute of Aging P30 AG08051, AG03051, and PO1 AG11531).     

ADHD and comorbid disorders in relation to family environment and symptom severity

BACKGROUND: To examine the comorbidity of ADHD in association with family environment and the severity of ADHD. METHOD: A screening for ADHD symptoms was conducted among adolescents in the Northern Finland 1986 Birth Cohort (N = 6622). A sample of those adolescents (n = 457), aged 16-18 years, with and without ADHD symptoms was assessed with a diagnostic interview (Kiddie-SADS-PL) and ADHD and comorbid disorders were studied in association with the family characteristics and the number of ADHD symptoms. RESULTS: Adolescents with ADHD had more commonly conduct disorder (P < 0.001), oppositional defiant disorder (P < 0.001), substance abuse (P < 0.001) and mild depression (P < 0.001) than adolescents without ADHD. Adolescents with ADHD and comorbid disorders had more ADHD symptoms (P < 0.001) than those with ADHD alone. Compared to adolescents with ADHD alone those with ADHD and comorbidity lived significantly more commonly in non-intact families, in low-income families, with mothers who were dissatisfied with life and with parents who showed little interest in their adolescents' activities. CONCLUSIONS: Adolescents who develop externalizing disorders comorbid to ADHD seem to suffer from a severe form of ADHD and live in family environments that may not provide sufficient support for optimal development of an adolescent with ADHD.     

Radiographic evaluation of idiopathic clubfeet undergoing Ponseti treatment

BACKGROUND: The Ponseti method for treatment of idiopathic clubfeet involves the use of serial casts, percutaneous Achilles tenotomy in most cases, and bracing with an abduction orthosis to prevent relapse. Although Ponseti recommended evaluation of the infant clubfoot strictly by palpation, many orthopaedic surgeons still rely on radiographs for decision-making during treatment. The aim of this study was to document with radiographs the effect of percutaneous Achilles tenotomy as described by Ponseti. METHODS: We conducted a study of idiopathic clubfeet treated, at two centers, with the Ponseti method, including percutaneous Achilles tenotomy. Cast treatment was started within three weeks after birth, and radiographs were made before and after the tenotomy. Lateral radiographs with the foot in maximal dorsiflexion at the ankle were made for all patients, and anteroposterior radiographs of the foot were made at one center. The lateral tibiocalcaneal angle, the anteroposterior talocalcaneal angle, and the lateral talocalcaneal angle were measured on the radiographs. Foot dorsiflexion at the ankle was evaluated clinically. The results from both centers were evaluated separately and in combination. RESULTS: Lateral dorsiflexion radiographs that showed the foot and ankle were evaluated for eighty-seven clubfeet, and anteroposterior radiographs that showed the foot were evaluated for sixty-five clubfeet. The mean improvement in the lateral tibiocalcaneal angle after the tenotomy was 16.9 degrees . The mean change in the anteroposterior talocalcaneal angle was 2.1 degrees , and the mean change in the lateral talocalcaneal angle change was 1.4 degrees . The mean increase in clinically measured dorsiflexion after the tenotomy (in sixty-five feet) was 15.1 degrees . Only the lateral tibiocalcaneal angle and dorsiflexion as measured clinically changed significantly after the Achilles tenotomy (p < 0.05). When the results at each center were analyzed separately, they were found to be nearly identical. CONCLUSIONS: The increase in the lateral tibiocalcaneal angle after Achilles tenotomy is essentially the same as the increase in ankle dorsiflexion seen on clinical examination. The anteroposterior and lateral talocalcaneal angles are not influenced significantly by the tenotomy. Radiographs confirmed that the additional dorsiflexion obtained from the percutaneous Achilles tenotomy is true dorsiflexion occurring in the ankle and hindfoot and not in the midfoot. LEVEL OF EVIDENCE: Therapeutic Level IV.     

A Novel Organotypic Model Mimics the Tumor Microenvironment

Carcinoma cell invasion is traditionally studied in three-dimensional organotypic models composed of type I collagen and fibroblasts. However, carcinoma cell behavior is affected by the various cell types and the extracellular matrix (ECM) in the tumor microenvironment. In this study, a novel organotypic model based on human uterine leiomyoma tissue was established and characterized to create a more authentic environment for carcinoma cells. Human tongue squamous cell carcinoma cells (HSC-3) were cultured on top of either collagen or myoma. Organotypic sections were examined by immunohistochemistry and in situ hybridization. The maximal invasion depth of HSC-3 cells was markedly increased in myomas compared with collagen. In myomas, various cell types and ECM components were present, and the HSC-3 cells only expressed ECM molecules in the myoma model. Organotypic media were analyzed by radioimmunoassay, zymography, or Western blotting. During carcinoma cell invasion, matrix metalloprotease-9 production and collagen degradation were enhanced particularly in the myoma model. To evaluate the general applicability of the myoma model, several oral carcinoma, breast carcinoma, and melanoma cell lines were cultured on myomas and found to invade in highly distinct patterns. We conclude that myoma tissue mimics the native tumor microenvironment better than previous organotypic models and possibly enhances epithelial-to-mesenchymal transition. Thus, the myoma model provides a promising tool for analyzing the behavior of carcinoma cells.Tumor growth and invasion are not just determined by the malignant tumor cells, but instead various cell types and the extracellular matrix (ECM) of the tumor microenvironment affect the outcome.¹ Particularly, fibroblasts have many prominent roles in the cancer progression. In fact, in many carcinomas, the majority of the stromal cells are fibroblasts that possess myofibroblastic characteristics and are called cancer-associated fibroblasts. They produce ECM molecules, proteases, growth factors, and chemokines that crucially affect the carcinoma cell behavior.^2,3 In this context, the organotypic three-dimensional skin model developed by Fusenig et al⁴ replicates the in vivo situation more closely in vitro than the two-dimensional cell culture experiments. The model allows studying of carcinoma cell invasion in three-dimensional collagen gel embedded with fibroblasts. The degree of invasion can also be quantitatively analyzed.^5,6 However, this kind of organotypic model remains somewhat artificial due to the lack of other cell types besides fibroblasts and ECM components that are present in vivo. In addition to the carcinoma cells and fibroblasts, endothelial and inflammatory cells, as well as several ECM molecules, are known to contribute to the tumor growth. The induction of angiogenesis, recruitment of inflammatory cells, and increased turnover of ECM components result in tumor progression.^7,8 Therefore, we wished to determine whether real human tissue can be used in the organotypic method to provide a more natural stroma-like environment for studying carcinoma cell invasion. We used uterine leiomyoma tissue, which mainly consists of smooth muscle actin (SMA)-positive cells and collagens.⁹ The existence of various additional cell types and proteins in the myoma tissue was characterized, and the invasiveness of malignant human tongue squamous cell carcinoma cells (HSC-3) into this novel myoma organotypic culture was measured by different methods and compared with the traditional collagen organotypic model. To test the general applicability of the myoma model, the invasion patterns of various cell lines were examined in myoma and collagen organotypic cultures.