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There has been ongoing development in the field of 3-dimensional (3-D) Surface Imaging by laser scanner and digital 3-D photography (Photogrammetry) in recent years. Manufacturers tend to make new 3-D cameras compact, light-weighted, mobile, and user-friendly, similar to the development on the smartphone market. Although 3D scans have been used for patient consultations and digital documentation in Plastic Surgery since the 1980, there has been no significant development lately regarding its use for objective assistance during surgery.Our research team presents a new intraoperative 3-D scanning method for plastic-surgical procedures with selected mobile 3-D scanner systems. In the future, these might assist surgeons with the pre-, post-, and intraoperative 3-D analysis, choice of therapy, consultation, and documentation.The 3-D scanners were successfully validated for their intraoperative application to several patients. With their introduction, an intraoperative, objective measurement of volume to evaluate form and symmetry was possible.In this work, we share our first experience with the intraoperative use of new mobile 3D camera systems, discuss pros and cons, and show selected patient examples.

Recent studies underscored the clinical potential of adipose-derived multipotent stem-/precursor cells (ASPCs). One of the main hurdles en route to clinical application was to isolate cells without having to perform expansion cultures outside the OR. A new generation of clinically approved, commercially available cell separation systems claims to provide ASPCs ready for application without further expansion cultures. However, it is unclear if the new systems yield sufficient cells of adequate quality for the use in autologous murine models. The aim of this study was to isolate and characterize adipose-derived precursor cells taken from the inguinal fat pat of wistar rats using InGeneron's clinically approved ARC™-cell separation system.We isolated cells from the inguinal fat pad of 3 male Wistar rats according to the manufacturer's protocol. In order to reduce the influence of the atmospheric oxygen on the multipotent precursor cells, one half of the cell suspension was cultivated under hypoxia (2% O2) simulating physiological conditions for ASPCs. As a control, the other half of the cells were cultivated under normoxia (21% O2). Cell surface markers CD90, CD29, CD45 and CD11b/c were analyzed by FACS, and osteogenic and adipogenic differentiation of the ASPCs was performed. Finally, cellular growth characteristics were assessed by evaluation of the cumulative population doublings and CFU assay, and metabolic activity was evaluated by WST-1 assay.Processing time was 90 (± 12) min. 1 g of adipose tissue yielded approximately 60 000 plastic adhering cells. Both groups showed a high expression of the mesenchymal stem cell markers CD90 and CD29 while they were negative for the leucocyte markers CD45 and CD11b/c. A strong osteogenic differentiation and a sufficient adipogenic differentiation potential was proven for all ASPCs. Under hypoxia, ASPCs showed increased proliferation characteristics and CFU efficiency as well as a significantly increased metabolic activity.This study showed that sufficient multipotent ASPCs of appropriate quality can be isolated from the inguinal fat pad of Wistar rats using the ARC™-cell separation system. As shown in previous studies, cultivation of cells under hypoxic conditions increased their stemness. Our findings will enable future studies that focus on autologous transplantation of ASPCs in a rat model, which most closely resembles a possible clinical application.

Neben der Abschatzung der Prothesengrosen stellt die adaquate Positionierung des Prothesenschafts eine Hauptaufgabe der praoperativen Hufttotalendoprothesen(HTEP)-Implantationsplanung dar. Studienziel war es daher, eine digitale Messmethode zum Vergleich zwischen geplanter und erreichter Schaftposition zu etablieren. Die geplante und die tatsachlich erreichte Schaftposition von 60 Huftgelenkprothesen wurden durch ein zur Migrationsmessung von Schaften entwickeltes Programm (EBRA-FCA) ermittelt. Die Analyse wurde mit 2 herkommlichen Messmethoden verglichen. An 25 Fallen wurde zusatzlich die intra- und interindividuelle Messabweichung bestimmt. Die modifizierte EBRA-FCA-Messung korrelierte am besten mit der Distanzmessung zwischen Trochanter major und Rotationszentrum (r=0,95). Die intra- und interindividuelle Messabweichung der digitalen Messung waren fur Schaftposition und -achse deutlich geringer als mit den herkommlichen Methoden. Insgesamt zeigten zementfreie Schafte eine um 0,65 mm leicht proximalere Position im Vergleich zu zementierten Schaften. Die modifizierte EBRA-FCA-Messung ermoglicht einen reproduzierbaren und schnellen Vergleich von geplanter und erreichter Schaftposition. Dadurch wird eine objektive Erfolgskontrolle des Operationsergebnisses bzgl. der Schaftposition realisiert.

OBJECTIVE Gestational diabetes mellitus (GDM) may cause obesity in the offspring. The objective was to assess the effect of treatment for mild GDM on the BMI of 4- to 5-year-old children. RESEARCH DESIGN AND METHODS Participants were 199 mothers who participated in a randomized controlled trial of the treatment of mild GDM during pregnancy and their children. Trained nurses measured the height and weight of the children at preschool visits in a state-wide surveillance program in the state of South Australia. The main outcome measure was age- and sex-specific BMI Z score based on standards of the International Obesity Task Force. RESULTS At birth, prevalence of macrosomia (birth weight ≥4,000 g) was 5.3% among the 94 children whose mothers were in the intervention group, and 21.9% among the 105 children in the routine care control group. At 4- to 5-years-old, mean (SD) BMI Z score was 0.49 (1.20) in intervention children and 0.41 (1.40) among controls. The difference between treatment groups was 0.08 (95% CI −0.29 to 0.44), an estimate minimally changed by adjustment for maternal race, parity, age, and socio-economic index (0.08 [−0.29 to 0.45]). Evaluating BMI ≥85th percentile rather than continuous BMI Z score gave similarly null results. CONCLUSIONS Although treatment of GDM substantially reduced macrosomia at birth, it did not result in a change in BMI at age 4- to 5-years-old.

After the first year of life, injury is the leading cause of mortality in children and adolescents in Australia and a major cause of morbidity and hospitalization. Studies from Europe and North American and more recently New Zealand have demonstrated that injury rates differ between different socio-economic groups, with a relatively consistent pattern of higher rates being found in lower socio-economic groups. To date, the pattern of child injury morbidity by socio-economic group has not been studied in Australia. Eighteen months of data from Brisbane and Melbourne collections of the National Injury Surveillance Unit data base were analysed and linked to census data from each postcode in the collecting area to calculate injury rates. Injury rates for each postcode were correlated with measures of disadvantage derived from the same census data. There was a consistent pattern of moderately strong statistically significant associations (Pearson correlation coefficients generally 0.30-0.60) found between measures of disadvantage and injury rate at the postcode level of aggregation. This association was present across cities, age groups, type of injury and for those hospitalized as well as those treated as outpatients. It is apparent that residence in a low income area is a significant predictor of child injury in Australia.

This study surveyed 313 parents to investigate how frequently parents used a parent-held child health record, and whether they saw the record as useful. Since 1981, The Child, Adolescent and Family Health Service has distributed a Personal Health Record (PHR) to the parents of all children in South Australia. The PHR has provided each family with an ongoing record that has been consistently used for immunization, child health checks and child health screening. However, little is known about how parents view the PHR, its usefulness, and how frequently the record is used. Previous studies, generally conducted prior to, or shortly after, a parent-held child health record was introduced, have shown a poor understanding of the uses of the PHR on the part of parents and a low level of use by health professionals such as general practitioners. In contrast, the results of this study show high levels of understanding of the health record on the part of parents, and an increase in the use of the health record by general practitioners over the 10 years since the record was introduced. Although moderated by the age of the child, the sections of the PHR seen as most useful (and the most frequently used) by parents were immunization, growth charts, progress notes and health checks.

Evaluation of the depositional environments of Upper Cretaceous strata in the Balambo-Garau sub-basin of the Zagros Foldbelt in western Iran into eastern Iraq provides insight into the distribution of reservoir and seal units, as well as potential trapping configurations. Such mapping within the upper sequences of the Cretaceous suggests a larger impact of Proto-Zagros flexure and localized re-activation of deeper seated structural trends in Iraq and Iran. Environment of deposition and unit thicknesses have been mapped and evaluated across western Iran into eastern Iraq using well logs and biostratigraphic data. From the middle Turonian to Santonian, outer-shelf argillaceous limestones overlie proximal to middle- shelf limestones. The deepening of the sub-basin, part of a broader trend of platform carbonates and associated deeper shelf and basinal facies, is concurrent with eustatic sea-level rise, but may also be affected by large-scale Cenomanian-Turonian adjustment. Environmental belts narrow and deposits lap onto highs exposed by localized uplifts as a result of the reactivation of deep-seated structural trends originating in the Permian (or possibly basement?). Outer- to middle-neritic sediments of the Ilam Formation, which onlap local structural highs, are higher quality reservoir facies of Coniacian–Santonian age and, where sealed, may be potential traps. Deposits of the latest Campanian to Maastrichtian also show deepening of lower-shelf and basinal environments within the study area. Non-deposition and onlap of deeper water carbonate wackestone to marls onto highs in the Dezful embayment may further reflect the localized reactivation of deeper seated structural trends. Siliciclastic sediments of the Tanjero Formation shed from highs to the northeast are associated with paleogeographic reversal of the Proto-Zagros, depositing turbidites within the proximal thrust-front basin. Despite time-equivalent prolific oil-producing reservoir intervals in Iraq, ongoing deepening due to the Proto-Zagros Foreland Thrust results in largely non-reservoir marl facies of the Gurpi Formation acting as a seal to the underlying units. The Tarbur Formation, present in the Fars region, consisting of shallow-water rudist grainstone and packstone suggests a lack of accommodation created in association with the Proto-Zagros subsidence event. Tectonostratigraphic trends of the Upper Cretaceous of the Zagros region of western Iran and eastern Iraq show the transition of a relatively quiescent ramp increasingly affected by localized effects of the Cenomanian-Turonian adjustment along with the Maastrichtian inception of Proto-Zagros thrusting and elucidates their impact on reservoir, seal and potential trap distribution within proven and unproven hydrocarbon systems in Iraq and Iran.

Therapy of scapholunate advanced collapse (SLAC) wrist should be guided by the degree of arthritic changes within the radioscaphoid and midcarpal joints (stage 1-3 after Watson). Diagnostic investigations usually include X-ray imaging and wrist arthoscopy. In the present study, the interrater reliability of SLAC wrist stage classification by means of X-ray image analysis was evaluated between radiologists and hand surgeons. Ultimately, the influence of diagnostic wrist arthroscopy on the final stage classification was determined.Retrospectively, 38 SLAC wrists of 37 patients were included in this study. Conventional X-ray images in a dorso-palmar and lateral view were performed before diagnostic wrist arthroscopy. The degree of carpal collapse on X-rays was determined by 2 radiologists and 2 surgeons (1 board certified hand surgeon, 1 plastic surgeon, both experienced in hand surgery since years). After 14 days the stages were re-evaluated by the surgeons with the digital images from the wrist arthroscopies at hand.While the interrater reliability turned out to be 'weak' amidst the radiologists, it was classified as 'light' among the surgeons. We found a 'weak' and a 'light' interrater reliability between the surgeons and the radiologists. Radiologists tended to assess the degree of severity higher than surgeons. The additional knowledge of the digital arthroscopy images led to a different classification in 55%. When X-rays were assessed in combination with the arthroscopy findings, both stage 1 and stage 3 were diagnosed less frequently.Our study suggests that interpreting X-ray films alone is an unreliable method to assess the stage of SLAC wrist. We believe that additional diagnostic measures such as wrist arthroscopy are needed to accurately diagnose the SLAC wrist stage.

Background/Goal: An arthroscopically assisted management of intra-articular distal radius fractures may improve the quality of reduction. Furthermore, concomitant ligament and triangular fibrocartilage complex injuries can be identified and treated. However, this approach increases the duration of surgery. If severe soft tissue lesions, such as SL-ligament disruptions are treated simultaneously, a longer post-operative immobilisation will be required. The aim of this study was to measure the clinical outcome one year after arthroscopically assisted treatment of intra-articular distal radius fractures.In a retrospective study from 2011 to 2013 we identified 27 patients with intra-articular distal radius fractures who were treated with volar fixed angle plates in an arthroscopically assisted fashion. The amount of associated injuries, the duration of surgery and the time of immobilisation were documented. One year postoperatively we evaluated 23 of these patients using several scores. Patient satisfaction, range of motion, visual analogue scale and grip strength were assessed using a standardised questionnaire.The mean surgery time was 111 min (60-190 min). On average, we found 1.4 (0-3) associated injuries per patient. Seventy percent (19) of all patients had a triangular fibrocartilage complex lesion, 67% (16) had some degree of scapholunate ligament lesion. The mean number of interventions in addition to the plate fixation was 1.1 per patient (0-3). Among these were debridements of the triangular fibrocartilage complex in 11 cases (41%) and scapholunate ligament repairs in 4 cases (15%). The mean immobilisation time was 22 (0-42) days. At one year after surgery, the mean Mayo wrist score was 79 (65-95) and the DASH score was 12 (0-49).The arthroscopically assisted management of intra-articular distal radius fractures helps to identify and treat associated injuries. However, it results in extended surgery and immobilisation time, especially if concomitant intra-articular lesions are treated. In our group of patients, the clinical outcome after one year was nonetheless very good.

A major factor contributing to cardiovascular mortality in type 2 diabetes is dyslipidemia, characterized by low HDL cholesterol and high triglycerides, rather than elevated LDL cholesterol. Lipoprotein lipase (LPL) is the rate-limiting enzyme of triglyceride removal from plasma and has been implicated in atherosclerosis. Since treatment with statins significantly reduces cardiovascular morbidity in diabetes, we analyzed the lipid profile and LPL activities in 61 patients with type 2 diabetes before and 8 weeks after initiation of atorvastatin (40 mg) or placebo treatment. Lipid parameters and LPL activity were unchanged under treatment with placebo. Atorvastatin treatment resulted in a 30% reduction of total and a 45% reduction of LDL cholesterol (6.06 +/- 1.39 mmol/L versus 4.14 +/- 1.27 mmol/L and 4.11 +/- 1.13 mmol/L versus 2.27 +/- 0.89 mmol/L, both P < 0.0001). Triglycerides and VLDL cholesterol were also significantly reduced by statin therapy (2.24 +/- 2.11 mmol/L versus 1.82 +/- 1.46 mmol/L and 1.08 +/- 1.56 mmol/L versus 0.67 +/- 0.66 mmol/L, both P < 0.05). HDL cholesterol was not different between the atorvastatin and the placebo group. Compared to baseline, LPL activity was increased by 25% after atorvastatin treatment (213.0 +/- 28.1 nmol/mL/min versus 171.9 +/- 17.7 nmol/mL/min, P < 0.01). Our data demonstrate that atorvastatin induces a significant improvement of diabetic dyslipidemia and a significant increase of LPL activity. Since low LPL activity indicates an increased cardiovascular risk, the statin-mediated increase in LPL activity may help to explain the reduction of CAD in diabetic patients treated with statins.

A new approach of using photographs from smartphones for three-dimensional (3D) imaging was introduced besides the standard high quality 3D camera systems. In this work, we investigated different capture preferences and compared the accuracy of this 3D reconstruction method with manual tape measurement and an established commercial 3D camera system.The facial region of one plastic mannequin head was labelled with 21 landmarks. A 3D reference model was captured with the Vectra 3D Imaging System®. In addition, 3D imaging was executed with the Autodesk 123d Catch® application using 16, 12, 9, 6 and 3 pictures from Apple® iPhone 4 s® and iPad® 3rd generation. The accuracy of 3D reconstruction was measured in 2 steps. First, 42 distance measurements from manual tape measurement and the 2 digital systems were compared. Second, the surface-to-surface deviation of different aesthetic units from the Vectra® reference model to Catch® generated models was analysed. For each 3D system the capturing and processing time was measured.The measurement showed no significant (p0.05) difference between manual tape measurement and both digital distances from the Catch® application and Vectra®. Surface-to-surface deviation to the Vectra® reference model showed sufficient results for the 3D reconstruction of Catch® with 16, 12 and 9 picture sets. Use of 6 and 3 pictures resulted in large deviations. Lateral aesthetic units showed higher deviations than central units. Catch® needed 5 times longer to capture and compute 3D models (average 10 min vs. 2 min).The Autodesk 123d Catch® computed models suggests good accuracy of the 3D reconstruction for a standard mannequin model, in comparison to manual tape measurement and the surface-to-surface analysis with a 3D reference model. However, the prolonged capture time with multiple pictures is prone to errors. Further studies are needed to investigate its application and quality in capturing volunteer models. Soon mobile applications may offer an alternative for plastic surgeons to today's cost intensive, stationary 3D camera systems.

A South Australian preschool study carried out in 1993 showed that the prevalence of respiratory symptoms was significantly associated with use of unflued gas appliances for cooking and heating. The authors sought to determine an association between domestic exposure to nitrogen dioxide and the excretion of total urinary nitrate and nitrite, and their association with asthma prevalence. The results indicated that the geometric mean concentrations of nitrogen dioxide were much higher in homes that had natural gas appliance(s) and other types of appliances (i.e., electric and solid fuel). Higher levels of nitrogen dioxide were found in homes of suburban areas with higher prevalence of asthma and respiratory symptoms. Nitrogen dioxide levels were lower in the summer, and there was a higher level in kitchens than in bedrooms. Urinary nitrate excretion was evaluated in 1,335 preschool children from the same sampling areas. No association existed between nitrogen dioxide levels and urinary nitrates, nor was there a relationship between urinary nitrates and asthma prevalence. These findings confirm that there is a positive association between nitrogen dioxide exposure from gas appliances and the prevalence of respiratory symptoms, but urinary nitrate is not a useful biomarker of exposure at these levels.

The Lhasa and Qiangtang terranes of Tibet collided following Late Jurassic– Early Cretaceous consumption of oceanic lithosphere along the intervening Bangong suture zone. This continental collision led to the development of the south-directed, northern Lhasa thrust belt that is exposed ~1200 km along strike in central Tibet. We conducted geologic mapping and stratigraphic and geothermochronologic studies in the Duba region of the northern Lhasa terrane, located ~250 km northwest of the city of Lhasa. In the Duba region, granites were emplaced into the mid-crust between 139 and 121 Ma and subsequently exhumed and juxtaposed against Cretaceous strata between 105 and 90 Ma in the footwall of an interpreted passive roof thrust system. We suggest that this structural style dominates the Cretaceous–early Cenozoic evolution of the northern Lhasa thrust belt and provides an explanation for the scarcity of basement rock exposures in the Lhasa terrane despite >50% upper crustal shortening. Furthermore, we highlight similarities between the collision-related northern Lhasa and Tethyan Himalayan thrust belts, both of which are bound by sutures and associated with underthrusting of lower plate lithosphere.

Severe hand traumata have a significant impact on our health system and on insurance companies, respectively. It is estimated that 33% of all occupational injuries and 9% of all invalidity pensions are due to severe hand trauma. Unfortunately, these high numbers are not only due to the severity of the trauma but to organisational deficiencies. Usually, the patient is treated at the general surgical emergency in the first place and only then forwarded to a microsurgeon. This redirection increases the time that is required for the patient to finally arrive at an expert for hand surgery. On the one hand, this problem can be explained by the population's lack of awareness for distinguished experts for hand and microsurgery, on the other hand, the emergency network, or emergency doctors in particular are not well informed about where to take a patient with a severe hand trauma - clearly a problem of communication between the hospitals and the ambulance. It is possible to tackle this problem, but put participating hand trauma centres have to work hand in hand as a network and thus exploit synergy effects. The French system "FESUM" is a good example for such a network and even comprises centres in Belgium and Switzerland. To improve the treatment of severe hand trauma, a similar alliance was initiated in Germany just recently. The pilot project "Hand Trauma Alliance" (www.handverletzung.com) was started in April 2013 and currently comprises two hospitals within the region of upper Bavaria. The network provides hand trauma replantation service on a 24/7 basis and aims at shortening the way from the accident site to the fully qualified hand surgeon, to improve the therapy of severe hand injuries and to optimise acute patient care in general. In order to further increase the alliance's impact it is intended to extend the project's scope from regional to national coverage - nevertheless, such an endeavour can only be done in collaboration with the German Society for Hand Surgery (DGH). This article comprises 2 parts. First, the state-of-the-art of acute severe hand trauma care is summarised and explained. Subsequently, the above-mentioned pilot project is described in every detail, including positive effects but also barriers that still have to be overcome.

The purpose of this retrospective study was to monitor hypertrophy of future liver remnant following portal vein embolization (PVE) before planned extended right hepatectomy. However, because individual responses to PVE are highly variable, our focus was to identify cofactors of successful hypertrophy.28 patients with primary or secondary liver tumours, mean age 64.1 ± 12.9 years, underwent PVE. Volumetric analysis of hypertrophy before and after PVE (median 39.0 ± 15.7 days) was performed. The embolized liver segments were investigated for occurrence of reperfusion of their portal branches. Blood parameters before PVE were additionally investigated.Patients were divided into responders (21/28) and non-responders (7/28) by post-PVE standardized future liver remnant being above or below 25%, respectively. No significant differences between the groups were found regarding biometric and volumetric parameters before PVE. In the entire group after PVE, the mean absolute increase of Segments 2 and 3 was 196.0 ± 84.7 cmCofactors associated with a favourable outcome regarding hypertrophy were the absence of collaterals in the control CT scans and high plasma total protein. Advances in knowledge: Portoportal collaterals negatively influence hypertrophy after PVE. On the other hand, plasma total protein is a positive prognostic indicator on hypertrophy of the liver in our cohort.

Objectives: This study investigated the relationship between indoor air quality and the prevalence of respiratory symptoms in South Australian preschool children. Methodology: Data were collected from 14124 families with a child aged 4 years 3 months to 5 years of age. This sample represents 73% of the targeted State preschool population. At the time of a routine preschool health check, parents completed a questionnaire regarding: their child's respiratory health and place of residence (postcode), parental smoking, type of fuel used for cooking and heating and method used for home cooling. Results: For preschool children residing in the greater Adelaide region, logistic regression analyses found that having a natural gas stove compared to an electric stove was significantly associated with increased prevalence rates for: (i) asthma (odds ratio [OR] 1.24); (ii) wheezing in the preceding 12 months (OR 1.16); excessive colds (OR 1.14); and hay fever (OR 1.13). The use of a liquid petroleum gas stove compared to an electric stove was not associated with any respiratory symptoms- The use of a flueless gas heater compared to other forms of heating was significantly associated with increased prevalence rates for dry cough (OR 1.26), ever having wheezed (OR 1.15) and wheezing in the preceding 12 months (OR 1.18). The use of a wood fire/heater compared to other forms of heating was significantly associated with a reduced prevalence rate for dry cough (OR 0.84) and ever having wheezed (OR 0.82). Parental smoking was significantly associated with increased prevalence rates for bronchitis (OR 1.21) and ever having wheezed (OR 1.24). The form of home cooling used was not associated with prevalence rates, after accounting for geographic location. Socio-economic status (postcode level) was not generally associated with prevalence rates. Conclusions: These results suggest that respiratory symptom prevalence is related to the fuel used for cooking and heating and parental smoking. Prospective investigation regarding indoor air quality and respiratory symptoms is required.

A reproducible 3-dimensional photographic system enables plastic surgeons to perform preoperative planning and helps them to understand the patient's expectations. There are a few systems available that allow a reproducible 3-dimensional scans of the patient with direct simulation of the planned procedure. The Vectra Volumetric 3D Surface Imaging® by Canfield® provides such an option and helps the surgeons to document and compare postoperative changes at different time points. Since January 2011 we are digitally documenting all patients receiving form-modulating procedures in our plastic surgery unit. We present the spectrum of clinical implications and discuss advantages and disadvantages of the system. Furthermore, we have studied the accuracy of the system in comparison to direct measurement in 15 volunteers. The system is especially suited for planning and evaluation of breast augmentation, facial aesthetic and reconstructive surgery as well as volumetric measurements before and after liposuction and lipofilling. Computer-assisted measurements correlate with a median deviation of 2.3% with manually measured distances in the face. We found the user-friendly Vectra® system to be a reliable and reproducible device for planning plastic surgery therapies and for documenting postoperative results.

One of the main goals of the preoperative planning of hip prostheses is adequate shaft positioning with reconstruction of leg length and offset. The purpose of this study was to compare the planned and achieved shaft positions using a modified program for migration measurement.In 60 cases of total hip replacement the preoperative planning was compared with the postoperative radiograph using a modified version of the well-established EBRA-FCA program. The results of this new measurement were compared to conventional measurements. In 25 cases the intraobserver and interobserver reliability was determined.The novel measurements correlated best with the measured distance between the greater trochanter and the center of rotation and yielded the best intraobserver and interobserver reliability. In general, cementless stems had a slightly more proximal position (0.65 mm) compared to cemented stems.The modified program for migration measurement facilitates a reproducible and fast comparison of the planned and achieved shaft positions thus implementing an early and objective control of postoperative shaft position.

Objective: Obesity rates have increased in children in Australia in the past 15 years. However, there is little available population data describing rates of overweight and obesity in Aboriginal children. Methods: Anthropometric data of four-year-old children (n=11,859) were collected by trained nurses at routine statewide preschool health checks during 2009. Weight status (underweight, healthy weight, overweight and obese) was determined using age and gender specific International Obesity Task Force (IOTF) cut-points. Results: There were 337 Aboriginal children (3%) in the study population. Aboriginal children had significantly higher rates of overweight and obesity compared to non-Aboriginal children (28% compared to 18% respectively, χ2p=0.0001). A statistically significant association between BMIz score and identifying as Aboriginal remained after controlling for rural/urban residence and socioeconomic status using multiple regression analyses. Conclusions: Aboriginal children have higher rates of overweight and obesity compared to their non-Aboriginal peers by the time they are four years of age. Aboriginal children have higher BMIz scores compared to non-Aboriginal children after controlling for rural/urban residence and socioeconomic status. Implications: A significant investment is required to optimise the health of Aboriginal women before pregnancy and throughout pregnancy. A rethink may be necessary in the approach to dietary management and catch-up growth of Aboriginal children of low birth weight or having growth failure in early childhood.

The knowledge of tissue perfusion has not only a prognostic value in microvascular surgery but also the intraoperative detection of malperfusion can lead to a quick surgical intervention. Indocyanine green (ICG) angiography allows a topographic analysis of perfusion and is used to assess lymphatic drainage pathways and to analyse the depth of burn injuries. Integrating the technique into an operating microscope enables visualisation of the flow over microanastomoses and allows the assessment of the transit time of blood flow between arterial and venous anastomosis. Using this method we analysed 11 microsurgical free flaps (3 latissimus dorsi, 3 rectus abdominis, 1 gracilis muscle, 2 radial forearm, 1 ALT, and 1 DIEP flap). The topographic analysis was performed after the assessment of the microanastomoses. We observed no flap loss or partial flap necrosis. The transit time between arterial inflow and venous outflow was 32.8 s on average. Here we observed distinct differences between muscle flaps (27.7 s) on the one hand and fasciocutaneous and perforator flaps (47.5 s) on the other hand. We detected one venous thrombosis by ICG angiography in a case where the clinical patency test was not distinct. Revision was performed immediately. Particularly for intraoperative assessment, ICG angiography is a useful, reliable and safe technique. The integration into the operating microscope allows an "angiographic patency test" and the analysis of the transit time allows the evaluation of blood flow within the flap. Especially when planning perforator flaps the method of ICG angiography provides a new level of safety in flap design by quickly demonstrating the borders of perfusion.

Despite its potential complications, partial aponeurectomy still is the mainstay of treatment whenever it comes to significant contracture in Dupuytren's disease. With the goal in mind to identify new therapeutic strategies we isolated and characterised cells from healthy palmar aponeurosis (Kon) and compared them to cells isolated from palmar aponeurosis of patients with a primary manifestation of Dupuytren's disease (PrimDup) as well as from patients with recurrent Dupuytren's disease (RezDup). As cells from palmar aponeurosis from patients with Dupuytren's disease share characteristics with stem cells, such as the ability to differentiate into other cell types, we analysed the stemness, morphology and integrin receptor profiles of the cells.A total of 15 Dupuytren samples were collected from regular partial aponeurectomy procedures. From these, 3 donors without extrinsic risk factors were selected per group (RezDup, PrimDup). Cells were isolated and expanded under standard cell culture conditions. Cells from healthy patients served as control (Kon). Growth curves were produced. Cells were subjected to osteogenic and adipogenic differentiation using standard protocols. Semiquantitative PCR analysis of the integrins α2, β3, β5 and fibronectin was performed.PrimDup cells proliferated significantly faster than control cells, which in turn proliferated faster than RezDup cells. Both PrimDup and control cells went into senescence after approximately 40 days whereas RezDup cells proliferated over the entire period of 100 days. Osteogenic and adipogenic differentiation was best in cells derived from Dupuytren patients while Kon cells differentiated poorly. PCR analysis revealed that fibronectin-binding integrins β3 and β5 are upregulated in Dupuytren's disease.PrimDup cells grow faster than the other cell types suggesting that their growth regulation may be altered. The fact that RezDup cells do not reach senescence over 100 days in culture indicates that senescence regulating factors may be altered. As cells from Dupuytren patients differentiate better along the osteogenic and adipogenic lineages, they probably possess a higher level of stemness. Their modified integrin profile may be a key to future therapies.

This research examines value differences in three samples: expatriate Iranian Baha'is (35 males, 30 females) resident in Australia, 59 Australian Baha'is (22 males, 37 females), and 66 unselected Australians (35 males, 31 females). Subjects rated a set of 30 terminal values and 26 instrumental values for importance, using the Schwartz Value Survey. Values were classified into domains in terms of the Schwartz and Bilsky (1987) analysis of their universal content and structure. The results showed that the two Baha'i groups rated values concerned with restrictive conformity, tradition, and spirituality as relatively more important and values concerned with hedonism, self-direction, and stimulation as relatively less important, when compared with the unselected Australian sample. Other group differences in value priorities were also obtained when groups were compared two at a time. Men assigned more relative importance than women to values from the hedonism, achievement, power, and stimulation domains. Women rated values from the benevolence and spirituality domains as relatively more important.

Ninety-nine high school students indicated their preference for each of eight problem-solving tasks on the understanding that they would subsequently work at their most preferred task Subjects also completed questionnaires that provided measures of the achievement striving and impatience-irritability components of Type A behaviour. Results showed that achievement striving was positively related to preference for problem-solving tasks that involved effort and working rapidly and to preferred level of task difficulty, but negatively related to preference for problem-solving tasks involving little effort and a slow pace of work. Impatience-irritability was negatively related to preference for problem-solving tasks involving both effort and working slowly. The results support the view that individuals prefer situations that are consistent with their personality characteristics. The results also underline the importance of studying the separate components of Type A behaviour and they have implications for health outcomes.

We present the case of a 60-year-old man who presented with a left hypochondrial swelling first noticed 4 weeks prior to admission to our clinic. Based on the findings of the ultrasound and magnetic resonance imaging investigation, a tumour of uncertain origin of the abdominal wall was suspected, also involving the small bowel. The swelling, including the affected lateral and transverse oblique muscles as well as the subcutaneous tissue and the adjacent omentum majus, was completely excised. The resulting myoaponeurotic defect of the left lateral abdominal wall was closed with interrupted Vicryl sutures and stabilised with a PTFE prosthesis (20 × 10 cm) that was placed intraabdominally and secured by spiral tackers and interrupted transfascial monofilament Prolene sutures. Microscopic examination of the excised specimen revealed an actinomycosis of the anterior abdominal wall, which is extremely rare. The surgical treatment was followed by antibiotic therapy for 6 months. This treatment resulted in full recovery with no further complications.

OBJECTIVE To investigate CO-alkene polymers, novel synthetic nonbiodegradable polymers, as a potential biomaterial for urological applications. MATERIALS AND METHODS Porcine urothelial cells were seeded on cover glasses (96 wells; 10 000 cells/well) coated with CO-alkene polymers [propylene/N-Acetyl-O′-(hex-5-enyl)-l-tyrosine ethyl ester/CO (PTCO) and hexene-CO (HxCO)]. The following conditions were investigated: cells seeded; (i) on PTCO, (ii) on HxCO, (iii) in PTCO-conditioned medium, (iv) in HxCO-conditioned medium, (v) on glass without polymers, (vi) on polystyrene, and (vii) on polystyrene treated with 1.25% NaCl (toxic control). Cell counts, cell death detection assay, and a cell activity assay (XTT, a tetrazolium-based colorimetric assay) were performed after 3, 6 and 9 days. Urothelial-cell seeded-PTCO films (0.5 × 106 cells/cm2) were implanted into the subcutaneous space of athymic mice for up to 12 weeks and unseeded PTCO polymers were implanted as a negative control. RESULTS The urothelial cell adherence rates on the polymers were similar to those for glass and polystyrene. The cell activity (XTT assay) was higher in cells seeded on the polymers than in cells seeded on polystyrene and glass after 3 and 6 days. There were no significant differences between the apoptosis rates of all groups at the given sample times, except for the high levels in the toxic control. In vivo the urothelial cells survived on the polymers for 12 weeks with no adverse reactions in any of the mice. CONCLUSIONS CO-alkene polymers are biocompatible materials for urothelial cells in vitro and in vivo, and thus are potential biomaterials for the urogenital tract.

Objective: To evaluate the validity of a parental questionnaire used to screen preschool children for persistent hearing impairment. Methodology: Six-hundred and eighty-five children aged 4–5 years from a Metropolitan area of Adelaide, Australia, were enrolled. Each parent completed a questionnaire aimed at detecting parental concerns about hearing impairment. Screening audiometry was then performed. Children who failed the initial audiometry screening underwent repeat audiometry screening 6–8 weeks later. The audiometry and questionnaire data were then compared. Results: Of the 657 children who successfully completed initial audiometry, 544 (83%) passed and 113 (17%) failed. Of the 84 children who had follow-up audiometry, 64 (76%) passed. Parental concerns were identified on questionnaire in 50% of all children. Neither individual questions nor the number of concerns were found to relate to audiometry results. Compared with audiometry results, the hearing screening questionnaire had a sensitivity of 56% and specificity of 52%. Conclusions: The hearing questionnaire used in this study and in several Australian states is an ineffective screening test for detecting persistent hearing loss.

Objectives: This study was designed to ascertain the prevalence of respiratory symptoms in South Australian preschool children and to investigate the relationship between prevalence rates and geographic location. Methodology: Data were collected from 14124 families with a child aged 4 years 3 months to 5 years of age. This sample represents 73% of the State preschool population of that age. At the time of a routine preschool health check, parents completed a questionnaire regarding their child's respiratory health and place of residence (postcode). Results: Results showed that the prevalence rates were as follows: (i) ever having chest wheezing 38.6%; (ii) chest wheezing within the preceding 12 months 25.2%; (iii) ever having asthma 22.5%; (iv) ever having a dry cough at night 33.7%; (v) ever having bronchitis or cough with sputum 55.3%; (vi) ever having hay fever 29.7%; (vii) prone to excessive head colds 32.6%; and (viii) ever having eczema 18.8%. Over 38% of parents claimed that winter was the season for the most frequent or severe attacks of wheezing and 31.7% claimed no seasonal difference. Winter was the season most associated with episodes of bronchitis (50.9%), with no seasonal difference in episodes for 29.8% of children. Prevalence rates differed by geographic location within South Australia and within the Adelaide metropolitan region. Conclusion: This population-based survey shows that over 22% of South Australian 4 to 5 year old preschool children have had (or continue to have) asthma. The study also documented the geographic distribution of respiratory symptom prevalence within South Australia.

Eighty subjects from an introductory psychology course rated the desirability of eight course structures that differed according to all combinations of the presence or absence of effort required for success, time pressure, and the provision of feedback. Subjects also completed questionnaire measures of the Type A behavior pattern, test anxiety, and external locus of control. Results showed that the Type A behavior pattern was negatively related to external locus of control and that externals tended to have higher test anxiety scores than internals. Multiple regression analyses that involved the personality variables and age and gender showed that the Type A variable predicted preference for course structures that involved effort and feedback and that external control predicted preference for course structures that were independent of effort and provided little feedback. Test anxiety and desirability ratings were positively correlated for the course structure that was not dependent on effort, had little time pressure, and had little feedback. The results were consistent with the view that individuals seek out and prefer situations that are consistent with their personality characteristics.