Joint-preserving surgery improves pain, range of motion, and abductor strength after Legg-Calvé-Perthes disease

Patients after Legg-Calvé-Perthes disease (LCPD) often develop pain, impaired ROM, abductor weakness, and progression of osteoarthritis (OA) in early adulthood. Based on intraoperative observations during surgical hip dislocation, we established an algorithm for more detailed characterization of the underlying pathomorphologies with a proposed joint-preserving surgical treatment.

[Joint preserving surgery of the adult hip: pelvic osteotomies]

Deformity and malposition of the acetabulum can occur during the development of the hip. Developmental hip dysplasia and acetabular retroversion are possible causes of osteoarthritis in the young adult. Surgical management with reorientation of the acetabulum allows causal therapy of the deformity and preservation of the native hip joint. Established techniques are the Bernese periacetabular osteotomy (PAO) and the Tönnis and Kalchschmidt triple osteotomy of the pelvis. Both techniques permit three-dimensional correction of the position of the acetabulum. Advantages and disadvantages of each technique must be considered and are summarized in the present paper. If performed early (osteoarthritis grade Tönnis 0 and 1) with correct indication and proper technique, good results can be expected.

THA performed using conventional and navigated tissue-preserving techniques

Less invasive methods of performing total hip arthroplasty have been considered controversial after increased complication rates and component malpositioning were reported. A new method of performing total hip arthroplasty through an incision in the superior capsule, posterior to the abductors and anterior to the posterior capsule, was developed with the aim of producing a technique that maintained the joint stability of the transgluteal exposure and the rapid abductor recovery of the posterior exposure. We assessed the recovery and complications of this technique performed with surgical navigation. The study group was compared with similar subjects who had conventional total hip arthroplasty, without surgical navigation, using the transgluteal exposure. There were 185 consecutive total hip arthroplasties in the study group and 189 nonconsecutive historical total hip arthroplasties in the control group. The two groups were controlled for complexity and had no differences in body mass index, gender, diagnosis, operative side, bilateral operations, and previous surgeries. Patients were evaluated for clinical recovery and perioperative complications at 9 and 24 weeks. The study group recovered faster at both followup examinations. The study group had fewer perioperative and postoperative complications compared with the control group. Accuracy of component positioning was not compromised compared to the control group. Less invasive surgery with the philosophy of maximally preserving the abductors, posterior capsule, and short rotators may result in a safer operation with faster recovery than traditional techniques.

Preserving middle lobe to improve lung function in non-small-cell lung cancer

When a lung tumor arises in segment 6, the close anatomical relationship to the middle lobe bronchus may make a lower bilobectomy necessary. Sleeve lobectomy may be an alternative. These procedures were compared retrospectively in 36 patients operated on between January 2005 and December 2006 with non-small-cell lung cancer (stage I-IIIB) of the right lower lobe. Sleeve lobectomy was performed in 21 patients and bilobectomy in 15 (41%). Preoperative lung function was comparable in both groups. Radical resection was achieved in 34/36 patients. Operation time was 121 min for sleeve lobectomy and 144 min for bilobectomy. Chest tubes were removed after 5 days in both groups. Postoperative lung function was better after sleeve lobectomy than bilobectomy (forced expiratory volume in 1st sec: 78% vs. 69%). Preservation of the middle lobe by sleeve lobectomy is feasible. There was no evidence that this resection was less radical, and complication rates were similar in both groups.

Testing for Measurement Equivalence in Surveys: Dimensions of Social Trust across Cultural Contexts

Our study evaluates the dimensionality and equivalence of social trust across cultural contexts, using new data from Switzerland and the World Values Survey 2005–2008. Whereas some scholars assert that trust should be regarded as a coherent concept, others claim that trust is better conceived of as a multidimensional concept. In contrast to the conventional dichotomy of the forms of social trust, we identify three distinct forms of trust, namely, particularized, generalized, and identity-based trust. Moreover, we dispute the view that respondents understand the wording of survey questions regarding social trust differently between different cultural contexts, which would imply that comparative research on trust is a pointless endeavor. Applying multiple-group confirmatory factor analysis to the various constructs of social trust, we conclude that one may study relationships among the three forms of trust and other theoretical constructs as well as compare latent means across cultural contexts. Our analyses therefore provide an optimistic outlook for future comparative analyses that investigate forms of social trust across cultural contexts.

Privacy-Preserving Optimal Meeting Location Determination on Mobile Devices

Equipped with state-of-the-art smartphones and mobile devices, today's highly interconnected urban population is increasingly dependent on these gadgets to organize and plan their daily lives. These applications often rely on current (or preferred) locations of individual users or a group of users to provide the desired service, which jeopardizes their privacy; users do not necessarily want to reveal their current (or preferred) locations to the service provider or to other, possibly untrusted, users. In this paper, we propose privacy-preserving algorithms for determining an optimal meeting location for a group of users. We perform a thorough privacy evaluation by formally quantifying privacy-loss of the proposed approaches. In order to study the performance of our algorithms in a real deployment, we implement and test their execution efficiency on Nokia smartphones. By means of a targeted user-study, we attempt to get an insight into the privacy-awareness of users in location-based services and the usability of the proposed solutions.

Extending resection and preserving function: modern concepts of glioma surgery

Recent studies have demonstrated that the improved prognosis derived from resection of gliomas largely depends on the extent and quality of the resection, making maximum but safe resection the ultimate goal. Simultaneously, technical innovations and refined neurosurgical methods have rapidly improved efficacy and safety. Because gliomas derive from intrinsic brain cells, they often cannot be visually distinguished from the surrounding brain tissue during surgery. In order to appreciate the full extent of their solid compartment, various technologies have recently been introduced. However, radical resection of infiltrative glioma puts neurological function at risk, with potential detrimental consequences for patients' survival and quality of life. The allocation of various neurological functions within the brain varies in each patient and may undergo additional changes in the presence of a tumour (brain plasticity), making intra-operative localisation of eloquent areas mandatory for preservation of essential brain functions. Combining methods that visually distinguish tumour tissue and detect tissues responsible for critical functions now enables resection of tumours in brain regions that were previously considered off-limits, and benefits patients by enabling a more radical resection, while simultaneously lowering the risk of neurological deficits. Here we review recent and expected developments in microsurgery for glioma and their respective benefits.