Most patients with degenerative lumbar spinal stenosis benefit from decompressive surgery. Patients with long-standing preoperative symptoms and concomitant diseases often have poor results and are less satisfied with the postoperative outcome.

Zusammenfassung Ziel Prospektive Untersuchung der mittelfristigen Ergebnisse nach autologer Fetttransplantation in arthrotische Sattelgelenke. Patienten und Methoden 23 von 27 Patienten (22 Frauen und 5 Männer) mit einem Durchschnittsalter von 59,8 (49–83) Jahren, bei denen bei einer Rhizarthrose eine autologe Fetttransplantation in das Sattelgelenk erfolgte, konnten durchschnittlich nach 45,3 (39,3–50,9) Monaten nachuntersucht werden. 4 Patienten wurden bei zwischenzeitlich erfolgter Trapezektomie von der Nachuntersuchung ausgeschlossen. Erfasst wurden das Schmerzniveau (VAS), die Grob- und die Pinchkraft und der DASH-Score. Ergebnisse Die durchschnittliche Pinchkraft verbesserte sich von präoperativ 3,7 kg auf 5,1 kg (p = 0,052). Die durchschnittliche Grobkraft von 22,2 kg auf 22,8 kg (p = 0,506). Der DASH-Score verbesserte sich hochsignifikant von präoperativ 50,8 Punkte auf 29,6 Punkte postoperativ (p = 0,000). Das durchschnittliche Schmerzniveau sank hochsignifikant von präoperativ 5,9 auf 1,9 (p = 0,000). Patienten mit einer fortgeschrittenen Sattelgelenksarthrose erzielten ähnlich gute Ergebnisse wie Patienten mit einer Arthrose im Anfangsstadium. Schlussfolgerung Die autologe Fetttransplantation in arthrotische Sattelgelenke zeigt auch im mittelfristigen Verlauf gute bis sehr gute Ergebnisse, Pinchkraft, Schmerzniveau und DASH-Score betreffend und ist eine sichere, minimalinvasive vielversprechende Therapiealternative zu den herkömmlichen Operationsverfahren.

Getting into the heart of the water movement into the vadose zone is essential due to the direct impact on the aquifer recharge, the flood hazards, the irrigation planning and the water resources management in general. Since soil profiles in nature appear in layers, the present study accomplishes a deep investigation of the water’s motion through soil layers with different hydraulic properties. A series of experiments were conducted in the laboratory where infiltration, tension, soil moisture and hydraulic conductivity data were collected and analyzed. In particular, a transparent column was filled with two soils (loamy sand over sand), and TDR probes, along with ceramic capsules connected to pressure transducers, were set to the column. Using the experimental data and the unsaturated zone modeling, hydraulic parameters were obtained, along with water motion simulation and prediction. An investigation into the drainage, imbibition, infiltration, soil water characteristic curves and, in general, the hydrodynamics of the vadose zone of the soil layers has been achieved. The results of the current study suggest a method to estimate the crucial hydraulic parameters that are involved in the soil-water interaction and have an impact on infiltration, runoff, aquifer horizon recharge, water management and water saving.

Background: Cryolipolysis—a popular noninvasive technique for body contouring—has fewer side effects compared with liposuction; however, its effectiveness in terms of reducing local adipose tissue is also lower. This study is, to the authors’ knowledge, the first prospective, controlled, investigator-blinded split-body trial to evaluate whether postcryolipolytic heating can increase the efficacy. Methods: Twenty-five subjects were treated with one session of cryolipolysis on the lower abdomen and a subsequent heating with a mud pack of a randomized side of the treated region (left or right). Epidemiologic, temperature, edema, erythema, hypesthesia, and pain level data were obtained. Photographs, fat layer thickness (on ultrasound, caliper, and abdominal girth), satisfaction, and side effects were documented over a follow-up period of 12 weeks. Results: The side effects—edema, erythema, and hypesthesia—faded almost completely with heating, whereas they remained on the nonheated site. However, the mean sonographic reduction of local adipose tissue after 12 weeks was significantly lower on the heated sites than on the control sites (9.6% versus 14.1%; P = 0.0003). The overall satisfaction was high (9.2 of 10 points), even though only 44% of participants had a subjective recognition of fat loss without difference between the sites. Conclusions: Active heating following cryolipolysis increases bodily well-being by reducing common side effects, but it reduces the effectiveness of cryolipolysis significantly and should therefore be avoided. Further improvements are necessary to enhance the efficacy of cryolipolysis. CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, I.