Fat Tissue Research Articles

Orbital Septum in Lateral Canthus

ABSTRACT Purpose To disclose the precise attachment site of the orbital septum in the lateral canthus. Methods Nine specimens of 7 Japanese cadavers aged 66 to 85 years at death were included. The attachment site of the orbital septum in the lateral canthus was grossly dissected. Two of the 9 specimens were exenterated and used to explore the anatomy from lateral and superior aspects, respectively. Results The orbital septum in the lateral canthus attached slightly lateral to the outer edge of the lateral commissure with the levator aponeurosis and the lower eyelid retractors in the upper and lower regions, respectively. In addition, the orbital septum attached to the arcus marginalis with regard to the orbital bone. Fat tissue occupied the space between the orbital septum and the lateral retinaculum. Conclusion The orbital septum in the lateral canthus attached around the lateral commissure and the orbital rim.

Evaluation of prognostic significance of histopathological characteristics and tumor-infiltrating lymphocytes for pancreatic cancer survival

With a 5-year survival of ˂ 10%, pancreatic cancer is one of the leading causes of cancer-related deaths. Given the role of the distribution of tumor-infiltrating lymphocyte (TILs) subtypes in the tumor and its microenvironment in predicting prognosis, the development of new targeted therapies based on T-cell adaptive response has gained considerable attention. This study aimed to examine the peritumoral spread of TILs and its relationship with other prognostic parameters and survival. This study included 60 patients with pancreatic cancer who had undergone surgery with follow-up between 2011 and 2021. Demographic characteristics, tumor histopathological features, peritumoral TILs counts, and intratumoral programmed cell death protein-1 (PD-1) and programmed death ligand − 1 (PD-L1) positivity were evaluated. Furthermore, overall survival and their efficacy in predicting survival according to TNM stage were analyzed. The number of cluster differentiation-3 positive (CD3 P) TILs increased with advancing pathological T stage. CD3 P and CD8 P TIL counts were higher in patients with peripancreatic fatty tissue invasion. Patients with PD-L1 positivity and higher TIL counts had better survival rates. PD-L1-negative patients with a low CD8 positive/total lymph node count (P/T) ratio had a longer survival. Moreover, patients with poorly differentiated tumors with low CD3 P/T and CD8 P/T ratios had a longer survival. The CD3 P/T and CD8 P/T ratios were compatible with the automatic and manual measurements. Age, tumor differentiation, N stage, and peritumoral TIL count and subtype, when evaluated together with the presence of PD-L1 in the tumor tissue, may have prognostic significance for survival in patients with pancreatic cancer.

Combined approach of nanoemulgel and microneedle pre-treatment as a topical anticellulite therapy

Background and purpose: Cellulite is caused by changes in the metabolism of the fatty tissue beneath the skin. Methylxanthines and retinoids are commonly added to the different anticellulite products. However, their topical permeation into the dermis is limited. Thus, the objective of this research is to formulate a nanoemulgel (NEG) containing a triple therapy of caffeine, aminophylline, and tretinoin as a topical anticellulite product to improve their skin permeation. Furthermore, the influence of microneedles (MNs) as skin pre-treatment on the permeation of the NEG was investigated. Experimental approach: Various nanoemulsion (NE) formulations were prepared using high-energy ultrasonication with different compositions and sonication amplitudes. Several characterisation tests were employed to select the optimum NE formulation. Then, the optimised NE formulation was incorporated with hyaluronic acid to prepare the NEG, which was, in turn, subjected to various evaluations. An ex vivo permeation study using human skin was performed for the NEG compared to a control preparation of plain gel. Additionally, a microneedling pen was applied as a skin pre-treatment at varying lengths prior to NEG application to examine its impact on the NEG’s permeation. Key results: The selected NEG has a homogenous and consistent texture with no coarse particles, a droplet size of 175.8 nm and polydispersity index (PDI) of 0.19, an optimum pH value of 5.28, high drug content of caffeine, aminophylline, and tretinoin (99.35, 98.48 and 98.05 %, respectively), high drug release values of approximately 100 % within 6 hours, appro-priate viscosity, minimum skin irritation, and adequate short-term stability. The ex vivo permeation study showed that caffeine, aminophylline, and tretinoin permeated more and deposited in the skin with higher percentages from the NEG than plain gel. This skin deposition within the dermis was increased by applying the microneedling pen at varying lengths of 0.5, 1, and 2 mm as a skin pre-treatment. Conclusion: This combined approach of NEG formulation containing a triple therapy of caffeine, aminophylline, and tretinoin, along with MNs application, has the potential to serve as a topical anticellulite product, reducing cellulite formation and improving skin appearance.

Fatty acid composition evaluation of abdominal adipose tissue using chemical shiftencoded MRI: Association with diabetes

AbstractThis study investigated the association between the fatty acid composition of abdominal adipose tissue in NAFLD patients using chemical shift–encoded MRI and the development of insulin resistance and T2DM. We enrolled 231 subjects with NAFLD who underwent both abdominal magnetic resonance spectroscopy and chemical shift–encoded MRI: comprising of 49 T2DM patients and 182 subjects without. MRI‐ and MRS‐based liver fat fraction was measured from a circular region of interest on the right lobe of the liver. The abdominal fatty acid compositions were measured at the umbilical level with chemical shift‐encoded MRI. Bland‐Altman analysis, Student's t test, Mann–Whitney U test, and Spearman correlation analysis were performed. The logistic regression was applied to identify the independent factors for T2DM. Then, the predictive performance was assessed by Receiver operating characteristic curve analyses. An excellent agreement was found between liver fat fraction measured by MRS and MRI. (slope = 0.8; bias =‐0.92%). In, patients with T2DM revealed lower fractions of mono‐unsaturated fatty acid (Fmufa) (33.68 ± 10.62 vs 38.62 ± 12.21, P =.0089) and higher fractions of saturated fatty acid (Fsfa) (34.11 ± 9.746 vs 31.25 ± 8.66, P =.0351) of visceral fat tissue compared with patients without. BMI, HDL‐c, Fmufa and Fsfa of visceral fat were independent factors for T2DM. Furthermore, Fsfa‐S% was positively correlated with liver enzyme levels (P =.003 and 0.04). However, Fmufa‐V% was negatively correlated with fasting blood glucose, HbA1c and HOMA‐IR (P =.004, P =.001 and P =.03 respectively). Hence, the evaluation of fatty acid compositions of abdominal fat tissue using chemical shift–encoded MRI may have a predictive value for T2DM in patients with NAFLD.

Cryo-EM structure of a lysozyme-derived amyloid fibril from hereditary amyloidosis

Systemic ALys amyloidosis is a debilitating protein misfolding disease that arises from the formation of amyloid fibrils from C-type lysozyme. We here present a 2.8 Å cryo-electron microscopy structure of an amyloid fibril, which was isolated from the abdominal fat tissue of a patient who expressed the D87G variant of human lysozyme. We find that the fibril possesses a stable core that is formed by all 130 residues of the fibril precursor protein. There are four disulfide bonds in each fibril protein that connect the same residues as in the globularly folded protein. As the conformation of lysozyme in the fibril is otherwise fundamentally different from native lysozyme, our data provide a structural rationale for the need of protein unfolding in the development of systemic ALys amyloidosis.

Diagnostic value of the flare sign in predicting extracapsular extension in metastatic axillary lymph nodes and nodal status on breast magnetic resonance imaging.

This study aimed to evaluate the diagnostic performance of breast magnetic resonance imaging (MRI) in predicting extracapsular extension (ECE) and axillary nodal status in the axillary metastatic lymph nodes of patients with breast cancer. The preoperative MRI scans of 92 patients with breast cancer and axillary metastases who did not receive neoadjuvant treatment between January 2018 and January 2024 were retrospectively examined. The presence of an increased signal in the axillary fatty tissue surrounding the lymph node (flare sign) on T2-weighted images, irregular nodal contour (shaggy margin), axillary asymmetry (difference in the number and size of lymph nodes compared with the unaffected axilla), loss of the fatty hilum in the most suspicious lymph node, and morphological features on T1-weighted images were assessed. Each dissected axillary lymph node was examined for ECE, and the histopathological results were recorded. Axillary flare sign was significantly associated with the presence of ECE (P < 0.001), number of lymph nodes with ECE (P < 0.001), the presence of ≥4 axillary metastatic lymph nodes (P < 0.001), size of the primary tumor (P = 0.033), lymphovascular invasion in the primary tumor (P < 0.001), and presence of perineural invasion (P = 0.001). The flare sign exhibited 65.7% sensitivity, 96% specificity, 97.8% positive predictive value, 51.1% negative predictive value, and 73.9% accuracy in predicting ECE. Additionally, the receiver operating characteristic curve analysis revealed an area under the curve of 0.808 (95% confidence interval: 0.719-0.898). The flare sign has high performance in predicting ECE and axillary nodal status and is associated with primary tumor aggressiveness, indicating its potential utility in preoperative evaluation. The flare sign on breast MRI may play a crucial role in preoperative planning, surgical decision-making, and axillary status assessment by accurately predicting ECE.

Relationship between Gadget Use, Sleep Patterns, Stress and the Incidence of Central Obesity in Adolescents in Jambi City

Obesity is a condition in which the body has excess body weight as measured by several measurements. The accumulation of fat in the body's subcutaneous tissue, or under the skin, around organs, and sometimes even in the tissues of those organs, is a sign of obesity. In the last five years, the prevalence of adolescent obesity in Indonesia has almost doubled. The purpose of this study was to determine the factors associated with the incidence of central obesity in adolescents in Jambi City. This descriptive quantitative research used a cross-sectional study. In this study, the Solvin formula was used to calculate the sample size, which consisted of 96 adolescents living in the working area of ??the Putri Ayu health center in 2024. Data collection used a questionnaire. Data processing was univariate and bivariate analysis. The analysis used was chi-square. The results showed that there was no relationship between the use of gadgets (p=0.219) with the incidence of central obesity in adolescents there was a relationship between sleep patterns (p = 0.000), stress (p = 0.001) with the incidence of central obesity in adolescents in Jambi City. Factors that can cause obesity in adolescents include unhealthy eating habits, it is important to maintain a balanced diet, rich in fiber, and frequently consume fruits and vegetables

Deciphering Mechanisms of Adipocyte Differentiation in Abdominal Fat of Broilers.

The excessive deposition of abdominal fat tissue (AFT) in broilers has emerged as a major concern in the poultry industry. Despite some progress in recent years, the molecular mechanisms underlying AFT development remain ambiguous. The current study combined RNA-seq with transposase-accessible chromatin sequencing (ATAC-seq) to map the dynamic profiling of chromatin accessibility and transcriptional reprogramming in AFT adipocyte differentiation in broilers at day 3 (D3) and D14. Our results found that the levels of CDK1 and PCNA were down-regulated at D14, D28, and D42 compared to D3, while the levels of C/EBPα and FABP4 were up-regulated at D14 and D42 compared to D3. Meanwhile, PPARγ was significantly up-regulated at D28 and D42. RNA-seq of AFT identified 1705 up-regulated and 1112 down-regulated differential expression genes (DEGs) between D3 and D14. Pathways based on up-regulated DEGs mainly enriched some pathways related to adipocyte differentiation, while down-regulated DEGs pointed to DNA replication, cell cycle, and gap junction. Gene set enrichment analysis (GSEA) revealed that DNA replication and the cell cycle were down-regulated at D14, while the insulin signaling pathway was up-regulated. In the OA-induced immortalized chicken preadipocyte (ICP2) model, protein dynamic changes were consistent with AFT from D3 to D14. Same pathways were enriched in ICP2. In addition, based on overlapped DEGs from AFT and ICP2, enriched pathways related to adipocyte differentiation or proliferation mentioned above were all involved. A total of 1600 gain and 16727 loss differential peaks (DPs) were identified in ICP2 by ATAC-seq. Predicted genes from DPs at the promoter regions were enriched in glycerophospholipid metabolism, TGF-β signaling, FoxO signaling, and ubiquitin-mediated proteolysis. DNA motifs predicted 159 transcription factors (TFs) based on gain and loss peaks from the promoter regions, where 1 and 10 TFs were overlapped with up or down TFs from DEGs. Overall, this study presents a framework for the comprehension of the epigenetic regulatory mechanisms of adipocyte differentiation and identifies candidate genes and potential TFs involved in AFT adipocyte differentiation in broilers.

Muscle characteristics of lower limb in association with physical activity in candidates of total knee arthroplasty with knee osteoarthritis

Background&AimsThis study aimed to clarify the association between physical activity (PA) and physical functions, including both muscle quantity and quality of ankle plantar flexor muscles in patients with knee osteoarthritis (OA). MethodsA retrospective cohort study was conducted with ninety-two patients with knee OA. PA, leg muscle cross-sectional area (CSA), knee strength, passive knee angle, and knee pain of the affected side were assessed. PA was assessed by the 2011 Knee Society scoring system. CSA of the quadriceps and ankle plantar flexor muscles on the affected side was measured using a computed tomography image. Based on muscle attenuation assessed with Hounsfield units (HU), the muscle quality of targeted muscle was divided into 4 groups as follows: fat tissue (-190 to -30 HU), very low-density muscle (-29 to -1 HU), low-density muscle (0 to 34 HU), and normal-density muscle (NDM, 35 to 100 HU). The CSA was obtained for each of the 4 groups. Univariate and multivariate linear regression analyses were performed to determine the factors associated with PA. ResultsThe regression analysis revealed that higher PA was independently associated with the NDM CSA of ankle plantar flexor (β = 0.51), higher knee extension strength (β = 0.28), and milder knee pain (β = -0.29) after adjustment with age, sex, height, weight, and body mass index. ConclusionThe present study suggested that NDM CSA of ankle plantar flexor in addition to knee function is one of the factors determining the PA in patients with knee OA.

ANAESTHESIA MANAGEMENT IN A CASE OF HYPERTHYROID WITH PROPTOSIS FOR ENDOSCOPIC DECOMPRESSION

This article describes a case of a 65-year-old man with hyperthyroid and who underwent left orbit endoscopic decompression for left eye proptosis. The article also discusses the management of thyroid eye disease (TED) in general. Thyroid associated orbitopathy, also known as Graves orbitopathy, is the most common cause of proptosis ( bulging of the eye). It is an autoimmune disease that affects the muscles and fatty tissues around the eye. TED is most commonly associated with Graves disease, an autoimmune disease that causes an overactive thyroid gland. However, TED can also occur in people with normal thyroid function or an hyperactive thyroid gland. The article presents a case of a 65-year-old man with TED who underwent decompressive surgery to relieve pressure . The article also discusses the importance of maintaining euthyroid (normal thyroid function) in patients with TED.

Lipoma of the Parotid Gland Extending from the Superficial to the Deep Lobe: Case Report

Lipoma is a benign mesenchymal tumor composed largely of fat tissue. It is one of the most common of all neoplasms, but its occurrence in the parotid gland is extremely rare.

Risk of right coronary artery injury and distance from tricuspid valve ring to right coronary artery in radiofrequency ablation

Abstract Background Coronary injury is a significant risk during catheter ablation (CA). While a shorter distance between the CA site and the coronary artery is known to increase this risk, less fat in this region might also heighten the chances of coronary damage due to greater penetration of RF energy. However, the relationship between the right coronary artery (RCA #1-3) and the basal right ventricle at the tricuspid annular ring (TVR) has not been thoroughly investigated, despite reports of coronary obstruction during ablation in this area (see Figure in reference). This study aimed to address this gap. Methods Forty-one consecutive patients (average age 64 ± 14 years, 30 males) who underwent coronary CT before ablation were enrolled. The distance between the TVR and RCA (#1-3) and the fat distribution between these structures were assessed (see Figure 1). Results The TVR-RCA#1 distance was 8.4 ± 4.7 mm, and TVR-RCA#2 was 4.1 ± 1.8 mm. In 30 (73%) patients, the closest TVR-RCA distance was &amp;lt;5 mm, with &amp;lt;2 mm in 4 (10%) patients, and 1.4 mm at the closest point (see Figure 2A). While the fat distribution at the closest TVR-RCA varied (-34.9 ± 78.1) among patients, almost no fat tissue was seen in 12 (30%) patients (see Figure 2B). Conclusion CA on the basal lateral RV should be approached with caution due to the very close proximity of TVR to RCA in 10% of cases and the lack of fat distribution in this area in 30% of cases.

Soft-tissue keratocyst: report of 3 new cases from Brazil.

To describe the clinicopathological features of 3 new cases of soft-tissue keratocyst (STK) of the buccal mucosa from Brazil. Clinical data from 3 patients diagnosed with STK were obtained from the archives of the Laboratory of Oral Pathology at the Federal University of Rio de Janeiro- Brazil from 2020 to 2023. Two oral pathologists reviewed conventional hematoxylin and eosin-stained slides of each case. Immunohistochemical stainings for CK19, Bcl-2, CD138, D2-40, EMA, and Ki-67 were performed in all cases. Case 1 was a 58-year-old man with a 2-year history of painless swelling of the right buccal mucosa, measuring approximately 5cm. Case 2 was of a 44-year-old man with a painful swelling in the left buccal mucosa lasting 3 years with drainage to the oral cavity. Case 3 was of a 74-year-old woman with a painful swelling in the left buccal mucosa of unknown duration. Microscopic evaluation of all 3 cases revealed a cyst lined with a few cell layers composed of columnar palisading basal cells and a corrugated parakeratin surface. The capsule comprised fibrous connective tissue with variable amounts of blood vessels with hemorrhage, nerve bundles, fat tissue, striated muscle fibers, and the absence of pilosebaceous units. No recurrence was observed after complete surgical removal. All epithelial layers of the 3 cases expressed positivity for CK19 and CD138, the basal cells were positive for Bcl-2 and D2-40, and the superficial epithelial layer was positive for EMA. All cases demonstrated a low proliferation index by Ki-67. This study represents a series of 3 cases of STK that affected the posterior buccal mucosa of middle-aged patients from Brazil, sharing histopathological and immunohistochemical features with odontogenic keratocyst.

Steatosarcopenia: A New Terminology for Clinical Conditions Related to Body Composition Classification

Body composition analysis focuses on measuring skeletal muscle mass and total body fat. The loss of muscle function and mass is related to clinical conditions such as frailty, increased risk of falls, and prolonged hospitalizations. Despite the relevance of the definition of sarcopenic obesity, there is still a gap in the monitoring of patients who have the combination of sarcopenia and myosteatosis, regardless of the presence of obesity. Therefore, we propose a new nomenclature, steatosarcopenia, a condition characterized by the loss of mass or skeletal muscle strength and performance associated with the excessive deposition of ectopic reserve fat in muscle tissue, in the same individual, not necessarily related to excess fat total body mass. A greater understanding of this condition may assist in developing strategies for preventing and treating metabolic diseases.

Valvular leaflets and epicardial fat have a significant effect on lesion size in RF ablation

Abstract Introduction Radiofrequency (RF) current is the classic ablation technology in the EP lab. Underlying RF ablation parameters, such as RF power, impedance, duration and contact force are used to calculate expected lesion size. Furthermore, lesion indices (LSI, AI) are applied to estimate expected lesion durability and contiguity. Purpose The aim of this ex-vivo study was to assess the influence of valvular tissue and epicardial fat on RF lesion creation. Methods An ex-vivo porcine model was created to create RF lesions under standardized conditions. Temperature was constantly kept at 37°C using a thermostat and a circulation pump was used to imitate blood flow. A contact force sensing ablation catheter (ST SF) was used to create RF lesions using predefined RF parameters (30W/50W, CF 10g, 30sec). Lesions using the same RF parameters were created above and right next to mitral valve leaflets as well as on epicardial fat tissue (figure 1). Lesions were then dissected, and lesion depths and diameters were measured using a digital precision caliper. Results A total of 210 lesions were created. RF lesions ablated on valvular leaflets showed significantly smaller lesion depth and lesion diameter when compared to RF lesions ablated right next to valvular (diameter 8.0±2.0mm vs 10.8±1.8mm; depth 4.4±1.2 vs 7.7±1.6mm, p&amp;lt;0.01). Lesions ablated on epicardial fat were significantly smaller in diameter (9.2±1.5) and depth (6.5±1.8) than purely endocardial lesions (p&amp;lt;0.01). Examples are depicted in figure 1. Conclusions Valvular leaflets as well as epicardial fat tissue have a significant influence on RF lesion creation. RF ablation performed on valvular leaflets or epicardial fat results in significantly (p&amp;lt;0.01) smaller lesions when compared to RF ablations directly on endocardial tissue. This should be considered in ablations of accessory pathways and epicardial procedures.Figure 1

Muscle Mass and Muscle Strength in Non-Dialysis-Dependent Chronic Kidney Disease Patients

Background: Sarcopenia is a state with a progressive and generalized loss of skeletal muscle mass and strength. However, muscle strength and muscle mass are different features, which are usually not studied separately. The aim of the study was to investigate anthropometric and clinical correlates and sources of variation in both skeletal muscle mass and muscle strength in chronic kidney disease (CKD). Methods: The study sample consisted of 84 patients with an estimated glomerular filtration rate (eGFR) &lt; 45 mL/min/1.73 m2. Muscle strength was estimated by measuring hand grip strength (HGS). Muscle quantity was measured with bioimpedance spectroscopy (BIS). Serum creatinine, urea, uric acid (UA), and albumin were measured as well. Results: Appendicular skeletal muscle mass (ASM) significantly and positively correlated with body mass, NH weight (normally hydrated weight), height, body mass index (BMI), lean tissue mass (LTM), lean tissue index (LTI), fat mass (FM), and fat tissue index (FTI), and was negatively associated with hydration status. HGS significantly and positively correlated with body mass, NH weight, height, LTM, LTI, and ASM, and was negatively associated with UA and urea. After adjustment for age, sex, and height, HGS remained significantly and negatively related with UA and hydration status. Conclusions: In CKD patients, ASM is determined by anthropometric parameters, but HGS is determined by both anthropometric and clinical variables specific for CKD. In order to study the determinants of HGS in CKD, relationships with HGS should be adjusted for anthropometric variables.

Adipose Tissue Macrophages of the Human Fetus

Prenatal adipose tissue development affects body composition and growth trajectory in early infancy, therefore it is a key determinant of adiposity in childhood. Childhood overweight and obesity increase the probability of being obese as an adult. After birth and in adulthood, adipose tissue macrophages (ATMs) are relevant constituents of the fat depots, and they are necessary for physiological adipose tissue development and fat metabolism. In obesity, however, ATMs may induce chronic inflammation leading to insulin resistance, pancreatic beta cell damage and self-immunity. Despite being relevant regulators of adipose tissue development and functioning, it is unknown whether ATMs are present in the fetal adipose tissue, therefore it is elusive whether they may affect the prenatal establishment of fat depots. Here we studied the distribution of ATMs in the human fetus between gestational weeks 17 and 38 and labeled ATMs in the early postnatal life. We found that CD45+/CD14+/CD68+ ATMs infiltrated the fetal adipose tissue from the 17th week of gestation and remained persistent throughout the second and third trimesters. ATMs were phagocytic in the neonate and expressed interleukin-6, along with other pro-inflammatory gene products. These findings show that ATMs colonize the adipose tissue early in gestation, raising the possibility that intrauterine ATM–adipocyte communication may exist, eventually allowing ATMs to affect prenatal adipose tissue development.

Acupuncture-assisted lifestyle intervention improve the metabolic status and spontaneous brain activity of type 2 diabetes Mellitus patients: a randomized, clinical trial

BackgroundAggressive weight management in patients with type 2 diabetes mellitus has demonstrated numerous metabolic advantages, however, existing therapies for weight control have not reached satisfactory results. This study aimed to evaluate the efficacy and safety of acupuncture in the weight management of type 2 diabetes mellitus (T2DM) patients by using a randomized, sham-controlled clinical trial design.MethodsIn this single-blind randomized clinical trial, 102 overweight adult T2DM patients were randomized into two groups. The control group receives diet, exercise, and sham acupuncture intervention, whereas the acupuncture group receives diet and exercise and acupuncture intervention, both for 1 month. Body weight and other anthropometric and laboratory indices were assessed at baseline and endpoint, meanwhile, the body fat content and spontaneous brain activity were measured by functional magnetic resonance imaging(fMRI)as the exploratory outcomes.ResultsNo significant difference was observed between the studied parameters at the baseline. The body weight and BMI were significantly reduced both in the control and acupuncture groups after intervention, without statistical difference between the two groups. What’s interesting is that compared to the control, the acupuncture group displayed a greater improvement in central fat tissue. It notes that the acupuncture group achieved significant liver fat content reduction than the sham acupuncture group. At the same time, the spontaneous brain activity in the occipital lobe and parietal lobe significantly increased in the acupuncture group.ConclusionOne month of acupuncture treatment preferentially improved ectopic fat deposition and was accompanied by changes in brain activity compared with the control group, even before significant changes in total body weight had occurred. further studies of longer duration are necessary for validation.Trial registration: The protocol of this clinical trial is registered at the Acupuncture-Moxibustion Clinical Trial Registry (AMCTR, http://www.acmctr.org/, No. AMCTR-IOR-20000341).

Wrapping method for better fat handling in endoscopic trans-sphenoidal surgery

Background: Fat is commonly used for preventing cerebrospinal fluid (CSF) leakage during endoscopic transsphenoidal surgery (ETSS). However, fat is soft, slippery, and sometimes not easy to handle. The present study aimed to examine the efficacy of our Surgicel® wrapping method, which allows for better fat handling, in preventing the occurrence of CSF leakage among patients undergoing ETSS. Methods: We used fat tissues removed from the abdomen. The fat was cut with scissors into pieces that were approximately 5 mm in size. Surgicel® was also cut into 2.5 cm2. The fat tissues were encased with these Surgicel® squares and slightly moistened with a saline solution. Results: Between January 2023 and August 2024, 34 patients aged 18–86 years (average 54.9 years) underwent ETSS. Among these patients, 20 had pituitary tumors, 6 had Rathke’s cysts, and 8 had other conditions. None of the patients had CSF leakage postoperatively. The use of Surgicel®-wrapped fat during ETSS is better than the use of fat alone. Conclusion: The Surgicel® wrapping method allows for better fat handling during ETSS.

VDR gene polymorphisms rs731236 and rsS2228570 affect vitamin D levels in people of the Kaliningrad region

Vitamin D is an essential micronutrient that is involved in numerous biological processes. It not only keeps bones healthy, but also has a protective effect on the cardiovascular system, the pancreas and fatty tissue. Around 50% of the world’s population suffers from vitamin D deficiency or insufficiency. The prevalence of these diseases is significantly higher in obese people, regardless of age and place of residence. The presence of polymorphisms in the VDR gene (vitamin D receptor) can explain individual differences in the concentration of vitamin D 25(OH) in blood serum. Of particular interest are the effects of the polymorphisms rs731236 and rs2228570 on vitamin levels. Thus, the VDR polymorphism rs731236 is a synonymous substitution, whereas the polymorphism rs2228570 is a non-synonymous substitution. The article investigated the polymorphisms of the VDR gene rs2228570 (T/C), rs731236 (T/C) and determined their association with blood vitamin D levels in people from the Kaliningrad region with different body mass index (BMI). The material for the study was venous blood taken in the morning on an empty stomach from 232 people (mean age 50±13.5 years, 103 men and 129 women). The vitamin D content in the blood was determined by ELISA and the polymorphisms of the VDR gene were analyzed by PCR. In individuals with a BMI 30 kg/m2, changes in the lipid profile and liver function tests were recorded. The vitamin D level did not depend on the BMI of the study participants. Significant changes in blood vitamin D levels were found depending on the distribution of the VDR genotype. Vitamin D levels were higher in individuals with the CC genotype than in the TT and CT genotypes of the rs2228570 polymorphism and did not depend on BMI. In contrast, the presence of the rs731236 polymorphism in the VDR gene is associated with BMI. In obesity, vitamin D levels are therefore only reduced in people with the TT genotype of the rs731236 polymorphism, but not in people with the CC and TC genotype.