Visceral Layer Research Articles

Epicardial Fat Volume Assessed by Multi-Detector Computed Tomography and it’s Relation with the Severity of Coronary Artery Disease

Abstract Background Recent studies have suggested that fat disposition in epicardial tissue may be a predictor of the severity of coronary artery disease (CAD). Epicardial adipose tissue (EAT) is defined as the adipose tissue located between the outer wall of the myocardium and the visceral layer of pericardium, surrounding the heart and the coronary vessels. EAT is closely related to the adventitia of the coronary arteries without a barrier that may directly influence the development and progression of atherosclerosis and CAD through pro-inflammatory mediators. Objective The aim of the work is to investigate the relation between epicardial fat volume (EFV) [assessed by multidetector computed tomography (MDCT)] and severity of CAD. Methods This cross sectional study was conducted on 40 patients referred for MDCT coronary angiography to assess their complaint. EFV was quantified during non-contrast phase and severity of CAD was assessed by segment involvement score (SIS) and segment stenosis score (SSS) during contrast phase at Nasr City Police Hospital in the period between August 2018 and April 2019. Results The 40 consecutive subjects consisted of 30 males (75%) and 10 females (25%) with mean age 56 ±10.27 years. Risk factors of atherosclerosis were analyzed among the studied population as followed; the BMI ranged between 24 and 30.9 kg/m2, hypertensive patients were 77.5%, diabetic patients were 55% and smokers were 67.5%. The laboratory finding of the studied group revealed that the serum LDL.C ranged between 70 and 218 mg/dl (Mean±SD =163.88±43.37, Median= 183.5). The serum HDL.C ranged between 30 and 62 mg/dl (Mean±SD = 41.45±9.87, Median= 37). The serum total cholesterol ranged between 136 and 280 mg/dl (Mean±SD = 214.35± 35.51, Median= 224). The serum triglycerides ranged between 110 and 215 mg/dl (Mean±SD = 164.13±27.38, Median= 173).The serum creatinine ranged between 0.8 and 1.8 mg/dl (Mean±SD = 1.12±0.19, Median= 1.1). 17.5% of the studied patients had normal coronaries while 37.5% had single vessel disease and 45% had multi-vessel disease. There was a significant relationship between EFV and CAC score (p = 0.011, r = 0.397), a highly significant relationship between EFV and SSS score (p = 0.001, r = 0.518) and significant relationship between EFV & SIS score (P = 0.003, r = 0.459). Patients with normal coronary arteries were noted to have a lower EFV value than those with coronary lesions (highly significant relationship, p = 0.004) either single vessel disease or multi-vessel disease. There is no significant difference between the effects of EFV on number of diseased coronaries either single vessel disease or multi-vessel disease. Conclusion EFV increased in patients with both significant coronary artery stenosis or coronary calcification. EFV is considered an independent risk factor for CAD.

Vacuolar-type proton ATPase is required for maintenance of apicobasal polarity of embryonic visceral endoderm

The endocytic compartments keep their interior acidic through the inward flow of protons and anions from the cytosol. Acidification is mediated by a proton pump known as vacuolar-type ATPase (V-ATPase) and transporters conferring anion conductance to the organellar membrane. In this study, we analysed the phenotype of mouse embryos lacking the V-ATPase c-subunit. The mutant embryos differentiated embryonic epithelial tissues, primitive endoderm, epiblast, and extraembryonic ectoderm; however, the organisation of these epithelia was severely affected. The apical-basal polarity in the visceral endoderm layer was not properly established in the mutant embryos, resulting in abnormal epithelial morphology. Thus, the function of V-ATPase is imperative for the establishment and/or maintenance of epithelial cell polarity, which is required for early embryogenesis.

Haemophagocytic lymphohistiocytosis in a patient with familial Mediterranean fever and miliary tuberculosis: a case report

Haemophagocytic lymphohistiocytosis (HLH) is a lethal complication of several infections, especially viral origin. Mycobacterium tuberculosis infection can also lead to HLH, yet it is an uncommon trigger. Considering the role of increased cytokines in HLH, autoinflammatory conditions, such as familial Mediterranean fever (FMF), might contribute to its development. Nevertheless, the possible relationship between FMF and HLH has been suggested only in some case reports. We present a case of FMF who admitted to the hospital with consitutional symptoms and chest pain regarding to recurrent pericarditis. On a blood test, pancytopenia and elevated acute phase reactants were seen. Fluorine-18 fluorodeoxyglucose (FDG) positron emission tomography/computed tomography demonstrated positive FDG uptake sites on both the right and left surrenal glands, the visceral layer of pericard, and reactive lymphadenomegalies at multiple mediastinal regions. Bone marrow biopsy revealed haemophagocytosis. Methylprednisolone treatment was initiated. Despite immunosuppressive treatment, clinical and biochemical parameters deteriorated; thus, a thorax computed tomography was executed. Findings were consistent with miliary tuberculosis infection. M. tuberculosis was detected in blood culture and bronchoalveolar lavage culture material. Also, bone marrow and surrenal biopsy material revealed necrotising caseating granuloma.

Recurrence of Primary Hydrocele 1 Month after Hydrocelectomy in a 35-Year-Old Patient

A hydrocele is a painless enlargement of the scrotum resulting from an irregular accumulation of serous fluid between the parietal and the visceral layers of the tunica vaginalis which surrounds the testis To treat hydrocele various modalities are used, the gold standard of which being open hydrocelectomy. Hydroceles can sometimes be recurrent. Rarely, in these cases, an underlying pathological condition such as hypoproteinemia, filarial infection, pelvic cavity malignancy, or a concurrent inguinal hernia is found during investigation. This paper describes a rare case of hydrocele recurrence immediately after open hydrocelectomy. The presence of intact tunical anatomy of the scrotum found during revision hydrocelectomy in our case raised questions concerning the extent of the previous excision and as such recurrence should be attributed to the uninverted remaining tunical sack.

Automatic quantification of epicardial adipose tissue volume.

Epicardial fat is the adipose tissue between the serosal pericardial wall layer and the visceral layer. It is distributed mainly around the atrioventricular groove, atrial septum, ventricular septum and coronary arteries. Studies have shown that the density, thickness, volume and other characteristics of epicardial adipose tissue (EAT) are independently correlated with a variety of cardiovascular diseases. Given this association, the accurate determination of EAT volume is an essential aim of future research. Therefore, the purpose of this study was to establish a framework for fully automatic EAT segmentation and quantification in coronary computed tomography angiography (CCTA) scans. A set of 103 scans are randomly selected from our medical center. An automatic pipeline has been developed to segment and quantify the volume of EAT. First, a multi-slice deep neural network is used to simultaneously segment the pericardium in multiple adjacent slices. Then a deformable model is employed to reduce false positive and negative regions in the segmented binary pericardial images. Finally, the pericardium mask is used to define the region of interest (ROI) and the threshold method is utilized to extract the pixels ranging from -175 Hounsfield units (HU) to -15HU for the segmentation of EAT. The Dice indices of the pericardial segmentation using the proposed method with respect to the manual delineation results of two radiology experts were 97.1% 0.7% and 96.9% 0.6%, respectively. The inter-observer variability was also assessed, resulting in a Dice index of 97.0% 0.7%. For the EAT segmentation results, the Dice indices between the proposed method and the two radiology experts were 93.4% 1.5% and 93.3% 1.3%, respectively, and the same measurement between the experts themselves was 93.6% 1.9%. The Pearson's correlation coefficients between the EAT volumes computed from the results of the proposed method and the manual delineation by the two experts were 1.00 and 0.99 and the same coefficients between the experts was 0.99. This work describes the development of a fully automatic EAT segmentation and quantification method from CCTA scans and the results compare favorably with the assessments of two independent experts. The proposed method is also packaged with a graphical user interface which can be found at https://github.com/MountainAndMorning/EATSeg.

Epicardial adipose tissue differentiates in patients with and without coronary microvascular dysfunction

Background/ObjectivesCoronary microvascular dysfunction (CMD) is a common disorder, leading to symptoms similar to obstructive coronary artery disease and bears important prognostic implications. Local inflammation is suggested to promote development of CMD. Epicardial adipose tissue (EAT) is a local visceral fat depot surrounding the heart and the coronary arteries, modifying the inflammatory environment of the heart. We compared EAT in patients with and without CMD.MethodsWe retrospectively included consecutive patients undergoing diagnostic coronary angiography as well as transthoracic echocardiography between March and October 2016. EAT thickness was defined as space between the epicardial wall of the myocardium and the visceral layer of the pericardium and EAT index was calculated as EAT thickness/body surface area. Logistic regression analysis was used to determine the association of EAT index with the presence of CMD.ResultsOverall, 399 patients (mean age 60.2 ± 14.0 years, 46% male) were included. EAT thickness was significantly higher in patients with CMD compared to patients without CMD (EAT thickness 4.4 ± 1.8 vs. 4.9 ± 2.4 mm, p = 0,048 for patients without and with CMD, respectively). In univariate regression analysis, EAT index was associated with a 30% higher frequency of CMD (odds ratio [95% confidence interval]: 1.30 [1.001–1.69], p = 0.049). Effect sizes remained stable upon adjustment for body mass index (BMI, 1.30 [1.003–1.70], p = 0.048), but were attenuated when ancillary adjusting for age and gender (1.17 [0.90–1.54, p = 0.25). The effect was more pronounced in patients >65 years of age and independent of BMI and sex (1.85 [1.14–3.00], p = 0.013).ConclusionEAT thickness is independently associated with CMD and can differentiate between patients with and without CMD especially in older age groups. Our results support the hypothesis that modulation of local inflammation by epicardial fat is involved in the development of CMD.

Porcelain gallbladder and its relationship to cancer

Summary Background Porcelain gallbladder (PGB) is defined as calcium deposits encrusting the internal visceral layer, which becomes hard, brittle, and bluish. Porcelain gallbladder is rare and has been found in less than 1% of routine cholecystectomy specimens. Several studies report an incidence of gallbladder carcinoma (GBC) associated with gallbladder calcification varying between 12.5 and 61%, data which have been known for 60 years. There is a lack of information concerning PGB and its association with GBC, and the aim of this study is to better define this relationship. Methods A total of 10 patients were found to have PGB in 1050 consecutive routine surgical cholecystectomies. Clinical and laboratory findings, gallbladder histologic examination, bile culture, and bile pH were related to stone composition analysis performed by X‑ray diffraction using Perkin–Elmer (Perkin Elmer Corp. Norwalk, CT, US) 1625 FTIR. Results Among the 10 patients with PGB, complete calcification of the entire gallbladder wall was present in six cases, while four patients had partial calcification. Gallstones were present in all cases of PGB, multiple stones in nine cases and a single stone in one case. Bile culture was performed in all patients of the series. Among the 10 cases with PGB, culture was positive in two cases. Conclusion PGB is a disease as rare as it is subtle. Moreover, the chronic stimulation by stones can generate an initial dysplasia that will subsequently turn into a neoplasm: the cancerization risk is probably no different from long-standing cholesterol or combined stones, but as risk factor for cancer it requires early cholecystectomy.

The Potential Teratogenic Effect of Tilmicosin in Rats: Visceral Malformations and Histomorphological Alterations in Fetal Internal Organs

Potential fetal adverse effects are well-known for several antibacterial classes. The present study was performed to evaluate the potential teratogenic effect of Tilmicosin (TMS) antibiotic in Sprague Dawley rats. TMS was daily administered orally to pregnant rats at two dose levels, 250 or 500 mg/kg bw, on 6-15 days of gestation. The morphological or skeletal malformations were non-significantly different from control values. However, visceral examination revealed elevation in the percentage of intrathoracic and intracranial haemorrhages, and kidney hypoplasia (unilateral or bilateral) in fetuses from dams treated with the high dose. In addition, both dose levels produced fetuses with increased percentages of dilated brain ventricles, heart ventricles and renal pelvis. Histopathologically, both TMS doses induced pathological changes in fetal liver and kidney, in a dose-dependent manner. Liver showed hepatocyte hydropic degeneration, congestion of hepatic blood vessels, engorgement of bile canaliculi and dilatation of hepatic lymphatic vessels. Kidney revealed coagulative necrosis of renal tubules and glomerular tuft, adhesion between the parietal and visceral layers of Bowman’s capsule and the glomerular tuft became ring shape with the presence of multiple layer glomerular tufts. In conclusion, TMS antibiotic has the potential to induce teratogenic effects (mainly visceral) and pathological changes in liver and kidneys tissues of rat fetuses when administered during the organogenesis period. This result demonstrated the ability of TMS to pass the placental barrier.

Topographic Relationships of the Peritoneal Canal of Testudines, Crocodylia, and Aves: Evolutionary Implications

Cloacae and peritoneal canals of species of Testudines, Crocodylia, and Aves were analyzed with the purpose of identifying and describing their morphology and investigating their possible relationship with other cloacal structures. Studies were conducted from dissections and routine histological preparations. The cloaca is located in the pelvic cavity and differs between Testudines and Crocodylia. In the former, the cloaca is divided into three compartments—the coprodeum, urodeum, and proctodeum—without folds separating them. In contrast, in Crocodylia the coprodeum, urodeum, and proctodeum are separated by discrete folds, the coprourodeal and uroproctodeal folds. The visceral layer of the peritoneum forms the peritoneal canal and also differs in Testudines and Crocodylia. In the former, the cranial opening of the peritoneal canal is lateral to the urogenital sinus and the canal is caudally projected into the phallus, laterally followed by the ejaculatory groove until the caudal end of the organ. In Crocodylia, the cranial opening of the peritoneal canal is lateral to the coprodeum and the canal extends caudally until reaching a papilla in the body of the phallus, where it terminates. Histologically, the mesothelium of the peritoneal canal has a simple pavement appearance. In Testudines, regions with a simple cubic epithelium were found, indicating intense cell activity. The lamina propria is characterized by a thickening of the connective tissue, moderately dense with a variable thickness and with a layer of bundles of smooth muscle arranged in different directions. In Caiman yacare, bundles of striated skeletal muscles were found on the loose connective tissue that involves the peritoneal canal. The cloacal and peritoneal fluids have a strong protein similarity. The peritoneal canal reflects functional characteristics related to reproduction. No peritoneal canals were found in birds.

ADDED VALUE OF POSITRON EMISSION TOMOGRAPHY/ COMPUTED TOMOGRAPHY IN DETECTION OF PERITONEAL CARCINOMATOSIS

The peritoneum consists of 2 layers the parietal layer covering the inner surface of abdomen and visceral layer which reflects over and surround the abdominal organs. Peritoneal carcinomatosis is one of the frequent sites of metastasis in many gastrointestinal and gynecological tumors mostly colorectal and ovarian cancer. Various forms of peritoneal carcinomatosis could be noted in the form of ascites, micronodular, nodular, plaque like, mass like, omental cake, teca aspect and ileal freezing.Positron emission tomography (PET) is being increasingly used for diagnosis, staging, and follow-up of various malignancies. In peritoneal carcinomatosis, FDG-PET/CT has been shown to have higher sensitivity and positive predictive value (up to 92%) compared to FDG-PET and CT alone. It also has higher specificity (up to 97%) compared to FDG-PET alone, with similar specificity compared to CT alone. It is more useful than just PET the addition of CT allows better anatomic visualization and can detect the presence of cancer lesions based on the glucose uptake of the cells. It identifies the exact localization and area of the peritoneal metastasis, PET-CT provides better accuracy. It adds good value to the conventional imaging mainly for monitoring response to the therapy, especially on long-term follow-up. PET/CT has multiple clinical applications in peritoneal oncology detecting the primary tumor in unknown primary, tumor staging and restaging; treatment planning, post therapy response, differentiating recurrence from post therapy changes; distinguishing malignant from benign peritoneal disease; can be used as a biomarker as well as alternative tracers for cancer evaluation.

Macroscopic, Histomorphological and Histochemical Studies on the Kidneys of Guinea Fowl (Numida meleagris)

Background: Kidneys, the paired organ which essentially plays for excreting nitrogenous wastes, excessive water, inorganic salts and toxic substances produced during the process of body metabolism. Maintenance of osmotic regulation and homeostatic fluid balance of the body has also be performed by kidneys. Each of the kidneys filtrate carried to cloaca by respective ureter from where the urine leaves the body. The present macroscopic, histomorphological and histochemical studies undertaken on the Kidneys of Guinea fowl (Numida meleagris) is nothing but the attempt to widen our thrust area for that bird which is nonexistent as on documentation.Methods: The present studies were carried upon 12 pairs of in-vitro kidney samples in Guinea fowl. Gross morphology and morphometrical observations were carried on fresh specimens. Histological studies were carried on fixed samples those were processed for dehydration, clearing, embedding into paraffin and sections of 5-6 μ thickness were obtained. Different staining procedure as to Haematoxylin and Eosin, Silver orcein, Aniline blue and Weigert’s staining methods were employed for different histological components. The histochemical and histoenzymic studies were also accomplished with Periodic acid Schiff‘s (PAS), Alcian blue methods (pH-2.5) and Gomori’s cobalt method for Alkaline phosphatase and Acid phosphatase. The Succinic dehydrogenase enzyme was also estimated on cryostat sections.Result: The observations on kidneys of Guinea fowl were accomplished after macroscopic, histomorphological and histochemical means. This reddish-brown colored paired organ of kidneys was retroperitoneally placed in synsacral fossa and had incomplete division of three parts. The wrapping material of capsule was the dense connective tissue. The outer cortex and inner medulla had different parts of nephrons. Two types of nephrons viz. mammalian type (with Henle loop) and reptilian type (without Henle loop) were observed. Collagen, elastic and reticular fibers were there in different components of the kidney. Histochemically it has determined the secretion of neutral as well as acidic mucopolysaccharide substances. PAS activity was observed at mesangial cells and basement membrane of DCT. The Alkaline phosphatase showed the positive activity in capsule, brush border of proximal and distal convoluted tubules. The Acid phosphatases were showing intense activity in parietal and visceral layer of renal corpuscles, lumen and basement membrane of PCT. The intense activity of Succinic dehydrogenase showed at PCT, DCT, collecting tubule whereas renal corpuscles showed feeble activity.

Simulation and Measurement Data-Based Study on Fat as Propagation Medium in WBAN Abdominal Implant Communication Systems

This paper presents comprehensive study on fat as propagation medium in abdominal implant communication system at low ultrawideband (UWB) frequency range 3.75-4.25 GHz. The main aim is to investigate how signal propagates through visceral and subcutaneous fat layers and how that information can be exploited in implant communication systems. The study is conducted using different methods: electromagnetic simulations, power flow analysis, propagation path calculations and radio channel measurements with animal meat pieces. Simulations are conducted using layer models and anatomical voxel models having different sizes. Results of channel simulations are verified with propagation path calculations. Power flow analysis on cross-cuts of the voxel models is conducted to investigate how the signal propagates inside the tissues. Furthermore, measurements using different animal meat pieces are performed to evaluate the impact of fat constitution on channel characteristics. It is found that similar tendency on fat propagation is seen in the evaluations with different methods. It is also observed that channel attenuation depends not only on the types and thicknesses of the tissues between transmitter and receiver antennas, but also how the tissues, especially fat, is located between the antennas. Channel attenuation difference between different voxels is maximum 14 dB in the studied antenna locations. Furthermore, propagation channel is evaluated with measurements using pork meat having different fat and muscle constitutions. It is found that antenna location respect to fat layers has clear impact on the channel strength although the fat tissue is not directly above the in-body antenna. The difference is noted to be 3-15 dB especially on the side peaks of channel impulse response. The knowledge on fat as a propagation medium is crucial when designing medical monitoring or implant communication systems. Location of antennas/sensor nodes for the monitoring devices can be established so that propagation through fat layer can be exploited.

Evaluation of epicardial fat tissue thickness in patients with multiple sclerosis

Aim: Multiple sclerosis (MS), which is inflammatory in its pathogenesis, damages the myelin sheath in the central nervous system (CNS) and causes axonal loss. Epicardial fat tissue (EFT), located between the myocardium and the visceral layer of the pericardium, surrounds the heart and several inflammatory cytokines is secreted from this tissue. In this study, we aimed to investigate EFT thickness in MS patients and compared with that of volunteer non-MS subjects. Methods: A total of 154 subjects comprising 61 MS patients and 93 volunteers matched for gender and age were included in our study. Epicardial fat tissue thickness was measured by echocardiography. All values were compared between groups. Results: Echocardiographic parameters were similar in both groups. However, the mean EFT thickness was significantly higher in the MS group than in the control group (p<0.001). Epicardial fat tissue thickness was also significantly correlated with the presence of MS (r=0.33, p<0.001). Conclusion: The results of our study suggest that the increase in epicardial adipose tissue thickness in MS patients may be a predictive factor for cardiovascular disease. However, the clinical significance of this finding and its relevance to MS pathogenesis should be investigated in further studies.

Roles of Epicardial Adipose Tissue in the Pathogenesis of Coronary Atherosclerosis - An Update on Recent Findings.

Adipose tissue serves not only as an energy store or a mechanical cushion, but also as an endocrine organ. Recent evidence revealed that perivascular adipose tissue is involved in vascular homeostasis and pathophysiology of adjacent arteries by producing various adipokines. Epicardial adipose tissue (EAT) is located between the surface of the heart and the visceral layer of the pericardium and surrounds the coronary arteries. Many clinical studies suggest that an increase in EAT volume is associated with coronary artery disease. It has been reported that exercise and some antidiabetic drugs can reduce EAT volume. In this review, we outline recent findings on the roles of EAT in the pathogenesis of coronary atherosclerosis.

Factors influencing the fascial closure rate after open abdomen treatment: Results from the European Hernia Society (EuraHS) Registry

PurposeDefinitive fascial closure is an essential treatment objective after open abdomen treatment and mitigates morbidity and mortality. There is a paucity of evidence on factors that promote or prevent definitive fascial closure.MethodsA multi-center multivariable analysis of data from the Open Abdomen Route of the European Hernia Society included all cases between 1 May 2015 and 31 December 2019. Different treatment elements, i.e. the use of a visceral protective layer, negative-pressure wound therapy and dynamic closure techniques, as well as patient characteristics were included in the multivariable analysis. The study was registered in the International Clinical Trials Registry Platform via the German Registry for Clinical Trials (DRK00021719).ResultsData were included from 630 patients from eleven surgical departments in six European countries. Indications for OAT were peritonitis (46%), abdominal compartment syndrome (20.5%), burst abdomen (11.3%), abdominal trauma (9%), and other conditions (13.2%). The overall definitive fascial closure rate was 57.5% in the intention-to-treat analysis and 71% in the per-protocol analysis. The multivariable analysis showed a positive correlation of negative-pressure wound therapy (odds ratio: 2.496, p < 0.001) and dynamic closure techniques (odds ratio: 2.687, p < 0.001) with fascial closure and a negative correlation of intra-abdominal contamination (odds ratio: 0.630, p = 0.029) and the number of surgical procedures before OAT (odds ratio: 0.740, p = 0.005) with DFC.ConclusionThe clinical course and prognosis of open abdomen treatment can significantly be improved by the use of treatment elements such as negative-pressure wound therapy and dynamic closure techniques, which are associated with definitive fascial closure.

Daily Use of Extra Virgin Olive Oil with High Oleocanthal Concentration Reduced Body Weight, Waist Circumference, Alanine Transaminase, Inflammatory Cytokines and Hepatic Steatosis in Subjects with the Metabolic Syndrome: A 2-Month Intervention Study.

Extra virgin olive oil (EVOO) intake is associated with reduced cardiovascular risk, and its phenolic compound oleocanthal (OC) has anti-oxidant and anti-inflammatory properties. The cardiometabolic effects of EVOO with a high OC concentration have not been fully elucidated. We administered EVOO with a high OC concentration daily to 23 subjects with the metabolic syndrome (MetS) and hepatic steatosis (15 men and 8 women, age: 60 ± 11 years) for 2 months. Anthropometric data, metabolic parameters, hepatic steatosis (by fatty liver index, FLI), abdominal fat distribution (by ultrasound), and pro- and anti-inflammatory cytokines were assessed before and after the intervention. EVOO supplementation was associated with a reduction in body weight, waist circumference, body mass index (BMI), alanine transaminase and FLI, as well as interleukin (IL)-6, IL-17A, tumor necrosis factor-α and IL-1B, while IL-10 increased. Maximum subcutaneous fat thickness (SFT max) also increased, with a concomitant decrease in the ratio of visceral fat layer thickness/SFT max. Correlation analysis revealed positive associations between changes in body weight and BMI and those in SFT max, along with an inverse association between changes in IL-6 and those in SFT max. In conclusion, ingestion of EVOO with a high OC concentration had beneficial effects on metabolic parameters, inflammatory cytokines and abdominal fat distribution in MetS subjects with hepatic steatosis, a category of patients at high cardiometabolic risk.

The American Society of Colon and Rectal Surgeons Clinical Practice Guidelines for the Management of Rectal Cancer.

The American Society of Colon and Rectal Surgeons Clinical Practice Guidelines for the Management of Rectal Cancer.

Effects of resistance training on kidney morphology of aged ovariectomized rats

With the advancing age, there is an increase of the incidence of chronic renal diseases. However, it is suggested that exercise, as resistance training, is a key factor in positively modulate the kidney structure and function. Thus, this study aimed to analyze the effects of estrogen deprivation and a moderate resistance protocol on the right kidney structure of rats. A total of 32 animals were randomly divided in four groups (n = 8/per group): control group (CG); resistance trained animals (RT); control ovariectomized animals (OvxC); and trained ovariectomized animals (OvxT). Sections of the right kidney were stained with hematoxylin and eosin for morphometry and blood was collected for biochemical analysis. Our results showed that the group submitted to both ovariectomy and resistance training had significant impact on renal corpuscle components (Bowman’s space, renal corpuscle area, and visceral layer), and proximal and distal tubules. Additionally, resistance training, with or without estrogen deprivation, increases creatine phosphokinase and decreases ultrasensitive C-reactive protein. In summary, we suggested that moderate resistance training may be a key factor to maintain the kidney structure and function across age. However, future studies are need to corroborate with our findings.

Anatomy of the Pericardial Space.

The pericardial cavity and its boundaries are formed by the reflections of the visceral and parietal pericardial layers. This space is an integral access point for epicardial interventions. As the pericardial layers reflect over the great vessels and the heart, they form sinuses and recesses, which restrict catheter movement. The epicardial vasculature is also important when performing nearby catheter ablation. The phrenic nerve and esophagus are other important structures to appreciate so as to avoid collateral injury. In addition, the Larrey space, or left sternocostal triangle, is a key avascular window through which pericardial access can be safely achieved.

Histological, Micrometrical and Histochemical Studies on the Testes of Large White Yorkshire Pig (Sus scrofa domesticus)

The study has been conducted on the testes of 10 adult Large White Yorkshire pig (1.5-2) years of age. The testis was surrounded by a capsule made up of dense irregular connective tissue comprising three layers viz., outer visceral layer of tunica vaginalis, middle tunica albugenia and inner tunica vasculosa. The connective tissue trabeculae were extended from the capsule and divided the parenchyma of the testis into number of lobules and consisted of collagen, elastic and reticular fibers along with rete testis and blood vessels. The Periodic Acid–Schiff shows strong affinity in basement membrane of seminiferous tubules and tunica albuginea with a moderate activity in Leydig cells. The Alcian blue shows strong affinity in basement membrane of seminiferous tubule and weak activity was observed in tunica albuginea and interstitial tissue. The different histomorphometrical parameters with regard to thickness of testicular capsule, diameter and height of seminiferous tubules were found to be higher in the left testicle.