Genetic strategies to tackle neurological diseases in fruit flies

Publication date: June 2018
Source:Current Opinion in Neurobiology, Volume 50
Author(s): Mümine Şentürk, Hugo J Bellen
Drosophila melanogaster is a genetic model organism that has contributed to the discovery of numerous genes whose human homologues are associated with diseases. The development of sophisticated genetic tools to manipulate its genome accelerates the discovery of the genetic basis of undiagnosed human diseases and the elucidation of molecular pathogenic events of known and novel diseases. Here, we discuss various approaches used in flies to assess the function of the fly homologues of disease-associated genes. We highlight how systematic and combinatorial approaches based on recently established methods provide us with integrated tool sets that can be applied to the study of neurodevelopmental and neurodegenerative disorders.



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Ausschreibung Thieme Teaching Award 2018

Anästhesiol Intensivmed Notfallmed Schmerzther 2017; 52: 663-663
DOI: 10.1055/s-0043-118833

Georg Thieme Verlag KG Stuttgart · New York

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Sterblichkeit bei Sepsis: Verbesserungen scheinen schwierig

Anästhesiol Intensivmed Notfallmed Schmerzther 2017; 52: 656-658
DOI: 10.1055/s-0043-118984

Georg Thieme Verlag KG Stuttgart · New York

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Ambulante Anästhesie: Regionalanästhesie im ambulanten Bereich

Anästhesiol Intensivmed Notfallmed Schmerzther 2017; 52: 691-702
DOI: 10.1055/s-0042-120237

Ausgewählte Regionalanästhesieverfahren sind für den ambulant tätigen Anästhesisten eine attraktive Alternative zu Analgosedierung und Narkose – und dies bei hoher Patientenzufriedenheit und seltenen Komplikationen. Dieser Beitrag widmet sich den organisatorischen und hygienischen Anforderungen, die es dabei zu beachten gilt. Des Weiteren gehen die Autoren auf einzelne Verfahren und ihre Anwendung in unterschiedlichen Körperregionen näher ein.
[...]

Georg Thieme Verlag KG Stuttgart · New York

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Perioperatives Vorhofflimmern: Alter und Art der Operation beeinflussen Inzidenz

Anästhesiol Intensivmed Notfallmed Schmerzther 2017; 52: 658-658
DOI: 10.1055/s-0043-117035

Georg Thieme Verlag KG Stuttgart · New York

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Ambulante Anästhesie: Grenzen und Möglichkeiten

Anästhesiol Intensivmed Notfallmed Schmerzther 2017; 52: 666-678
DOI: 10.1055/s-0042-120247

Ambulante Operationen werden künftig zunehmend nachgefragt werden – Ursachen sind u. a. die alternde Bevölkerung und die finanzielle Lage der Krankenkassen. Der Beitrag geht ausführlich auf Begleiterkrankungen ein, bei denen die Entscheidung ambulant oder stationär sorgfältig abgewogen werden muss. Darüber hinaus nimmt er die betriebs- und volkswirtschaftlichen Grenzen und Möglichkeiten des ambulanten Operierens unter die Lupe.
[...]

Georg Thieme Verlag KG Stuttgart · New York

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Neuronenspezifische Enolase zur Prognose nach Herz-Kreislauf-Stillstand

Anästhesiol Intensivmed Notfallmed Schmerzther 2017; 52: 659-660
DOI: 10.1055/s-0043-117055

Georg Thieme Verlag KG Stuttgart · New York

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Der zerebrale Notfall – wichtige anästhesiologische Aspekte

Anästhesiol Intensivmed Notfallmed Schmerzther 2017; 52: 716-725
DOI: 10.1055/s-0042-120989

Der zerebrale Notfall ist eine häufige Notfallsituation – und das Gehirn unterscheidet sich durch seine Unersetzbarkeit und minimale Ischämietoleranz von allen anderen Organen. Dieser Beitrag verwendet bewusst den Begriff des zerebralen Notfalls und will sich so von einzelnen Erkrankungsbildern lösen. Der Fokus liegt auf der anästhesiologischen Praxis, aber auch auf dem „Notfall in uns", den jeder Notfall für das Behandlungsteam bedeuten kann.
[...]

Georg Thieme Verlag KG Stuttgart · New York

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Paravertebrale Katheteranalgesie – wirksame Alternative zum Kaudalblock

Anästhesiol Intensivmed Notfallmed Schmerzther 2017; 52: 660-660
DOI: 10.1055/s-0043-112726

Georg Thieme Verlag KG Stuttgart · New York

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Ambulante Anästhesie

Anästhesiol Intensivmed Notfallmed Schmerzther 2017; 52: 664-665
DOI: 10.1055/s-0043-118408

Georg Thieme Verlag KG Stuttgart · New York

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Langzeitversorgung von Patienten verbessern

Anästhesiol Intensivmed Notfallmed Schmerzther 2017; 52: 662-663
DOI: 10.1055/s-0043-118974

Georg Thieme Verlag KG Stuttgart · New York

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Ambulante Anästhesie: Organisation in Praxis und Krankenhaus

Anästhesiol Intensivmed Notfallmed Schmerzther 2017; 52: 679-690
DOI: 10.1055/s-0042-120238

Ambulante Anästhesie erfolgt immer im Rahmen einer ambulanten Operation – somit hängt der Erfolg davon ab, wie gut die „Einheit ambulantes Operieren" organisiert und aufeinander abgestimmt ist. Dieser Beitrag beleuchtet die vielen rechtlichen Vorgaben, die es beim ambulanten Operieren und Anästhesieren zu erfüllen gilt. Darüber hinaus werden die Organisationsstrukturen im niedergelassenen Bereich und im Krankenhaus erläutert und verglichen.
[...]

Georg Thieme Verlag KG Stuttgart · New York

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Einfühlsame Ärzte sind die besseren Ärzte

Anästhesiol Intensivmed Notfallmed Schmerzther 2017; 52: 662-662
DOI: 10.1055/s-0043-118976

Georg Thieme Verlag KG Stuttgart · New York

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Perioperative Anaphylaxie auf Arzneimittel

Anästhesiol Intensivmed Notfallmed Schmerzther 2017; 52: 704-715
DOI: 10.1055/s-0043-100231

Im Rahmen eines operativen Eingriffs erhalten Patienten zahlreiche Arzneimittel. Entwickeln sie eine anaphylaktische Reaktion, so ist akut schwer zu beurteilen, welche Substanz für diese verantwortlich ist. Die meisten der intraoperativen Einschätzungen zur Ursache einer Anaphylaxie sind falsch. Umso wichtiger ist es, die verursachende Substanz später zu identifizieren, um eine Reexposition, z. B. bei einer erneuten OP, zu verhindern.
[...]

Georg Thieme Verlag KG Stuttgart · New York

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Geburtshilfliche Anästhesie: Altbewährtes, Kontroversen und neue Perspektiven – Teil 1

Anästhesiol Intensivmed Notfallmed Schmerzther 2017; 52: 727-736
DOI: 10.1055/s-0043-104921

In der „Whatʼs New in Obstetric Anesthesia" Lecture, die jedem an der anästhesiologischen Kreißsaalversorgung Interessierten in abgedruckter Form sehr ans Herz gelegt werden kann, werden seit 1975 durch die Society for Obstetric Anesthesia and Perinatology die im Rahmen des Annual Meeting als relevant für die klinische Versorgung erachteten Vorträge zusammengefasst. Nach dem Tode von Gerard W. Ostheimer, Professor of Anesthesiology im Brigham and Womenʼs Hospital in Boston, Massachusetts, wurde sie zur Gerard W. Ostheimer „Whatʼs New in Obstetric Anesthesia" Lecture umbenannt, um dessen Beiträge zur Regionalanästhesie und geburtshilflichen Anästhesie zu würdigen. Jedes Jahr gewährt die von ausgewählten Fachvertretern gehaltene Veranstaltung und ihr Abdruck in namhaften Anästhesie-Journalen Einblick in eine kritische Würdigung rezenter Literatur und die möglichen Konsequenzen für – aber nicht nur – die anästhesiologische Kreißsaalpraxis.Eine ähnliche Veranstaltung hat in Deutschland seit über 16 Jahren Tradition: Das Geburtshilfliche Anästhesiesymposium des Wissenschaftlichen Arbeitskreises Regionalanästhesie und Geburtshilfliche Anästhesie. Anders als in den von Einzelpersonen gehaltenen Vortragsveranstaltungen werden „Evergreens" oder „Hot Topics" der anästhesiologischen Kreißsaalversorgung in regelmäßigem Zyklus oder aus aktuellem Anlass aufgegriffen, präsentiert und vor allem diskutiert. In den Vortragsveranstaltungen offenbart sich oft wesentlich früher als in traditionellen Lehrbuchkapiteln der subtile Wandel in Hinblick auf die diskutierten Themen.Der 2-teilige Beitrag fasst das Symposium 2016 zusammen, stellt jedoch keine offizielle Meinungsbekundung seitens des Arbeitskreises dar. Teil 1 geht auf mütterliche Todesursachen während Schwangerschaft, Geburt und Stillzeit sowie strukturelle Voraussetzungen im Kreißsaal, Adipositas in der Schwangerschaft und Sepsis bei der Schwangeren und im Wochenbett ein. Teil 2 behandelt etablierte Standards und neue Perspektiven im Rahmen der geburtshilflichen Analgesie und Anästhesie bezüglich Epiduralanalgesie, postpunktionellem Kopfschmerz, Anästhesie und Analgesie während und nach Sectio, hämodynamischem Monitoring und postpartaler Blutung.
[...]

Georg Thieme Verlag KG Stuttgart · New York

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Levosimendan bei herzchirurgischen Patienten mit linksventrikulärer Dysfunktion

Anästhesiol Intensivmed Notfallmed Schmerzther 2017; 52: 656-656
DOI: 10.1055/s-0043-118982

Georg Thieme Verlag KG Stuttgart · New York

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Remifentanil up2date – Teil 2

Anästhesiol Intensivmed Notfallmed Schmerzther 2017; 52: 630-639
DOI: 10.1055/s-0043-114676

Remifentanil wird seit 20 Jahren mit Erfolg in vielen Bereichen der Anästhesiologie eingesetzt. Im 1. Teil wurde die Substanz mit ihren pharmakologischen Charakteristika sowie ihren erwünschten und unerwünschten Wirkungen beschrieben. Der hier vorliegende 2. Teil befasst sich mit der Anwendung des Opioids bei speziellen Patientengruppen und in den verschiedenen anästhesiologisch betreuten Fachdisziplinen.
[...]

Georg Thieme Verlag KG Stuttgart · New York

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Analgosedierung bei OSA-Patienten: Ist der Standard hier sinnvoll?

Anästhesiol Intensivmed Notfallmed Schmerzther 2017; 52: 645-648
DOI: 10.1055/s-0043-114467

Georg Thieme Verlag KG Stuttgart · New York

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Katastrophenmedizin in und außerhalb der Klinik: auf das Ungeplante vorbereitet sein

Anästhesiol Intensivmed Notfallmed Schmerzther 2017; 52: 588-593
DOI: 10.1055/s-0043-116913

Georg Thieme Verlag KG Stuttgart · New York

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Aktuell, übersichtlich und knapp

Anästhesiol Intensivmed Notfallmed Schmerzther 2017; 52: 586-586
DOI: 10.1055/s-0042-120977

Georg Thieme Verlag KG Stuttgart · New York

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Nervenschäden nach Regionalanästhesie – welche Risikofaktoren gibt es?

Anästhesiol Intensivmed Notfallmed Schmerzther 2017; 52: 579-580
DOI: 10.1055/s-0043-116930

Georg Thieme Verlag KG Stuttgart · New York

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Pelvic bone anatomy vs implanted gold seed marker registration for image-guided intensity modulated radiotherapy for prostate carcinoma: Comparative analysis of inter-fraction motion and toxicities

Publication date: Available online 9 November 2017
Source:Journal of the Egyptian National Cancer Institute
Author(s): Madhup Rastogi, Sambit Swarup Nanda, Ajeet Kumar Gandhi, Divakar Dalela, Rohini Khurana, Surendra Prasad Mishra, Anoop Srivastava, S. Farzana, Madan Lal Brahma Bhatt, Nuzhat Husain
ObjectivesWe compared the prostate motion variability and toxicities between patients treated with gold marker registration based IG-IMRT (IG-IMRT-M) and bony landmark registration based IG-IMRT (IG-IMRT-B).MethodsT1c-T3b (node negative), intermediate and high risk (non-metastatic) adenocarcinoma of prostate, age ≥18years, Karnofsky Performance Status of ≥70 were included in this retrospective study. The prostate motion variability, acute and late radiation toxicities between the two treatment arms (IG-IMRT-M versus IG-IMRT-B) were compared.ResultsTotal of 35 patients (17 for IG-IMRT-M and 18 for IG-IMRT-B) were treated with a median radiotherapy dose of 76 Gray. The prostate variability observed with and without markers in millimeter was 4.1±2.3 vs 3.7±2.1 [Antero-Posterior (A-P); p=0.001], 2.3±1.5 vs 2.1±1.2 [Superior-Inferior (S-I); p=0.095] and 1.1±1.7 vs 0.4±1.4 [Left-Right (L-R); p=0.003]. There was higher acute toxicity in IG-IMRT-B arm compared to IG-IMRT-M arm in terms of grade ≥2 diarrhea [50% vs 11% OR=7.5 (1.3–42.7); p=0.02] and grade ≥2 proctitis [38% vs 5.8%, OR=10.1 (1.09–94.1); p=0.04]. At a median follow up of 36months, the late genitourinary toxicities grade ≥2 [27% vs 0%; p=0.04] were higher in the IG-IMRT-B arm compared to IG-IMRT-M arm.ConclusionsIG-IMRT-M detects higher prostate motion variability as compared to IG-IMRT-B, inferring a significant prostate motion inside fixed pelvic bony cavity. The addition of marker based image guidance results in higher precision of prostate localization and lesser acute and late toxicities.



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Educational Effects of Radiation Reduction During Fluoroscopic Examination of the Adult Gastrointestinal Tract

Publication date: Available online 9 November 2017
Source:Academic Radiology
Author(s): Moon Hyung Choi, Seung Eun Jung, Soon Nam Oh, Jae Young Byun
Rationale and ObjectivesThis study aimed to evaluate the effects of educating radiology residents and radiographers about radiation exposure on reduction of dose area product (DAP) and fluoroscopy time in diagnostic fluoroscopy of the gastrointestinal (GI) tract in adult patients.Materials and MethodsIn April 2015, we offered 1 hour of education to radiology residents and radiographers on how to reduce radiation doses during fluoroscopic examinations. Fluoroscopic examinations of the GI tracts of adult patients performed from June 2014 to February 2016 were evaluated. A total of 2326 fluoroscopic examinations (779 and 1547 examinations before and after education, respectively) were performed, including 10 kinds of examinations. Fluoroscopy time and DAP were collected. A radiologist evaluated the number of spot images, captured images, cine video, captured video, and the use of collimation or magnification. We used the Mann-Whitney U test to assess the difference in fluoroscopy-related factors before and after education.ResultsMedian DAP decreased significantly after education, from 21.1 to 18.2 Gy∙cm² (P < .001) in all examinations. After education DAP decreased significantly in defecography (P < .001) and fluoroscopy time decreased significantly in upper gastrointestinal series with water-soluble contrast (P < .001). Spot and cine images that increased the radiation dose were used less frequently after education than before in some kinds of examinations, especially in defecography (P < .001). More images were collimated after education in barium swallow than before (P < .001).ConclusionsEducating radiologist residents and radiographers could reduce DAP in fluoroscopy examinations of the GI tract in adult patients.



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Does sex influence biceps brachii muscle stiffness?

Publication date: Available online 10 November 2017
Source:Clinical Imaging
Author(s): Chueh-Hung Wu




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Response to “Providing dermatological care in resource-limited settings: barriers and potential solutions” – reply from authors

We thank Drs. Mahé and Faye for their interest in our article. We applaud them for their tremendous work in improving the delivery of dermatologic care through their programme with healthcare professionals in Mali.

This article is protected by copyright. All rights reserved.

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Psychological stress and psoriasis. A systematic review and meta-analysis

Abstract

Background

Psychological stress has long been linked with psoriasis exacerbation/onset. However, it is unclear if they are associated.

Objective

To determine if antecedent psychological stress and psoriasis exacerbation/onset are associated.

Methods

A comprehensive search of Pubmed, PsycINFO, Cochrane library, and clinicaltrials. gov databases was performed. Studies investigating the association between preceding psychological stress and psoriasis exacerbation/onset were classified as cross-sectional, case-control or cohort. Surveys evaluating beliefs regarding stress-reactivity were analysed separately. Suitable studies were meta-analysed.

Results

Thirty-nine studies were included evaluating 32,537 patients: 19 surveys, 7 cross-sectional, 12 case-controls and 1 cohort. Based on surveys and cross-sectional studies, 46% of patients believed their disease was stress-reactive and 54% recalled preceding stressful events. Case-control studies evaluating stressful events rates prior to psoriasis exacerbation (N=6) or onset (N=6) varied in time lag to recollection (≤9 month to ≥ 5 years). Pooling 5 studies evaluating stressful events preceding psoriasis onset yielded an OR of 3.4 (95%CI, 1.8-6.4, I² =87%), however the only study evaluating documented stress disorder diagnosis reported similar rates (OR 1.2, 95%CI, 0.8-1.8) between patients and controls. Four studies evaluating stressful events prior to psoriasis exacerbation reported comparable rates with controls, while 2 found more frequent/severe preceding events among psoriasis patients. A small prospective cohort study reported a modest association between stress-levels and psoriasis exacerbation (r = 0.28, p < 0.05).

Conclusions

The association between preceding stress and psoriasis exacerbation/onset is based primarily on retrospective studies with many limitations. No convincing evidence exists that preceding stress is strongly associated with psoriasis exacerbation/onset.

This article is protected by copyright. All rights reserved.

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Response to “Providing dermatological care in resource-limited settings: barriers and potential solutions”

We read with interest the paper from Chang et al (1). However, the authors overlooked certain solutions that were developed by our team to improve on a large scale the problem of skin diseases (SD) in resource limited settings (RLS), through an organized, public health approach (2-4).

This article is protected by copyright. All rights reserved.

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Evaluation of the Triple Code Model of numerical processing—Reviewing past neuroimaging and clinical findings

Publication date: January 2018
Source:Research in Developmental Disabilities, Volume 72
Author(s): Julia Siemann, Franz Petermann
This review reconciles past findings on numerical processing with key assumptions of the most predominant model of arithmetic in the literature, the Triple Code Model (TCM). This is implemented by reporting diverse findings in the literature ranging from behavioral studies on basic arithmetic operations over neuroimaging studies on numerical processing to developmental studies concerned with arithmetic acquisition, with a special focus on developmental dyscalculia (DD). We evaluate whether these studies corroborate the model and discuss possible reasons for contradictory findings. A separate section is dedicated to the transfer of TCM to arithmetic development and to alternative accounts focusing on developmental questions of numerical processing. We conclude with recommendations for future directions of arithmetic research, raising questions that require answers in models of healthy as well as abnormal mathematical development.What this paper addsThis review assesses the leading model in the field of arithmetic processing (Triple Code Model) by presenting knowledge from interdisciplinary research. It assesses the observed contradictory findings and integrates the resulting opposing viewpoints. The focus is on the development of arithmetic expertise as well as abnormal mathematical development. The original aspect of this article is that it points to a gap in research on these topics and provides possible solutions for future models.



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Nitrogen enrichment of host plants has mostly beneficial effects on the life-history traits of nettle-feeding butterflies

Publication date: November 2017
Source:Acta Oecologica, Volume 85
Author(s): Susanne Kurze, Thilo Heinken, Thomas Fartmann
Butterflies rank among the most threatened animal groups throughout Europe. However, current population trends differ among species. The nettle-feeding butterflies Aglais io and Aglais urticae cope successfully with the anthropogenic land-use change. Both species are assumed to be pre-adapted to higher nitrogen contents in their host plant, stinging nettle (Urtica dioica). However, it is currently unknown, whether this pre-adaptation enables both Aglais species to cope successfully or even to benefit from the excessive nitrogen availabilities in nettles growing in modern farmlands. For this reason, this study focused on the response of both Aglais species to unfertilized nettles compared to nettles receiving 150 or 300 kg N ha⁻¹ yr⁻¹ (i.e., common fertilizer quantities of modern-day agriculture). Fertilized nettles were characterized by higher nitrogen concentrations and lower C:N ratios compared to the control group. In both Aglais species, the individuals feeding on fertilized nettles had higher survival rates, shorter larval periods and heavier pupae and, in A. urticae also longer forewings. All these trait shifts are beneficial for the individuals, lowering their risk to die before reproduction and increasing their reproductive potential. These responses agree with the well-accepted nitrogen-limitation hypothesis predicting a positive relationship between the nitrogen content of the diet and the performance of herbivorous insects. Furthermore, our findings suggest that the increasing abundance of both Aglais species may result not only from the increasing spread of nettles into the farmland but also from changes in their quality due to the eutrophication of the landscape during recent decades.



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Metal availability, soil nutrient, and enzyme activity in response to application of organic amendments in Cd-contaminated soil

Abstract

The study investigated the effects of organic amendments: green tea amendment (GTA) and oil cake amendment (OCA) on Cd bioavailability, soil nutrients, and soil enzyme activity in Cd-contaminated soil. The amendments were added to the soil at the doses of 1, 3, and 5% and were incubated for 45 days. Then, pakchoi cabbage was planted to test the remediation effect of the above two organic amendments. The diethylenetriaminepentaacetic acid (DTPA)-extractable Cd in GTA and OCA treatments was reduced by 14.69–27.51 and 13.75–68.77%, respectively, compared to no amendment-applied treatment. The application of GTA and OCA notably decreased the proportion of exchangeable fraction of Cd, but increased the percentage of oxide and organic-bound fraction of Cd, thereby suppressing the uptake by pakchoi cabbage. Cd concentration of aboveground parts decreased by 8.21–18.05 and 7.77–35.89% in GTA and OCA treatments, respectively. Relative to the no amendment-applied treatment, both GTA and OCA had enhanced soil nutrients and enzyme activities largely. Redundancy analysis showed that organic matter, total P, available N, and DTPA-extractable Cd significantly affected the enzyme activities. Furthermore, the application of OCA at the dose of 5% was more effective in reducing bioavailable Cd, enhancing soil available nutrients and urease and catalase activities in contaminated soil. These results indicated that oil cake should be used to immobilize metal and improve fertility and quality of Cd-contaminated soil.

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Godina's Principles in the Twenty-First Century and the Evolution of Lower Extremity Trauma Reconstruction

J reconstr Microsurg
DOI: 10.1055/s-0037-1607348

Background February of 2016 marked 30 years since the passing of Marko Godina, a pioneer and prodigy in the field of reconstructive microsurgery. Most noteworthy among his many contributions was his method of radical debridement of contaminated compound fractures followed by early free tissue transfer for wound closure. In the last three decades, the landscape of reconstructive surgery has undergone significant transformation owing to advances in reconstructive techniques and wound care technology, as well as new data. Methods Dr. Godina's work and legacy are reviewed, compared and contrasted with new and evolving data regarding lower extremity trauma reconstruction. Results Advancements in technique and technology have greatly molded lower extremtiy reconstruction over the past thirty years. Nonetheless, Dr. Godina's principles of timely care and early vascularized soft tissue coverage have withstood the test of time. Conclusion Marko Godina's contribution to reconstructive microsurgery cannot be overstated and his groundbreaking work continues to serve as the foundation of lower extremity trauma reconstruction. Three decades after his seminal work, we honor Dr. Godina's legacy and explore how his principles have endured, evolved, or been replaced.
[...]

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Events

Publication date: Available online 9 November 2017
Source:Materials Today





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Use of Incisional Negative Pressure Wound Therapy in Skin-Containing Free Tissue Transfer

J reconstr Microsurg
DOI: 10.1055/s-0037-1608621

Background Negative pressure wound therapy (NPWT) was initially introduced for wound management, but its benefits have stimulated the investigation of its use in new clinical scenarios. Most recently, incisional NPWT has been shown to be a benefit. Incisional NPWT applied to skin-containing free tissue transfer has not been well defined. This may originate from concerns of dressing material obscuring frequent examination of the newly transferred tissue or risk of pedicle compression and potential for increased risk of tissue loss. We aim to describe incisional NPWT in cutaneous free tissue transfer. Methods An institutional review board-approved retrospective review of consecutive free tissue transfer patients was completed over a 3-year period. Free tissue transfer procedures were performed in standard manner. After fixation of the flap to the donor site with interrupted sutures, one or two drainage tubes were inserted in the subflap position. The surface of the flap was protected with Vaseline gauze followed by a 1 cm thick layer of sterile cotton. The vacuum-assisted closure (VAC) sponge (KCI, TX) was then placed in the standard fashion and negative pressure at −125 mm Hg was initiated in a continuous mode. A window was routinely made over the flap's distal region to allow for serial flap examination. For extremity procedures, no splints were utilized, and patients were limited to motion in the hospital bed. NPWT was employed continuously for 7 days and subsequently removed along with operative drains. Results A total of 24 consecutive patients underwent free tissue transfer. The average patient age was 39.8 years with a mean body mass index of 23. Tobacco use was noted in 58% of patients in the series. The indication for the free tissue transfer included trauma (N = 21), malignancy (N = 2), and burn reconstruction (N = 1). The areas of reconstruction included scalp (N = 5), lower extremity (N = 11), and upper extremity (N = 8). Skin-containing free flaps employed consisted of the latissimus dorsi myocutaneous free flap (N = 16), anterolateral thigh free flap (N = 6), thoracodorsal artery perforator free flap (N = 1), and radial forearm free flap (N = 1). The average defect size reconstructed was 238.3 cm2 with a mean operative time of 501 minutes. Postoperatively, patients remained in the hospital an average of 15.5 days (range: 9–32 days) with a mean follow-up of 8.1 months. No hematomas, seromas, surgical-site infections, or deep vein thrombosis/pulmonary embolism occurred in the series. None of the flaps required return to the operating room. There were no documented cases of partial or complete flap loss. Conclusions NPWT may be employed in a fashion similar to the standard incisional application. With this technique, serial flap examination remains possible and is not associated with pedicle compression or increased rates of flap loss. Interestingly, no splints were utilized with the VAC device which itself may serve as a relative immobilizer of an extremity.
[...]

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Pattern of Bone Generation after Irradiation in Vascularized Tissue Engineered Constructs

J reconstr Microsurg
DOI: 10.1055/s-0037-1607322

Background Regenerative medicine modalities provide promising alternatives to conventional reconstruction techniques but are still deficient after malignant tumor excision or irradiation due to defective vascularization. Methods We investigated the pattern of bone formation in axially vascularized tissue engineering constructs (AVTECs) after irradiation in a study that mimics the clinical scenario after head and neck cancer. Heterotopic bone generation was induced in a subcutaneously implanted AVTEC in the thigh of six male New Zealand rabbits. The tissue construct was made up of Nanobone (Artoss GmbH; Rostock, Germany) granules mixed with autogenous bone marrow and 80 μL of bone morphogenic protein-2 at a concentration of 1.5 μg/μL. An arteriovenous loop was created microsurgically between the saphenous vessels and implanted in the core of the construct to induce axial vascularization. The constructs were subjected to external beam irradiation on postoperative day 20 with a single dose of 15 Gy. The constructs were removed 20 days after irradiation and subjected to histological and immunohistochemical analysis for vascularization, bone formation, apoptosis, and cellular proliferation. Results The vascularized constructs showed homogenous vascularization and bone formation both in their central and peripheral regions. Although vascularity, proliferation, and apoptosis were similar between central and peripheral regions of the constructs, significantly more bone was formed in the central regions of the constructs. Conclusion The study shows for the first time the pattern of bone formation in AVTECs after irradiation using doses comparable to those applied after head and neck cancer. Axial vascularization probably enhances the osteoinductive properties in the central regions of AVTECs after irradiation.
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Soft Tissue Coverage in Distal Lower Extremity Open Fractures: Comparison of Free Anterolateral Thigh and Free Latissimus Dorsi Flaps

J reconstr Microsurg
DOI: 10.1055/s-0037-1607323

Background When microsurgical transfers are required in posttraumatic lower limb reconstruction, surgeons must choose among many types of free flaps. Historically, surgeons have advocated muscular flaps for coverage of open lower extremity wounds, but fasciocutaneous free flaps are now often used with good results. This study aimed to compare the functional and aesthetic outcome of reconstruction by free muscular latissimus dorsi (LD) flap and free fasciocutaneous anterolateral thigh (ALT) flap used for soft tissue coverage of distal lower extremity open fractures. Methods We performed a single-center, retrospective study of subjects with distal lower limb open fractures treated with LD flaps or ALT flaps between 2008 and 2014. Patients with limited follow-up or incomplete data were excluded from the analysis. Donor and recipient sites, early complications and long-term outcomes (functional and aesthetic) were studied and compared according to the type of flap. Results A total of 47 patients were included: 27 patients in the LD flap group and 20 patients in the ALT flap group. No significant difference was found regarding early and late complications and long-term functional outcomes (bone healing, infectious bone complications, flap healing). As for aesthetic outcome and donor-site morbidity, reconstruction using the ALT free flap had significantly better results (p < 0.05). Conclusions In posttraumatic lower limb injury, either LD or ALT free flaps can be used for wound coverage with comparable long-term functional outcomes. The ALT flap provides better cosmetic results than LD.
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Effect of Preoperative Medical Status on Microsurgical Free Flap Reconstructions: A Matched Cohort Analysis of 969 Cases

J reconstr Microsurg
DOI: 10.1055/s-0037-1607309

Background Free tissue transfers have become standard for a wide variety of reconstructive purposes. In an era of increasing economic pressure, it is important to precisely define appropriate candidates and indications for a complex surgery to optimize efficiency and patient outcomes. This study evaluates the feasibility to perform microsurgical procedures in a medically compromised patient cohort at a major academic microsurgical center. Methods Within 7 years, 897 patients underwent 969 microvascular free flap reconstructions. The data were retrospectively screened for patients' demographics, perioperative details, flap survival, surgical complications, and outcomes. The cases were divided into two groups in "low-risk" (American Society of Anesthesiologists [ASA] I and II) or "high-risk" (ASA III and IV) as per the preoperative medical status classified according to the ASA score of physical status. Results Despite the significantly higher prevalence of hypertension, peripheral artery disease, diabetes, obesity, and smoking status in the "high-risk" group (p < 0.05), there was no significant difference in the rate of surgical or medical complications, in operative times regarding overall as well as different flap entities, flap failures, need for revision surgery, or hospital length of stay between the two patient groups during our 3-months follow-up period (p > 0.05). Conclusion In this study, free flap reconstruction in medically compromised patients was not associated with higher rates of revision surgeries, overall complication rates, or surgery-related costs. Complex microsurgical free flap reconstruction can therefore also be advocated in patients with high preoperative risk constellation.
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Microsurgery Fellowships—Development of a Clinical Curriculum

J reconstr Microsurg
DOI: 10.1055/s-0037-1607435

Background Microsurgery fellowships have become an integral part of every plastic surgery training program. While each subspecialty differs in terms of reconstructive requirements, the basic tenets and skill sets remain the same. We explore the possibility of designing a clinical curriculum for microsurgery that can provide residents and fellows with a more foundational and structured approach to microsurgical training. Methods Thirteen core and desired skills to accommodate an "ideal" microsurgery curriculum were listed and categorized according to the level of difficulty. The curriculum was then sent to plastic surgery trainees, fellows, and consultants within Scotland in the form of a survey. They were asked to assign a level of difficulty, basic, intermediate, or advanced, to each of the 13 skill sets. Results A total of 27 surgeons were surveyed; the majority of which were plastic surgery registrars. Overall a broad, generic clinical curriculum was felt to be lacking, but would be beneficial at the start of training. The curriculum should emphasize a step-wise progression, starting from achieving competency in safe, efficient anastomosis at the basic level to eventually mastering the principles of complex reconstruction at a more advanced level. Conclusions A generic clinical curriculum offers a framework for tracking progress, the potential for competency-based assessment, and aid in designing a microsurgery fellowship. The curriculum should reflect the evolving nature of the specialty and provide a foundational platform for future innovations.
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Does Postoperative Anticoagulation Therapy Lead to a Higher Success Rate for Microvascular Free-Tissue Transfer in the Head and Neck? A Systematic Review and Meta-Analysis

J reconstr Microsurg
DOI: 10.1055/s-0037-1606346

Background Due to limited evidence, it is unclear whether postoperative anticoagulation therapy may lead to higher success rates for microvascular free-flap surgery in the head and neck. This review evaluated whether postoperative anticoagulation therapy can lead to a better result in head and neck reconstruction. Methods PubMed, Embase, and the Cochrane Library were used to search for articles on the efficacy of postoperative antithrombotic therapy in free-flap transfer during head and neck reconstruction without language restrictions in February of 2017. A random-effects model was used to estimate the relative risk ratio (RR) with 95% confidence intervals (CIs). The measured outcomes were flap loss, thromboembolic events, and hematoma formation. Results A total of 2,048 free-flap surgery procedures in the head and neck were analyzed. There was no significant difference in the occurrence of flap loss and thromboembolic events in the anticoagulation group compared with the nonanticoagulation group (RR = 1.25, 95% CI = 0.85–1.81, p = 0.26; and RR = 1.05, 95% CI = 0.74–1.48, p = 0.79, respectively). The risk of hematoma was twice as high in the anticoagulation group than the nonanticoagulation group, which was statistically significant (RR = 2.02, 95% CI = 1.08–3.76, p = 0.03). Conclusion The findings from our meta-analysis indicate that postoperative anticoagulation therapy barely decreases the risks of flap loss and thromboembolic events in free-flap surgery in the head and neck. However, it may significantly increase the risk of hematoma formation. Considering the limitations of this meta-analysis, additional high-quality, multicenter, prospective, randomized controlled studies are needed to confirm these findings.
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Quantity of Lymph Nodes in the Vascularized Lymph Node Transfer Influences Its Lymphaticovenous Drainage

J reconstr Microsurg
DOI: 10.1055/s-0037-1606320

Background The purpose of this study was to: (1) evaluate the mechanism of lymph drainage through a vascularized lymph node (VLN) flap, and (2) investigate if the number of VLNs impacts lymph transit time through the flap. Methods Twenty-seven axillary VLN flaps were elevated in 14 Sprague-Dawley rats and divided into three groups (n = 9 each) based on the number of lymph nodes present: group 1 (0-VLNs), group 2 (2-VLNs), and group 3 (4-VLNs). Indocyanine green (n = 8/group) and Alexa680-albumin (n = 1/group) were injected into the edge of flaps and the latency period between injection and fluorescence in the axillary vein was recorded. Stereomicroscopic fluorescent lymphography was performed to directly visualize lymphatic transit through VLNs. Results Fluorescence was detected in the axillary vein after 229s [47–476], 79s [15–289], and 56s [16–110] in group 1, 2, and 3, respectively (p < 0.01). There was a negative correlation between the number of VLNs in the flap and the latency period (r = -0.59; p < 0.05). Median flap weights were comparable in group 1, 2, and 3 (258 mg [196–349], 294 mg [212–407], 315 mg [204–386], respectively; p = 0.54). Stereoscopic lymphography allowed direct visualization of lymphatic fluid transit through VLNs. Conclusion Lymphatic fluid in VLN flaps drains into the venous system mainly by passing through the afferent lymphatics and lymph nodes. A secondary mechanism appears to be the diffusion of fluid into the venous system via intratissue lymphaticovenous connections created during flap elevation. Increasing the number of lymph nodes in the flap is associated with a more rapid transit of fluid.
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Effects of Tirofiban on Random Skin Flap Survival in Rats

J reconstr Microsurg
DOI: 10.1055/s-0037-1607304

Background Tirofiban is a glycoprotein IIb/IIIa receptor antagonist that is widely used clinically. In the present study, we investigated whether tirofiban promotes flap survival in rat random skin flap model. Methods "McFarlane flaps" models were developed in 60 male rats. The rats were divided into a tirofiban-treated group (n = 30) and a saline-treated group (n = 30). The flap surviving rate was calculated 7 days after surgery. Tissue samples were collected and subjected to histopathological evaluation. Lead oxide–gelatin angiography and immunohistochemical staining analysis were taken to evaluate angiogenesis. Analysis of oxidative stress was performed by measuring the activity of superoxide dismutase (SOD) and malondialdehyde (MDA). Results Compared with controls, the tirofiban-treated groups exhibited significantly larger mean areas of flap survival, significantly increased SOD activity, and vascular endothelial growth factor (VEGF) expression, and significantly reduced MDA level. Hematoxylin and eosin staining revealed that naringin promoted angiogenesis and inhibited inflammation. Conclusion These findings demonstrate that tirofiban increases flap survival of random skin flaps in rats.
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First Experiences with Incisional Negative Pressure Wound Therapy in a High-Risk Poststernotomy Patient Population treated with Pectoralis Major Muscle Flap for Deep Sternal Wound Infection

J reconstr Microsurg
DOI: 10.1055/s-0037-1605379

Background Radical debridement and wound closure with vascularized flaps has become a standard procedure in the treatment of deep sternal wound infections. Negative pressure incision management systems have been proven to diminish wound infections after sternotomy. In this study, the utility of Prevena Incision Management System (KCI Licensing Inc.) was evaluated in obese patients who received unilateral pectoralis major flap for the treatment of deep sternal wound infections. Methods The outcome and wound-related complication rates of 19 obese patients (mean body mass index, 33.7) treated for deep sternal wound infection with pectoralis major muscle flap in combination with Prevena between 2011 and 2016 were compared with 28 obese patients treated with conventional wound dressing only between 2000 and 2010. Results In patients additionally treated with Prevena, significantly fewer surgical revisions due to wound-related complications were necessary as compared with patients who received conventional wound dressing (5.3 vs. 32.1%, p = 0.034). A significantly shorter ICU length of stay (median 0 vs. 3.5 days, p < 0.001) and a trend toward shorter length of hospitalization (median 14 vs. 19.5 days after pectoralis major flap) could be observed. Conclusion The application of Prevena significantly reduced revision surgery rates in obese patients treated with unilateral pectoralis major flap for deep sternal wound infections.
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Surgical Duration Impacts Venous Thromboembolism Risk in Microsurgical Breast Reconstruction

J reconstr Microsurg
DOI: 10.1055/s-0037-1606339

Background Increased surgical duration can impact patient outcomes and operative efficiency metrics. In particular, there are studies suggesting that increased surgical duration can increase the risk of venous thromboembolism (VTE). One of the longer duration plastic surgery procedures commonly performed is microsurgical breast reconstruction. With the widening indications for multiple and "stacked" free flaps to reconstruct breasts, we endeavored to assess (1) the relationship between duration of microsurgical breast reconstruction and VTE; and (2) determine if a threshold operative time exists that connotes VTE higher risk. Methods Patients from the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) between 2005 and 2014 who underwent microsurgical breast reconstruction were identified by Current Procedural Terminology code. Three models of multivariate logistic regression were used to characterize the adjusted risk for VTE by operative duration, bilaterality, the length of stay, and patient demographics. Results A total of 4,782 patients who underwent microsurgical breast reconstruction were identified. Overall VTE incidence was 1.13%. The mean operative duration was 8:31 hours:minutes (standard deviation: 2:59). Operative duration was statistically associated with VTE in continuous, quintile, and dichotomized risk models. Beyond an operative duration of 11 hours, adjusted VTE risk increases fourfold corresponding to a number needed to harm of 45.8. Conclusions Increasing surgical duration heightens the risk of VTE in microsurgical breast reconstruction. Increasing body mass index and age enhances this VTE risk. Moreover, limiting surgical duration to 11 hours or less can decrease VTE risk by fourfold vis-à-vis baseline. Level of Evidence Risk, II.
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Variations in the Anterolateral Thigh Flap's Vascular Anatomy in African Americans

J reconstr Microsurg
DOI: 10.1055/s-0037-1604087

Background Variations in anterolateral thigh (ALT) arterial anatomy are well documented. Ethnicity is a known risk factor for vascular variation in several organ systems, but its impact on ALT anatomy has not been studied. Anecdotally, we observed frequent ALT arterial variation in African American (AA) patients. We thus hypothesized that AA patients have higher rates of anomalous branching. Materials and Methods A total of 277 computed tomography angiograms (513 lower extremities) captured between May 1, 2013 and May 31, 2015 at a tertiary academic medical center were retrospectively analyzed to determine ALT arterial branching. Patient records were examined to ascertain demographics. Data were analyzed using descriptive statistics and multinomial logistic regression. Results Males comprised 84.5%. Ethnic distribution was 55.2% AA and 36.5% Caucasian. The descending branch of the lateral circumflex femoral artery (dLCFA) originated from non-LCFA arteries (deep femoral, common femoral, or superficial femoral arteries) in 18.9% of Caucasian versus 9.1% of AA (odds ratio [OR]: 2.28; 95% confidence interval [CI]: 1.33–3.93, p < 0.01). An oblique branch was identified in 41.1% of Caucasian versus 51.9% of AA (OR: 1.56; 95% CI: 1.08–2.24, p = 0.02). Ethnicity was the only driving factor of dLCFA and oblique branch of the LCFA (oLCFA) anatomy (Wald chi-square: 14 and 11, p = 0.03 and 0.02, respectively). Conclusions Ethnicity significantly affects ALT arterial anatomy. AA are more likely to have classical dLCFA branching with a fourth oLCFA branch. A flap with an unrecognized oLCFA-dominant supply places patients at a higher risk for flap failure and loss. We recommend preoperative imaging before undertaking an ALT flap reconstruction.
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Achilles Region Soft-Tissue Defects: A Reconstructive Algorithm Based on a Series of 46 Cases

J reconstr Microsurg 2017; 33: S40-S47
DOI: 10.1055/s-0037-1606554

Background Several options have been described for soft-tissue reconstruction in Achilles tendon region (ATR). The best procedure should be customized according to any single case taking into account the number of structures involved, the quality of the neighboring skin, and patient's general condition. The aim of this article is to describe a simplified reconstructive algorithm based on personal experience and reviewing literature. Methods Forty-four patients, who underwent ATR soft-tissue reconstruction between 1998 and 2016, have been retrospectively reviewed. Etiologies of the defect include the following: 18 posttraumatic, 10 postoncologic, 14 dehiscence/infection, and 2 chronic ulcers. Follow-up ranges between 12 and 96 months. Free flaps have been used in 30 cases (including two secondary surgeries due to propeller flap failure) and propeller flaps have been used in 16 cases. Results Thirty-six flaps survived uneventfully (78.3%). Total flap necrosis occurred in three cases (6.5%), namely, two propeller flaps and one free flap. Partial necrosis of the flap was observed in seven cases (15, 2%): three in the free flap group and four in the propeller group. The functional recovery was very good in all the patients without involvement of the tendon and also all the patients who underwent a simultaneous reconstruction of the tendon with different techniques recovered a full weight bearing and a satisfactory range of motion. Conclusion Propeller flaps are a valuable option for skin reconstruction in case of defects of small and medium size not involving the tendon. In case of larger defects and when a simultaneous ATR reconstruction is required, a free flap seems to be a better option.
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Below Knee Stump Reconstruction with a Foot Fillet Flap

J reconstr Microsurg 2017; 33: S20-S26
DOI: 10.1055/s-0037-1606538

Background The "spare parts" approach to the reconstruction of below knee amputation, applied in acute trauma patients, can also be employed in elective surgery, ensuring knee salvage and a sensitive stump and enabling tissue harvesting without further donor-site morbidity. Methods We present a series of eight cases, where leg amputation due to trauma or its sequelae was followed by reconstruction with skin or a composite flap from the foot. An osteocutaneous flap was used in two emergency patients with below knee amputation, where it allowed stump elongation and knee coverage, and in five secondary procedures, where it provided both stump length and sensitive skin coverage. The skin of the foot was used in one case to cover the tibial stump. Fixation was accomplished with 2-mm Kirschner wires in the emergency patients and with an external fixator (n = 5) or by internal fixation (n = 1) in the elective procedures. Any complications were minor. Secondary compression with an external fixator was required in one emergency patient due to delayed bone healing. Results All knees healed. Sensibility was restored in all patients with a posterior tibial nerve suture (S4) and was well preserved in those without nerve coaptation. No patients reported problems with the prosthesis at a minimum follow-up of 3 years. Knee flexion and extension were comparable to those of the contralateral limb. Conclusion The "spare parts" concept is a reliable approach to tibial stump reconstruction. External fixation in elective procedures allowed immediate weight bearing and bone healing. In emergency patients, rapid fixation with wires provided satisfactory results.
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Vascular Grafts and Flow-through Flaps for Microsurgical Lower Extremity Reconstruction

J reconstr Microsurg 2017; 33: S14-S19
DOI: 10.1055/s-0037-1606560

Background The use of vascular grafts is indicated in case of insufficient pedicle length or for complex defects involving both soft tissues and vessels. Venous grafts (for both venous and arterial reconstructions) and arterial grafts (arterial reconstruction) can be used. This study retrospectively evaluated the needs for vascular reconstruction and its results in a clinical series of lower limb reconstructions with microsurgical free flaps. Materials and Methods From 2010 to 2015, a total of 16 vascular grafts or flow-through flaps were used in 12 patients out of a total of 150 patients undergoing microsurgical reconstruction (8%). Arterial reconstruction was performed in seven cases (six flow-through flaps, one arterial graft), combined arterial and venous reconstruction in four cases (three vein grafts, one combined venous/arterial graft), and venous reconstruction in one case (one venous graft). The rate of complications and donor-site morbidity related to vascular graft harvest were evaluated. Results Reconstruction was successful in all cases, despite an overall complication rate of 17 and 8% of surgical revision. Donor-site morbidity, subjectively evaluated, was minimal with respect to functional deficits and aesthetic outcome. Indications for the different types of grafts are discussed. Conclusion The use of vascular grafts is needed in a relevant percentage of microsurgical reconstruction cases. Venous and arterial vascular grafts, transient arteriovenous fistulas, and "flow-through" microsurgical flaps showed a safe reconstruction comparable to microsurgical reconstructions without the use of grafts. Donor-site morbidity secondary to vascular graft harvest is minimal, and in almost 70% of cases no additional scars are needed.
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Role of Negative Pressure Therapy as Damage Control in Soft Tissue Reconstruction for Open Tibial Fractures

J reconstr Microsurg 2017; 33: S08-S13
DOI: 10.1055/s-0037-1606542

The concept of damage control orthopaedics (DCO) is a strategy that focuses on managing orthopaedic injuries in polytrauma patients who are in an unstable physiological state. The concept of DCO is an extension of damage control surgery or damage limitation surgery (DCS/DLS). Recently, it has become clear that certain patients, following extensive soft tissue trauma, could benefit from the idea of DCS. In the management of severe lower extremity trauma with exposed fracture sites, aggressive early wound excision debridement, early internal fixation, and vascularized wound coverage within a few days after trauma were proposed. A negative-pressure dressing can be easily and rapidly applied to obtain a temporary closure between surgical stages. While negative pressure wound therapy (NPWT) has clear indications in the management of chronic wounds, its applications in the acute setting in victims of polytrauma are uneven. We conducted a review of the current clinical literature to evaluate the role of NPWT in this field, which points out that the negative pressure, applied immediately after the first debridement, seems to be an optimal bridge to the final reconstruction up to 7 days.
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Muscle versus Fasciocutaneous Flap in Lower Limb Reconstruction: Is There a Best Option?

J reconstr Microsurg 2017; 33: S27-S33
DOI: 10.1055/s-0037-1606559

Soft tissue defects of the lower extremity that expose underlying bones, joints, and tendons pose challenging problems and generally require free tissue transfer for a successful reconstruction. Historically, muscle flaps were the gold standard choice for lower limb reconstruction. To obviate the unpredictable appearance and high donor-site morbidity of muscle flaps, fasciocutaneous flaps were introduced. Recently, perforator flaps, such as the anterolateral thigh flap, gained a leading role in the reconstructive scenario. There is growing evidence in the literature supporting that fasciocutaneous and perforator flaps are comparable to muscle flaps in terms of flap survival, postoperative infection, osteomyelitis, bone union, and ambulation. With the advances of knowledge in perforator anatomy and their mapping, a new era of lower limb reconstruction has begun. Propeller flap could be raised on any suitable perforator vessel and, without the aid of microsurgical anastomosis, used to restore small- to middle-sized soft tissue defects. In this review, we intend to analyze pros and cons of muscle and fasciocutaneous free flaps and the applicability of the propeller flaps in lower limb reconstruction.
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The role of smell, taste, flavour and texture cues in the identification of vegetables

Publication date: 1 February 2018
Source:Appetite, Volume 121
Author(s): V.L. van Stokkom, A.E. Blok, O. van Kooten, C. de Graaf, M. Stieger
It has been shown that the identification of many foods including vegetables based on flavour cues is often difficult. The effect of providing texture cues in addition to flavour cues on the identification of foods and the effect of providing taste cues only on the identification of foods have not been studied. The aim of this study was to assess the role of smell, taste, flavour and texture cues in the identification of ten vegetables commonly consumed in The Netherlands (broccoli, cauliflower, French bean, leek, bell pepper, carrot, cucumber, iceberg lettuce, onion and tomato). Subjects (n = 194) were randomly assigned to one of four test conditions which differed in the sensory cues available for vegetable identification: taste, smell (orthonasal), flavour (taste and smell) and flavour-texture (taste, smell and texture). Blindfolded subjects were asked to identify the vegetable from a list of 24 vegetables. Identification was the highest in the flavour-texture condition (87.5%). Identification was significantly lower in the flavour condition (62.8%). Identification was the lowest when only taste cues (38.3%) or only smell cues (39.4%) were provided. For four raw vegetables (carrot, cucumber, onion and tomato) providing texture cues in addition to flavour cues did not significantly change identification suggesting that flavour cues were sufficient to identify these vegetables. Identification frequency increased for all vegetables when perceived intensity of the smell, taste or flavour cue increased. We conclude that providing flavour cues (taste and smell) increases identification compared to only taste or only smell cues, combined flavour and texture cues are needed for the identification of many vegetables commonly consumed in The Netherlands.



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Negative eating attitudes and behaviors among adolescents: The role of parental control and perceived peer support

Publication date: 1 February 2018
Source:Appetite, Volume 121
Author(s): Ugo Pace, Giulio D'Urso, Carla Zappulla
In the present study, we examined from a longitudinal perspective the relationship between parental (both maternal and paternal) psychological control, perceived peer support, and negative eating attitudes and behaviors, focusing on the moderating role that perceived peer support may play in the relationship between parental psychological control in early adolescence and negative eating attitudes and behaviors in late adolescence. In Wave 1, participants were 507 adolescents (249 boys and 258 girls) aged from 14 to 15 years (M = 14.76; SD = 0.63). Three years later (Wave 2), the same adolescents participated again in the study (M = 17.88 years; SD = 0.57). Regression analyses displayed that paternal, but not maternal, achievement-oriented psychological control during early adolescence positively predicted negative eating attitudes and behaviors in late adolescence, whereas perceived peer support negatively predicted negative eating attitudes and behaviors. Results also showed a moderator effect of perceived peer support in the relationship between father's psychological control and negative eating attitudes and behaviors, such that at higher levels of paternal achievement-oriented psychological control, negative eating attitudes and behaviors tended to be higher when perceived peer support was low and to be lower when perceived peer support was high.



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Intergenerational mobility and omnivorism in eating

Publication date: 1 February 2018
Source:Appetite, Volume 121
Author(s): Henryk Domański, Zbigniew Karpiński
Drawing on three hypotheses concerned with cultural consequences of social mobility, we investigate whether intergenerational class mobility influences omnivorism in eating, regarded as a new dimension of lifestyle. Using data from a national survey carried out in Poland in 2013 and diagonal reference models, we find most support for the hypothesis of maximization saying that upward mobility encourages conformity to the habits of the class of destination. It shows that in Poland, as in other societies, the upwardly mobile tend to align their behaviour with that of their highest status reference group. Accordingly, the downwardly mobile representatives of the top category conform more to the norms of the class of origin than those of the destination class. At the same time, individuals who experience intergenerational inflow to the highest managerial and professional categories display higher levels of highbrow tastes than their non-mobile counterparts from the origin classes. Contrary to the thesis about replacement of traditional class barriers by omnivorism we see that the omnivore/univore divide does not obliterate the highbrow/lowbrow one.



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Comparison of microvascular perfusion evaluation among IVIM-DWI, CT perfusion imaging and histological microvessel density in rabbit liver VX2 tumors

Publication date: February 2018
Source:Magnetic Resonance Imaging, Volume 46
Author(s): Jing-Lei Li, Wei-Tao Ye, Zai-Yi Liu, Li-Fen Yan, Wei Luo, Xi-Ming Cao, Changhong Liang
ObjectTo explore microcirculation features with intravoxel incoherent motion (IVIM) and to compare IVIM with CT perfusion imaging (CTPI) and microvessel density (MVD).Materials and methodsHepatic CTPI and IVIM were performed in 16 rabbit liver VX2 tumor models. Hepatic arterial perfusion (HAP), hepatic arterial perfusion index (HPI), Blood flow (BF), and blood volume (BV) from CTPI were measured. Apparent diffusion coefficient (ADC), true diffusion coefficient (D), perfusion fraction (f), and pseudo-diffusion coefficient (D*) from IVIM were measured. MVD was counted with CD34 stain. The microcirculation features with IVIM were compared with CTPI parameters and MVD.ResultsStrong linear correlations were found between D value (0.89±0.21×10⁻³mm²/s) and HAP (15.83±6.97ml/min/100mg) (r=0.755, P=0.001) and between f value (12.64±6.66%) and BV (9.74±5.04ml/100mg) (r=0.693, P=0.004). Moderate linear correlations were observed between ADC (1.07±0.32×10⁻³mm²/s) and HAP (r=0.538, P=0.039), respectively; and between D value and MVD (9.31±2.57 vessels at 400×magnification) (r=0.509, P=0.044). No correlations were found between D* (119.90±37.67×10⁻³mm²/s) and HAP, HPI (68.34±12.91%), BF (4.95±2.16ml/min/100mg), BV.ConclusionIVIM parameters can characterize microcirculation to certain extent and separate it from pure water molecular diffusion. There is fair correlation between D or ADC value and CTPI parameters or MVD, but no correlation between D* or f value and CTPI parameters or MVD except f value and BV, which is still unclear and need further clinical studies to validate.



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Smartphone based bioanalytical and diagnosis applications: A review

Publication date: 15 April 2018
Source:Biosensors and Bioelectronics, Volume 102
Author(s): Suvardhan Kanchi, Myalowenkosi I. Sabela, Phumlane Selby Mdluli, Inamuddin, Krishna Bisetty
A smartphone is a facile, handy-analytical device that makes our lives comfortable and stress-free in terms of health care diagnostic assessments. Due to recent advancements in the technology and the introduction of user friendly operating systems and applications, the smartphones have replaced laptops and desktop computers. Taking this fact into account, researchers have designed sensing systems which are more compatible with smartphones. Consequently, these devices are attracting the attention of researchers from fields such as telemedicine, biotechnology, chemical sciences and environmental sciences. In this review, our focus is on recent advances on smartphone based sensing and diagnosis applications.



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Non-enzymatic electrochemical detection of glucose with a disposable paper-based sensor using a cobalt phthalocyanine–ionic liquid–graphene composite

Publication date: 15 April 2018
Source:Biosensors and Bioelectronics, Volume 102
Author(s): Sudkate Chaiyo, Eda Mehmeti, Weena Siangproh, Thai Long Hoang, Hai Phong Nguyen, Orawon Chailapakul, Kurt Kalcher
We introduce for the first time a paper-based analytical device (PAD) for the non-enzymatic detection of glucose by modifying a screen-printed carbon electrode with cobalt phthalocyanine, graphene and an ionic liquid (CoPc/G/IL/SPCE). The modifying composite was characterized by UV–visible spectroscopy, energy dispersive X-ray spectroscopy (EDX), transmission electron microscopy (TEM) and scanning electron microscopy (SEM). The disposable devices show excellent conductivity and fast electron transfer kinetics. The results demonstrated that the modified electrode on PADs had excellent electrocatalytic activity towards the oxidation of glucose with NaOH as supporting electrolyte (0.1M). The oxidation potential of glucose was negatively shifted to 0.64V vs. the screen-printed carbon pseudo-reference electrode. The paper-based sensor comprised a wide linear concentration range for glucose, from 0.01 to 1.3mM and 1.3–5.0mM for low and high concentration of glucose assay, respectively, with a detection limit of 0.67µM (S/N = 3). Additionally, the PADs were applied to quantify glucose in honey, white wine and human serum. The disposable, efficient, sensitive and low-cost non-enzymatic PAD has great potential for the development of point-of-care testing (POCT) devices that can be applied in healthcare monitoring.

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Multiplex immunoassays using virus-tethered gold microspheres by DC impedance-based flow cytometry

Publication date: 15 April 2018
Source:Biosensors and Bioelectronics, Volume 102
Author(s): Jihun Rho, Woohyuk Jang, Inseong Hwang, Dahye Lee, Chang Heon Lee, Taek Dong Chung
Bead-based multiplex immunoassays for common use require enhanced sensitivity and effective prevention of non-specific adsorption, as well as miniaturization of the detection device. In this work, we have implemented virus-tethered gold microspheres for multiplex immunoassay applications, employing a DC impedance-based flow cytometer as a detection element. The advantages of virus-tethered gold microspheres, including excellent prevention of non-specific adsorption, are extended to signal enhancement arising from the large quantity of antibody loading on each virion, and to flexible movement of filamentous virus. Individual virus-tethered beads generate their own DC impedance and fluorescence signals, which are simultaneously detected by a chip-based microfluidic flow cytometer. This system successfully realized multiplex immunoassays involving four biomarkers: cardiac troponin I (cTnI), prostate specific antigen (PSA), creatine kinase MB (CK-MB), and myoglobin in undiluted human sera, elevating sensitivity by up to 5.7-fold compared to the beads without virus. Constructive integration between filamentous virus-tethered Au-layered microspheres and use of a microfluidic cytometer suggests a promising strategy for competitive multiplex immunoassay development based on suspension arrays.

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Fabrication of ordered metallic glass nanotube arrays for label-free biosensing with diffractive reflectance

Publication date: 15 April 2018
Source:Biosensors and Bioelectronics, Volume 102
Author(s): Wei-Ting Chen, Shao-Sian Li, Jinn P. Chu, Kuei Chih Feng, Jem-Kun Chen
In this study, a photoresist template with well-defined contact hole array was fabricated, to which radio frequency magnetron sputtering process was then applied to deposit an alloyed Zr55Cu30Al10Ni5 target, and finally resulted in ordered metallic glass nanotube (MGNT) arrays after removal of the photoresist template. The thickness of the MGNT walls increased from 98 to 126nm upon increasing the deposition time from 225 to 675s. The wall thickness of the MGNT arrays also increased while the dimensions of MGNT reduced under the same deposition condition. The MGNT could be filled with biomacromolecules to change the effective refractive index. The air fraction of the medium layer were evaluated through static water contact angle measurements and, thereby, the effective refractive indices the transverse magnetic (TM) and transverse electric (TE) polarized modes were calculated. A standard biotin–streptavidin affinity model was tested using the MGNT arrays and the fundamental response of the system was investigated. Results show that filling the MGNT with streptavidin altered the effective refractive index of the layer, the angle of reflectance and color changes identified by an L*a*b* color space and color circle on an a*b* chromaticity diagram. The limit of detection (LOD) of the MGNT arrays for detection of streptavidin was estimated as 25nM, with a detection time of 10min. Thus, the MGNT arrays may be used as a versatile platform for high-sensitive label-free optical biosensing.



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Environmental impacts the of production and use of biodiesel

Abstract

Biodiesel as renewable, environmental friendly, less toxic, and biodegradable is an attractive alternative to fossil fuels and is produced mainly from vegetable oils and animal fats. It is expected, globally, that the use of renewable biofuels, in general, will increase rapidly in the near future. The growing biodiesel production and usage have encouraged assessment of its impact on the environment. The present paper reviews various aspects of biodiesel production using commercial processing technology and biodiesel use through evaluation and analysis of the studies concerning environmental impacts of biodiesel. As a general conclusion, it can be said that biodiesel has the potential to offer a series of perceived benefits such as political, economical, and agricultural, as well as environmental (due to its biodegradability, less toxicity, renewability) and health (greenhouse gas-saving, less harmful exhaust emissions).

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Olive oil polyphenols extracts inhibit inflammatory markers in J774A.1 murine macrophages and scavenge free radicals

Publication date: Available online 8 November 2017
Source:Acta Histochemica
Author(s): Marwa Abdallah, Stefania Marzocco, Simona Adesso, Mokhtar Zarrouk, Mokhtar Guerfel
Here we evaluate the olive oil antiradical and anti-inflammatory potential through its polyphenols extracts and examine the influence of olive maturity on olive oil quality properties, polyphenols composition and biological potentials. Samples have been obtained from minor Tunisian olive cultivars (Chemchali, Fouji and Zarrazi) at different maturity indices. Principal quality properties were evaluated and polyphenols analysis was carried out by Folin Ciocalteu reagent and HPLC-UV-MS. Antiradical activity was examined by DPPH and FRAP scavenging assays while J774A.1 murine macrophages were used to evaluate anti-inflammatory potential by analyzing NO production with Griess reagent method and iNOS and COX-2 expression by cytofluorimetric analysis. Our results revealed that quality characteristics, total phenol content, as well as phenolic compound concentrations were significantly affected by the olive maturity levels. On the other hand, the polyphenols extracts showed an interesting radical scavenging capacity and a potential ability to inhibit inflammatory markers at 90% for NO release and 75% for iNOS expression. Thus, our study establishes that olive oil through its polyphenols extracts has a substantial antiradical and anti-inflammatory potential. Likewise a lot of attention should be attributed to olive ripening level in order to decide the optimum harvesting time.

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Plasma Free Fatty Acids Metabolic Profile Among Uyghurs and Kazaks With or Without Type 2 Diabetes Based on GC-MS

Exp Clin Endocrinol Diabetes
DOI: 10.1055/s-0043-121263

Free fatty acids (FFAs) participate in a variety of physiological functions. FFAs are associated with the development of type 2 diabetes mellitus (T2DM). Uyghurs and Kazaks have a different prevalence of T2DM, which cannot be explained by traditional risk factors. This study aimed to examine FFAs as potential biomarkers to distinguish between healthy and T2DM Uyghurs and Kazaks. This was a prospective study conducted at the Xianjiang Medical University from 01/2007 to 06/2010 in Uyghurs and Kazaks. The subjects were grouped as T2DM patients (Uyghurs: n=39; Kazaks, n=21) and controls (Uyghurs: n=35; Kazaks, n=40). Gas chromatography-mass spectrometry (GC-MS) and partial least squares discriminant analysis (PLS-DA) models were used to study the FFA profiles between Uyghurs and Kazaks with T2DM. PLS-DA analysis showed that among Kazaks, T2DM patients had lower C22:6, C18:3 n-6, and C20:3 n-6, but higher C22:0 levels compared with controls. Among Uyghurs, the most important variables to discriminate T2DM patients from controls were higher C22:6 and C20:4 n-6, and lower C22:0, C14:1, C18:3 n6, and C20:3 n6. Kazaks and Uyghurs displayed different FFA profiles between patients with T2DM and controls. These results suggest different risk factors and pathogenesis of T2DM between Kazaks and Uyghurs.
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Gender Differences in Cardiometabolic Risk Factors in Metabolically Healthy Normal Weight Adults with Central Obesity

Exp Clin Endocrinol Diabetes
DOI: 10.1055/s-0043-119877

We investigated whether metabolically healthy normal weight adults with central obesity display worse cardiometabolic profile compared with their centrally lean counterparts. This retrospective, cross-sectional study, comprised 1 135 subjects (64% females) aged 18-to-81 years, presenting ≤2 components of metabolic syndrome. They were classified as centrally lean (waist-to-height ratio (WHtR)<0.5 and waist circumference<80 cm in females and<94 cm in males) or presenting central obesity (WHtR ≥0.5, regardless of waist circumference). Data on blood pressure, glucose homeostasis, lipid profile, renal function, high-sensitive C-reactive protein (hsCRP), uric acid, adiponectin, leptin, and soluble receptor for advanced glycation end products were compared between the groups, separately in males and females. 5.7% of males and 6.9% of females presented WHtR ≥0.5. Compared with centrally lean subjects, those with central obesity had higher BMI-adjusted fasting plasma glucose (p<0.001), and leptin levels (p<0.05); females also presented higher blood pressure (p<0.001), while males had higher hsCRP concentrations (p=0.021). These changes associated with significantly higher BMI-adjusted odds to present fasting plasma glucose >5.6 mmol/l in both genders, higher odds to present hsCRP >3 mg/l in males, and those to present elevated blood pressure in females. Our analysis suggests that in metabolically healthy normal weight subjects WHtR ≥0.5 might indicate "early increased health risk".
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Effect of Diabetes on the Assessment Role of 2-Oxoglutarate to the Severity of Chronic Heart Failure

Exp Clin Endocrinol Diabetes
DOI: 10.1055/s-0043-119076

Background Serum 2-oxoglutarate can reflect the severity of chronic heart failure (CHF) in patients without diabetes. Whether this predictive role persists in type 2 diabetes mellitus (T2DM) patients is unclear. In this study, we investigated this predictive role in T2DM patients and whether 2-oxoglutarate can indicate the diastolic or systolic function of left ventricle. Methods One hundred eighty CHF patients (76 with T2DM) and 66 healthy controls were studied. 2-Oxoglutarate was assayed by liquid chromatography-mass spectrometry/mass spectrometry. Echocardiographic parameters, N-terminal pro-B-type natriuretic peptide (NT-proBNP) and other parameters were measured. Results 2-Oxoglutarate was increased in CHF patients with or without T2DM compared with controls (both P<0.01). Patients with a lower left ventricular ejection fraction or a higher NT-proBNP or left ventricular end-diastolic volume index had higher levels of 2-oxoglutarate (median, 18.77 μg/mL versus 11.25 μg/mL; median, 14.06 µg/ml versus 9.39 µg/ml; median, 18.06 µg/mL versus 11.60 µg/mL, all P<0.05) in nondiabetic patients but not in T2DM patients. In multiple logistic regression analysis, NT-proBNP (OR=3.445, 95% CI=1.098 to 10.816, P=0.034) and left ventricular end-diastolic diameter (OR=2.544, 95% CI=1.033 to 6.268, P=0.042) were independently associated with increased 2-oxoglutarate in nondiabetic patients. Conclusions The levels of 2-oxoglutarate can reflect the clinical severity of CHF in nondiabetic patients but not in those with T2DM, and it can be used as a potential indicator of the systolic dysfunction of the left ventricle.
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Development of Obesity-Associated Comorbidities Post Bariatric Surgery with a Special focus on Diabetes Remission and Short-Term Relapse

Exp Clin Endocrinol Diabetes
DOI: 10.1055/s-0043-119985

Purpose The purpose of this study is to study a heterogeneous group of obese patients undergoing Bariatric surgery(BS) and its impact on glycemic control. Secondary endpoints include changes in lipid profile and albuminuria. BS has shown to effectively reduce body-weight. However, the impact on obesity-related comorbidities varies strongly between individuals. Especially postoperative short- and long-term improvement of Diabetes is an active area of investigation. Methods We conducted a retrospective analysis from baseline to 24 months post bariatric surgery in our interdisciplinary obesity outpatient-clinic. Follow-up data was collected from 215 patients who had undergone either Roux-en-Y gastric bypass or Sleeve Gastrectomy. The prevalence of and changes in the major obesity-related comorbidities and concurrent medication were assessed. Results Standard parameters of diabetic control showed a U-shaped curve with initial improvement after six months, but with a gradual worsening after the first year of follow-up. Weight loss resulted in dose reduction of oral antidiabetic medication and insulin in 85% and 100% of patients, respectively. With weight loss, a significant improvement in lipid profile one year after surgery was seen. Subgroup analysis demonstrated gender- and age-dependent differences in overall benefit. Conclusions Current data on diabetes remission might be too optimistic and close follow-up should be provided to prevent gradual worsening of glucose metabolism after BS.
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Evaluation of the Relation Between Omentin-1 and Vitamin D in Postmenopausal Women With or Without Osteoporosis

Exp Clin Endocrinol Diabetes
DOI: 10.1055/s-0043-120110

Introduction Crosstalk between bone and adipose tissues is implicated in several pathologic conditions related to bone metabolism. Omentin-1, a 34-kD protein, is released from omental adipose tissue. A few studies indicated the effect of omentin-1 on bone health and bone mineral density (BMD) and the interaction of omentin-1 with vitamin D. Therefore, this study aimed to investigate the relationship between omentin-1, vitamin D, and BMD in postmenopausal women with osteoporosis compared with non-osteoporotic counterparts. Materials and methods Forty postmenopausal women with osteoporosis (OP), 40 counterparts without OP, and 30 premenopausal women were enrolled. Dual-energy X-ray Absorptiometry results, body mass index, and some demographic and biochemical data were recorded. Vitamin D (25-hydroxyvitamin D3) levels were measured using liquid chromatography-tandem mass spectrometry. Serum omentin-1 was determined using an enzyme-linked immunosorbent assay. Results Omentin-1 levels tended to increase in both postmenopausal women groups compared with the control group, but this increase was significant only in women with osteoporosis. Vitamin D levels were not different between the groups. When women were categorized according to vitamin D levels, women with normal vitamin D levels had significantly higher omentin-1 levels. A positive correlation was found between omentin-1 and vitamin D levels in all groups (r=0.197, p=0.041, n=110). Conclusion The tendency to an increase in omentin-1 levels in postmenopausal women with osteoporosis may be due to a physiologic compensation against bone loss after menopause. The linear relationship between omentin-1 and vitamin D suggests that adipose tissue is one of the target tissues for the vitamin D effect.
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Comments to the Editor Concerning the Paper Entitled “Mitochondrial Dysfunction in Diabetic Cardiomyopathy: Effect of Mesenchymal Stem Cell with PPAR-γ Agonist or Exendin-4” Mohamed Abd Elaziz Wassef et al.

Exp Clin Endocrinol Diabetes
DOI: 10.1055/s-0043-121266

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The Effect of Hypolipidemic Agents on Thyroid Autoimmunity in Women with Hashimoto’s Thyroiditis Treated with Levothyroxine and Selenomethionine

Exp Clin Endocrinol Diabetes
DOI: 10.1055/s-0043-120342

Background Levothyroxine and selenomethionine were found to reduce thyroid antibody titers in patients with Hashimoto's thyroiditis. The same effect was produced by intensive statin therapy. The aim of the present study was to assess whether hypolipidemic agents modulate the impact of thyroid hormone supplementation and selenomethionine on thyroid autoimmunity. Methods The study included 62 women with Hashimoto's thyroiditis treated for at least 6 months with levothyroxine and selenomethionine. On the basis of plasma lipids, women were divided into three groups: women with isolated hypercholesterolemia (group A; n=20), women with isolated hypertriglyceridemia (group B; n=17), and women with normal plasma lipids (group C; n=25). Group A were then treated with atorvastatin (20 mg daily), while group B received micronized fenofibrate (200 mg daily). Serum titers of thyroid peroxidase and thyroglobulin antibodies, as well as serum levels of thyrotropin, free thyroxine and free triiodothyronine were measured at the beginning of the study and 6 months later. Results Fenofibrate decreased triglycerides and increased HDL cholesterol, while simvastatin decreased total and LDL cholesterol. Fenofibrate reduced titers of thyroid peroxidase and, to a lesser extent, thyroglobulin antibodies. Atorvastatin tended to increase thyroid peroxidase antibodies. No changes in thyrotropin, free thyroxine and free triiodothyronine were observed in any treatment group. Fenofibrate-induced changes in thyroid antibody titers correlated with baseline antibody titers, as well as with treatment-induced changes in HDL cholesterol and insulin sensitivity. Conclusions The obtained results indicate that only fibrates may potentiate the effect of selenomethionine and levothyroxine on thyroid autoimmunity in women.
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Safety of Metformin Therapy in Patients with Type 2 Diabetes Living on an Oxygen-Deficient Plateau, Tibet, China

Exp Clin Endocrinol Diabetes
DOI: 10.1055/s-0043-113830

Background In the general population, the absolute risk of lactic acidosis in patients treated with metformin appears to be low. However, in the Tibetan plateau, an extreme oxygen-deficient environment, there are no data available concerning the safety of metformin. The aim of our study is to assess the safety of metformin in people of the plateau area. Methods We conducted an observational cross-sectional study in Tibet. All the 166 subjects were divided into two groups: T2DM+metformin group and T2DM group. Clinical characteristics as well as lactate levels were measured in all subjects. The association between lactate, metformin use, FBG, HbA1c, eGFR, and other potential predictors was evaluated. Results A total of 166 subjects were enrolled in this study. Average age was 51.7±12.3 years, and the percentage of male participants was 67%. The median level of lactate was 1.89 (1.35–2.91) mmol/L in all the subjects. The mean (±SD) lactate concentration in patients treated with metformin, versus those who were not, was 2.35±1.42 vs 2.29±1.65 mmol/L, respectively (mean difference 0.06 mmol/L, 95% CI: −0.48–0.60, P=0.556). FBG was significantly higher in the high lactate group than in the low lactate group (12.1±4.1 vs. 10.5±4.0 mmol/L, P=0.018). Similarly, HbA1c level was also significantly higher in the high lactate group than in the low lactate group (12.3±2.6 vs. 11.0±3.0%, P=0.008). Conclusions In the oxygen-deficient Tibetan plateau, lactate concentration among patients on metformin was not significantly different from patients without metformin. The level of lactate was significantly associated with FBG and HbA1c levels.
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The Effects of a Modified High-carbohydrate High-fat Diet on Metabolic Syndrome Parameters in Male Rats

Exp Clin Endocrinol Diabetes
DOI: 10.1055/s-0043-119352

Metabolic syndrome is a cluster of metabolic abnormalities including central obesity, hyperglycemia, hypertension, and dyslipidemia. A previous study has established that high-carbohydrate high-fat diet (HCHF) can induce MetS in rats. In this study, we modified components of the diet so that it resembled the diet of Southeast Asians. This study aimed to determine the effects of this modified HCHF diet on metabolic parameters in rats. Male Wistar rats (n=14) were randomised into two groups. The normal group was given standard rat chow. The MetS group was given the HCHF diet, comprises of fructose, sweetened condensed milk, ghee, Hubble Mendel and Wakeman salt mixture, and powdered rat food. The diet regimen was assigned for a period of 16 weeks. Metabolic syndrome parameters (abdominal circumference, blood glucose, blood pressure, and lipid profile) were measured at week 0, 8, 12, and 16 of the study. The measurement of whole body composition (fat mass, lean mass, and percentage of fat) was performed using dual-energy X-ray absorptiometry at week 0, 8, and 16. Our results indicated that the components of MetS were partially developed after 8 weeks of HCHF diet. Systolic blood pressure, triglyceride, low density lipoprotein cholesterol, fat content, and percentage of fat was significantly higher in the HCHF group compared to normal group (p<0.05). After 12 weeks of HCHF diet, the rats showed significant increases in abdominal circumference, blood pressure, glucose intolerance, and dyslipidemia compared to normal control (p<0.05). In conclusion, MetS is successfully established in male rats induced by the modified HCHF diet after 12 weeks.
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Invasive Pituitary Adenoma-Derived Tumor-Associated Fibroblasts Promote Tumor Progression both In Vitro and In Vivo

Exp Clin Endocrinol Diabetes
DOI: 10.1055/s-0043-119636

Tumor-associated fibroblasts are the most abundant population in tumor stroma and impact on tumor initiation and progression. However, the biological function of tumor-associated fibroblasts in pituitary adenomas has not been fully elucidated to date. So, this study aims to clarify the function and significance of primary cultured pituitary adenoma-derived tumor-associated fibroblasts on rat pituitary adenoma cells. We identified primary cultured tumor-associated fibroblasts and normal fibroblasts based on the expression of α-smooth muscle actin as well as morphology. Furthermore, we investigated cell biological influences on rat pituitary adenoma cells through indirectly co-culturing tumor-associated fibroblasts with GH3 cells and subcutaneous xenograft model. All sorts of fibroblasts showed positive staining for α-smooth muscle actin. But α-smooth muscle actin and vascular endothelial growth factor highly expressed in invasive pituitary adenoma-derived tumor-associated fibroblasts compared to non-invasive pituitary adenoma-derived tumor-associated fibroblasts and normal fibroblasts. Besides, invasive pituitary adenoma-derived tumor-associated fibroblasts promoted the proliferation of GH3 cells in vitro as well as tumor growth in vivo. Finally, vascular endothelial growth factor was highly expressed in tumor specimens co-injected with invasive pituitary adenoma-derived tumor-associated fibroblasts. Our results suggested that invasive pituitary adenoma-derived tumor-associated fibroblasts displayed apparent growth promotion effects on rat pituitary cells both in vitro and in vivo accompanied by over-expression of vascular endothelial growth factor in invasive pituitary adenoma-derived tumor-associated fibroblasts and tumor specimens.
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Visceral Adiposity Index was a useful Predictor of Prediabetes

Exp Clin Endocrinol Diabetes
DOI: 10.1055/s-0043-120440

Aim To study the relationship of visceral adiposity index (VAI) and prediabetes and the power of which in predicting of prediabetes. Methods A cross-sectional epidemiological survey was conducted. All participants were divided into four groups: VAI and WC (both are normal), VAI↑ and WC (postcritical VAI and normal WC), VAI and WC↑ (Normal VAI and postcritical WC), and VAI↑ and WC↑ (postcritical VAI and postcritical WC). A multivariate logistic analysis was used to analyze the relationship between the four groups and prediabetes, and diabetes. A receiver operating characteristic (ROC) curve analysis was used to evaluate the accuracy of predictions for prediabetes and diabetes. Results Both VAI and WC were independent risk factors of Prediabetes. The ORs for Prediabetes in the VAI↑&WC group were 1.641 (95%CI 1.146–2.349), P=0.007, in males, in Model 2. The ORs for Prediabetes in the VAI&WC↑ group were 1.454 (95%CI 1.055–2.005), P=0.022, in males, in Model 2. The ORs for Prediabetes in the VAI↑&WC group were 2.305 (95%CI 1.623–3.273), P=0.000, in females, in Model 2. The ORs for Prediabetes in the VAI&WC↑ group were 1.997 (95%CI 1.529–2.608), P=0.000, in females, in Model 2. The AUC value of VAI were 0.601 (95%CI 0.568–0.634), P=0.000, in prediabetes of men; which were 0.645 (95%CI 0.618–0.672), P=0.000, in prediabetes women. WC had the highest AUC value of 0.605 (95%CI 0.571–0.638), P=0.000, in prediabetes of men, also had the highest of AUC value of 0.673 (95%CI 0.648–0.697), P=0.000, in prediabetes of women. Conclusion VAI was positively associated with prediabetes, and also a usefulindicator of prediabetes.
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