A Two-Dimensional Mathematical Model to Analyze Thermal Variations in Skin and Subcutaneous Tissue Region of Human Limb during Surgical Wound Healing

During wound healing, the metabolic activity associated with each phase must occur in the proper sequence, at a specific time, and continue for a specific duration at an optimal intensity. Any disturbance in appropriate thermal environment may complicate the wound healing process and may give rise to wound infection. In the presented paper a transient state two-dimensional mathematical model has been developed to analyse thermal variations in skin and subcutaneous tissue (SST) region of human limb. Due to circular shape of human limb, model has been developed in polar coordinates. The domain of the study consists of two types of tissues: abnormal tissues and normal tissues. The post surgery peripheral tissue of human limb during healing time is considered as abnormal tissues. The effect of variable density of blood vessels in dermal layer of both tissues on the physical and physiological parameters is incorporated in the model. The effect of healing on physiological parameters of abnormal tissue is incorporated by considering the physiological parameters to be function of time “t”. The effect of different climatic conditions is considered in the model. Taking into account the variable core temperature due to anatomy of arteries and variable physiological parameters in dermal layer of peripheral region, the well known Pennes’ bio heat equation is used to analyse the time-dependent temperature distribution of both normal and abnormal tissues. Comparison between temperature profiles of both normal and abnormal tissue has been done using finite element approach with bilinear shape functions in polar coordinates. A computer program in MATLAB has been developed to simulate the results.

The Physical and Clinical Aspects of Radiation Therapy in Skin Cancer and Subcutaneous Tissue Neoplasm

Cancers, malignant melanoma and sarcomas of the skin represent the most common group of malignancies in humans. The main treatment method of almost all skin cancers and subcutaneous tissue tumours is surgery, which consists of complete removal of a neoplastic lesion, with an adequate margin of healthy tissue. Radiotherapy plays an adjuvant role in this process, meaning complementing of the surgical procedure. This study compared four methods of irradiation treatment of cancer located in the skin or in subcutaneous tissues: contact brachytherapy, conventional orthovoltage therapy, electron beam conformal teleradiotherapy and IMRT dynamically shaped photonic beams conformal teleradiotherapy. In order to compare the methods and techniques of surface radiotherapy, following specific objectives were formulated. At the beginning in order to compare the scopes of the absorbed doses at different tissue depths, an analysis of parameters describing particular beams or radiation source has been performed—the curves for the absorbed-dose depth drop-offs. Doses distribution in tissue-like phantoms stimulating homogeneous cuboidal tissue block has been determined. A quality comparison of dose distribution in 2D and 3D treatment planning system for contact brachytherapy application has been made. The dose distribution for electron beam in the system has been determined. Conformal plannings for electron beam treatment, contact brachytherapy applicator treatment and 4 photon beams treatment optimized in IMRT technology have been performed. Dose distribution has been performed for the irradiated female patient within the well chest—the target included the recurrence area in the post-operative scar. The radiation therapy with X-rays has actually been completely eliminated from skin cancer and subcutaneous tissue radiotherapy by the electrons generated in linear accelerators, contact brachytherapy HDR and by high-energy photons used in conformal techniques, ex. IMRT. It is because the residual dose beyond the target is the highest for single X-ray beam. Although in brachytherapy HDR a rapid dose drop-off is observed, 5 cm from its normalization level for the target the residual radiation remains at the level of several percent. So, both X-rays beam radiation and brachytherapy in skin cancer treatment is connected with the administration of the dose with a high gradient in the health tissues. The dose distribution for photon conformal techniques IMRT or for electron radiation looks different. There with the dose normalization at the level of 90% or 85% we deal with the dose layer, the division does not exceed 15% of heterogeneity.

Waist subcutaneous soft tissue metastasis of rectal mucinous adenocarcinoma: A case report

BACKGROUND Rectal mucinous adenocarcinoma(MAC)is a rare pathological type of rectal can-cer with unique pathological features and a poor prognosis.It is difficult to diag-nose and treat early because of the lack of specific manifestations in some aspects of the disease.The common metastatic organs of rectal cancer are the liver and lung;however,rectal carcinoma with metastasis to subcutaneous soft tissue is a rare finding.CASE SUMMARY In this report,the clinical data,diagnosis and treatment process,and postope-rative pathological features of a patient with left waist subcutaneous soft tissue masses were retrospectively analyzed.The patient underwent surgical treatment after admission and recovered well after surgery.The final pathological diagnosis was rectal MAC with left waist subcutaneous soft tissue metastasis.CONCLUSION Subcutaneous soft tissue metastasis of rectal MAC is rare,and it can suggest that the tumor is disseminated,and it can appear even earlier than the primary ma-lignant tumor,which is occult and leads to a missed diagnosis and misdiagnosis clinically.When a subcutaneous soft tissue mass of unknown origin appears in a patient with rectal cancer,a ma-lignant tumor should be considered.

Observation of viable alloskin vs xenoskin grafted onto subcutaneous tissue wounds after tangential excision in massive burns

Background:Staged excision and grafting with viable cryopreserved alloskin or fresh pigskin at an early stage is a main strategy for wound management in massive burns.Alloskin is the gold standard of a biological temporary skin substitute,and the main drawback to its wider use is the limited number of donors.In this paper,we compare the use of fresh pigskins to cryopreserved alloskins as temporary skin substitutes on subcutaneous tissue wounds after tangential excision by observing the clinical performances of these grafts in cases of a massive burn.Methods:We selected six adult massive burn patients undergoing tangential excision and skin grafting on subcutaneous tissue wounds(TESGSTW)at our burn center from January 1,2003 to December 31,2013.The general clinical data and survival percentage of skins at postoperative weeks(POWs)1,2,and 3 were analyzed.In our clinical practice,we also observed the phenomenon that several viable cryopreserved alloskin or fresh pigskin grafts used as temporary coverage on subcutaneous tissue wounds had long-term survival after repeated desquamation.The macroscopic and histological results of one typical case were also analyzed.Results:In this study,the first three TESGSTW operations were performed at 2–3,5–8,and 11–16 days post-injury.The operation areas were 30.3±7.9%total body surface area(TBSA),19.0±6.0%TBSA,and 12.0±1.7%TBSA,respectively.The survival percentage of the cryopreserved alloskins or fresh pigskins at POWs 1,2,and 3 were 80.0±10.0%vs 75.7±5.3%(t=1.01,P=0.16),71.2±10.6%vs 66.4±6.2%(t=1.09,P=0.30),and 48.7±2.5%vs 35.0±7.0%(t=3.83,P=0.03),respectively.The microscopic observation of the survival of alloskins or pigskins in one typical case showed rete ridges and a basilar membrane at the joint of the epidermis and dermis at an early stage;these structures disappeared with extended time post-operation.Conclusions:From the clinical observations,fresh pigskin and cryopreserved alloskins could be used with equal effectiveness at an early stage(within 2 weeks post-operation)as temporary coverage on massive burns after TESGSTW.After engraftment,several cryopreserved alloskins or fresh pigskins could co-survive in a massive burn patient for an extended amount of time.The co-survival of alloskin and pigskin will provide clues for further research into skin transplantation.

Non-closure of the peritoneum and subcutaneous tissue at radical hysterectomy: A randomized controlled trial

We conducted a trial to assess the influence of closure or nonclosure of the peritoneum and subcutaneous tissue on the clinical outcomes of cervical cancer patients who underwent radical hysterectomy with lower abdom-inal cross incision.This randomized controlled trial was performed on 158 cervical cancer patients in our hospital between January 2002 and June 2004.Eighty-two patients were allocated to the“closure”group and 76 patients to the“nonclosure”group.Results showed that non-closure of the peritoneum and subcutaneous tissue could shorten operation time and febrile duration,reduce antibiotics requirement,increase the volume of drainage and decrease the incidence of liquefaction of subcutaneous fat(P<0.05).There was no difference in blood loss,postoperative complications,bowel function restoration and post-operative stay between the two groups(P>0.05).Our study revealed that closure of the peritoneum and subcutaneous tissue provides no immedi-ate postoperative benefits while unnecessarily lengthening surgical time and anesthesia exposure.The practice of closure of the peritoneum and subcutaneous tissue at radical hysterectomy should be questioned.

Transcriptional Features of Cattle Visceral and Subcutaneous Adipose Tissues: A Study of RNA-seq

Visceral and subcutaneous are the two major types of bovine adipose tissues, and they show metabolic and functional differences according to their distribution, exploring the transcriptional features of visceral and subcutaneous adipose tissues is necessary. In the present study, we conducted RNA-seq analysis to compare the transcriptome between visceral (great omental) and subcutaneous (backfat) adipose tissues from Chinese Simmental cattle and validate them by qRT-PCR. We found that 5864 genes were differentially expressed between two tissues, including 2979 up-regulated and 2885 down-regulated in visceral adipose tissue. Functional analysis revealed a variety of differentially expressed genes (DEGs) involved in lipid metabolism and immune response processes. This may provide valuable information to further our understanding of the complexity of gene regulation governing the physiology of different fat depots. This work highlighted potential genes regulating lipid metabolism and immune responses;it may contribute to a better understanding of the metabolic and functional differences between visceral and subcutaneous adipose tissues.

Prepartum dietary energy intake alters adipose tissue transcriptome profiles during the periparturient period in Holstein dairy cows

Background:The aim of the study was to investigate the effect of energy overfeeding during the dry period on adipose tissue transcriptome profiles during the periparturient period in dairy cows.Methods:Fourteen primiparous Holstein cows from a larger cohort receiving a higher-energy diet(1.62 Mcal of net energy for lactation/kg of dry matter;15%crude protein)for ad libitum intake to supply 150%(OVR)or 100%(CTR)of energy requirements from dry off until parturition were used.After calving,all cows received the same lactation diet.Subcutaneous adipose tissue(SAT)biopsies were collected at−14,1,and 14d fromparturition(d)and used for transcriptome profiling using a bovine oligonucleotide microarray.Data mining of differentially expressed genes(DEG)between treatments and due to sampling time was performed using the Dynamic Impact Approach(DIA)and Ingenuity Pathway Analysis(IPA).Results:There was a strong effect of over-feeding energy on DEG with 2434(False discovery rate-corrected P<0.05)between OVR and CTR at−14 d,and only 340 and 538 at 1 and 14 d.The most-impacted and activated pathways in the Kyoto Encyclopedia of Genes and Genomes(KEGG)database that were highlighted by DIA analysis at−14 d in OVR vs.CTR included 9 associated with carbohydrate metabolism,with‘Pyruvate metabolism’,‘Glycolysis/gluconeogenesis’,and‘Pentose phosphate pathway’among the most-activated.Not surprisingly,OVR led to marked activation of lipid metabolism(e.g.‘Fatty acid biosynthesis’and‘Glycerolipid metabolism’).Unexpected metabolic pathways that were activated at−14 d in OVR included several related to metabolism of amino acids(e.g.branched chain)and of cofactors and vitamins(thiamin).Among endocrine and immune system pathways,at−14 d OVR led to marked activation of‘PPAR signalling’and‘Antigen processing and presentation’.Among key pathways affected over time in OVR,a number were related to translation(e.g.mTOR signaling),endocrine/immune signaling(CXCR4 and IGF1),and lipid metabolism(oxidative phosphorylation)with greater activation in OVR vs.CTR specifically at−14 d.Although statistical differences for several pathways in OVR vs.CTR nearly disappeared at 1 and 14 vs.−14 d,despite the well-known catabolic state of adipose depots after calving,the bioinformatics analyses suggested important roles for a number of signaling mechanisms at−14 vs.14 than 1 vs.-14 d.This was particularly evident in cows fed to meet predicted energy requirements during the dry period(CTR).Conclusions:Data underscored a strong activation by overfeeding energy of anabolic processes in the SAT exclusively prepartum.The study confirmed that higher-energy diets prepartum drive a transcriptional cascade of events orchestrated in part by the activation of PPARγthat regulate preadipocyte differentiation and lipid storage in SAT.Novel aspects of SAT biology to energy overfeeding or change in physiologic state also were uncovered,including the role of amino acid metabolism,mTOR signaling,and the immune system.

Determinants of Regional Obesity (Visceral and Subcutaneous Obesity) within Cardiovascular Risk Factors in the Cardiology Department of the University Clinics of Kinshasa

Objective: This study aimed to determine searching for the determinants of regional obesity (visceral and subcutaneous obesity) within the cardiovascular risk factors (CVRF) in patients followed in cardiology at the University Clinics of Kinshasa (UCK) in the Democratic Republic of Congo (DRC). Material and Methods: Cross-sectional and analytical study had sought the determinants of regional obesity (visceral and subcutaneous obesity) by bio-impedance inside the CVRF during the period from July 1 to September 31, 2014. The multivariate analysis (logistic regression) has established the levels of association between regional obesity and CVRF. The statistical significance threshold was set at p Results: A total of 642 patients participated in the present study. The frequencies of visceral and subcutaneous obesity were respectively 45.5% (without significant distinction between the two sexes: Men 48% n = 92/188 vs. Women 44.1 n = 200/454;p = 0.148) and 60.7% with a predominance in women (36.2 n = 68/188 vs. 70.9% n = 322/454;p that alongside regional obesity was: advanced age, tobacco use, alcohol use, physical inactivity, high blood pressure (HBP), diabetes mellitus (DM) and Chronic renal failure (CRF) in the respective proportions of 50.8%, 13.4%, 44.2%, 86.3%, 10.7%, 13.4% and 0.3%. The determinants of regional obesity were advanced age, smoking and obesity on body mass index (BMI) for visceral obesity;advanced age, female gender, alcohol intake and obesity on BMI and waist circumference (WC) as well as hypertriglyceridemia for subcutaneous obesity. Conclusion: This study showed a significant frequency of regional obesity with the following determinants: advanced age, female gender, smoking, alcohol, BMI/WC obesity and hypertriglyceridemia.

Subcutaneous implantation of benign thyroid tissue： a rare complication after thyroidectomy

Subcutaneous implantation of benign thyroid tissue is a rare complication of thyroid surgery. Here the authors report two cases of subcutaneous implantation of benign thyroid tissue following conventional thyroid surgery. The diagnosis and differential diagnosis of cervical subcutaneous thyroid tissue implantation, and their clinical pathological characteristics are retrospectively investigated. The mechanism of the implantation process is analyzed. The management of patient with cervical subcutaneous soft tissue implantation is also discussed.

Semi-automated segmentation of magnetic resonance images for thigh skeletal muscle and fat using threshold technique after spinal cord injury

Magnetic resonance imaging is considered the ＂gold standard＂ technique for quantifying thigh muscle and fat cross-sectional area. We have developed a semi-automated technique to segment seven thigh compartments in persons with spinal cord injury. Thigh magnetic resonance images from 18 men（18–50 years old） with traumatic motor-complete spinal cord injury were analyzed in a blinded fashion using the threshold technique. The cross-sectional area values acquired by thresholding were compared to the manual tracing technique. The percentage errors for thigh circumference were（threshold： 170.71 ± 38.67; manual： 169.45 ± 38.27 cm2） 0.74%, subcutaneous adipose tissue（threshold： 65.99±30.79; manual： 62.68 ± 30.22） 5.2%, whole muscle（threshold： 98.18 ± 20.19; manual： 98.20 ± 20.08 cm2） 0.13%, femoral bone（threshold： 6.53 ± 1.09; manual： 6.53 ± 1.09 cm2） 0.64%, bone marrow fat（threshold： 3.12 ± 1.12; manual： 3.1 ± 1.11 cm2） 0.36%, knee extensor（threshold： 43.98 ± 7.66; manual： 44.61 ± 7.81 cm2） 1.78% and % intramuscular fat（threshold： 10.45 ± 4.29; manual： 10.92 ± 8.35%） 0.47%. Collectively, these results suggest that the threshold technique provided a robust accuracy in measuring the seven main thigh compartments, while greatly reducing the analysis time.

Adipose stromal/stem cells in regenerative medicine:Potentials and limitations

This article presents the stem and progenitor cells from subcutaneous adipose tissue,briefly comparing them with their bone marrow counterparts,and discussing their potential for use in regenerative medicine.Subcutaneous adipose tissue differs from other mesenchymal stromal/stem cells(MSCs)sources in that it contains a pre-adipocyte population that dwells in the adventitia of robust blood vessels.Pre-adipocytes are present both in the stromal-vascular fraction(SVF;freshly isolated cells)and in the adherent fraction of adipose stromal/stem cells(ASCs;in vitro expanded cells),and have an active role on the chronic inflammation environment established in obesity,likely due their monocyticmacrophage lineage identity.The SVF and ASCs have been explored in cell therapy protocols with relative success,given their paracrine and immunomodulatory effects.Importantly,the widely explored multipotentiality of ASCs has direct application in bone,cartilage and adipose tissue engineering.The aim of this editorial is to reinforce the peculiarities of the stem and progenitor cells from subcutaneous adipose tissue,revealing the spheroids as a recently described biotechnological tool for cell therapy and tissue engineering.Innovative cell culture techniques,in particular 3D scaffold-free cultures such as spheroids,are now available to increase the potential for regeneration and differentiation of mesenchymal lineages.Spheroids are being explored not only as a model for cell differentiation,but also as powerful 3D cell culture tools to maintain the stemness and expand the regenerative and differentiation capacities of mesenchymal cell lineages.

Dissecting the Contributing Role of Divergent Adipose Tissue to Multidimensional Frailty in Cirrhosis

Background and Aims:Emerging evidence has demonstrated that abnormal body composition may potentiate the development of frailty,whereas little work focuses on the role of divergent adipose tissue.Therefore,we aimed to determine the potential contribution of adipose tissue distribution to multidimensional frailty in decompensated cirrhosis.Methods:We conducted a retrospective cohort study.Divergent adipose tissues were assessed by computed tomography-derived subcutaneous adipose tissue index(SATI),visceral adipose tissue index(VATI)and total adipose tissue index(TATI),respectively.Frailty was identified by our validated self-reported Frailty Index.Multiple binary logistic models incorporating different covariates were established to assess the relationship between adipose tissue distribution and frailty.Results:The study cohort comprised 245 cirrhotic patients with 45.3%being male.The median Frailty Index,body mass index(BMI)and model for end-stage liver disease(MELD)score were 0.11,24.3 kg/m2 and 8.9 points,respectively.In both men and women,patients who were frail exhibited lower levels of SATI in comparison with nonfrail patients.SATI inversely correlated with Frailty Index in the entire cohort(rs=−0.1361,p=0.0332).Furthermore,SATI or TATI was independently associated with frail phenotype in several multiple logistic regression models adjusting for age,BMI,presence of ascites,sodium,Child-Pugh class or MELD score in isolation.Conclusions:In the context of decompensated cirrhosis,low SATI and concomitant TATI were associated with higher risk of being frail.These findings highlight the importance to further apply tissue-specific tools of body composition in place of crude metric like BMI.

Preoperative Assessment of Abdominal Adipose Tissue to Predict Microvascular Invasion in Small Hepatocellular Carcinoma

Background and Aims:Microvascular invasion(MVI)affects recurrence after treatment of small hepatocellular carcinoma(sHCC)of≤3 cm in size.The present study aimed to investigate whether abdominal subcutaneous adipose tissue(SAT),visceral adipose tissue(VAT),and intermuscular adipose tissue(IMAT)are associated with MVI in patients with sHCC.Methods:A total of 124 patients with pathologicallyconfirmed sHCC diagnosed on surgical resection at the First Hospital Affiliated to Army Military University were recruited and divided into two groups according to MVI classification criteria(i.e.,MVI-positive or MVI-negative).The SAT,VAT,and IMAT areas at the lumbar 3 vertebral level were imaged with abdominal computed tomography and measured using ImageJ software.Their association with MVI in sHCC was analyzed.Results:Of the 124 patients with sHCC,67 were MVIpositive and 57 were MVInegative.Univariate analysis revealed a significant difference in the abdominal VAT and SAT between the MVI-positive and MVI-negative groups(p<0.05),with an area under the receiver operating characteristic curve of 0.76 and 0.65,respectively.Conclusions:The results of this study suggest that the areas of abdominal SAT and VAT are of significant clinical value because they can effectively predict the MVI status in patients with sHCC.

Tissue engineering in burn scar reconstruction

Nowadays,most patients with severe burns will survive their injury.This evolution is accompanied by the challenge to cover a large percentage of total body surface area burned.Consequently,more and more patients have to deal with the sequelae of burn scars and require(multiple)reconstructions.This review provides a gross overview of developments in the field of tissue engineering for permanent burn wound coverage and reconstructive burn surgery,focusing on usage and clinical effectiveness.Not only skin substitutes will be discussed but also the replacement of subcutaneous fat tissue and cartilage.

A comparative study on the tolerance of tilapia(Oreochromis niloticus)to high carbohydrate and high lipid diets

A 12-wk trial was conducted to compare the tolerance of tilapia to high carbohydrate and high lipid diets.Three isonitrogenous and isoenergetic diets,whose carbohydrate and lipid levels were the following:35.0%and 8%(control),44.2%and 4%(D1,high carbohydrate),and 25.8%and 12%(D2,high lipid),respectively.Three hundred tilapias(27±0.11 g)were fed the diets for 10 wk(4 replicates per group);72 fish from the D1 group were continually fed the D1(D1D1)and 72 fish from the D2 were continually fed the D2(D2D2)diet for 2 wk(3 replicates each group)to evaluate the tilapia's capacity to tolerate high carbohydrate and high lipid diets,respectively.Another 36 fish from D1 group were continually fed D2(D1D2)for comparison with D1D1 and D2D2 groups.In phase 1,hepatosomatic index,liver triglycerides(TG),glucose tolerance(GT)and crude protein in the whole body in D1 group were higher than those in D2 group(P<0.05).During phase 2,D1D1 group had lower feed intake and weight gain,as well as lower serum total protein and albumin than that of D2D2 group(P<0.05),while its liver glycogen was significantly higher than that in D1D2 and D2D2 groups(P<0.05).Moreover,serum glucose and GT were higher in D1D1 and D1D2 groups than those in D2D2 group(P<0.05).By contrast,D2D2 group had significantly higher intraperitoneal fat,subcutaneous adipose tissue(SCAT)and liver TG than those in D1D1 group(P<0.05).The mRNA expression of brain npy,hepatic nrf2,gst1 and hepatic transcriptomic data showed that immune-related genes(gama,mrc2,mhc2 and cd163),were downregulated in D1D1 group compared to D2D2 and D1D2 groups.Taken together:1)tilapia have higher tolerance to a high lipid diet than high carbohydrate diet;2)despite retention of glucose tolerance,the continuous feeding of D1 diet impaired tilapia's appetite,weight gain rate and host immune response;3)specific distri-bution of fat in intraperitoneal regions,SCAT and liver may be a risk-avoidance strategy in tilapia in response to a continuous D2 diet.