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Wang Z, Buqi N, Zhang P, Wang Y, Lv Y, An G. Clinical significance of increased peripheral venous blood adipocyte-specific protein FABP4 after joint replacement. Medicine (Baltimore) 2020; 99:e20649. [PMID: 32629636 PMCID: PMC7337534 DOI: 10.1097/md.0000000000020649] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2019] [Revised: 04/07/2020] [Accepted: 05/10/2020] [Indexed: 11/27/2022] Open
Abstract
A new method of diagnosing fat embolism (FE) at the molecular level was proposed, and the diagnostic value of adipocyte-specific protein fatty acid-binding protein 4 (Homo sapiens [human]) gene ID = 2167 (FABP4) for FE was preliminarily explored. Eight joint replacement patients, 5 internal medicine patients, and 6 healthy persons were recruited. Serum of internal medicine patients, healthy people, and patients before and 24 hours after joint replacement were taken as study samples. Subcutaneous adipose, intra-articular adipose and intramedullary yellow bone marrow of patients undergoing joint replacement were taken as study samples. The level of FABP4 in the above samples was detected by enzyme-linked immunoassay. Normal distribution was tested. Paired sample T test was used for self-control. Univariate analysis of variance was used for multigroup comparison.There was no significant difference in serum FABP4 level between healthy persons, medical patients, and preoperative patients. The FABP4 level in yellow bone marrow and subcutaneous adipose was significantly higher than that in serum of healthy people, medical patients, and preoperative patients. FABP4 level in the serum after joint replacement was significantly higher than that before joint replacement. FABP4 may be a specific indicator of FE diagnosis, but further studies are needed to confirm its clinical value.
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Affiliation(s)
- Zhuo Wang
- Department of Respiratory and Critical Care Medicine
| | - Na Buqi
- Department of Respiratory and Critical Care Medicine
| | - Pingji Zhang
- Department of Respiratory and Critical Care Medicine
| | - Yanxun Wang
- Department of Respiratory and Critical Care Medicine
| | | | - Guisheng An
- Department of Traumatic Orthopaedic, Beijing Jishuitan Hospital, Beijing, China
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Abstract
BACKGROUND The frequency of fat embolism mortality after liposuction has increased. As the only dependable evidence for this problem is that available in the medical literature, a study of clinical case reports is warranted. METHODS The authors reviewed the medical literature by searching for case reports of fat embolism after liposuction in humans who manifested either of the variants of the condition: microscopic fat embolism or macroscopic fat embolism. The authors performed a literature search of the PubMed and PubMed Central databases from the first case of fat embolism syndrome associated with liposuction reported until March of 2017; keywords Fat Embolism (Fat Embolism Syndrome), Liposuction, and Case (((fat embolism) AND liposuction) AND case) were used. A detailed analysis of the data contained in the clinical case reports was conducted. RESULTS In total, 39 and 98 articles were found in PubMed and PubMed Central, respectively, using the keywords (((Fat + Embolism) + AND + Liposuction) + AND + Case). After analysis, only 15 reports corresponded to cases of macroscopic or microscopic fat embolism after liposuction, and the basic statistics of the two proposed variants were examined. CONCLUSIONS This work provides relevant information regarding very important characteristics of microscopic and macroscopic fat embolism. Despite the diagnostic difficulty, clinical diagnosis remains the gold standard for identifying microscopic and macroscopic fat embolism. The establishment of a rapid and timely diagnosis is of great help for appropriate treatment.
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Critical Differences between Microscopic (MIFE) and Macroscopic (MAFE) Fat Embolism during Liposuction and Gluteal Lipoinjection. Plast Reconstr Surg 2018; 141:880-890. [PMID: 29257003 DOI: 10.1097/prs.0000000000004219] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
BACKGROUND Liposuction and gluteal lipoinjection are two of the most frequent surgical procedures in body contouring surgery, and two of the most important complications are microscopic (MIFE) and macroscopic (MAFE) fat embolism. Despite a high index of morbidity and mortality, few reports exist about these complications, and although they have the same causal agent, their etiopathogenesis, clinical evolution, treatment, prognosis, and prevention are totally different. Therefore, the authors performed a comprehensive review of the literature to exhaustively analyze both pathologic conditions and present the differences between them. METHODS A detailed search was carried out in PubMed of studies on humans from 1946 to March of 2017 in any language and including the keywords microscopic fat embolism and macroscopic fat embolism with either liposuction or gluteal lipoinjection. The articles found were selected according to the search criteria and were analyzed to provide the final data and recommendations. RESULTS Of the 1245 and 26 articles that were found on complications related to liposuction and gluteal lipoinjection, respectively, only 41 on liposuction and microscopic fat embolism and seven on gluteal lipoinjection and microscopic fat embolism met the specific criteria for inclusion in the analysis. Only two articles on liposuction and two on gluteal lipoinjection referred to macroscopic fat embolism as a complication. CONCLUSION Although microscopic fat embolism and macroscopic fat embolism are pathologic conditions with high morbidity and mortality rates in association with liposuction and gluteal lipoinjection, few reports about them exist; therefore, the authors made recommendations based on this study for their diagnosis, prevention, and treatment.
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Szychlinska MA, Castrogiovanni P, Nsir H, Di Rosa M, Guglielmino C, Parenti R, Calabrese G, Pricoco E, Salvatorelli L, Magro G, Imbesi R, Mobasheri A, Musumeci G. Engineered cartilage regeneration from adipose tissue derived-mesenchymal stem cells: A morphomolecular study on osteoblast, chondrocyte and apoptosis evaluation. Exp Cell Res 2017; 357:222-235. [PMID: 28529106 DOI: 10.1016/j.yexcr.2017.05.018] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2017] [Revised: 04/23/2017] [Accepted: 05/18/2017] [Indexed: 02/08/2023]
Abstract
The poor self-repair capacity of cartilage tissue in degenerative conditions, such as osteoarthritis (OA), has prompted the development of a variety of therapeutic approaches, such as cellular therapies and tissue engineering based on the use of mesenchymal stem cells (MSCs). The aim of this study is to demonstrate, for the first time, that the chondrocytes differentiated from rat adipose tissue derived-MSCs (AMSCs), are able to constitute a morphologically and biochemically healthy hyaline cartilage after 6 weeks of culture on a Collagen Cell Carrier (CCC) scaffold. In this study we evaluated the expression of some osteoblasts (Runt-related transcription factor 2 (RUNX2) and osteocalcin), chondrocytes (collagen I, II and lubricin) and apoptosis (caspase-3) biomarkers in undifferentiated AMSCs, differentiated AMSCs in chondrocytes cultured in monolayer and AMSCs-derived chondrocytes seeded on CCC scaffolds, by different techniques such as immunohistochemistry, ELISA, Western blot and gene expression analyses. Our results showed the increased expression of collagen II and lubricin in AMSCs-derived chondrocytes cultured on CCC scaffolds, whereas the expression of collagen I, RUNX2, osteocalcin and caspase-3 resulted decreased, when compared to the controls. In conclusion, this innovative basic study could be a possible key for future therapeutic strategies for articular cartilage restoration through the use of CCC scaffolds, to reduce the morbidity from acute cartilage injuries and degenerative joint diseases.
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Affiliation(s)
- Marta Anna Szychlinska
- Department of Biomedical and Biotechnological Sciences, Human Anatomy and Histology Section, School of Medicine, University of Catania, Catania, Italy
| | - Paola Castrogiovanni
- Department of Biomedical and Biotechnological Sciences, Human Anatomy and Histology Section, School of Medicine, University of Catania, Catania, Italy
| | - Houda Nsir
- Biotechnology Laboratory of Olive Tree, Centre of Biotechnology of Borj Cedreya, University of Carthage, Tunisia
| | - Michelino Di Rosa
- Department of Biomedical and Biotechnological Sciences, Pathology Section, School of Medicine, University of Catania, Catania, Italy
| | - Claudia Guglielmino
- Department of Biomedical and Biotechnological Sciences, Human Anatomy and Histology Section, School of Medicine, University of Catania, Catania, Italy
| | - Rosalba Parenti
- Department of Biomedical and Biotechnological Sciences, Physiology Section, School of Medicine, University of Catania, Catania, Italy
| | - Giovanna Calabrese
- Department of Biomedical and Biotechnological Sciences, Physiology Section, School of Medicine, University of Catania, Catania, Italy
| | - Elisabetta Pricoco
- Department of Medical and Surgical Sciences and Advanced Technologies, Anatomic Pathology Section, School of Medicine, University of Catania, Catania, Italy
| | - Lucia Salvatorelli
- Department of Medical and Surgical Sciences and Advanced Technologies, Anatomic Pathology Section, School of Medicine, University of Catania, Catania, Italy
| | - Gaetano Magro
- Department of Medical and Surgical Sciences and Advanced Technologies, Anatomic Pathology Section, School of Medicine, University of Catania, Catania, Italy
| | - Rosa Imbesi
- Department of Biomedical and Biotechnological Sciences, Human Anatomy and Histology Section, School of Medicine, University of Catania, Catania, Italy
| | - Ali Mobasheri
- The D-BOARD European Consortium for Biomarker Discovery, The APPROACH Innovative Medicines Initiative (IMI) Consortium, School of Veterinary Medicine, Faculty of Health and Medical Sciences, University of Surrey, Duke of Kent Building, Guildford GU2 7XH, Surrey, United Kingdom; Center of Excellence in Genomic Medicine Research (CEGMR), King Fahd Medical Research Center (KFMRC), King AbdulAziz University, Jeddah 21589, Saudi Arabia; Arthritis Research UK Centre for Sport, Exercise and Osteoarthritis, Arthritis Research UK Pain Centre, Medical Research Council and Arthritis Research UK Centre for Musculoskeletal Ageing Research, University of Nottingham, Queen's Medical Centre, Nottingham NG7 2UH, United Kingdom
| | - Giuseppe Musumeci
- Department of Biomedical and Biotechnological Sciences, Human Anatomy and Histology Section, School of Medicine, University of Catania, Catania, Italy; Department of Health, Institut des Etudes Universitaries, UniPoliSI, Veyras, Switzerland.
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Abstract
Background: Liposuction is the commonest aesthetic procedure performed by Indian plastic surgeons. However, there exists substantial disparity amongst Indian surgeons about guidelines concerning liposuction. To address this disparity, a nationwide email survey (Association of Plastic Surgeons of India [APSI] database) was started in December 2013 and continued for 5 months. Material and Methods: The survey was developed with software from www.fluidsurveys.com. The study was designed to cover most aspects of patient selection, perioperative management, technical considerations, postoperative management and complications. This is the first survey to be conducted in India for an extremely popular procedure. It is also one of the most exhaustive surveys that have been conducted in terms of the topics covered. Results and Conclusions: One hundred and eighteen surgeons (including a majority of the cosmetic surgery stalwarts in the country) completed the survey. As expected, the results show a disparity in most parameters but also consolidation on some issues. Liposuction is considered extremely safe (86.1%). The majority of surgeons (70.3%) aspirated >5 L at onetime. The majority (80.2%) felt that the limits for liposuction should be relative and not absolute. The survey highlights lack of standardization with respect to infiltration solutions. The commonest complications observed were contour irregularities, followed by seroma and inadequate skin redrape. The amount of aspirate is the only factor, which achieves statistical significance with respect to major complications. A review of the current evidence and recommendations has been incorporated, along with an in depth analysis of the survey.
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Affiliation(s)
- Bijoy Methil
- Department of Plastic Surgery Jaslok Hospital, Saifee Hospitals, Sir HN Hospitals Mumbai, Maharashtra, India
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Ely SF. The Forensic Implications of Liposuction: A Review. Acad Forensic Pathol 2013. [DOI: 10.23907/2013.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Liposuction continues to be one of the most popular cosmetic procedures in developed cultures worldwide. Since a 1999 report describing five liposuction-related deaths in New York City, three of which were incompletely explained, abundant analysis and literature has emerged. This paper aims to present the history of liposuction, review recent clinical safety/guidelines and forensic fatality literature, describe current and emerging trends and techniques, and offer an approach to the forensic investigation of these deaths.
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Affiliation(s)
- Susan F. Ely
- Office of Chief Medical Examiner of the City of New York New York University School of Medicine
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Felzemburgh VA, Barbosa RCDN, Nunes VLC, Campos JHO. Fat embolism in liposuction and intramuscular grafts in rabbits. Acta Cir Bras 2012; 27:289-93. [PMID: 22666740 DOI: 10.1590/s0102-86502012000500002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2011] [Accepted: 03/19/2012] [Indexed: 11/22/2022] Open
Abstract
PURPOSE To evaluate the effects of fat embolism in organs such as lung and liver. METHODS Twenty rabbits underwent autologous intramuscular fat grafting in the right thigh after liposuction. The groups were determined according to the postoperative day that occurred in euthanasia: 60, 90 and 120 day. Then, lung and liver were excised and sent to the histopathology laboratory for analysis in search of late injury secondary to a prior event of fat embolism in the tissues. RESULTS The results showed a change in the macroscopic sample with discoloration of the liver tissue heterogeneously. There were no changes consistent with embolic effect under the microscope. CONCLUSION The option of performing a technique of fat grafting with a less traumatic surgical procedure can be considered protective against embolic events, with no impact to late embolic events on the tissues.
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