Ruptured Suprasellar Dermoid Cyst Treated With Lumbar Drain to Prevent Postoperative Hydrocephalus: Case Report and Focused Review of Literature

Background: Ruptured intracranial dermoid cysts are extremely rare. Standard treatment consists of endonasal decompression or craniotomy with evacuation and copious irrigation of subarachnoid spaces to remove any disseminated cystic contents. Disseminated fat particles in the subarachnoid space may be the cause of further sequalae, including the subsequent development of chemical meningitis and hydrocephalus. Here, we present a case of ruptured suprasellar dermoid cyst treated with craniotomy for emergent optic nerve decompression, followed by postoperative hydrocephalus successfully treated with lumbar drain.Case description: We describe a 30-year-old man with a history of migraines who presented with acute onset of headache, photophobia, nausea, vomiting, and vision loss in the left eye. Head CT and brain MRI demonstrated a ruptured suprasellar dermoid cyst with associated mass effect on the optic nerves and frontal lobes as well as fat attenuation material within the subarachnoid spaces. The patient underwent left frontotemporal craniotomy for cyst resection and developed non-obstructive hydrocephalus on postoperative day 1, refractory to external ventricular drainage. Placement of a lumbar drain cleared the subarachnoid space of debris derived from the ruptured dermoid cyst, and the hydrocephalus resolved. The patient did not require permanent CSF diversion.Conclusions: Intracranial dermoid cysts are uncommon, and rupture is a rare event. Standard surgical treatment with craniotomy for evacuation may leave disseminated dermoid contents and fat particles throughout the subarachnoid spaces. We highlight a case of ruptured suprasellar dermoid cyst with postoperative communicating hydrocephalus treated with lumbar drain when external ventricular drain (EVD) was ineffective. Review of the current literature reveals inconsistent findings on the effects of remaining fat particles. In cases with clinical evidence of increased intracranial pressure due to non-obstructive hydrocephalus attributable to chemical meningitis, temporary lumbar drainage is an option to be considered before committing the patient to permanent shunting.

A morphological classification of the fat particles found in the urinary sediment of patients with Fabry disease

Objectives The search in the urinary sediment (U-sed) of fat particles with peculiar morphology is a simple and inexpensive tool for the diagnosis of Fabry disease (FD) nephropathy. In this study we investigated the morphology of a high number of such fat particles with the aim to obtain a morphological classification to be used for their identification. Methods Study of the morphology of fat particles in the U-sed of a cohort of FD patients using: bright field plus phase contrast microscopy (BF + PC), polarized light microscopy (POL), and transmission electron microscopy (TEM). Comparison of these results with those obtained for the fat particles seen in the U-sed of a control group (CG) of patients with non-FD glomerulopathies. Results FD: 18 U-sed from six patients (three samples/patient) were prospectively investigated and 506 fat particles identified. With BF + PC, these were classified in eight morphological categories (seven of which were confirmed by TEM), and with POL in 10 others. CG: eight U-sed from eight patients were investigated and 281 fat particles identified. These fell into four BF + PC morphological categories and into eight POL categories. While some categories were significantly more frequent in FD others were more frequent in the CG. Conclusions Our study demonstrates that 1. The morphology of fat particles found in the U-sed of FD patients is much wider and complex than that described so far 2. Several significant differences exist in the morphology of such fat particles between FD and CG patients.

Evaluating a Topical Adjunctive Post Submental ATX-101 (Deoxycholic Acid) Injections for Improved Recovery: A Single Center, Double-Blind, Randomized Controlled Pilot Study

Background Optimizing post procedural recovery and outcomes for patients is the aim for all physicians. TransFORM Body Treatment with TriHex Technology (TFB) is a topical product that aids in the elimination of fat particles created during procedures and the reduction of associated inflammation, thus, speeding up post procedure recovery time. Objectives Evaluation of post procedural symptoms, signs and healing following submental deoxycholic acid (DCA) injections in combination with TFB post treatment. Methods Participants received two treatments of submental DCA injections. Post treatment 1 every participant received TFB to apply twice daily to the submental area. Follow-up visits included weeks 1, 2 and 4. After week 4, participants discontinued TFB for 30 days prior to the second treatment. At the second treatment visit, participants were randomized to receive either TFB or a bland moisturizer to apply twice daily with the same follow-up visits as post treatment one. Skinfibrometer measurements (objective induration measurements), submental fullness grading and standardized photography were captured at every visit. At all follow-up visits and prior to treatment 2, investigator assessments and participant assessments were completed. Results Post treatment two, investigator assessments of edema and induration decreased in participants using TFB at weeks 1 and 2 compared to the bland moisturizer. Skinfibrometer measurements objectively showed a statistically significant reduction in induration at week 2 (post treatment two) in participants using TFB compared to the bland moisturizer. Furthermore, participants reported less tenderness and soreness in the TFB group over the bland moisturizer. Conclusions Investigator assessments, participant query and objective skinfibrometer analyses have demonstrated that the use of TFB post DCA injections may reduce induration, edema and discomfort associated with this procedure.

Computational Fluid Dynamic (CFD) Simulation of Bifurcate Artery

Heart attacks and strokes are one of the leading causes of death in the world today, and heart attacks caused by clogged arteries that carry blood to the heart muscle are a significant part of these strokes. These are caused by the accumulation of fat particles in the walls of the arteries and the reduction of blood flow through it over a long process. The process of fat penetration in the underlying layers of the Artery wall has been the focus of many researchers, and various researches and Simulations have been done on it, in each of them, the effect of specific parameters has been considered. In the present study, the effect of blood flow rate on the flow pattern in a bifurcate artery with two ducts has been investigated using FLUENT software with Computation fluid dynamic Method. The effect of the angle between the two ducts of the Artery on the flow pattern has been investigated.

Effects of Ultrasound-Assisted Emulsification on the Emulsifying and Rheological Properties of Myofibrillar Protein Stabilized Pork Fat Emulsions

The current study aimed to investigate the effects of ultrasound-assisted emulsification on the emulsifying and rheological properties of myofibrillar protein (MP) pork fat emulsions under different protein/fat ratios. Changes in emulsion profile, confocal laser scanning microscope images, cryo-scanning microscope images, particle size, protein solubility, surface hydrophobicity and free sulfhydryl groups were determined. Ultrasound significantly increased the emulsifying activity, the emulsifying stability and the flow index for all emulsions, while it decreased the viscosity coefficient of emulsions except for the treatment of protein/fat ratio of 1:15. The results showed that sonication reduced the particle size of the fat particles and evenly distributed the emulsion droplets. Sonication moved the distribution curve of droplet size to the smaller particle size direction and decreased the D3,2 and D4,3 values of emulsion. Sonication resulted in increased bindings between protein hydrophobic groups and fat particles. After ultrasound treatment, more sulfhydryl groups were exposed to aqueous solution, which might decrease the protein solubility in aqueous solution. Ultrasound-assisted emulsification could directly enhance the emulsifying and rheological properties of MP-stabilized pork fat emulsions at different protein/fat ratios, in particular at the ratio of 1:10.

Inert hydrophilic particles enhance the thermal properties and structural resilience of meat protein gels during heating

Meat protein gels are present in a variety of foods and are frequently filled with fat particles.

AGE-RELATED EXTERNAL STRUCTURE OF HUMAN GREATER OMENTUM

Currently, the greater omentum is widely used in surgery as a source of grafts in reconstructive plastic surgery. Postmortem studies of the greater omentum taken from male and female died individuals of the second mature, elderly and senile age with brachiomorphic, mesomorphic and dolichomorphic body types were carried out. The methodology included aomatoscopic, morphometric methods and the methods of anatomical preparation. It has been established that the greater omentum consists of two parts: secured and unsecured. The secured part of the greater omentum is located between the great curvature of the stomach and the omental band of the transverse colon and is called the gastrocolic ligament. In the second mature, elderly and senile age, the shape and size of the greater omenta are not dependent on the human body type. At the same age periods, the greater omenta of the quadrangular, triangular and irregular shapes are found in women and men. Quadrangular greater omenta occupy the largest area; while the area occupied by the greater omenta of triangular and irregular shape is less. The quadrangular shape of the greater omentum is more favourable for obtaining the graft for transplantation to organs with a large defect. At all ages, the intensity of the development of the adipose tissue in the greater omentum depends on the prominence of subcutaneous adipose tissue, especially in overweight individuals. In the presence of adipose tissue, the following types of the greater omentum have been identified: 1) the greater omentum without adipose tissue; 2) the greater omentum with moderately developed adipose tissue; 3) the greater omentum with excessively developed adipose tissue. The greater omenta without adipose tissue are plastic with clearly visible vessels and their branching. The adipose tissue is located along the vessels, and the areas without adipose tissue are transparent, resembling a thin lace. In greater omenta with excessively developed adipose tissue, the vessels were not verified due to the numerous fat particles that cover the entire surface of the omentum in a continuous layer. The greater omentum with excessively developed adipose tissue becomes thick and loses its flexibility. Before omentoplasty, laparoscopic examination of the greater omentum of overweight patient is advisable in the preoperative period. One of the causes of bowel entrapment there are through holes in the unsecured part of the greater omentum.

Embolismo Graso secundario a Fractura de Huesos Largos: Reporte de un Caso.

<p>[Fatty Embolism Secondary to Long Bone Fracture: Case Report.]</p><p><br /><strong>Resumen</strong><br />El embolismo graso es un subtipo del embolismo pulmonar, donde el embolo está formado por partículas de grasa y corresponde a una complicación infrecuente de las fracturas de huesos largos. Presentamos un caso de un paciente masculino de 23 años con politraumatismo y fractura del tercio medio del fémur derecho secundario a accidente automovilístico con colisión frontal entre 2 vehículos en calidad de conductor, quien posteriormente desarrolla un cuadro de distrés respiratorio por embolismo graso.<br /><br />Esta entidad suele manifestarse en la radiografía de tórax como extensas áreas homogéneas y heterogéneas de aumento de atenuación y en la tomografía computarizada como áreas de consolidación focal u opacidad en vidrio deslustrado, y ganglios en los lóbulos superiores luego de 12-24 horas del inicio del cuadro.<br /> <br /><strong>Abstract</strong><br />Fat embolism is a subtype of Pulmonary embolism where the embolus is composed of fat particles. It is an uncommon complication of long bone fractures. We present a case of a 23 year old male patient with the diagnosis of polytrauma and fracture of the middle third of the right femur due to a car accident consisting of a head-on crash between 2 cars, the patient being one of the drivers, who later develops acute respiratory distress secondary to fat embolism.<br /><br />This condition usually manifests on plain chest radiographs as homogeneous and heterogeneous widespread zones of high attenuation and on chest computed tomography as zones of focal consolidation or ground-glass opacities and upper lobe adenopathy’s 12-24 hours from the onset of the symptoms. <br /><br /></p>