Her yol Roma'ya varmaz!

Taha Toros Arşivi, Dosya Adı: Taha Torosİstanbul Kalkınma Ajansı (TR10/14/YEN/0033) İstanbul Development Agency (TR10/14/YEN/0033

Adult Intussusception Due to Endometriosis Arising from the Uterine Tube: Report of a Case

Introduction: Endometriosis is a rare cause of intussusceptions in adults. Although intestinal endometriosis sometimes arises as a consequence of direct involvement of the pelvic organs with endometrial tissue, there is no report that this type of endometriosis causes ileocecal intussusception. Case presentation: Computed tomography assessment of a 40-year-old woman who presented with abdominal pain revealed ileocecal intussusceptions. The patient was managed by endoscopic reduction followed by laparoscopic resection. Adhesion between the right uterine adnexa and caecum was identified during surgery; therefore, combined resection of the uterine adnexa and ileocecum was performed. Pathological findings revealed that endometriosis, arising from the uterine tube and directly involving the cecal wall, had caused the intussusceptions. Conclusion: Although rare, endometriosis should be considered as part of a differential diagnosis of intussusception in adult women who present with abdominal pain. A preoperative diagnosis is sometimes difficult, therefore, surgical resection could be a reasonable strategy to achieve a precise diagnosis

Reduced skin lipid content in obese Japanese women mediated by decreased expression of rate-limiting lipogenic enzymes

<div><p>Skin barrier function is often deficient in obese individuals, but the underlying molecular mechanisms remain unclear. This study investigated how skin structure and lipid metabolism, factors strongly associated with barrier function, differed among 50 Japanese women of greatly varying body mass index (BMI). Subjects receiving breast reconstruction surgery were chosen for analysis to obtain skin samples from the same site. The subjects were classified into two groups, control (BMI < 25 kg/m²) and obese (25 kg/m² ≤ BMI < 35 kg/m²), according to standards in Japan. Hematoxylin and eosin staining was used to assess skin thickness, Ki-67 immunostaining to examine keratinocyte proliferation, and real-time polymerase chain reaction to measure skin expression levels of genes associated with lipid metabolism. Total lipids, cholesterol, and fatty acids were also measured from these same skin samples. In the obese group, structural changes included epidermal thickening and an increase in the number of Ki-67-positive (proliferating) cells. Both skin cholesterol and fatty acid levels exhibited an “inverted-U” relationship with BMI, suggesting that there is an optimal BMI for peak lipid content and barrier function. Decreased lipid levels at higher BMI were accompanied by downregulated expression of <i>PPARδ</i> and other genes related to lipid metabolism, including those encoding acetyl-CoA carboxylase and HMG-CoA reductase, the rate-limiting enzymes for fatty acid and cholesterol synthesis, respectively. Thus, elevated BMI may lead to deficient skin barrier function by suppressing local lipid synthesis.</p></div

Levels of each lipid in the skin.

<p>Total lipids (a), cholesterol (b), and fatty acids (c) in the skin are compared between the control group (BMI < 25 kg/m², n = 39) and obesity group (25 kg/m² ≤ BMI < 35 kg/m², n = 11). Data are presented as mean ± SD. Statistical comparisons between the groups are performed using the unpaired Student’s <i>t</i>-test (**<i>p</i> < 0.01). (d-i) Spearman’s rank correlation coefficients (r) between BMI and each lipid for all subjects (d, g), subjects with BMI < 22 kg/m² (e, h), and subjects with BMI from 22–35 kg/m² (f, i) (**<i>p</i> < 0.01).</p

Correlation between gene expression and the amounts of each lipid in the skin.

<p>Correlation between gene expression and the amounts of each lipid in the skin.</p