Expanding the role of bitter taste receptor in extra oral tissues : TAS2R38 is expressed in human adipocytes

Increasing evidence indicates that taste receptors mediate a variety of functions in extra-oral tissues. The present study investigated the expression of bitter taste receptor TAS2R38 in human adipocytes, the possible link with genetic background and the role of TAS2R38 in cell delipidation and lipid accumulation rate in vitro. Subcutaneous (SAT) and visceral (VAT) adipose tissues were collected in 32 obese and 18 lean subjects. The TAS2R38 gene expression and protein content were examined in whole tissues, differentiated adipocytes and stroma-vascular fraction cells (SVF). The P49A SNP of TAS2R38 gene was determined in each collected sample. The effect of two bitter agonists (6-n-propylthiouracil and quinine) was tested. TAS2R38 mRNA was more expressed in SAT and VAT of obese than lean subjects and the expression/protein content was greater in mature adipocytes. The expression levels were not linked to P49A variants. In in vitro differentiated adipocytes, bitter agonists induced a significant delipidation. Incubation with 6-n-propylthiouracil induced an inhibition of lipid accumulation rate together with an increase in TAS2R38 and a decrease in genes involved in adipocyte differentiation. In conclusion, TAS2R38 is more expressed in adipocytes of obese than lean subjects and is involved in differentiation and delipidation processes

Climate change and the aquatic ecosystems of the Rwenzori Mountains, Uganda

The Rwenzori Mountains are home to one of the last remaining tropical icefields outside of the Andes. Over the last century, equatorial icefields of the East African highlands have been steadily shrinking but the precise climate tropical alpine glaciers remain unclear. More than a decade had passed since the last detailed measurements of glacial cover were made in the Rwenzori Mountains. Recent evidence from Kilimanjaro suggests that its icecap will disappear entirely by the year 2020(1). The Rwenzori glaciers contribute meltwater flows to aquatic ecosystems of the Rwenzori Mountains National Park, a Word Heritage Site featuring spectacular, rare Afroalpine flora and fauna, and are headwaters of the River Nile. With the overall aim of assessing the impact of recent climate change on alpine aquatic ecosystems of the Rwenzori Mountains, a collaborative, international research team led by the University College London (United Kingdom) and Makerere University (Uganda), and involving the Institut für Geographie from the University of Innsbruck (Austria) and Water Resources Management Department (Uganda) was assembled in order to pursue three primary scientific objectives: • to assess the magnitude of current glacial recession; • to assess the impact of glacial recession on alpine riverflow; and • to assess recent environmental change from observational datasets and available, environmental archives stored in lake sediment and glacial ice

Cardiac tamponade occurred after endoscopic submucosal dissection : conservative management of the esophagopericardial fistula

Key Clinical Message We describe the case of an esophagopericardial fistula generated after endo- scopic submucosal dissection in a patient affected by a superficial esophageal squamous cell carcinoma immediately treated with percutaneous pericardial drainage and placement of a partially covered self-expanding metal stent that has been removed using the stent-in-stent technique after 35 days

Laparoscopic paraesophageal hernia repair with absorbable mesh: a systematic review

Background: Laparoscopic repair is the standard of care for patients with paraesophageal hernia (PEH). Different prosthetic materials have been proposed to bolster the hiatus thus theoretically minimizing the probability for hernia recurrence. The use of non-absorbable mesh has been reported however, their safety profile has been questioned because the noteworthy mesh-related complication rate. Opposite, absorbable mesh (synthetic and biologic) seems associated with mitigated mesh-related complications and comparable hernia recurrence in the short- and medium-term. Methods: PubMed, MEDLINE, EMBASE, Scopus, Google Scholar, and ClinicalTrials.gov were executed according to the PRISMA statement until May 2022. Primary endpoints were technical details and surgical outcomes of adult patients (>= 18 years old) that underwent laparoscopic PEH repair and crural reinforcement with absorbable mesh. The ROBINS-I tool was used to assess the methodological quality of included studies. Results: Thirty-nine studies (3,103 patients) were included. The age of the patient population ranged from 18 to 93 years old and 62.8% were females. Posterior cruroplasty was performed in all patients. U-shape (83.7%), circumferential (8.1%), keyhole (5.4%) and starburst (2.8%) mesh configuration were described. Different methods for mesh fixation (sutures vs. fibrin glue vs. absorbable tacks) were adopted while Nissen (75.1%) and Toupet (21.1%) fundoplication were mainly fashioned. The overall postoperative complication rate was 2.5%. Pulmonary and cardiac complication rates were 1.8% and 0.9%, respectively while in-hospital mortality was 0.2%. Postoperative follow-up ranged from 12 to 166 months. Mesh-related complication rate was 0.06% (esophageal stricture related to fibrosis). Hernia recurrence rate was 12.7% while re-do surgery was required in 1.9% of patients. Postoperative dysphagia rate was 5.1%. Discussion: Consensus concerning the optimal mesh material for crural buttressing is lacking. Given the potential for tissue ingrowth rather than encapsulation and reduced degree of perivisceral inflammation, absorbable meshes are mostly preferred over non-absorbable meshes. The use of absorbable mesh seems safe and effective with low overall and mesh-related complications, acceptable recurrence rate and low need for re-do surgery in the short/medium-term. Because heterogeneity related to different hernia characteristics, intraoperative technical variations (i.e., method for mesh fixation, etc.), definition of hernia recurrence and diverse follow-up, a conclusive evidence is still to be defined

Laparoscopic trans-abdominal right adrenalectomy for a large primitive adrenal oncocytic carcinoma:a case report and review of literature

Rare disease Background: Adrenocortical oncocytic neoplasms (AONs) are extremely rare tumors. AONs are classified as: oncocytoma (AO), oncocytic neoplasm of uncertain malignant potential (AONUMP), and oncocytic carcinoma (AOC). Among the 162 reported cases of AONs in the literature, 30 cases were classified as malignant. Adrenalectomy is the treatment of choice for AON. Case Report: We report the case of a 48-year-old man with a primitive 12-cm mass affecting the right adrenal gland, detected by ultrasonography during follow-up for alcoholic liver cirrhosis. Computed tomography (CT) scan and magnetic resonance imaging (MRI) showed a mass of the right adrenal gland compressing the inferior vena cava (IVC) and dislocating the right lobe of the liver, with no invasion of kidney, liver, or IVC. Preoperative blood tests showed mild transaminase increase. Laparoscopic right adrenalectomy with lateral transperitoneal approach was performed. The postoperative course was uneventful. The lesion was diagnosed as a primitive adrenal oncocytic carcinoma (AOC). No recurrence was evidenced during 24-month follow-up. Conclusions: Although AONs are very rare, they must be considered in the differential diagnosis of adrenal masses due to their prognostic difference compared to non-oncocytic tumors. AOCs are a rare presentation of AONs. Only 30 cases are described in the literature. Laparotomic adrenalectomy is the treatment of choice for AOC. We report the first case of laparoscopic lateral trans-abdominal adrenalectomy for a voluminous AOC (120 795 7110 mm) and we review the literature regarding AOCs. Laparoscopy in experienced hands is safe and effective for the treatment of AONs. Despite the rarity of AOC, a case series should be performed to confirm the results of our case report

Changing nutrient cycling in Lake Baikal, the world's oldest lake

Lake Baikal, lying in a rift zone in southeastern Siberia, is the world's oldest, deepest, and most voluminous lake that began to form over 30 million years ago. Cited as the "most outstanding example of a freshwater ecosystem" and designated a World Heritage Site in 1996 due to its high level of endemicity, the lake and its ecosystem have become increasingly threatened by both climate change and anthropogenic disturbance. Here, we present a record of nutrient cycling in the lake, derived from the silicon isotope composition of diatoms, which dominate aquatic primary productivity. Using historical records from the region, we assess the extent to which natural and anthropogenic factors have altered biogeochemical cycling in the lake over the last 2,000 y. We show that rates of nutrient supply from deep waters to the photic zone have dramatically increased since the mid-19th century in response to changing wind dynamics, reduced ice cover, and their associated impact on limnological processes in the lake. With stressors linked to untreated sewage and catchment development also now impacting the near-shore region of Lake Baikal, the resilience of the lake's highly endemic ecosystem to ongoing and future disturbance is increasingly uncertain

TOpic: rare and special cases, the real "Strange cases"

Introduction: The bladder hernia represents approximately 1-3% of all inguinal hernias, where patients aged more than 50 years have a higher incidence (10%). Many factors contribute to the development of a bladder hernia, including the presence of a urinary outlet obstruction causing chronic bladder distention, the loss of bladder tone, pericystitis, the perivesical bladder fat protrusion and the obesity

Cholesterol metabolism after bariatric surgery in grade 3 obesity : differences between malabsorptive and restrictive procedures

OBJECTIVEdMalabsorptive bariatric surgery (biliopancreatic diversion and biliointestinal bypass [BIBP]) reduces serum cholesterol levels more than restrictive surgery (adjustable gastric banding [AGB]), and this is thought to be due to greater weight loss. Our aim was to evaluate the changes of cholesterol metabolism induced by malabsorptive and restrictive surgery independent of weight loss. RESEARCH DESIGNANDMETHODSdIn a nonrandomized, self-selected, unblinded, active-comparator, bicenter, 6-month study, glucose metabolism (blood glucose and serum insulin levels and homeostasis model assessment of insulin resistance [HOMA-IR] index) and cholesterol metabolism (absorption: serum campesterol and sitosterol levels; synthesis: serum lathosterol levels; catabolism: rate of appearance and serum concentrations of serum 7-a- and serum 27-OH-cholesterol after infusions of deuterated 7-a- and 27-OH-cholesterol in sequence) were assessed in grade 3 obesity subjects undergoing BIBP (n = 10) and AGB (n = 10). Evaluations were performed before and 6 months after surgery. RESULTSdSubjects had similar values at baseline.Weight loss was similar in the two groups of subjects, and blood glucose, insulin levels, HOMA-IR, and triglycerides decreased in a similar way. In contrast, serumcholesterol, LDL cholesterol, non-HDL cholesterol, serum sitosterol, and campesterol levels decreased and lathosterol levels increased only in BIBP subjects, not in AGB subjects. A significant increase in 7-a-OH-cholesterol occurred only with BIBP; serum 27-OHcholesterol decreased in both groups. CONCLUSIONSdMalabsorptive surgery specifically affects cholesterol levels, independent of weight loss and independent of glucose metabolism and insulin resistance. Decreased sterol absorption leads to decreased cholesterol and LDL cholesterol levels, accompanied by enhanced cholesterol synthesis and enhanced cholesterol catabolism. Compared with AGB, BIBP provides greater cholesterol lowering

Modelling silicon supply during the Last Interglacial (MIS 5e) at Lake Baikal

Limnological reconstructions of primary productivity have demonstrated its response over Quaternary timescales to drivers such as climate change, landscape evolution and lake ontogeny. In particular, sediments from Lake Baikal, Siberia, provide a valuable uninterrupted and continuous sequence of biogenic silica (BSi) records, which document orbital and sub-orbital frequencies of regional climate change. We here extend these records via the application of stable isotope analysis of silica in diatom opal (δ30Sidiatom) from sediments covering the Last Interglacial cycle (Marine Isotope Stage [MIS] 5e; c. 130 to 115 ka BP) as a means to test the hypothesis that it was more productive than the Holocene. δ30Sidiatom data for the Last Interglacial range between +1.29 to +1.78‰, with highest values between c. 127 to 124 ka BP (+1.57 to +1.78‰). Results show that diatom dissolved silicon (DSi) utilisation, was significantly higher (p=0.001) during MIS 5e than the current interglacial, which reflects increased diatom productivity over this time (concomitant with high diatom biovolume accumulation rates [BVAR] and warmer pollen-inferred vegetation reconstructions). Diatom BVAR are used, in tandem with δ30Sidiatom data, to model DSi supply to Lake Baikal surface waters, which shows that highest delivery was between c. 123 to 120 ka BP (reaching peak supply at c. 120 ka BP). When constrained by sedimentary mineralogical archives of catchment weathering indices (e.g. the Hydrolysis Index), data highlight the small degree of weathering intensity and therefore representation that catchment-weathering DSi sources had, over the duration of MIS 5e. Changes to DSi supply are therefore attributed to variations in within-lake conditions (e.g. turbulent mixing) over the period, where periods of both high productivity and modelled-DSi supply (e.g. strong convective mixing) account for the decreasing trend in δ30Sidiatom compositions (after c. 124 ka BP)

Constraining modern day silicon cycling in Lake Baikal

Constraining the continental silicon cycle is a key requirement in attempts to understand both nutrient fluxes to the ocean and linkages between silicon and carbon cycling over different timescales. Silicon isotope data of dissolved silica (δ30SiDSi) are presented here from Lake Baikal and its catchment in central Siberia. As well as being the world's oldest and voluminous lake, Lake Baikal lies within the seventh largest drainage basin in the world and exports significant amounts of freshwater into the Arctic Ocean. Data from river waters accounting for c. 92% of annual river inflow to the lake suggest no seasonal alteration or anthropogenic impact on river δ30SiDSi composition. The absence of a change in δ30SiDSi within the Selenga Delta, through which 62% of riverine flow passes, suggest a net balance between biogenic uptake and dissolution in this system. A key feature of this study is the use of δ30SiDSi to examine seasonal and spatial variations in DSi utilisation and export across the lake. Using an open system model against deep water δ30SiDSi values from the lake, we estimate that 20-24% of DSi entering Lake Baikal is exported into the sediment record. Whilst highlighting the impact that lakes may have upon the sequestration of continental DSi, mixed layer δ30SiDSi values from 2003 and 2013 show significant spatial variability in the magnitude of spring bloom nutrient utilisation with lower rates in the north relative to south basin