ABSTRACT
OBJECTIVE: The purpose of this study was to describe the probable mechanism of the volume increase of laparoscopically harvested omentum flaps used to treat breast deformities. METHODS: A histological analysis of omentum samples was performed to study the volume increase of laparoscopically harvested omentum flaps. Samples were harvested immediately after the transposition of the omentum from the abdominal cavity to the breast region and during the second surgical procedure for breast symmetrization of eight patients submitted to the transposition of the omentum flap. Changes in the morphometric measurements of the adipocytes (perimeter, diameter, and area), microvascular density (as measured by the CD31 endothelial marker), and immunohistochemical expression of VEGF were documented. RESULTS: The increases in adipocyte size and microvascular density were statistically significant (P < 0.012). The expression levels of VEGF were lower in the second set of samples when compared to the first set, but the differences were not statistically significant (P < 0.093). CONCLUSION: These results demonstrate an increase in cellular volume as measured by adipocyte perimeter, diameter, and area. Moreover, the increase in the number of vessels in the second set of samples suggests that neoangiogenesis was stimulated by the initial increase in VEGF expression levels observed in the first set of samples. The increase in VEGF expression in the flap may have been caused by adipocyte hypertrophy resulting from neoangiogenesis.
Subject(s)
Adolescent , Adult , Female , Humans , Middle Aged , Young Adult , Adipocytes/cytology , Breast Neoplasms/surgery , Breast/growth & development , Omentum/transplantation , Surgical Flaps , Vascular Endothelial Growth Factors/physiology , Body Mass Index , Breast Neoplasms/blood supply , Breast Neoplasms/pathology , Breast/blood supply , Breast/surgery , Cell Enlargement , Laparoscopy , Neovascularization, Physiologic/physiology , Organ Size , Omentum/blood supply , Omentum/cytology , Postoperative Period , Statistics, Nonparametric , Surgical Flaps/blood supply , Surgical Flaps/pathology , Time FactorsABSTRACT
It has been proposed that differences in adipocyte function and/or metabolism between obese and lean individuáis may manifest themselves in functional adipose tissue abnormalities that lead to metabolic disorders in obesity. We studied lipogenesis and lipolysis of omental adipocytes from obese (OB) and non-obese (NOB) humans. The specific activity of the lipogenic marker enzyme G3PDH was 50 percent lower in total adipocytes of OB compared to that of NOB subjects. Omental adipocytes from OB subjects also had lower basal lipolytic levéis, and a lower lipolytic response to p-adrenergic stimulus. Cholesterol depletion of adipocyte plasma membrane using methyl β-cyclodextrin caused a lipolytic effect on adipocytes of both groups together, but when obese and lean subjects were analyzed separately, the response was significant only in the obese. We present evidence of a different lipogenic and lipolytic profile in obese individuáis' omental adipocytes, and propose a relevant role of plasma membrane cholesterol, where the impact of its removal in OB and NOB adipocyte lipolysis differs.