Enxertos compostos de gordura para correção de distrofia facial em caso de esclerodermia localizada / Composite fat grafts for correcting facial dystrophy in a case of localized scleroderma

A esclerodermia localizada (morfeia linear) é uma doença rara que causa distrofia e assimetria faciais em mulheres jovens. É relatado o caso de uma paciente de 20 anos que foi tratada com enxertos compostos de gordura. Após a coleta do lipoaspirado de gordura subcutânea profunda, a microgordura e a nanogordura não filtrada foram processadas separadamente para formar enxertos compostos de gordura. Estes foram meticulosamente transplantados em camadas, para reconstruir o subcutaneo da face da paciente. Após um ano, observou-se boa pega de gordura com correção bem-sucedida da assimetria e restabelecimento do equilíbrio facial.

Localized scleroderma (linear morphea) is a rare disease that causes facial dystrophy and asymmetry in young women. We report the case of a 20-year-old female patient who was treated with novel composite fat grafts. After extracting lipoaspirate from deep subcutaneous fat, the microfat and the unfiltered nanofat were processed separately, and amalgamated, obtaining composite fat grafts. These were meticulously transplanted layer by layer to rebuild the subcutaneous tissue of the patient's face. After one year, a good volume of fat retention was observed with successful correction of asymmetry and restoration of facial balance.

Tratamento não invasivo com ultrassom não focado transcutâneo na redução do tecido subcutâneo abdominal / Non-invasive treatment with transcutaneous non-focused ultrasound for the reduction of abdominal subcutaneous tissue

Introdução: O ultrassom não focado é alternativa não invasiva para melhora do contorno corporal. Métodos: São relatados cinco casos tratados com oito sessões semanais de ultrassom não focado no abdômen. Resultados: O tratamento não interferiu na rotina dos pacientes, tendo sido considerado confortável e seguro. Houve redução na espessura do subcutâneo avaliado por ultrassom e nas medidas circunferenciais em todos os pacientes, com melhora clínica evidenciada na documentação fotográfica principalmente nos pacientes com subcutâneo de baixa espessura. Conclusão: O tratamento se mostrou seguro, com evidências de redução do tecido subcutâneo abdominal.

Introduction: Introduction: Not focused ultrasound is a noninvasive alternative to improve body contour. Methods: It's reported five cases treated with eight weekly sessions of not focused ultrasound on the abdomen. Results: The treatment did not affect the routine of patients; it was comfortable and safe for most. There was a reduction in the thickness of the fat layer evaluated by ultrasound and in the circumferential measures in all patients, with clinical improvement evidenced in the photographic documentation especially in patients with lesser thickness of subcutaneous. Conclusion: The device was safe, and was shown clear reduction in abdominal subcutaneous tissue.

Redução de medidas corporais após nove sessões de tratamento com laser de baixa intensidade / Reduction of body measures after a ninesession protocol with Low Level Laser Therapy

Introdução: A terapia com laser de baixa intensidade tem sido considerada alternativa não invasiva para remodelamento corporal e redução do tecido subcutâneo. Objetivo: Avaliar a eficácia do laser de baixa intensidade na redução de medidas corporais e do tecido adiposo subcutâneo da região do abdômen e do quadril. Métodos: Estudo aberto, prospectivo, unicêntrico incluiu 25 mulheres com acúmulo de gordura localizada na região do quadril e abdômen. Nove sessões de low level laser therapy foram realizadas ao longo de três semanas. As participantes foram avaliadas no basal e em 1, 4 e 12 semanas após o tratamento. Aferição de peso e medidas de circunferência corporal, exames de perfil lipídico e de ressonância magnética foram realizados. Resultados: As medidas de circunferência abdominal apresentaram redução significativa até 12 semanas após o tratamento. Na região do quadril, as participantes apresentaram redução mais marcante uma semana após a última sessão. Também uma semana após a finalização do tratamento, 80% das participantes consideraram que o tratamento melhorou o contorno do seu corpo. Nenhum evento adverso relacionado ao tratamento foi relatado. Conclusões: O tratamento com a low level laser therapy é seguro e eficaz na redução das medidas de circunferência, principalmente na região abdominal.

Introduction: Low level laser therapy has been considered a non-invasive treatment alternative to body remodeling and fat tissue reduction. Objective: To evaluate the efficacy of low level laser therapy in reducing body circumference measures and subcutaneous adipose tissue of the abdomen and hips areas. Methods: An open, prospective, monocentric study was performed including 25 women with localized fat on the hips and abdomen. Nine sessions of low level laser therapy were performed over 3 weeks. The participants were assessed at baseline and at 1, 4 and 12 weeks after treatment. Assessment of weight and body circumferences, lipid profile tests and MRI were performed. Results: The abdominal circumference measurements showed a significant reduction up to 12 weeks after the treatment. Participants showed a more marked reduction in the hips region one week after the last session. Also one week after the completion of the treatment, 80% of the participants considered that the treatment improved their body contour. There was absence of reports of adverse events related to the treatment. Conclusion: Low level laser therapy is safe and effective in reducing the circumference measurements, particularly in the abdominal region.

Abdominal Subcutaneous Fat Thickness Measured by Ultrasonography Correlates with Hyperlipidemia and Steatohepatitis in Obese Children / 대한소아소화기영양학회지

PURPOSE: The aim of this study is to evaluate the relationship between abdominal subcutaneous fat thickness measured by ultrasonography (US) and serum lipid profile and liver transaminases in obese children. METHODS: One hundred and sixty-six children diagnosed with obesity from May 2001 to December 2013 were included in this study. Data on serum lipid profile and liver transaminases were collected from clinical records. Abdominal subcutaneous fat thickness and grade of hepatic steatosis were evaluated by US. RESULTS: Of the 166 children, 107 were diagnosed with hepatic steatosis by US, 46 with grade I, 56 with grade II, and five children with grade III. According to the grade of hepatic steasosis, the average values of midline abdominal subcutaneous fat thickness and right flank abdominal subcutaneous fat thickness measured 2.9+/-0.8 cm and 1.9+/-0.7 cm in the normal group, 3.3+/-0.8 cm and 2.0+/-0.7 cm in grade I, 3.8+/-0.8 cm and 2.3+/-0.8 cm in grade II, and 4.1+/-0.8 cm and 2.8+/-1.4 cm in grade III, respectively. Abdominal subcutaneous fat thickness correlated with grade of hepatic steatosis (p<0.01). In addition, abdominal subcutaneous fat thickness correlated with concentration of serum lipids and liver transaminases in the age group of 12-14 years (p<0.01). CONCLUSION: Abdominal subcutaneous fat thickness measured by US can be used as a reliable predictor of possible hyperlipidemia and steatohepatitis in children, especially during the adolescent stage.

Grading scale o visceral adipose tissue thicknss and their relation to the noonalcoholic fatty liver disease / Escala de classificação da espessura do tecido adiposo visceral e sua relação com a doença gordurosa hepática não alcoólica

Context The mesenteric fat is drained by the portal system, being related to the metabolic syndrome which is an impor­tant risk factor for non-alcoholic fatty liver disease (NAFLD). Objectives Graduate of visceral fat thickness and correlate with the NAFLD degree through ultrasonography method. Methods We studied 352 subjects for age, gender, measures of subcutaneous fat thickness and visceral fat thickness as well as the presence and degree of liver fatty. Was analyzed the independent relationship between visceral fat thickness and NAFLD, and linear regression analysis was used in order to predict the visceral fat thickness from subcutaneous fat thickness. Results The mean age of 225 women (63.9%) and 127 men (36.1%) was 47.5 ± 14.0 (18-77) years, 255 subjects had normal examinations, 97 had NAFLD thus distributed, 37 grade 1, 32 grade 2, and 28 grade 3. The subcutaneous fat thickness ranged from 0.26 to 3.50 cm with a mean of 1.3 ± 0.6 cm and visceral fat thickness ranged from 0.83 to 8.86 cm with a mean of 3.6 ± 1.7 cm. Linear regression showed that for every increase of 1 cm in subcutaneous fat thickness the visceral fat thickness will increase 0.9 cm. Conclusions The visceral fat thickness measured by ultrasonography is a useful and seems to be able to help estimate the risk of NAFLD. .

Contexto A gordura mesentérica é drenada pelo sistema venoso portal, estando relacionada à síndrome metabólica, que é um importante fator de risco para doença de infiltração gordurosa do fígado. Objetivos Graduar a espessura do tecido adiposo visceral e correlacionar com o grau de doença de infiltração gordurosa do fígado através do exame ultrassonográfico. Métodos Foram estudados 352 indivíduos, avaliando-se idade, gênero, medidas da espessura da gordura subcutânea e tecido adiposo visceral, a presença e o grau de doença de infiltração gordurosa do fígado. Foi analisada a relação independente entre tecido adiposo visceral e doença de infiltração gordurosa do fígado, e a regressão linear foi utilizada para prever a tecido adiposo visceral pela espessura da gordura subcutânea. Resultados A idade média de 225 (63,9%) mulheres e 127 (36,1%) homens foi 47,5 ± 14,0 (18-77) anos, 255 indivíduos apresentaram exames normais, 97 apresentaram doença de infiltração gordurosa do fígado assim distribuídos: 37 grau 1, 32 grau 2 e 28 grau 3. A espessura da gordura subcutânea variou de 0,26 e 3,50 cm, com uma média de 1,3 ± 0,6 cm e a tecido adiposo visceral variou de 0,83 a 8,86 cm, com uma média de 3,6 ± 1,7 cm. A regressão linear demonstrou que para cada aumento de 1 cm da espessura da gordura subcutânea o tecido adiposo visceral aumentará 0,9 cm. Conclusão O tecido adiposo visceral medido por ultrassonografia é um instrumento útil e parece ser capaz de estimar o risco de doença de infiltração gordurosa do fígado. .

The Correlation between Plasma Leptin Concentration and Adiposity in Obesity

BACKGROUND: Obesity can be considered as hyperaccumulation of body fat. Therefore, the aim to treat obesity is to decrease body fat. Abdominal total fat calculated in computed tomography is thought to be the most accurate index measuring body fat. The body mass index (BMI) and body fat mass are the representative indices also. Leptin is a protein hormone expressed by obesity gene in adipose tissue. It inhibits food intake and increases energy consumption, thereby controls obesity. With a study of relationship between plasma leptin level and body mass index and abdominal total fat area, we tried to find the usefulness of leptin as an index of adiposity. METHODS: The adiposity level was approximated by BMI, computed tomography and bioelectical impedence. To further explore the relationship with body composition, body fat distribution was determined by computed tomograph. To quantify the relationship between serum leptin level and adiposity, correlation analyses have been conducted. RESULTS: The subjects were 32 females with a BMI of over 25 kg/m2. The mean plasma leptin level was 14.2 5.9 ug/L. We investigated the correlation of plasma leptin level with subcutaneous and visceral fat. The plasma leptin level showed a significant correlation with BMI and body fat mass, and was significantly correlated with subctaneous fat (P<0.01), but not with abdominal visceral fat. CONCLUSION: A significant correlation between plasma leptin level and body fat mass was observed. The distribution of subcutaneous fat showed differences in plasma leptin level. Therefore, the plasma leptin level may be used as an index of change of body fat mass, especially subcutaneous fat.

Comparative Analysis of Subcutaneous Thickness of Each Compartment of Abdomen & the Selection of Cannula Insertion Site in Liposuction

The thickness of the abdominal subcutaneous tissues is discussed in the data obtained in 40 middle-aged female patients(the range of the age 31 to 60 years) examined on a modern computed tomographic system. The authors have shown that the superficial fascia, which separates the superficial and deep layers of subcutaneous fat, forms a continuous circumferential fascial plane. We have analyzed cross-sectional CT images at the umbilical level in a middle ged women. The authors have made several linear measurements of the thickness of the superficial and deep fat compartments at various reference points around the trunk in order to demonstrate the regional distribution of the deep fat compartment. Our data shows the mean, standard deviation(SD) concerning the thickness measurements of the superficial and deep fat compartments around the abdomen in the 40 women. From these observations, we concluded that the thickness of subcutaneous tissue of superficial layer is relatively constant and the thickness of subcutaneous tissue of deep layer is greatest at posterolateral region with decrements in thickness at anterior, lateral region respectively. And such pattern is same as the total subcutaneous tissue thickness, therefore, relatively safe parts for much amount of liposuction around the abdomen are paralumbar region and anterior abdomen. Such study result could offer the appropriate depths for cannula insertion, that is, 18.8mm at anterior, 16.9mm at lateral and 32.5mm at posterolateral region. Such knowledge could offer a guide to the necessary depth of cannula insertion when performing of the SAL (suction-assisted lipectomy). It is deemed desirable to place the tip in the middle of the deep compartment.