The lateral wall of the inferior meatus as a new graft source for rhinoplasty: radiological study and surgical technique.

Generally, revision rhinoplasty cases require use of stiff grafts to restore the lost support. However, the majority of patients indicated for revision surgery presents with lack of bony cartilaginous framework of the septum, especially after previous septoplasty. Thus, surgeons compel to harvest costal cartilage. At the same time rib graft harvesting is associated with additional trauma and risk of serious complications. Being ENT surgeons, we often resect a part of the lateral wall of inferior nasal meatus during extended endoscopic approach to the maxillary sinus. We supposed, that this bone plate can be used as a donor site for rhinoplasty graft harvesting. The aim of our study was radiological assessment of feasibility and limits of using the inferior meatus lateral wall (IMW) as a donor site for rhinoplasty bone graft. A retrospective evaluation of 100 CT scans of sinuses was conducted. Further measurments of the inferior meatus lateral wall were performed: average length and width (28.06 ± 4.03 mm and 19.73 ± 3.08 mm, respectively,) thickness (0.62 ± 0.21 mm), and average deviation from the sagittal plane (17.7 ± 9.53 degree). According to obtained measurements, described donor site is appropriate to harvest nice straight bony fragment. The IMLW bone graft was used in 4 revision rhinoplasty cases. There were no postoperative complications. During the long-term follow-up, patients reported significant improvement in esthetics, function, and social aspects according to ROE. Thus, described technique is an easy and safe method for bone harvesting for revision rhinoplasty. Our first experience demonstrated convenience and stability of IMLW grafts for revision rhinoplasty during the follow-up period of up to 2 years.

Fibroblast Growth Factor 21 (FGF21) Administration Sex-Specifically Affects Blood Insulin Levels and Liver Steatosis in Obese Ay Mice.

FGF21 is a promising candidate for treating obesity, diabetes, and NAFLD; however, some of its pharmacological effects are sex-specific in mice with the Ay mutation that evokes melanocortin receptor 4 blockade, obesity, and hepatosteatosis. This suggests that the ability of FGF21 to correct melanocortin obesity may depend on sex. This study compares FGF21 action on food intake, locomotor activity, gene expression, metabolic characteristics, and liver state in obese Ay males and females. Ay mice were administered FGF21 for seven days, and metabolic parameters and gene expression in different tissues were assessed. Placebo-treated females were more obese than males and had lower levels of blood insulin and liver triglycerides, and higher expression of genes for insulin signaling in the liver, white adipose tissue (WAT) and muscles, and pro-inflammatory cytokines in the liver. FGF21 administration did not affect body weight, and increased food intake, locomotor activity, expression of Fgf21 and Ucp1 in brown fat and genes related to lipolysis and insulin action in WAT regardless of sex; however, it decreased hyperinsulinemia and hepatic lipid accumulation and increased muscle expression of Cpt1 and Irs1 only in males. Thus, FGF21's beneficial effects on metabolic disorders associated with melanocortin obesity are more pronounced in males.

The Same Metabolic Response to FGF21 Administration in Male and Female Obese Mice Is Accompanied by Sex-Specific Changes in Adipose Tissue Gene Expression.

The preference for high-calorie foods depends on sex and contributes to obesity development. Fibroblast growth factor 21 (FGF21) beneficially affects taste preferences and obesity, but its action has mainly been studied in males. The aim of this study was to compare the effects of FGF21 on food preferences and glucose and lipid metabolism in C57Bl/6J male and female mice with diet-induced obesity. Mice were injected with FGF21 or vehicle for 7 days. Body weight, choice between standard (SD) and high-fat (HFD) diets, blood parameters, and gene expression in white (WAT) and brown (BAT) adipose tissues, liver, muscles, and the hypothalamus were assessed. Compared to males, females had a greater preference for HFD; less WAT; lower levels of cholesterol, glucose, and insulin; and higher expression of Fgf21, Insr, Ppara, Pgc1, Acca and Accb in the liver and Dio2 in BAT. FGF21 administration decreased adiposity; blood levels of cholesterol, glucose, and insulin; hypothalamic Agrp expression, increased SD intake, decreased HFD intake independently of sex, and increased WAT expression of Pparg, Lpl and Lipe only in females. Thus, FGF21 administration beneficially affected mice of both sexes despite obesity-associated sex differences in metabolic characteristics, and it induced female-specific activation of gene expression in WAT.