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The progress in bariatric surgery

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Morbid obesity, caused by fat tissue accumulation, is a serious multi-factorial chronic disease, with rapidly increasing prevalence in most countries in the world including Poland. Conservative treatment of morbid obesity is almost always unsatisfactory and that is why several surgical methods have been developed. There are four kinds of methods: malabsorptive procedures; restrictive procedures; malabsorptive/restrictive procedures and experimental procedures. The development of bariatric surgery goes back to 1952 and since that time it has been evolving dynamically. All the surgical methods have benefits and disadvantages. Presently the introduction of minimally invasive surgical techniques seems to be very safe, efficient and cost-effective in treatment for morbid obesity. New methods are also being evaluated, such as gastric myo-electrical stimulation. Bariatric surgery will still be developing until we understand all the factors responsible for it is origin.
This study aims to find relationships between nutritional status, leptin and puberty. Methods. The research covered 66 healthy girls aged 9.8 ± 0.6 years, in prepubertal period. Body height, weight, arm circumference and skinfolds were measured, and serum leptin concentration was estimated. The evaluation of the pubertal stage and anthropometrical measurements was carried out again in a year's period. Results. During the observation, 32 girls reached the time of puberty (group I), while the other 34, at the same age, were still at prepubertal stage (group II). The girls in group II were shorter, lighter, had lower arm circumference, thinner skin fold on abdomen (p<0.02) and lower serum leptin concentration (p<0.003). Highly positive correlations between BMI, skin folds thickness and leptin concentration were proved. Conclusion. The results indicate relationships between the fat tissue amount, blood leptin concentration and puberty in girls.
60 White Koluda W31® geese (30 females and 30 males) constituted the experimental material. The birds were raised in the intensive system to 10 weeks of age in a closed space, under the conditions specified by the recommended technology. The birds were fed only concentrate mixtures ad libitum. In the 10th week the birds were individually weighed, which was the basis for selecting 5 males and 5 females for slaughter. The slaughter analysis and carcass division into individual tissue components were conducted. PH! of breast muscles as well as thigh and shank muscles, their chemical composition water binding capacity and thermal drip were determined. Moreover, the fatty acid profiles for the skin with subcutaneous fat and abdominal fat were studied. Breast muscles of 10- week 60 White Koluda W31® geese broilers contained 20.01% of crude protein and 2.76% of crude fat whereas the respective values for thigh and shank muscles were 18.50 and 4.73%. Additionally, the analysed muscles were characterized by beneficial values of processing characteristics. The fatty acid profile analysis for the skin with subcutaneous fat and abdominal fat showed that both tissues have got a relatively good profile of fatty acids. The analysis of the content of individual fatty acids of examined tissues showed that oleic acid was dominating (about 55-61) and it was followed by palmitic acid (about 22-23%) and linolic acid (about 8-10%). Monounsaturated fatty acids constituted 57.8-63.8% and polyunsaturated acids 8.50-12.15%. The SFAiPUFA ratio ranged from 2.34 in the thigh and shank muscles to 3.42 in subcutaneous fat. The results obtained show that both the meat and fat of geese broilers are characterized by a relatively good nutritive and processing value and can diversify the range of poultry products on the market.
In the Mediterranean province of Murcia (SE Spain) around 610,000 hectares of land are devoted to agriculture and organochlorine insecticide use has been common in the region for many years. To investigate HCH and DDT (isomers and metabolites) residues, a total of 231 fat samples were taken from the general population and analyzed. Organochlorine residues were found in 63.2% of the samples. The pattern of overspreading by these substances in this part of the world is similar to that described by different authors in other countries. p,p'-DDE, ß-HCH and lindane residues, in this order, show the highest occurrence in the region and also the highest mean levels. Areas devoted to greenhouses, traditional dry farming of paprika pepper, and traditional horticultural cultivation are the most contaminated. Therefore, the past use of DDT and the actual employment of lindane seem to be reflected in the residents of these areas.
The experiment described in the paper focused on the effects of complementary and excess diet supplementation on body weight changes and fat tissue accumulation. Untreated wheat, corn grains, and barley grits in the original diet were isocalorically substituted with wheat flour, sucrose, and minerals (calcium, magnesium, chromium, and zinc). The feed in which whole cereal grains were replaced by flour and sucrose did not significantly affect the amount of feed consumed, body weight gains nor fat accumulation. Diet supplementation with selected mineral components to compensate for the deficiencies caused by the modification produced, in the female rats, significantly reduced body weight gains (0.3± 1.9 g/100 g diet) and perivisceral fat accumulation (pericardial fat 0.009±0.005 g/100 g diet; peri- intestinal 0.790±0.575 g/100 g diet), whereas significantly increased muscle fat content (6.49±0.15 g). At comparable body weight gains, the male rats showed a significantly higher perivisceral (pericardial fat 0.039±0.008 g/100 g diet; peri-intestinal 0.769±0.152 g/100 g diet) and intramuscular fat accumulation (6.49 ±0.15 g). Excess supplementation resulted, in both sexes, in a significantly reduced feed consumption accompanied, however, by significantly higher body weight gains per unit feed consumed (females 4.8±2.3g/100g diet; males 3.7±3.1 g/100 g diet) as well as by a significantly higher accumulation of perivisceral and intramuscular fat (females 0.058±0.024 g/100 g diet; 2.060±0.676 g/100 g diet; 7.53±0.12 g; males 0.42±0.16 g/100 g diet; 0.934±0.305 g/100 g diet; 5.48±0.16 g, respectively). The modified diet and its supplementation resulted in significant changes in the contents of individual fatty acids in the perivisceral fat, the changes involving mainly an increase in saturated and monounsaturated acids and a reduction in polyunsaturated acids, particularly in the males.
Preservation of hepatocyte functions in vitro will undoubtedly help the management of acute liver failure. The coculture system may be able to prevent functional decline of hepatocytes. It has already been shown that hepatocytes, when cocultured with bone marrow mesenchymal stem cells, could undergo long-term culture in vitro without loss of functions. In this study, human orbital fat-derived stem cells were isolated and cocultured with rat hepatocytes. When treated with serum from an acute liver failure patient, rat hepatocyte monoculture showed reduction of cell viability and loss of liverspecific functions. However, rat hepatocytes in the coculture system were still able to secret albumin and synthesize urea. IL-6 was significantly elevated in the coculture of rat hepatocyte with orbital fat-derived stem cells, and it might be the key immunoregulator which protects rat hepatocytes against inflammation. Our data confirmed that orbital fat-derived stem cells, or other adipose tissue-derived stem cells, are an ideal candidate to support rat hepatocyte functions in vitro.
Fatness traits are important in pig production since they influence meat quality and fattening efficiency. On the other hand, excessive fat accumulation in humans has become a serious health problem due to worldwide spread of obesity. Since the pig is also considered as an animal model for numerous human diseases, including obesity and metabolic syndrome, comparative genomic studies may bring new insights into genetics of fatness/obesity. Input of genetic factors into phenotypic variability ofthese traits is rather high and the heritability coefficient (h²) of these traits oscillates around 0.5. Genome scanning revealed the presence of more than 500 QTLs for fatness in the pig genome. In addition to QTL studies, many candidate gene polymorphisms have been analyzed in terms of their associations with pig fatness, including genes encoding leptin (LEP) and its receptor (LEPR), insulin-like growth factor 2 (IGF-2), fatty acid-binding proteins (FABP3 and FABP4), melanocortin receptor type 4 (MC4R), and the FTO (fat mass and obesity-associated) gene. Among them, a confirmed effect on pig fatness was found for a well-known polymorphism of the IGF-2 gene. In humans the strongest association with predisposition to obesity was shown for polymorphism of the FTO gene, while in pigs such an association seems to be doubtful. The development of functional genomics has revealed a large number of genes whose expression is associated with fat accumulation and lipid metabolism, so far not studied extensively in terms of the association of their polymorphism with pig fatness. Recently, epigenomic mechanisms, mainly RNA interference, have been considered as a potential source of information on genetic input into the fat accumulation process. The rather limited progress in studies focused on the identification of gene polymorphism related with fatness traits shows that their genetic background is highly complex.
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Adipocytokines - novel link between inflammation and vascular funktion?

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Obesity and obesity related diseases are a major public health problem. Recent studies have shown that fat tissue is not a simple energy storage organ, but exerts important endocrine and immune functions. These are achieved predominantly through release of adipocytokines, which include several novel and highly active molecules released abundantly by adipocytes like leptin, resistin, adiponectin or visfatin, as well as some more classical cytokines released possibly by inflammatory cells infiltrating fat, like TNF-alpha, IL-6, MCP-1 (CCL-2), IL-1. All of those molecules may act on immune cells leading to local and generalized inflammation and may also affect vascular (endothelial) function by modulating vascular nitric oxide and superoxide release and mediating obesity related vascular disorders (including hypertension, diabetes, atherosclerosis, and insulin resistance) but also cancer or non-alcoholic fatty liver diseases. Present review, in a concise form, focuses on the effects of major adipocytokines, characteristic for adipose tissue like leptin, adiponectin, resistin and visfatin on the immune system, particularly innate and adaptive immunity as well as on blood vessels. Macrophages and T cells are populating adipose tissue which develops into almost an organized immune organ. Activated T cells further migrate to blood vessels, kidney, brain and other organs surrounded by infiltrated fat leading to their damage, thus providing a link between metabolic syndrome, inflammation and cardiovascular and other associated disorders. Ceretain treatments may lead to significant changes in adipocytokine levels. For example include beta-2 adrenoreceptor agonists, thiazolidinediones as well as androgens lead to decrease of plasma leptin levels. Moreover future treatments of metabolic system associated disorders should focus on the regulation of adipocytokines and their modes of action.
Fatty acid composition of muscle triaciloglicerols and micro morphological structure of m. longissimus thoracis et lumborum and m. semimembranosus were determined. Linolenic acid (Cl8:3) level in m. longissimus triaciloglicerols significantly (0.5%, 1.2% and 2.1%) increased for I, II and III group respectively. Omega ratio expressed as ratio C18:2/C 18:3 in fat at m. longissimus was 9.0, 4.7 and 2.3 respectively for the three groups. Linolenic acid level in fat at m. semimembranosus rose significantly (0.4%, 1.8% and 2.6%) and omega ratio was 15.75, 3.78 and 2.58 respectively for I, II and III group. No statistically significant differences were found in mean diameter of muscle fibers, in ratio between dark and light muscle fibers and content of different tissue components in studied muscles caused by including of flax seed in the diets.
W przeprowadzonym doświadczeniu zbadano wpływ składu diety i jej suplementacji wybranymi witaminami z grupy B na ilość, rozmieszczenie i skład kwasów tłuszczowych okołonarządowej tkanki tłuszczowej oraz stężenie wskaźników peroksydacji lipidów u szczura. W doświadczeniu zastosowano trzy diety: I - podstawową, którą stanowiła pasza zawierająca między innymi pełne ziarna zbóż, II - zmodyfikowaną, w której pełne ziarna zbóż zastąpiono częściowo mąką pszenną i sacharozą i III - zmodyfikowaną, suplementowaną wybranymi witaminami z grupy B. Stwierdzono, że samice, których dieta była suplementowana, przyrastały istotnie więcej w porównaniu z samicami żywionymi paszą podstawową, ale porównywalnie do samic żywionych paszą zmodyfikowaną niesuplementowaną. Zwiększonym przyrostom masy ciała w grupie suplementowanej towarzyszyło istotnie większe odkładanie tłuszczu okołonarządowego, śródmięśniowego i wątrobowego. Zastosowana suplementacja sprzyjała również zmianie składu kwasów tłuszczowych wisceralnej tkanki tłuszczowej, w kierunku wzrostu zawartości monoenowych i spadku zawartości polienowych kwasów tłuszczowych oraz powstawaniu wolnych rodników, co manifestowało się istotnym spadkiem stężenia glutationu zredukowanego oraz wzrostem stężenia produktów peroksydacji lipidów w krwi i wątrobie badanych zwierząt.
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