Biofabrication of 3D adipose tissue via assembly of composite stem cell spheroids containing adipo-inductive dual-signal delivery nanofibers.

Reconstruction of large 3D tissues based on assembly of micro-sized multi-cellular spheroids has gained attention in tissue engineering. However, formation of 3D adipose tissue from spheroids has been challenging due to the limited adhesion capability and restricted cell mobility of adipocytes in culture media. In this study, we addressed this problem by developing adipo-inductive nanofibers enabling dual delivery of indomethacin and insulin. These nanofibers were introduced into composite spheroids comprising human adipose-derived stem cells (hADSCs). This approach led to a significant enhancement in the formation of uniform lipid droplets, as evidenced by the significantly increased Oil red O-stained area in spheroids incorporating indomethacin and insulin dual delivery nanofibers (56.9 ± 4.6%) compared to the control (15.6 ± 3.5%) with significantly greater gene expression associated with adipogenesis (C/EBPA, PPARG, FABP4, and adiponectin) of hADSCs. Furthermore, we investigated the influence of culture media on the migration and merging of spheroids and observed significant decrease in migration and merging of spheroids in adipogenic differentiation media. Conversely, the presence of adipo-inductive nanofibers promoted spheroid fusion, allowing the formation of macroscopic 3D adipose tissue in the absence of adipogenic supplements while facilitating homogeneous adipogenesis of hADSCs. The approach described here holds promise for the generation of 3D adipose tissue constructs by scaffold-free assembly of stem cell spheroids with potential applications in clinical and organ models.

Impact of Sarcopenia on Acute Kidney Injury after Infrarenal Abdominal Aortic Aneurysm Surgery: A Propensity Matching Analysis.

BACKGROUND: Sarcopenia contributes to increased morbidity and mortality in patients undergoing surgery for abdominal aortic aneurysms (AAA). However, few reports have demonstrated whether sarcopenia would affect the development of postoperative acute kidney injury (AKI) in these patients. This study aimed to examine whether sarcopenia is associated with AKI and morbidity and mortality after infrarenal AAA operation. METHODS: We retrospectively analysed 379 patients who underwent infrarenal AAA surgery. The diagnosis of sarcopenia was performed using the skeletal muscle index, which was calculated from axial computed tomography at the level of L3. The patients were separated into those with sarcopenia (n = 104) and those without sarcopenia (n = 275). We applied multivariable and Cox regression analyses to evaluate the risk factors for AKI and overall mortality. A propensity score matching (PSM) evaluation was done to assess the postoperative results. RESULTS: The incidence of AKI was greater in sarcopenia than non-sarcopenia group before (34.6% vs. 15.3%; p < 0.001) and after the PSM analysis (34.6% vs. 15.4%; p = 0.002). Multivariable analysis revealed sarcopenia to be associated with AKI before (p = 0.010) and after PSM (p = 0.016). Sarcopenia was also associated with overall mortality before (p = 0.048) and after PSM (p = 0.032). A Kaplan-Meier analysis revealed that overall mortality was elevated patients with sarcopenia before and after PSM than in those without (log-rank test, p < 0.001, p = 0.022). CONCLUSIONS: Sarcopenia was associated with increased postoperative AKI incidence and overall mortality among individuals who underwent infrarenal AAA operation.

Current practice pattern for dry eye patients in South Korea: a multicenter study.

PURPOSE: To assess current practice patterns for dry eye patients in South Korea and to evaluate the preference according to the ages and clinic types of physicians. METHODS: Dry eye patients (n = 1,612) were enrolled in this multicenter cross-sectional, observational study. The severity level of dry eye patients was classified based on the Korean guidelines for dry eye treatment. The medical records of the enrolled dry eye patients were evaluated, and the practice styles and the preferences were analyzed according to the ages and clinic types of physicians. RESULTS: Of all patients, dry eye level 1 was most common (47.5%), followed by level 2 (33.5%), level 3 (9.1%), and level 4 (1.1%). Topical anti-inflammatory agents were used in 70.7% of patients with dry eye level 2 and in 80.6% of patients at levels 3 and 4. Topical anti-inflammatory agents were also used in 48.7% of patients with dry eye level 1. Preservative-free artificial tears were preferred at all dry eye levels. The use of topical anti-inflammatory agents did not differ with investigator ages, but older physicians preferred preserved artificial tears more than younger ones. Physicians at referral hospitals also tended to use topical anti-inflammatory agents and preservative-free artificial tears earlier, beginning at dry eye level 1, than those who worked at private eye clinics. CONCLUSIONS: Topical anti-inflammatory agents were commonly prescribed for the treatment of dry eye patients in South Korea, even from dry eye level 1. Preservative-free artificial tears were preferred at all dry eye levels. Practice styles differed somewhat depending on the ages and clinic types of physicians.

Nosocomial infection of malnourished patients in an intensive care unit.

Malnutrition is one of the most important factors for the development of nosocomial infection (NI). We performed a study of the correlation between abnormal nutritional factors and NI risk by investigating the patients who stayed longer than 3 days in the intensive care unit (ICU) of our university hospital. The patients were classified into three groups based on serum albumin levels and total lymphocyte counts (TLC). The criteria of Group I (well nourished group) were serum albumin level of 3.5 g/dl or higher and TLC of 1,400/mm3 or higher. The criteria of Group III (severely malnourished group) were serum albumin of less than 2.8 g/dl and TLC of less than 1,000/mm3. The other patients were classified as Group II (moderately malnourished group). The occurrences of NI were monitored during the study period and the APACHE III Score was calculated. The probability of first NI infection in Group III was 2.4 times higher than that in Groups I and II. The mortality rate of 20.5% was more significantly correlated with APACHE III Score than nutritional status. Nineteen (53%) of the total 36 NI patients were infected within 10 days after ICU admission and they all belonged to Group III. When we compared the gap period between infections, the time to first infection was significant.