Renal sinus lipomatosis and body composition in hypertensive, obese rabbits

OBJECTIVE: To test whether renal lipomatosis, an accretion of fat in the renal sinus associated with chronic renal infections, abscesses and calculi, can also be caused by rapid weight gain. DESIGN: New Zealand white rabbits were fed either standard rabbit chow (n = 24) or chow fortified with 10% corn oil plus 5% lard (n = 25) for 8-12 weeks. MEASUREMENTS: The rabbits and constituent tissues were weighed initially, after drying and after organic extractions. Renal tissue cholesterol and triglycerides were measured chemically. RESULTS: Rabbits made obese by increased fat intake were 1.8 kg heavier than controls (5.5 +/- 0.3 kg vs 3.7 +/- 0.2; n = 24,25), had 1.54 kg more body fat (1.90 +/- 0.25 vs 0.36 +/- 0.11 kg/rabbit; n = 10,9), and had a mean arterial blood pressure that was 9.2 mm Hg greater than controls (95.1 +/- 8.5 vs 85.9 +/- 5.6 mm Hg; n = 23,24). Individual organs grew in mass (lung, 15%; gastrocnemius, 17%; liver, 27%; kidney, 30%) and their parenchyma gained extractable lipids (lung, 5.5 mg/g tissue; gastrocnemius, 9.6 mg/g tissue; liver, 17.9 mg/g tissue). Total renal triglycerides were increased 2.1 fold, from 103 +/- 36 to 219 +/- 59 mg/kidney (n = 8,8), compared to the 5.3 fold increase in whole body fat. Renal cholesterol was increased 1.7 fold, from 7.5 +/- 1.1 to 12.7 +/- 2.9 mg/kidney, (n = 8,8). Within experimental error, the sum of the total renal triglycerides plus the total renal cholesterol equaled the net fat extracted from the renal sinus alone: 95 +/- 29 mg/kidney in lean rabbits and 253 +/- 71 mg/kidney in obese (n = 17,17). CONCLUSION: Obesity alone can cause renal lipomatosis. This increased volume of anatomically localized fat may be sufficient to externally compress renal veins and lymphatics, thus altering renal hemodynamic behavior.     

Mediastinal lipomatosis

Mediastinal lipomatosis is a benign condition characterized by a large amount of mature adipose tissue within the mediastinum. It widens the mediastinum and may simulate mass lesions, thus leading to diagnostic errors. We describe a new case of a huge mediastinal lipomatosis and review 36 cases previously reported in the literature. Computed tomography has an important role in the diagnosis of this disease. To avoid invasive and unnecessary procedures, this diagnosis should be considered in any patient with Cushing's syndrome.     

Parotid lipomatosis

A case of parotid lipomatosis is reported, and the literature is reviewed. This rare condition presents as a slow growing parotid mass, which may be diagnosed preoperatively using computed tomography or magnetic resonance imaging. Long-term clinical follow-up is important because apparently complete surgical excision may be complicated by recurrence.     

Ultrasonography and intravenous urography in the diagnosis of blunt renal trauma

OBJECTIVE: To analyze the sensitivity of renal ultrasonography and intravenous urography in renal trauma. METHODS: An extensive analysis on the sensitivity of IVP and US in the assessment of renal trauma was conducted using CT, renal selective arteriography or surgical exploration as the gold standard tests of reference to validate the initial diagnosis. RESULTS: IVP and US are useful techniques because of their high sensitivity in the diagnosis of renal trauma. The sensitivity of US decreases as the severity of the trauma increases (75% for grade I, 88.9% for grade II, 73.3% for grade III and 0% for grade IV), while that of IVP remains high for all degrees of severity (100% for grade I, 92% for grade II, 100% for grade III and 100% for grade IV). CONCLUSIONS: IVP and US were found to be useful techniques because of their high sensitivity in the diagnosis of blunt renal trauma. The sensitivity of US decreases as the severity of the trauma increases, while that of IVP remains high for all degrees of severity.     

The radiographic diagnosis of pelvic lipomatosis

Cultured human gastric cancer cell line PAMC82 was studied in vitro to further verify anti-tumor effect sof rare-earth elements and explore their mechanism of tumor inhibition. Inhibitory effects of elements lanthanum and cerium on cell growth, reverse effects of them on reduction of malignancy and effects of them on level of expression of oncogene and cancer suppressor gene were observed. Lanthanum chloride, cerium chloride and mixed rare-earth chloride at levels of 0.5 to 1.5 mmol/L could inhibit obviously growth of cancer cells and change cell morphology and microtubule structure of PAMC82, similar to that of normal cells, their colony-forming ability lowered in soft agar, and expression of tumor suppressor gene p53, p16 and p21 increased and that of gene nm23 lowered.     

Mediastinal lipomatosis in simple obesity

A case of superior mediastinal widening due to unusual amounts of fat accumulations is reported in a patient with simple obesity, not associated with iatrogenic or primary Cushing's syndrome. The radiographic features included a smooth bilateral widening of the superior mediastinum, relative lucency, no definable mass in the lateral view, and no pressure effects on the trachea. Such mediastinal lipomatosis is a benign condition and may be related to general obesity. although rare, it should be considered in the differential diagnosis of mediastinal masses, particularly in obese individuals.     

Partition of carotid sinus baroreceptor response in dogs with chronic renal hypertension

This study was designed to determine whether resetting of the carotid sinus baroreceptors in chronic renal hypertension is due to altered distensibility of the wall, or changes in the properties of the receptor elements, or both. Dogs were made hypertensive by 50% constriction of the left renal artery with a Goldblatt clamp and by right nephrectomy one week later. Five to nine weeks after nephrectomy, when mean blood pressure had risen by 35-46 mm Hg, the isolated carotid sinus wall deformation, measured from still photographs, and gross baroreceptor nerve action potentials (N) were recorded in response to step intrasinus pressure forcings (P), ranging from zero to 300 mm Hg, in increments of 25 mm Hg. Measured wall deformation was converted to strain-energy density (SED), a scalar value, as the best indicator of the mechanical state of the sinus wall. Plots of N vs. P data followed an S-shaped pattern, but were shifted toward the P-axis, as compared to controls. Plots of SED vs. P, though linear over most of the pressure range, were shifted toward the SED-axis, as compared to controls. A plot of N vs. SED, derived from the composite plots of N vs. P and SED vs. P, followed an S-shaped pattern and also was shifted toward the SED-axis. We conclude that the nonlinearity in the N vs. P curve is due largely to the inability of the receptor elements to respond to increasing wall strain and to resetting of the baroreceptors due to changes in the receptor properties rather than in the wall elements.     

Benign symmetrical lipomatosis: Madelung''s disease

The relationship between smoking and bladder cancer risk was investigated using data from a case-control study conducted between January 1994 and July 1996 in Alexandria, Egypt. Cases were 151 males with incident, histologically confirmed invasive cancer of the bladder, and controls were 157 males admitted to hospital for acute, non-neoplastic, non-urinary tract, non-smoking-related conditions. With reference to never smokers, ex-smokers had a multivariate odds ratio (OR) of 4.4 [95% confidence interval (CI) 1.7-11.7] and current smokers of 6.6 (95% CI 3.1-13.9). The ORs were 5.4 for < 20 and 7.6 for > or = 20 cigarettes per day. After adjustment for cigarette smoking, the ORs were 0.8 for waterpipe and 0.4 for hashish smokers. The risk was significantly related to duration of smoking (OR of 16.5 for > 40 years), and inversely related to age at starting (OR of 8.8 for starting < 20 years), and inversely related to time since quitting smoking. Compared with never smokers who did not report a clinical history of schistosomiasis, the OR was 9.4 for smokers with a history of schistosomiasis, and 10.7 for smokers ever employed in high-risk occupations compared with non-smokers not reporting such a history. Thus, our results, while not giving indications of an increased bladder cancer risk with habits other than cigarette smoking, found a remarkably strong association with various measures of cigarette smoking that could explain 75% of bladder cancer cases among males from Alexandria. The prevalence of smoking was very low among women, and consequently tobacco was not a relevant risk factor for female bladder cancer.     

Benign symmetrical lipomatosis. Case report

We present a patient who had benign symmetrical lipomatosis. He was treated surgically (6 operations), and the results were satisfactory. we discuss various factors in this disease and suggest the possibility of a nonsurgical treatment being developed in the future.     

Pulmonary lipomatosis: a variant of placental transmogrification

An unusual pulmonary lesion is presented. The patient is a 55-year-old white man with a 2-week history of pleuritic chest pain, shortness of breath, and bronchopneumonia. The patient had also a history of smoking and chronic cough for 12 years. Chest radiographic studies showed a 20-cm bulla in the left upper lobe. A left upper lobectomy was performed obtaining an almost completely collapsed lobe with destruction of the normal architecture by a meshwork of yellowish tissue. Histologically, there were strikingly papillary structures composed almost exclusively of mature adipose tissue with small collections of inflammatory cells. Minimal emphysema in the adjacent lung parenchyma was observed. The case herein presented most likely represents part of the spectrum of placental transmogrification or placentoid bullous lesions of the lung.     

Ultrasonography of veins

PURPOSE: The high incidence of acute and chronic diseases of the venous system requires the application of reliable, non-invasive, low-cost methods in diagnosis and follow-up after therapy. MATERIAL AND METHODS: Current technology, principles of examination, and results of ultrasonography of the peripheral venous systems are reviewed. RESULTS: Since the mid 1980s, compression ultrasonography (US) has been introduced in the diagnosis of deep venous thrombosis. Doppler-US methods reach the hallmarks of venous imaging, particularly since the advent of color duplex US. In thrombosis, postthrombotic syndrome, and primary varicosis, color duplex US increasingly replaces the "gold standard" of phlebography as the imaging method of choice. Venous diseases of the neck, and of the upper and lower extremities are reliably recognized by color duplex US. New areas of application of Doppler and duplex-US include examinations of the venous system in patients in intensive care units, evaluation of transplanted organs, and the demonstration of blood flow in hemodialysis shunts. CONCLUSIONS: Color duplex US is useful in most imaging investigations of the peripheral veins. In view of cost development in the medical imaging sector, however, in which ultrasonography takes a major part, critical indication for the application of Doppler- and duplex-US in the diagnosis and follow-up of venous disease is out most importance.     

Mitochondrial DNA mutations in multiple symmetric lipomatosis

We describe an analytical technique for measuring residues of imidacloprid, a relatively new and highly active insecticide, in water and soil using high-performance liquid chromatography (HPLC). All analyses were performed on reversed-phase HPLC with UV detection at 270 nm using a mobile phase of acetonitrile-water (20:80, v/v). Fortified water samples were extracted with either solid-phase extraction (SPE) or liquid-liquid extraction methods. A detection limit of 0.5 microgram/l was achieved using the SPE method. The imidacloprid residues in soils were extracted with acetonitrile-water (80:20, v/v), and the extract was then evaporated using a rotary evaporator. The concentrated extract was redissolved in 1 ml of acetonitrile-water (20:80, v/v) prior to analysis by reversed-phase HPLC. A detection limit of 5 micrograms/kg was obtained by this method which is suitable for analysis of environmental samples. Accuracy and precision at 10 and 25 micrograms/kg soil samples were 85 +/- 6% and 82 +/- 4%, respectively.     

Corticosteroid-induced epidural lipomatosis. Efficacy of medical treatment]

The authors analyse the clinical and therapeutic aspects of myocardial bridges in a series of 6 male patients between the ages of 41 and 61 years. In every cases, the presenting signs were ischaemic order: one myocardial infarction, three cases of unstable angina and two case of stable angina. On coronary angiography, these muscle bridges involved the left anterior descending artery in all cases. The causal relationships between muscle bridges and myocardial ischaemia are discussed. Among the various factors incriminated, spasm, tachycardia and thrombosis appear to play an important role. Depending on the case, treatment modalities consist of beta-blockers, platelet antiaggregants and calcium channel blockers. Surgical treatment is reserved for patients who remain symptomatic despite medical treatment.     

Jejunal lipomatosis with diverticulosis: report of a case

We herein report the very rare case of a 68-year-old Japanese man with multiple jejunal lipomatosis and diverticulosis. He was admitted to our hospital with the chief complaint of melena and anemia. A barium study of the small bowel showed multiple lipomatosis and diverticulosis. An approximately 200-cm length of the jejunum was therefore resected. Thereafter, two diverticula and 215 lipomas were recognized in the resected specimen. A pathological examination showed mature adipose tissue with fibrous septa in the submucosal and muscularis propria. These findings were thus suggested to be due to the attenuation of the muscularis propria. The complications of lipomatosis are also discussed.