Abdominal Compartments Research Articles

Comparative analysis of body composition using torso CT from PET/CT with bioelectrical impedance and muscle strength in healthy adults

The role of torso computed tomography (CT) in evaluating body composition has been unexplored. This study assessed the potential of low-dose torso CT from positron emission tomography (PET)/CT for analyzing body composition and its relation to muscle strength. We retrospectively recruited 384 healthy Korean adults (231 men, 153 women) who underwent torso 18F-FDG PET/CT, bioelectrical impedance analysis (BIA), and muscle strength tests (handgrip strength [HGS] and knee extension strength [KES]). CT images were segmented into three compartments: torso volumetric, abdominal volumetric, and abdominal areal. Muscle amounts from each compartment were indexed to height (m2). BIA and HGS served as reference standards, with correlation coefficients (r) calculated. Torso muscle volumetric index (TorsoMVI) had the strongest correlations with BIA-derived values (r = 0.80 for men; r = 0.73 for women), surpassing those from the abdominal compartments. TorsoMVI was also correlated significantly with HGS (r = 0.39, p < 0.01) and differentiated between normal and possible sarcopenia in men (n = 225, 5960 ± 785 cm3/m2 vs. n = 6, 5210 ± 487 cm3/m2, p = 0.02). In women, KES correlated more strongly with muscle parameters than HGS. Despite gender-specific variations, torso CT-derived parameters show promise for evaluating body composition and sarcopenia.

Influence of head-over-body and body-over-head posture on craniospinal, vascular, and abdominal pressures in an acute ovine in-vivo model

IntroductionOptimal shunt-based hydrocephalus treatments are heavily influenced by dynamic pressure behaviors between proximal and distal ends of shunt catheters. Posture-dependent craniospinal, arterial, venous, and abdominal dynamics thereby play an essential role.MethodsAn in-vivo ovine trial (n = 6) was conducted to evaluate communication between craniospinal, arterial, venous, and abdominal dynamics. Tilt-testing was performed between –13° and + 13° at 10-min intervals starting and ending at 0° prone position. Mean pressure, pulse pressure, and Pearson correlation (r) to the respective angle were calculated. Correlations are defined as strong: |r|≥ 0.7, mild: 0.3 <|r|< 0.7, and weak: |r|≤ 0.3. Transfer functions (TFs) between the arterial and adjacent compartments were derived.ResultsStrong correlations were observed between posture and: mean carotid/femoral arterial (r = − 0.97, r = − 0.87), intracranial, intrathecal (r = − 0.98, r = 0.94), jugular (r = − 0.95), abdominal cranial, dorsal, caudal, and intravesical pressure (r = − 0.83, r = 0.84, r = − 0.73, r = 0.99) while mildly positive correlation exists between tilt and central venous pressure (r = 0.65). Only dorsal abdominal pulse pressure yielded a significant correlation to tilt (r = 0.21). TFs followed general lowpass behaviors with resonant peaks at 4.2 ± 0.4 and 11.5 ± 1.5 Hz followed by a mean roll-off of − 15.9 ± 6.0 dB/decade.ConclusionsTilt-tests with multi-compartmental recordings help elucidate craniospinal, arterial, venous, and abdominal dynamics, which is essential to optimize shunt-based therapy. Results motivate hydrostatic influences on mean pressure, with all pressures correlating to posture, with little influence on pulse pressure. TF results quantify the craniospinal, arterial, venous, and abdominal compartments as compliant systems and help pave the road for better quantitative models of the interaction between the craniospinal and adjacent spaces.

Body fat compartment determination by encoder\u2013decoder convolutional neural network: application to amyotrophic lateral sclerosis

The objective of this study was to automate the discrimination and quantification of human abdominal body fat compartments into subcutaneous adipose tissue (SAT) and visceral adipose tissue (VAT) from T1-weighted MRI using encoder-decoder convolutional neural networks (CNN) and to apply the algorithm to a diseased patient sample, i.e., patients with amyotrophic lateral sclerosis (ALS). One-hundred-and-fifty-five participants (74 patients with ALS and 81 healthy controls) were split in training (50%), validation (6%), and test (44%) data. SAT and VAT volumes were determined by a novel automated CNN-based algorithm of U-Net like architecture in comparison with an established protocol with semi-automatic assessment as the reference. The dice coefficients between the CNN predicted masks and the reference segmentation were 0.87 ± 0.04 for SAT and 0.64 ± 0.17 for VAT in the control group and 0.87 ± 0.08 for SAT and 0.68 ± 0.15 for VAT in the ALS group. The significantly increased VAT/SAT ratio in the ALS group in comparison to controls confirmed the previous results. In summary, the CNN approach using CNN of U-Net architecture for automated segmentation of abdominal adipose tissue substantially facilitates data processing and offers the opportunity to automatically discriminate abdominal SAT and VAT compartments. Within the research field of neurodegenerative disorders with body composition alterations like ALS, the unbiased analysis of body fat components might pave the way for these parameters as a potential biological marker or a secondary read-out for clinical trials.

O-072 Markers of cardiometabolic health of adolescents conceived through assisted reproductive technologies (ART) appear reassuring

Abstract Study question Is the cardiometabolic health of adolescents conceived through ART worse than that of their spontaneously-conceived counterparts? Summary answer The majority of cardiometabolic and vascular health parameters of ART-conceived adolescents are more favourable than those of their spontaneously-conceived counterparts of similar age. What is known already It has been proposed that ART induces epigenetic alterations during embryonic development which could lead to cardiometabolic disease later in life. However, individuals requiring ART may themselves be metabolically less healthy than the general population, which could lead to a genetically increased risk of cardiometabolic disorders in the offspring, rather than the ART procedure. The literature pertaining to cardiometabolic health of ART-conceived offspring is contradictory, but generally suggests unfavourable cardiometabolic health parameters. With over 8 million children and adults born through ART worldwide, it is imperative to investigate whether early signs of adverse cardiometabolic differences persist into adolescence and beyond. Study design, size, duration The Growing Up Healthy Study (GUHS) is a prospective study that recruited 303 ART-conceived adolescents, born 1991-2001 in Western Australia. Their health parameters, including cardiometabolic factors, were assessed and compared with spontaneously conceived counterparts of similar socioeconomic background and age from the Raine Study Generation 2 (Gen2). The 2868 Gen2 participants were born 1989-1992 and are representative of the Western Australian adolescent population. At age 16-17 (2013-2017), GUHS participants replicated assessments previously completed by Gen2. Participants/materials, setting, methods Cardiometabolic parameters were compared between 165 GUHS (male = 50.9%) and 1690 Gen2 (male = 49.8%) adolescents. Assessments consisted of a detailed questionnaire; health and demographic parameters, anthropometric assessments; height, weight, body-mass index (BMI), waist circumference and skinfold thickness, fasting serum biochemistry, arterial stiffness and blood pressure assessment using applanation tonometry, assessment of non-alcoholic fatty liver (NAFLD) and thickness of abdominal fat compartments using ultrasonography. Chi2, Fisher’s Exact and Mann-Whitney U tests, performed in SPSS V25, examined cohort differences. Main results and the role of chance GUHS adolescents appeared to be healthier from a cardiometabolic perspective than their Gen2 counterparts. They were leaner, with lower BMI (median: 21.23 vs. 22.06, P = 0.004), lower waist circumference (median: 74.10 vs. 76.75 cm, P = 0.031), and thinner skinfolds (triceps median: 12.1 vs. 14.0 mm, P = 0.019, subscapular median: 10.6 vs. 11.9 mm, P &amp;lt; .001, mid-abdominal median: 16.0 vs. 19.9 mm, P &amp;lt; 0.001, supraspinal median: 10.7 vs. 13.5 mm, P &amp;lt; 0.001). No significant differences were detected in the following serum fasting parameters: glucose, insulin, HOMA-IR, LDL cholesterol, total cholesterol, cholesterol/HDL-ratio, triglycerides, CRP and ALT. HDL cholesterol levels were more favourable in GUHS (P &amp;lt; 0.001). NAFLD was present in 10.9% of GUHS vs. 15.2% of Gen2 adolescents (P = 0.174), with no difference in steatosis severity score (P = 0.309). ART offspring had less subcutaneous adipose tissue (median: 8.0 vs. 14.0 mm, P &amp;lt; .001), more visceral adipose tissue (median: 40.0 vs. 32.0 mm, P &amp;lt; 0.001), with no difference in pre-peritoneal adipose tissue (P = 0.087). Measures of arterial stiffness were lower in GUHS. Pulse wave velocity: median 6.1 vs. 6.4 m/s, P &amp;lt; 0.001 and heart rate corrected augmentation index: median -10.25 vs. -8.00, P = 0.006. No significant differences in blood pressure or heart rate were detected. Stratification by sex did not greatly alter the results. Limitations, reasons for caution Despite the substantial study size and the unique study design, we were unable to differentiate between different types of ART (e.g. IVF vs. ICSI), draw definite conclusions or relate outcomes to cause of infertility. Given the observational character of this study, causation cannot be proven. Wider implications of the findings In this study we did not detect any adverse effect of ART on cardiometabolic health at adolescence, in contrast to some studies. Given the lack of consensus, future well-designed and appropriately-powered studies are necessary to investigate cardiometabolic health in ART adults. Trial registration number not applicable

Diabetes and Insulin Resistance Show Association With Femoral Instead of Abdominal Adipocyte Size in Asian Indians

Objectives: Energy intake exceeding expenditure results in adipogenesis, which consists of adipocyte hyperplasia and hypertrophy. Adipocyte hypertrophy is the pathological hallmark of ‘sick fat’ responsible for the development of insulin resistance and diabetes mellitus. In Asian Indians, who show a thin, fat phenotype, the association of adipocyte hypertrophy in various fat depots with insulin resistance and diabetes is not precisely known. The objective of this study is to find an association between adipocyte size of abdominal and thigh fat depot and certain parameters of diabetes mellitus. Material & Methods: In this cross-sectional analytical study, 172 patients were recruited. Abdominal subcutaneous and visceral fat samples were available of 100 patients (Non-diabetics: 56; Diabetics: 44), whereas thigh fat was analyzed in 72 patients (Non-diabetics: 40; Diabetics: 32). All participants had a BMI of less than 30 kg/m2 to negate the effect of obesity on adipocyte size. Fasting glucose, insulin, HbA1c, lipid profile including triglycerides, and total cholesterol were measured in all participants, and HOMA-IR was calculated. Adipocyte size in biopsied tissue after fixation was measured with the help of Motic Panthera Moticam 5 trinocular microscope (BA210LED) and Adobe Photoshop CC image analysis tool. Results: Mean adipocyte size in abdominal visceral compartment in diabetics and non-diabetics were 16610.3 ± 889.5 um2 and 16129.8 ± 878.5 um2 respectively. Whereas, mean adipocyte size in abdominal subcutaneous fat in diabetics and non-diabetics were 15071.0 ± 1261.1 um2 and 14356.8 ± 1004.7 um2 respectively. Adipocyte size difference of both the abdominal compartments between diabetic and non-diabetic group was statistically non-significant (p= 0.70 & 0.65 in omental and abdominal subcutaneous compartments respectively). Mean adipocyte size of thigh in diabetics and non-diabetics were 13070.2 ± 1416.2 um2 and 9020.1 ± 811.1 um2 respectively and difference between adipocyte size between both groups was statistically significant (p = 0.01). Thigh Adipocyte size in diabetic subgroup was positively correlated with HOMA -IR (r = 0.4, p = 0.02), triglycerides (r= 0.4, p = 0.03), waist circumference (r = 0.32, p = 0.03). On multivariate linear regression analysis HOMA-IR (β= 0.45, p=0.00), triglycerides (β=0.38, p=0.01) and waist circumference (β=0.35, p=0.02) are predictor of increased adipocyte size. Conclusion: We found that thigh adipocyte size was significantly larger in diabetics in comparison to non-diabetics, whereas no such difference was found in the abdominal fat compartment. In diabetic patients’ thigh, adipocyte size was positively correlated with HOMA-IR, waist circumference, and triglyceride levels, underlining the role of peripheral fat depots in the pathogenesis of diabetes type 2.

Respiratory synchrony comparison between preterm and full-term neonates using inertial sensors.

Due to inefficient respiratory control, newborns become prone to asynchronous thoracoabdominal (TA) movements. The present study quantitatively estimated the synchrony of TA in preterm and full-term newborns through an inertial and magnetic measurement units (IMMUs) system. This cross-sectional study was conducted with 20 newborns divided into Preterm Group (PTG, n = 10) and Full-Term Group (FTG, n = 10). Each neonate had IMMUs placed on the sternum and near the umbilicus, thus the TA motion was estimated through the resultant inclination angles calculated using a sensor fusion filter. The respiratory incursions were also manually counted and video-recorded for two minutes, then used to validate a Matlab custom-written routine for their automatic identification. The respiratory cycles were used to calculate the phase change angle (φ) between the thoracic and abdominal compartments. Association between the manual and automatic methods were verified by Pearson's correlation and root mean squared errors (RMSE), and the comparison between the groups was performed through the Student's t test with α = .05. The values of respiratory incursions measured by both methods showed a high association and low measurement error (r = .96, RMSE = 9.8, p < .001). The FTG presented a higher occurrence of TA synchrony (p = .049) while the PTG group presented a higher occurrence of TA asynchrony (p = .036). No difference was found between the groups regarding the paradoxical classification (p = .071). The proposed method was valid to quantitatively assess the TA synchrony of hospitalized neonates. Preterm infants had a higher occurrence of the asynchronous respiratory pattern in comparison to full-term infants.

Association of abdominal fat with metabolic syndrome components in overweight women: effect of menopausal status

BackgroundThe association between abdominal fat distribution and metabolic syndrome (MetSyn) components by menopausal status has yet to be explicated. The purpose of this study was to examine a cross-sectional association between abdominal fat compartments and MetSyn components in pre- and post-menopausal overweight Japanese women.MethodsOf 212 overweight Japanese women, 76 pre-menopausal overweight (BMI ≥ 25) women (PreM age, 42.1 ± 5.9 years) and 87 post-menopausal overweight women (PostM: age, 56.2 ± 4.5 years) were analyzed in this study. Measurements were taken for body mass index (BMI), abdominal compartments [visceral fat (VF), subcutaneous fat (SF), superficial subcutaneous fat (SSF), and deep subcutaneous fat (DSF)], serum high-density lipoprotein cholesterol (HDLC), low-density lipoprotein cholesterol, triglycerides (TG), and fasting plasma glucose (FPG). Abdominal compartments were assessed using computed tomography.ResultsNo significant differences were found for BMI, SF, SSF, or DSF between the PreM and PostM. Despite this, the PreM had a significantly smaller VF area than that of the PostM. However, the difference in VF area disappeared when age was adjusted for. VFA significantly correlated with HDLC, TG, and FPG independently of menopause status.ConclusionsThese results suggest that the effect of menopause status on the association between VF and MetSyn components is negligible. Abdominal subcutaneous fat compartments were not associated with MetSyn components in overweight women regardless of menopausal status.

Successful patient-oriented surgical outcomes in robotic vs laparoscopic right hemicolectomy for cancer - a systematic review.

Minimally invasive surgical approaches for cancer of the right colon have been well described with significant patient and equivalent oncological benefits. Robotic surgery has advanced in its ability to provide multi-quadrant abdominal access, leading the surgical community to widen its application outside of the pelvis to other abdominal compartments. Globally it is being realized that a patient's surgical episode of care is becoming the epicentre of cancer treatment. In order to establish the role of robotic surgery in a patient's episode of care, 'successful patient-oriented surgical' parameters in right hemicolectomy for malignancy were measured. The objective was to examine the rates of successful patient-oriented surgical outcomes in robotic right hemicolectomy (RRH) compared to laparoscopic right hemicolectomy (LRH) for cancer. A systematic search of MEDLINE (Ovid: 1946-present), PubMed (NCBI), Embase (Ovid: 1966-present) and Cochrane Library was conducted using PRISMA for parameters of successful patient-oriented surgical outcomes in RRH and LRH for malignancy alone. The parameters measured included postoperative ileus, anastomotic complication, surgical wound infection, length of stay (LOS), incisional hernia rate, conversion to open, margin status, lymph node harvest and overall morbidity and mortality. There were 15 studies which included 831 RRH patients and 3241 LRH patients, with a median age of 62-74years. No study analysed the concept of successful patient-oriented surgical outcomes. There was no significant difference in the incidence of postoperative ileus, with less time to first flatus in RRH (2.0-2.7days, compared with 2.5-4.0days, P<0.05). Anastomotic leak rate in one study reported a significant increase in LRH compared to RRH (P<0.05, 0% vs 8.3%). Significantly decreased LOS following RRH was outlined in six studies. One study reported a significantly higher rate of incisional hernias following LRH with extracorporeal anastomoses compared to RRH with intracorporeal anastomoses. Overall rates of conversion to open surgery were less with RRH (0%-3.9% vs 0%-18%, P<0.001, 0.05). One study outlined significantly higher rates of incomplete resection with an open right hemicolectomy compared with minimally invasive laparoscopic and robotic resections, with positive margin rates of 2.3%, 0.9% and 0% respectively (P<0.001). Two studies reported significantly higher lymph node harvest in RRH (P<0.05). Overall morbidity and 30-day mortality were comparable in both approaches. Thirty-day morbidity and mortality were comparable between the two approaches, with patients undergoing RRH having lower anastomotic complications, increased lymph node harvest, and reduced LOS, conversion to open and incisional hernia rates in a number of studies. There are limited data on surgical approach and impact on quality of life and what patients deem successful surgical outcomes. There is a further need for a randomized controlled trial examining successful patient-oriented outcomes in right hemicolectomy for malignancy.

Breath-stacking and incentive spirometry in Parkinson’s disease: Randomized crossover clinical trial

Patients with Parkinson’s disease often exhibit respiratory disorders and there are no Respiratory Therapy protocols which are suggested as interventions in Parkinson’s patients. The aim of this study is to evaluate the effects of Breathing-Stacking (BS) and incentive spirometer (IS) techniques in volume variations of the chest wall in patients with Parkinson’s Disease (PD). 14 patients with mild-moderate PD were included in this randomized cross-over study. Volume variations of the chest wall were assessed before, immediately after, then 15 and 30 min after BS and IS performance by optoelectronic plethysmography. Tidal volume (VT) and minute ventilation (MV) significantly increased after BS and IS techniques (p < 0.05). There was greater involvement of pulmonary and abdominal compartments after IS. The results suggest that these re-expansion techniques can be performed to immediately improve volume.

Visceral and subcutaneous abdominal adiposity and pulmonary function in 30-year-old adults: a cross-sectional analysis nested in a birth cohort

BackgroundSeveral studies have verified body fat distribution in association with pulmonary function (PF), mainly waist circumference, but few have used measures able to distinguish abdominal fat compartments. The present study aims to verify the association of visceral adipose tissue (VAT) and subcutaneous adipose tissue (SAT) with PF measures.MethodsIn 1982, all hospital births occurring in Pelotas, Brazil, were identified and those livebirths have been followed. In 2012–13, the cohort participants were evaluated and VAT and SAT measured using ultrasound; forced expiratory volume in the first second (FEV1) or forced vital capacity (FVC) were patronized in z-scores stratified by sex. The associations were verified using crude and adjusted linear regressions.ResultsThe present analyses comprised 3438 individuals (1721 women). VAT was inversely associated with spirometric parameters, in both crude and adjusted models. SAT showed inverse associations in the crude analyzes in males and a positive trend after adjustment, except for SAT and FVC in males. To each centimeter of VAT, mean adjusted FEV1 z-scores decreased 0.072 (95% CI -0.107; −0.036) in men and 0.127 (95% CI -0.164; −0.090) in women, and FVC z-scores decreased −0.075 (95% CI -0.111; −0.039) and 0.121 (95% CI -0.158; −0.083), in men and women, respectively.ConclusionsVAT has a consistent inverse association with FEV1 and FVC in both sexes. On the other hand, SAT showed inconsistent results with PF parameters.

Magnetic Resonance Imaging of Changes in Abdominal Compartments in Obese Diabetics during a Low-Calorie Weight-Loss Program.

ObjectivesTo investigate changes in the fat content of abdominal compartments and muscle area during weight loss using confounder-adjusted chemical-shift-encoded magnetic resonance imaging (MRI) in overweight diabetics.MethodsTwenty-nine obese diabetics (10/19 men/women, median age: 59.0 years, median body mass index (BMI): 34.0 kg/m2) prospectively joined a standardized 15-week weight-loss program (six weeks of formula diet exclusively, followed by reintroduction of regular food with gradually increasing energy content over nine weeks) over 15 weeks. All subjects underwent a standardized MRI protocol including a confounder-adjusted chemical-shift-encoded MR sequence with water/fat separation before the program as well at the end of the six weeks of formula diet and at the end of the program at 15 weeks. Fat fractions of abdominal organs and vertebral bone marrow as well as volumes of visceral and subcutaneous fat were determined. Furthermore, muscle area was evaluated using the L4/L5 method. Data were compared using the Wilcoxon signed-rank test for paired samples.ResultsMedian BMI decreased significantly from 34.0 kg/m2 to 29.9 kg/m2 (p < 0.001) at 15 weeks. Liver fat content was normalized (14.2% to 4.1%, p < 0.001) and vertebral bone marrow fat (57.5% to 53.6%, p = 0.018) decreased significantly throughout the program, while fat content of pancreas (9.0%), spleen (0.0%), and psoas muscle (0.0%) did not (p > 0.15). Visceral fat volume (3.2 L to 1.6 L, p < 0.001) and subcutaneous fat diameter (3.0 cm to 2.2 cm, p < 0.001) also decreased significantly. Muscle area declined by 6.8% from 243.9 cm2 to 226.8 cm2.ConclusionMRI allows noninvasive monitoring of changes in abdominal compartments during weight loss. In overweight diabetics, weight loss leads to fat reduction in abdominal compartments, such as visceral fat, as well as liver fat and vertebral bone marrow fat while pancreas fat remains unchanged.

Visceral adiposity is associated with cytokines and decrease in lung function in women with persistent asthma

Abdominal obesity is associated with a risk of cardiovascular diseases, metabolic syndrome and decreased lung function. However, it is not known whether asthma control is influenced by the accumulation of adipose tissue in the various abdominal compartments. ObjectiveTo determine associations among abdominal adiposity distribution, asthma control, lung function and cytokines in women. Methods and designIn this cross-sectional study of asthmatic women, data on demographic variables, comorbid conditions, disease history, anthropometric and spirometric measurements were collected. Subcutaneous (SAT) and visceral (VAT) adipose tissues were measured by ultrasound, and the steatosis level was obtained. Asthma control was assessed according to Global Initiative for Asthma (GINA) criteria. Atopy was defined on the basis of allergen-specific Immunoglobulin E and/or skin prick testing. Cytokine levels were determined using enzyme-linked immunosorbant assays (ELISAs). ResultsEighty-three asthmatic women were included, 37% of whom had uncontrolled asthma. After controlling for variables, a negative association between asthma control and VAT and the VAT/SAT ratio was observed. VAT was negatively associated with respiratory parameters after controlling for explanatory variables. In an adjusted model, body mass index (BMI) and SAT were inversely associated with the adiponectin serum level and VAT was associated with the interleukin 6 level. In conclusion, visceral obesity was negatively associated with asthma control and lung function; and positively associated with increased levels of interleukin 6 in women. We hypothesize that women should be studied as a separate group, and we suggest further studies with a control group to know if the uncontrolled asthmatic group is directly affected by visceral adipose inflammatory markers.

Abstract 3437: Visceral abdominal fat is associated with incisional hernia occurrence after colorectal cancer surgery - the ColoCare Study

Abstract Introduction: Abdominal surgery for tumor removal is essential in the treatment of colorectal cancer (CRC). Incisional hernias (IH) are a common long-term complication after abdominal surgery with an incidence of 9-20%. Several risk factors for developing IH have been identified, including a higher body mass index (BMI). However, it is unknown whether specific abdominal fat compartments, such as subcutaneous or visceral fat, are associated with IH occurrence. Thus, the aim of this study was to explore whether subcutaneous or visceral fat compartments might be predictors of IH occurrence in CRC patients after oncologic surgery. Methods: This study was conducted on 139 newly-diagnosed colorectal cancer patients of the prospective cohort study ColoCare (NCT, Heidelberg, Germany) who underwent oncologic surgery at the surgical clinics of the University Hospital Heidelberg. Self-administered questionnaires were used to assess hernia occurrence at 3, 6, 12 and 24 months post-surgery. BMI was calculated (kg/m^2) and abdominal fat compartments were assessed by routine computed tomography (CT) scans. The total (TFA), subcutaneous (SFA) and visceral fat area (VFA) was quantified as area (cm^2) on level L3/L4 and L4/L5. Before analyses, fat data were grouped into two categories (high vs. low) by the median. Logistic regression was used to measure the association between BMI, TFA, SFA or VFA and IH occurrence. Results: Patients were on average 61.3 (±12.5) years old with 37% being female and 63% being male. Patients were diagnosed with either colon/rectosigmoid (53%) or rectal (47%) primary cancer. CT data on abdominal fat compartments were available for 56% (n = 80) of patients as CT scans were not performed on every subject during clinical routine. BMI was a statistically significant predictor of IH occurrence after adjusting for gender and age (Wald p-value &amp;lt;0.001, OR = 1.19). Of all fat values, only VFA on level L3/L4 was statistically significant associated with IH occurrence after adjusting for gender and age (Wald p-value &amp;lt;0.05, OR = 2.36), while TFA and SFA on level L3/L4 and all level L4/L5 fat values were not associated with IH occurrence. Conclusion: Our findings underline BMI as a known predictive risk factor for IH. In addition, our study newly identified visceral, but not total or subcutaneous fat, as risk factors for IH. Further studies with an increased sample size are needed to test these associations in subgroups of patients, e.g. by gender or surgical procedures. In the future, these findings may help to preoperatively decide on prophylactic interventions, such as intraoperative mesh implantations, to reduce hernia occurrence. Citation Format: Jürgen Böhm, Johanna Nattenmüller, Frank Pianka, Biljana Gigic, Yesilda Balavarca, Nina Stüttgen, Petra Schrotz-King, Dominique Scherer, Alexis Ulrich, Markus K. Diener, Hans-Ulrich Kauczor, Cornelia M. Ulrich. Visceral abdominal fat is associated with incisional hernia occurrence after colorectal cancer surgery - the ColoCare Study. [abstract]. In: Proceedings of the 106th Annual Meeting of the American Association for Cancer Research; 2015 Apr 18-22; Philadelphia, PA. Philadelphia (PA): AACR; Cancer Res 2015;75(15 Suppl):Abstract nr 3437. doi:10.1158/1538-7445.AM2015-3437

Why are associations with health risks better for waist circumference than for visceral adipose tissue? A mechanistic explanation (391.5)

Visceral adipose tissue (VAT) is strongly associated with health risks, although an anomalous finding is that VAT‐surrogate waist circumference (WC) is often an even better risk predictor. This led us to hypothesize that other compartments might in‐part account for the stronger WC‐health risk relationship. We tested this hypothesis by conducting whole‐body MRI in 314 adults with additional measures including WC and cardiovascular disease risk markers. Regression models were developed with health risk factors as dependent variables and abdominal compartments (VAT and liver, spleen, kidney, skeletal muscle, and total adipose tissue [TAT] volumes) as independent variables. Liver volume (LV, P=0.002), VAT (P&lt;0.001), TAT (P&lt;0.001), and skeletal muscle (P=0.048) all independently contributed to WC in regression models. LV independently contributed to fasting plasma triglyceride levels, HDL‐cholesterol, insulin, and systolic‐diastolic BP (all P&lt;0.001 except HDL P=0.005) after VAT and TAT adjustment. LV, in turn, was borderline significantly correlated with spectroscopy‐measured liver fat (r=0.33, p=0.08) in a 30 subject subsample. LV changes with 3‐month dieting were significantly correlated with liver fat changes (r=0.44, P=0.03). WC as a phenotypic measure thus detects risk factor effects beyond that produced by VAT, notably the well‐characterized metabolic effects of hepatic steatosis.

G159 The Use of Structured Light Plethysmography to Assess the Effect of Feeding on Tidal Breathing Patterns in Newborns

AimsThe aim of the study was to evaluate tidal breathing patterns in healthy newborns using Structured Light Plethysmography (SLP), and to compare the relative contributions of the ribcage and abdominal...

In vitro validation of a new respiratory ultrasonic plethysmograph

ObjectiveThe in-vitro validation of a novel Respiratory Ultrasonic Plethysmography (RUP) system designed to detect circumference changes of rib cage and abdominal compartments in large and small animals. Study designExperimental in vitro study. MethodsThe experimental system includes two compliant fluid-filled rubber tubes functioning as ultrasonic waveguides. Each has an ultrasonic transmitter and a detector at the opposing ends. Sensor length can be individually adapted in the range of 0.15–2 m. Data are downloaded to a computer at a sampling rate of 10 or 100 Hz. Measurements have a resolution of 0.3 mm. Baseline stability, linearity and repeatability were investigated with dedicated experiments. The base line drift was tested measuring a fixed distance for 2 hours continuously and then 18 hours later. A hand-operated horse thorax dummy (elliptically shaped, circumference 1.73 m) was used to compare waveforms of RUP with a respiratory inductive plethysmograph (RIP). The electromagnetic interference was tested by approaching metallic objects. ResultsBaseline drift and repeatability (10 repeated steps of 1.6% and 6.6% elongations and contractions) were within ± 0.3 mm. The response of the system for tube stretching up to 11% of total length was linear with a coefficient of determination for linearity of 0.998. In contrast to RIP, electromagnetic interference could not be observed with RUP. Conclusions and clinical relevanceThe low baseline drift and the lack of electromagnetic interference favours the use of RUP compared to an RIP device when studying the breathing pattern and end expiratory lung volume changes in conscious and anaesthetized animals.

INTRAOSSEOUS SPINAL GLOMUS TUMORS

Glomus tumors are rare lesions that can arise intraosseously along the entire spinal axis. Only four cases have been reported, usually manifesting with severe back pain and involving the midthoracic spine or sacrum. The current report describes the largest such lesion reported in the literature to date and summarizes the clinical and pathological characteristics of these rare tumors. A single, recent case arising from the lumbar vertebra of L3 is described, and the literature of intraosseous spinal glomus tumors is reviewed. The lesion described arose in a 44-year-old man with a 1-year history of neurological symptoms and a large dumbbell-shaped lesion involving the lumbar vertebra, which extended through the neural foramen at L3. The lesion was resected using a two-stage approach. Severe intraoperative hemorrhage necessitated emergent angiographic embolization. Histopathological examination confirmed the presence of a glomus tumor arising from the smooth muscle cells of the glomus body. These rare lesions may extend into the epidural space and through the neural foramina and abdominal compartments; over time, they grow very large. Preoperative embolization may be indicated for large tumors suspected to be glomus tumors.

EFFECTS OF INTRA-ABDOMINAL ADMINISTRATION OF RECOMBINANT TISSUE PLASMINOGEN ACTIVATOR ON COAGULATION, FIBRINOLYSIS AND INFLAMMATORY RESPONSES IN EXPERIMENTAL POLYMICROBIAL PERITONITIS

Peritonitis represents a procoagulant state because of activated coagulation and inhibited fibrinolysis. Intra-abdominal fibrin deposition-entrapping bacteria-prevents bacterial spread but impairs bacterial clearance. Activating intra-abdominal fibrinolysis by recombinant tissue-type plasminogen activator (r-tPA) early during peritonitis may enhance bacterial clearance and reduce inflammation. This study examines effects of abdominal r-tPA lavage on local and distant coagulation, fibrinolysis, and inflammatory responses in experimental polymicrobial peritonitis. Twenty-four hours after cecal ligation and puncture, mice were exposed to therapeutic abdominal lavage with varying doses of r-tPA or saline (controls). Coagulation, fibrinolysis, and inflammation were assessed in abdominal, systemic, and pulmonary compartments (n = 6 per group per time point). Survival was assessed during 96 h (n = 16 per group). Highest-dose (2 mg/mL) r-tPA lavage caused immediate death. High-dose (0.5 mg/mL) r-tPA lavage increased fibrinolysis, demonstrated by low abdominal plasminogen activator inhibitor 1 levels and elevated pulmonary tPA levels, resulting in reduced abdominal bacterial load, chemokine levels, leukocyte influx, and thrombin generation, along with less pulmonary fibrin depositions and organ damage on histological examination (P < 0.05 vs. saline lavage). Low-dose (0.05 mg/mL) r-tPA lavage showed hardly any effect compared with saline lavage. Adversely, abdominal and plasma interleukin (IL) 12 were elevated, whereas IL-10 levels were decreased after high-dose r-tPA lavage (P < 0.05 vs. saline). Survival rate was not affected by any dose of r-tPA lavage compared with saline lavage. Delayed local stimulation of fibrinolysis by peritoneal r-tPA lavage enhanced intra-abdominal bacterial clearance and reduced intra- and extra-abdominal coagulation responses in a dose-dependent manner. Survival rate was unaffected likely due to adverse changes in IL-12 and IL-10 levels.

Plethysmographic Comparison of Breathing Pattern in Heaves (Recurrent Airway Obstruction) Versus Experimental Bronchoconstriction or Hyperpnea in Horses

Horses with recurrent airway obstruction (heaves) are described as exhibiting "increased abdominal effort," but it is unknown whether this translates to an effective contribution to ventilation. We hypothesized that heaves is characterized by asynchrony between rib cage and abdominal motions, and that the abdominal component is the major contributor to ventilation. The rib cage versus abdominal motion in naturally occurring heaves (n = 15) was compared to controls at rest (n = 7) and during hyperpnea because of lobeline treatment, and the effects of histamine-induced bronchoconstriction in controls (n = 10). Flow patterns, phase angle (theta) between the rib and abdominal compartments, abdominal (Vabd) contribution to tidal volume (VT), and lung mechanics were measured. Findings unique to the heaves group included the loss of biphasic expiratory flow, severely increased theta with the abdomen consistently lagging behind the rib cage, and a reduced contribution of the abdomen to ventilation. A subgroup of heaves (n = 5) with abdominal paradox showed a significant (P < .05) reduction in tidal volume, and increased respiratory rate. Bronchodilation reduced theta in heaves (P = .06), but theta remained significantly higher after bronchodilation than found in controls. We conclude that breathing pattern in horses with heaves is characterized by severe rib cage/abdominal asynchrony, with the rib cage motion in synchrony with flow, therefore dominating ventilation. In a subset of heaves, the abdominal compartment (diaphragm, abdominal muscles) was completely out of synchrony with flow ("abdominal paradox") despite the clinical appearance of "increased abdominal effort."

Plethysmographic Comparison of Breathing Pattern in Heaves (Recurrent Airway Obstruction) Versus Experimental Bronchoconstriction or Hyperpnea in Horses

Background: Horses with recurrent airway obstruction (heaves) are described as exhibiting “increased abdominal effort,” but it is unknown whether this translates to an effective contribution to ventilation.Hypothesis: We hypothesized that heaves is characterized by asynchrony between rib cage and abdominal motions, and that the abdominal component is the major contributor to ventilation.Animals: The rib cage versus abdominal motion in naturally occurring heaves (n = 15) was compared to controls at rest (n = 7) and during hyperpnea because of lobeline treatment, and the effects of histamine‐induced bronchoconstriction in controls (n = 10).Methods: Flow patterns, phase angle (9) between the rib and abdominal compartments, abdominal (Vabd) contribution to tidal volume (VT), and lung mechanics were measured.Results: Findings unique to the heaves group included the loss of biphasic expiratory flow, severely increased 9 with the abdomen consistently lagging behind the rib cage, and a reduced contribution of the abdomen to ventilation. A subgroup of heaves (n = 5) with abdominal paradox showed a significant (P&lt; .05) reduction in tidal volume, and increased respiratory rate. Bronchodilation reduced 9 in heaves (P= .06), but 9 remained significantly higher after bronchodilation than found in controls.Conclusions and Clinical Importance: We conclude that breathing pattern in horses with heaves is characterized by severe rib cage/abdominal asynchrony, with the rib cage motion in synchrony with flow, therefore dominating ventilation. In a subset of heaves, the abdominal compartment (diaphragm, abdominal muscles) was completely out of synchrony with flow (“abdominal paradox”) despite the clinical appearance of “increased abdominal effort.”