Fatty Mass Research Articles

Measurement of lipogenic flux by deuterium resolved mass spectrometry

De novo lipogenesis (DNL) is disrupted in a wide range of human disease. Thus, quantification of DNL may provide insight into mechanisms and guide interventions if it can be performed rapidly and noninvasively. DNL flux is commonly measured by 2H incorporation into fatty acids following deuterated water (2H2O) administration. However, the sensitivity of this approach is limited by the natural abundance of 13C, which masks detection of 2H by mass spectrometry. Here we report that high-resolution Orbitrap gas-chromatography mass-spectrometry resolves 2H and 13C fatty acid mass isotopomers, allowing DNL to be quantified using lower 2H2O doses and shorter experimental periods than previously possible. Serial measurements over 24-hrs in mice detects the nocturnal activation of DNL and matches a 3H-water method in mice with genetic activation of DNL. Most importantly, DNL is detected in overnight-fasted humans in less than an hour and is responsive to feeding during a 4-h study. Thus, 2H specific MS provides the ability to study DNL in settings that are currently impractical.

Fortuitous Discovery of a Bochdalek Hernia in an Adult

Bochdalek hernia is the most common type of congenital diaphragmatic hernia. It is due to a defect in the posterior attachment of the diaphragm muscle, subsequent to a failure of pleuroperitoneal membrane closure in utero. Bochdalek hernia is often asymptomatic in adults, hence, it is fortuitously discovered as an incidental finding on CT scan. Alternatively, it may be diagnosed only after complications occur, such as empyema, cardiac tamponade and gastrointestinal strangulation. CT usually demonstrates a fatty mass above the diaphragm (Figure 1: arrow), which may be associated with other organs entrapment. Coronal and sagittal reformatted images show the diaphragmatic defect (Figure 2: arrows).

Association between mesenteric panniculitis and non-neoplastic disorders

PurposeTo assess the relationship between MP and coexisting non-neoplastic disorders. MethodsConsecutive abdominal computed tomography (CT) scans of 4674 patients were evaluated retrospectively for CT features of MP between January 2017 and January 2018. Clinical findings of patients were analyzed. Four control patients were selected from our cohort for each MP patient such that they matched for age, gender and CT protocol. Statistical analysis was performed using a t, Mann–Whitney U, χ2, or Fisher's test. Results976 patients were excluded from the study due to the exclusion criteria and finally, 102/3698 patients were diagnosed with MP (mean age = 57.2 ± 12.5 years, 52% male). On CT, a hyperattenuated fatty mass (120/120), subcentimeter lymph nodes (117/120), congregation of mesenteric vessels (82/120) within the mass, a fat halo sign (28/120) and a pseudocapsule (88/120) were seen at the mesentery.The intra-observer agreement was almost perfect for the fatty mass and lymph nodes and moderate or substantial for other CT features (p < 0.001). The most prominent disorders were metabolic syndrome (MetS) and urogenital diseases in MP (45%, 37%, respectively) and control groups (31%, 26%, respectively). Between groups, no significant differences were found in the history of abdominal surgery, gastrointestinal and autoimmune diseases (p-value range 0.064–0.663); however, significant differences were found in the rates of vascular, urogenital diseases and MetS (p-value range 0.012–0.036). ConclusionMetS and urolithiasis were significantly more common in patients with MP than in those without MP. Therefore, there may be a clinically relevant association between these disorders. MetS may be a risk factor for MP and urolithiasis, and treatment of metabolic disorders should be undertaken to prevent these diseases.

1003 A Case of Tunnel-Vision in Upper Renal Tract Imaging: The Invisible Gorilla

Abstract We present an interesting case of a 70-year-old female who presented with haematuria on the suspected cancer pathway. Renal ultrasound showed a vascular renal mass on her right kidney measuring 8x7cm with an unremarkable left kidney. She underwent a laparoscopic radical nephrectomy following confirmation of an 8cm renal mass in the right kidney on the contrasted staging CT scan with a repeat review at the multidisciplinary meeting. Post-operatively a subsequent review of the pre-operative CT and ultrasound scan, showed an incidental large left(contralateral) upper quadrant retroperitoneal fatty mass sized 15x10cm, displacing the stomach and spleen. Further investigation in the form of an MRI Abdomen excluded features of a liposarcoma, resulting in the diagnosis of a large retroperitoneal lipoma. This case highlights the significance of selective attention in imaging interpretation. We believe this to be a prime example of the level of meticulousness required as fat-rich tissues have low attenuation on CT-scans, which can be easily missed out. A cautious multi-clinician interpretation of scans should be performed to avoid missing potentially sinister pathology which would impact patient care dramatically. This case has led to more thorough review of future pre-operative imaging by the operating surgical team.

Saturation of thylakoid-associated fatty acids facilitates bioenergetic coupling in a marine diatom allowing for thermal acclimation.

In a rapidly warming world, we ask, "What limits the potential of marine diatoms to acclimate to elevated temperatures?," a group of ecologically successful unicellular eukaryotic photoautotrophs that evolved in a cooler ocean and are critical to marine food webs. To this end, we examined thermal tolerance mechanisms related to photosynthesis in the sequenced and transformable model diatom Phaeodactylum tricornutum. Data from transmission electron microscopy (TEM) and fatty acid methyl ester-gas chromatography mass spectrometry (FAME-GCMS) suggest that saturating thylakoid-associated fatty acids allowed rapid (on the order of hours) thermal tolerance up to 28.5°C. Beyond this critical temperature, thylakoid ultrastructure became severely perturbed. Biophysical analyses revealed that electrochemical leakage through the thylakoid membranes was extremely sensitive to elevated temperature (Q10 of 3.5). Data suggest that the loss of the proton motive force (pmf) occurred even when heat-labile photosystem II (PSII) was functioning, and saturation of thylakoid-associated fatty acids was active. Indeed, growth was inhibited when leakage of pmf through thylakoid membranes was insufficiently compensated by proton input from PSII. Our findings provide a mechanistic understanding of the importance of rapid saturation of thylakoid-associated fatty acids for ultrastructure maintenance and a generation of pmf at elevated temperatures. To the extent these experimental results apply, the ability of diatoms to generate a pmf may be a sensitive parameter for thermal sensitivity diagnosis in phytoplankton.

Evaluation of endothelial function in obese children and adolescents

Evaluation of endothelial function in obese children and adolescents

Continuous Anaerobic Treatment of the Aqueous Phase of Hydrothermal Liquefaction from Spirulina Using a Horizontal-Flow Anaerobic Immobilized Biomass (HAIB) Reactor

Anaerobic digestion is a possibility for post-hydrothermal liquefaction wastewater (PHWW) treatment because this wastewater is rich in nutrients and organic compounds. However, the PHWW presents many toxic compounds. A strategy for the anaerobic treatment of toxic compounds is using biomass adhered to inert supports forming biofilms, which can offer more resistance to the microorganism and protection from such compounds. The continuous treatment of PHWW is the essential key to obtaining a sustainable hydrothermal liquefaction process. In this work, the use of immobilized biomass was evaluated for the anaerobic degradation of PHWW from Spirulina in batch assays and continuous treatment. Higher methane production potential and volatile fatty acid mass balance showed the advantages of using biomass immobilized in polyurethane foam. Continuous treatment in a horizontal-flow anaerobic immobilized biomass (HAIB) reactor reached chemical organic demand (COD) removal efficiencies of 67% and 58% for volumetric organic load rates of 0.8 and 1.6 g COD.L−1.d−1, respectively. After 200 days of continuous treatment, Anaerobaculum and Coprothermobacter, fermentative proteolytic genera of bacteria with potential for hydrogen production, were favored.

A Giant Mesentric Lipoblastoma in a Two-Year Girl: A Case Report

Back ground: Abdominal lipoblastomas which are benign but uncommon soft tissue tumors in children rarely arise from the mesentery.However, benign, these may attain in large size and cause compression symptoms. Complete resection and close post-operative monitoring are necessary for avoidance of recurrence. Histopathology with immunohistochemistry in conjunction with the morphology is the gold standard for diagnosis. Herein such a rare a case of mesenteric lipoblastoma with huge abdominal distention is reported.&#x0D; Case presentation: A 2-year-old girl presented with an enormous abdominal swelling occupying almost all quadrants of the abdomen with repeated dull abdominal pain. The swelling was a non-tender and tensely cystic. USG and CT Scan could not distinguish the proper origin or location of the mass but demonstrated as a large encapsulated and lobulated fatty mass measuring about (16.4x10.0x18.6cm) involving right hypochondriac, epigastric, bilateral ilio-lumber, umbilical &amp; hypogastric regions, pushing the bowel loops upward &amp; laterally with mild mesenteric thickening of perilesional mesentery and separated from the liver &amp; both kidneys and other intraabdominal organs. After exploratory laparotomy there revealed a well capsuled large (about 15x11x14cm)soft yellow mass displacing the entire intra-abdominal contents, connected by a single vascular pedicle with the mesentery and loosely enclosing the mesentery as a whole. Histology and immunohistochemistry of completely resected mass conûrmed the presence of mature adipocytes and immuno-morphology was compatible with Lipoblastoma.&#x0D; Conclusion: This case represents one of the largest mesenteric lipoblastomas in accordance to the patient’s age that histologically, mostly composed of mature adipocytes with few lipoblasts.&#x0D; J Shaheed Suhrawardy Med Coll, December 2020, Vol.12(1); 54-57

Tethering of the spinal cord in cervical region in adult male patient.

We report a case of a 31-year-old male, came to the medicine department with complains of pain and numbness in upper limb and cervical region. On clinical examination fatty lump was seen in cervical region and muscles had decreased tone Investigations were done. Magnetic resonance imaging (MRI) showed abnormal mass at C5-C6-C7 level in spinal cord region (A). Initially MRI was taken for cervical region from lateral as well as posterior aspect considering the findings, MRI was repeated to see any involvement in lumbar region (B). No significant abnormality was seen in lumbar region vertebral bodies showed wedging in the cervical region and fatty mass was seen in. Patient was then admitted for the same and surgery was planned. Detethering of the spinal cord in cervical region was planned. Myelomeningocele correction was done. Complications of the surgery include cerebrospinal leakage and bladder dysfunction. This patient showed no complications post operatively and was referred to physiotherapy department. The primary goal of the physiotherapist was to prevent secondary complications and to increase the strength of muscles. Special care was taken for cervical region as the patient was post-operative, cervical collar was given and the patient was ambulated on post-operative day 5.

Recognizing the Ultrasound Patterns of Mesenteric Panniculitis.

Mesenteric panniculitis (MP) is a rare, benign, and nonspecific chronic fibrosing inflammation of the mesenteric adipose tissue. Abdominal pain is the most frequent presentation.The objective was to recognize ultrasound (US) features in MP. A retrospective 9-year review of computed tomography- (CT) or US-diagnosed cases of MP recorded in the radiology department was performed. The inclusion criteria included an US recorded in PACS imaging data base within 10 days before CT, to compare and evaluate the correlation of MP diagnosis.The prevalence of MP on CT was 2.8%. The 120 selected patients had an abdominal US 10 days before CT. Male-to-female ratio was 4:1. Fifty-three percent of MP was suggested by US. The US finding was increased volume with fatty mass in the mesentery root (98%). The fatty mesenteric mass had oval shape or convex anterior border in 94%, central abdominal location in 91%, and focal mesenteric increased echogenicity in 95%. Lateral bowel loop displacement was observed in 59%. Detection of lymph nodes was less frequent (55%).In conclusion, MP is an entity to be considered in the differential diagnosis of abdominal pain. Knowledge and recognition of the US findings of MP and central abdominal compression may improve detection during the abdominal US examination.

In situ fatty acid production supports shrimp yields in diets lacking fish oil and fishmeal

Using capture fishery-derived fish oil and fishmeal in aquafeeds is unsustainable. This study mimicked semi-intensive shrimp ponds, including primary producers, in mesocosm tanks. Fatty acid mass balances were computed to distinguish between diet-based and primary production-based LC-PUFA contributions to shrimp (Litopenaeus vannamei) production and meat quality. Performance and body fatty acid composition were compared of shrimp fed a commercial diet containing fish oil and fishmeal (control), with a fishmeal- and fish oil-free diet (low LC-PUFA diet: LOW). Six mesocosms were each stocked with 60 juvenile shrimp and randomly assigned to the two diets. After an 8-week grow-out period, biomass production, survival and proximate body composition were similar between diets. Control shrimp contained twice as much LC-PUFA and omega-3 fatty acids than LOW shrimp. Large quantitative losses (85%) were found in both treatments of the LC-PUFA-precursors alpha-linolenic acid (ALA) and linoleic acid (LA) that were being used as energy source by the shrimp instead for LC-PUFA synthesis. Whereas losses were also observed for eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) in the control group, there was a gain for these components in the LOW tanks. LOW shrimp sourced at least 32% of their total EPA gain and 15% of their total DHA gain from the algal-based food web. This quantitative analysis of the fate of major dietary fatty acids strongly suggests that the pond's primary production can provide shrimp additional LC-PUFA. Finding a balance between LC-PUFA contribution through formulated feed and natural production seems possible and deserves further research.

The Prevalence of Sarcopenic Obesity in Postmenopausal Women with a History of Breast Cancer Depending on Adopted Methodology - A Case-Control Study.

IntroductionSarcopenic obesity (SO) is characterized as the cooccurrence of sarcopenia and obesity. It is associated with many adverse health consequences, also in oncological patients. The study aimed to assess the prevalence of SO in postmenopausal women with a history of breast cancer depending on adopted methodology.Materials and MethodsThe case–control study enrolled 103 women over the age of 50 with a history of breast cancer, including women who completed oncological treatment and had remained in remission for at least 5 years (group I, n=78) and women in whom the disease recurred (group II, n=25). The control group included women with no history of breast cancer (group III, n=73).ResultsIn group II sarcopenia occurred significantly more commonly compared to both group I and the control group (for the skeletal muscle index (SMI) ≤29.20%: 13 (52%) in group II vs 16 (20.5%) in group I, p=0.004 and 3 (4.1%) in group III, p<0.001; for SMI ≤26.60%: 10 (40%) in group II vs 9 (11.5%) in group I, p=0.003 and 3 (4.1%) in group III, p<0.001; for SMI ≤33.87%: 17 (68%) in group II vs 21 (26.9%) in group I, p<0.001 and 5 (6.8%) in group III, p<0.001). Depending on the assessment criteria, SO was diagnosed in 0–11.5% of cases in group I, 0–40% of cases in group II and 0–4.1% in the control group. Intergroup differences were not statistically significant, irrespective of the adopted pair of diagnostic criteria. The highest detectability of SO was observed when SMI was combined with each of the diagnostic criteria for obesity used.DiscussionSO diagnosis based on the percentage of fatty tissue mass in the body of >38% and SMI value were associated with a higher detection rate of SO in each study group, regardless of the adopted cut-off value. Similar results were obtained in each analyzed group when using the remaining diagnostic criteria for obesity and SMI value, regardless of the cut-off value.

Benign mesenteric lipomatous tumor in a child: a case report and literature review

BackgroundLipomatous tumors are the most common type of soft-tissue tumors. Benign lipomatous tumors are lipomas and lipoblastoma. We herein report a case of benign mesenteric lipomatous tumor and the largest collection of known benign mesenteric lipomatous tumors in children in the literature.Case presentationA 3-year-old girl presented with repeated dull abdominal pain and left abdominal mass swelling. On a physical examination, the child had a soft, moderately distended left abdomen that was not tender when palpated. Computed tomography and magnetic resonance imaging demonstrated a large fatty mass within the mesentery, measuring approximately 8 × 6 cm. The mass extended from the right upper quadrant to the lower pole of the kidneys. Laparotomy with resection of the mesenteric tumor was performed under general anesthesia. A well-capsuled tumor was a soft, yellow mass and found loosely attached to the mesenterium of the ileum. A histopathological examination demonstrated the lobular proliferation of mature adipocytes. Atypical lipoblasts were not seen. These features are compatible with benign lipomatous tumor, such as lipoma or lipoblastoma with maturation.ConclusionIn conclusion, benign mesenteric lipomatous tumors tend to be large in size over 10 cm in longitudinal length. However, resection is well tolerated in the vast majority of cases with benign post-operative courses.

Fluorodeoxyglucose positron emission tomography/computed tomography findings after percutaneous cryoablation of early breast cancer

BackgroundTo document 18F-Fluorodeoxyglucose positron emission tomography/computed tomography (PET/CT) findings after percutaneous cryoablation for early breast cancer.MethodsData of 193 consecutive patients who had undergone cryoablation for invasive ductal carcinoma or ductal carcinoma in situ ≤ 15 mm without a history of ipsilateral breast cancer, synchronous ipsilateral lesion, and with estrogen receptor positive/human epidermal growth factor 2 negative were enrolled. The imaging characteristics of the treated areas were evaluated and classified on CT images as one of two types: fatty mass or non-fatty mass type. The maximum standardized uptake value (SUVmax) of the initial post-cryoablation PET/CT, the CT type of the treated area and selected clinical factors (age, menopausal status, lesion area, breast density, timing of PET/CT) were retrospectively evaluated.ResultsThe median interval between cryoablation and the initial post-cryoablation PET/CT was 12 months. The median SUVmax of the treated area was 1.36. The CT findings of the treated area were classified as fatty mass type (n = 137, 71.0%) or non-fatty mass type (n = 56, 29.0%). The treated areas of patients with lower breast density, of older age, post-menopausal status, and lower radiation dose were significantly more likely to be of fatty mass type (P < 0.001). Non-fatty mass type averaged a significantly higher SUVmax than did fatty mass type.ConclusionsPost-cryoablation PET/CT findings are of fatty or non-fatty mass type. A non-fatty appearance, which can show higher SUVmax, does not necessarily denote recurrence.

Role of pregravid body mass and its gestational increase in development of various variants of preeclampsia

Aim. To evaluate the effects of maternal pre-pregnancy body weight and excessive gestational weight gain (GWG) on the risk of different subtypes of preeclampsia (PE).Methods. A cohort study of 289 pregnant women: 41 with early-onset (less than 34 weeks) preeclampsia (EPE), 76 with late-onset (more than 34 weeks) preeclampsia (LPE) and 172 normotensive women (control). Associations between anthropometric indicators (pre-pregnancy BMI, GWG, fat mass in the 1st, 2nd, 3rd trimesters, on the 2–3rd day after birth) and risk of PE and its subtypes were evaluated.Results. Pre-pregnancy body weight (r = 0.36; р = 0.000) and BMI (r = 0.38; р = 0.000) moderately increased risk of PE. GWG had independent risk of developing PE (r = 0.46; р = 0.000). Women with excessive GWG had an increased risk of PE in normal BMI (RR = 2.2; р = 0.019), in overweigh (RR = 2.7; р = 0.028), in obese (ОР = 5.2; р = 0.000). The risk of developing preeclampsia increased in normal weight with GWG more than 500 g per week in the 2nd trimester (р = 0.000) and more than 400 g per week in the 3d trimester (р = 0.000), total GWG more than 16.5 kg increased risk of preeclampsia in 3.4-fold (ОР = 3.4; р = 0.001). Overweight and obesity had an increased risk of late-onset preeclampsia (RR = 4.9; р = 0.000). No association was found for early-onset preeclampsia (p &gt; 0.050). Gestational metabolic disorders were independent risk of LPE: weekly GWG and the per cent of fat mass in normal weight pregnant women with LPE were significantly higher compared to the women with EPE and control. The per cent of fat mass in the 1st trimester in PPE (23.90 ± 4.40 %) exceeded control (20.50 ± 4.30 %; р = 0.003) and EPE (21.20 ± 3.65 %; р = 0.008) groups. Differences were aggravated during pregnancy (р &lt; 0.050).Conclusions. Pre-pregnancy overweight and obesity, excessive GWG and gain of fatty mass were an independent risk of developing PE with synergistic negative effect. Pre-pregnancy and gestational lipid dismetabolism were associated with LPE. Our results suggested that no correlation between pre-pregnancy BMI, GWG, fatty mass and risk of EPE.

SUN-310 Growth Hormone Deficiency and Replacement Therapy: Association with Health-Related Physical Fitness

Objective: To compare health-related physical fitness (HRPF) in patients with severe adult growth hormone deficiency (AGHD) according to the deficiency onset phase, and to evaluate the effects of a six-months human growth hormone (rhGH) replacement therapy on HRPF, in a subgroup of patients. Methods: First arm: cross-sectional observational study at baseline of naive rhGH multiple pituitary hormonal deficiency (MPHD) hypopituitarism patients - adult-onset growth hormone deficiency (AO-GHD) versus child onset growth hormone deficiency (CO-GHD). Second arm: a 6-month intervention clinical trial in a selected group of a non-randomized, non-controlled cohort. HRPF was evaluated by measuring isokinetic and isometric torque stensor strength at the knee using an isokinetic dynamometer, handgrip strength and six-minute walk test. Body composition was assessed by DXA. Results: Patients who presented AO-GHD had higher BMI than CO-GHD (28.1±3.5 x 22.4±4.8; p=0.017), but body composition (lean body mass%:57.9±7.9 x 58.9±8.6;p=0.816/fatty body mass%:39.3±6.8 x 36.0±9.1;p=0.434), stensor peak torque/body weight at 60, 90 and 180deg/s (2.18±0.6 x 2.18±0.6; p=0.580/1.99±0.5 x 2.14±0.5;p=0.546/1.52±0.4 x 1.64±0.4;p=0.547), isometric torque/body weight at the knee (2.62±0.7 x 2.91±0.6;p=0.357) and six-minute walk test (570.2±76.0cm x 554.1±91.0cm;p= 0.703) did not differ between groups. Handgrip strength test also showed significant reduction in scores for age and gender in both groups of GHD patients. After six months of rhGH, no improvement in muscular strength tests was found. There was a significant worsening in the six-minute walk test (575.1±84cm x 545.4±90.6cm; p=0.033) despite the improvement in body composition (lean body mass%:59.7±8.6 x 63.6±11.1;p=0.005/fatty body mass%:35.7±9.2 x 32.9±10.0;p=0.003). Conclusion: Despite differences in BMI, there were no other differences in HRPF between AO-GHD and CO-GHD patients. The decrease of the six-minute walking test performance after rhGH replacement therapy supports the clinical evidence that the GH regulates bioenergetics in human skeletal muscle fibers. Although the treatment had a short period, GH might have stimulated the anaerobic and suppressed the aerobic energy system.

SUN-174 Giant Bilateral Myelolipomas in a Patient with Congenital Adrenal Hyperplasia

INTRODUCTION Adrenal myelolipomas are rare, benign adrenal tumors composed of adipose and hematopoietic tissue. The first mass was identified by Gierke in 1905 and named by Oberling in 1929. Myelolipomas often coexist with CAH and other hormonal disorders although this relationship is still unclear. We present a rare case of giant bilateral myelolipomas in a patient with CAH. CASE REPORT A 28-year-old female with a history of CAH due to 21-hydroxylase deficiency diagnosed at birth presented to our endocrinology clinic after being lost to follow up for 4 years and a history of poor follow up for several years before that. She reported being on varying doses of hydrocortisone throughout her life with the most recent being 10mg TID with poor adherence. Over the past 4 years, the patient noticed increased hair growth on her face, abdomen, inner thighs and back, abdominal striae, and weight gain of 80-100lbs. She also reported a history of bilateral flank pain for the last several years, requiring several ER visits where she was told she had adrenal nodules based on scans that were done. A few months prior to her first visit to our clinic she developed increasing flank pain, which prompted a visit to a local ER. A CT of the abdomen revealed bilateral adrenal septated complex cystic masses measuring 19x12x20 cm on the left and 12x11x11 cm on the right. Initial biochemical workup was consistent with poorly managed CAH: ACTH 45.2 pg/mL (n 7.2 - 63.3), total testosterone 401 ng/dl (n 8-48), androstenedione 2085 ng/dl (n 41-262), 17-OH progesterone 18880 ng/dl, (n 15-290), DHEA-sulfate 423.5 ug/dl, (n 84.8-378), and estradiol 72.0 pg/dl, (n 12.5-498). Plasma renin activity was 13.904 ng/mL/hr (n 0.167-5.380 ng/mL/hr). Based on laboratory results hydrocortisone was decreased to 10mg BID and dexamethasone was added. Due to severe recurrent pain the patient underwent bilateral adrenalectomy. On pathology the bilateral masses were found to be myelolipomas with the left diameter measuring 22.3 cm and the right measuring 16.5 cm. Post-operatively her lab values showed significant improvement compared to her initial workup: ACTH 4.1 pg/mL, total testosterone 6.7 ng/dl, androstenedione 73 ng/dl, 17-OH progesterone 29 ng/dl, DHEA sulfate 7.2 ug/dl, and estradiol 228.3 pg/dl. Plasma renin was also within normal range at 1.776 ng/mL/hr. On follow up, the patient had recovered well and reported improvement in her flank pain. CONCLUSION This is a rare case of giant bilateral adrenal myelolipomas. Despite these tumors being benign and often asymptomatic, they are clinically relevant due to their role in the differential diagnosis of an adrenal mass. The presence of megakaryocytes in a biopsy specimen of a fatty adrenal mass is pathognomonic for myelolipoma. Treatment is guided by the tumor size and patient presentation; masses >7 cm, hormonally active, or causing abdominal pain should be surgically removed as demonstrated in this case

Assessment of Respiratory Muscle Strength in Obese Young Adults

Introduction: Obesity is also called as disease of 21st century. Obesity is defined by WHO as “A Medicalcondition in which excess body fat has accumulated to the extent that it may have adverse effects on healthconsequences”. The BMI is an attempt to quantify the amount of fatty mass in an individual.Various complications of obesity on respiratory functions were studied by many researchers. Few studiesare conducted in India on obesity to assess the respiratory muscle strength, obtained controversial findings.Objectives: To assess the respiratory muscle strength in obese and non obese young adults.Material and Method: After getting clearance from ethics committee, experiments were performed as perstudy protocol in the Department of Physiology, Narayana medical College, Nellore.Based on BMI values subjects were classified as borderline obese (BMI more than 25) and non obese groups(34 in each group, age group between 18 to 25 yrs) .Anthropometric measures were taken along with the total body fat % using Bio-impedance instrument.PIP &amp; PEP were recorded by using digital manometer device capable of measuring both negative and positivepressures along withthe mouth piece, which was in house built and calibrated by using mercury manometer.Results: In our study, PIP &amp; PEP of non obese is 111.7 ± 17.3 mmHg &amp; 61.8 ± 12.5 mmHg respectively.Similarly PIP &amp; PEP of borderline obese was found to be 121.2 ± 17.3 mmHg &amp; 62.3 ± 12.2 mmHgrespectively. There is an increase in PIP values which is statistically significant in borderline obese group.Similar findings were observed in other studies.Conclusion: We conclude that, PIP increased in borderline obese subjects but not in PEP . According toprevious studies, obesity enhances the strength of respiratory muscles. This continuous overburden adapts therespiratory muscles to generate more pressure during respiration . This we could observe only in inspiratorygroup of muscles in borderline obese subjects.

A lipomatous variant of scrotal angiomyofibroblastoma – A case report

Angiomyofibroblastoma-like tumour of the male genital tract is a rare benign mesenchymal tumour arising in the scrotum, perineum or inguinal region. It is usually seen in females of reproductive age. Clinical presentation has no pathgnomic findings. In the largest series to date, Iwasa and Fletcher1 reported 25 cases in men with the mean age being 52 years. This case report is of an 18-year-old male with a scrotal angiomyofibroblastoma that was 35 cm in maximum dimension, in the paratesticular tissue separate from testicular parenchyma. Macroscopically, the lesion was a fibrous, fatty and mucoid mass. Histologically, it showed a lobulated pattern of epithelioid and spindle cells arranged around various calibre vessels. Other differential diagnoses including myxoid liposarcoma and rhabdomyosarcoma were ruled out with the help of FISH studies for FOX 10 and PAX3. DDIT3 and FUS were negative. To date, in all open-access literature, there has only been 34 cases reported of this rare tumour, of which there is only one reported case <20 years of age; this will be the second case in the <20 age group in men. The poster will describe the clinical presentation, imaging, macroscopic findings, histology and immunohistochemistry along with a literature review. Reference1.Iwasa Y, Fletcher CD. Cellular angiofibroma: clinicopathologic and immunohistochemical analysis of 51 cases. Am J Surg Pathol 2004; 28: 1426–35.

Substrate availability and soil microbes drive temperature sensitivity of soil organic carbon mineralization to warming along an elevation gradient in subtropical Asia

Subtropical forest soil exerts a large, but uncertain effect on terrestrial carbon (C) cycling. Global warming is anticipated to alter subtropical soil C cycling but currently, there is no consensus on how warming will affect soil C at different elevations. We conducted a short-term laboratory soil warming incubation experiment (ambient temperature +4 °C) along an elevational gradient in Wuyi Mountains of southeastern China to examine the response of soil organic carbon (SOC) mineralization to rising temperatures. Soil samples were collected from three elevations (630 m, 1450 m and 2130 m), and microbial community composition was determined using phospholipid fatty acids (PLFAs). The SOC mineralization increased with rising mean annual temperature (i.e., with decreasing elevation) and with experimental warming. Unlike most other similar experimental studies, we found that the temperature sensitivity (Q10) of SOC mineralization to short-term experimental warming significantly decreased with increasing elevation. We also found that temperature sensitivity of SOC mineralization in response to warming depends on substrate availability, as indicated by the significant relationship between dissolved organic carbon (DOC) and Q10 values. In addition, soil microbial biomass increased significantly with increasing elevations, but was not significantly affected by short-term experimental warming. Experimental warming reduced the abundance of total PLFAs, bacteria, fungi, and actinomycetes in the low-elevation soil. Experimental warming significantly changed soil microbial community composition at low elevation, with increases in the ratios of cyclopropyl to monoenoic precursor fatty acids (cy:pre), saturated to monounsaturated fatty acids (sat:mono), and isomers to trans-isomers fatty acids (i:a), all of which are stress indicators, indicating that warming treatment increased microbial respiration rather than microbial growth, because the microbial respiration per biomass increases under environmental stress. Microorganisms likely altered their membrane fatty acid components and mass in response to changes in available C. The differences in Q10 associated with short-term warming and among elevations with long-term temperature differences indicate that the effect of warming on SOC mineralization may change through time and this should be taken into account when predicting SOC mineralization in response to continual rising temperatures.