Omental Fat Research Articles

Effect of melatonin on visceral fat deposition, lipid metabolism and hepatic lipo-metabolic gene expression in male rats.

Melatonin (MT) influences lipid metabolism in animals; however, the mechanistic effect of melatonin on liver fat and abdominal adipose deposition requires further clarity. In order to study the effects of melatonin on lipid metabolism, and hepatic fat and abdominal adipose deposition in animals, twenty Sprague-Dawley (SD) rats of 6weeks of age with similar bodyweight were randomly divided into two groups: control (CTL) and MT-treated (10mg/kg/day). During a 60-day experiment, food intake and bodyweight were measured daily and weekly respectively. At the end of treatment, blood samples were collected to collect plasma to quantify hormones and metabolic indicators of lipid metabolism. In addition, organ and abdominal adipose depots including liver, and omental, perirenal, and epididymal fat were weighed. Liver tissue was sampled for sectioning, long-chain fatty acid (LCFA) quantification, and gene chip and Real-time quantitative PCR (qPCR) analyses. The results showed that liver weight and index (ratio of liver weight to body weight) in MT group reduced by 20.69% and 9.63% respectively; omentum weight and index reduced by 59.88% and 54.93% respectively, and epididymal fat weight reduced by 45.34% (p=0.049), relative to CTL. Plasma lipid indices, triglyceride (TG), high-density lipoprotein (HDL), low-density lipoprotein (LDL) and total cholesterol (TC) with MT treatment decreased significantly compared with the control. Fat and 8 LCFA content in liver in MT group also decreased. Gene chip and qPCR demonstrated that there were 289 genes up-regulated and 293 genes down-regulated by MT. Further analysis found that the mRNA expression of lipolysis-related genes increased, while the mRNA expression of lipogenesis-related enzymes decreased (p<0.05) with MT. This study concluded that melatonin greatly affected fat deposition, and hepatic LCFA supply and the expression of genes associated with lipogenesis and lipolysis.

Adipose to serum ratio and mixtures of persistent organic pollutants in relation to endometriosis: Findings from the ENDO Study

BackgroundEndometriosis is an estrogen-dependent disease. Endocrine disrupting chemicals (EDCs) and their mixtures may play an etiologic role. ObjectivesWe evaluated an adipose-to-serum ratio (ASR) of lipophilic EDCs and their mixtures associated with incident endometriosis. MethodsWe quantified 13 polychlorinated biphenyl (PCB) congeners, 6 polybrominated diphenyl ether (PBDE) congeners, and 11 organochlorine pesticides (OCPs) in serum and omental fat among women from the ENDO Study (2007–2009) aged 18–44 years diagnosed with (n=190) or without (n=283) surgically-visualized incident endometriosis. Odds ratios (OR) and 95% confidence intervals (CI) between ASR and endometriosis were estimated using logistic regression models adjusted for age (years), body mass index (kg/m2), serum cotinine (ng/ml), and breastfeeding conditional on parity. Bayesian hierarchical models (BHM) compared estimated associations for adipose and ASR to serum. Bayesian kernel machine regression (BKMR) estimated change in latent health and 95% posterior intervals (PI) between chemical mixtures and endometriosis. ResultsSelect ASR for estrogenic PCBs and OCPs were associated with an increased odds of an endometriosis diagnosis, but not for anti-estrogenic PCBs or PBDEs. Across all chemicals, BHMs generated ORs that were on average 14% (95% PI: 6%, 22%) higher for adipose and 20% (95% PI: 12%, 29%) higher for ASR in comparison to serum. ORs from BHMs were greater for estrogenic PCBs and OCPs, with no differences for PBDEs. BKMR models comparing the 75th to 25th percentile were moderately associated with endometriosis for estrogenic PCBs [adipose 0.27 (95% PI: 0.18, 0.72) and ASR 0.37 (95% PI: 0.06, 0.80)] and OCPs [adipose 0.17 (95% PI: 0.21, 0.56) and ASR 0.26 (95% PI: 0.05, 0.57)], but not for antiestrogenic PCBs and PBDEs. DiscussionASR added little insight beyond adipose for lipophilic chemicals. BKMR results supported associations between ASR and adipose estrogenic PCB and OCP mixtures and incident endometriosis. These findings underscore the importance of choice of biospecimen and considering mixtures when assessing exposure-disease relationships.

Isolated caudate lobectomy using a modified hanging maneuver.

The caudate lobe is located deep in the dorsal portion of the liver. Complete resection is an extremely demanding surgery due to the limited surgical field, especially in cases with severe intra-abdominal complications. A major concern of isolated caudate lobectomy is the difficulty associated with securing the contralateral visual field during parenchymal transection. To overcome this issue, we present a new technique for isolated caudate lobectomy that uses a modified hanging maneuver. We performed an anatomical isolated caudate lobectomy via the high dorsal resection technique using our new modified hanging maneuver in two patients with HCC in November and December 2019. Patient 1 was severely obese, so the upper abdominal cavity was occupied by a large amount of great omental fat, and fibrous adhesions were observed around the spleen. Patient 2 had undergone six preoperative treatments, and a high degree of adhesion was observed in the abdominal cavity around the liver. It was difficult to secure the surgical field due to severe abdominal complications in both cases. The total operation times in these two cases were 617 and 763min, respectively, while the liver parenchymal dissection times of the caudate lobe were 96 and 108min, respectively. The resection margin was negative in both patients (R0). Neither patient had any complications after surgery; both were discharged on postoperative day 14. Our modified hanging maneuver is useful, particularly in cases with a narrow surgical field due to severe adhesions, bulky tumors, and/or hypertrophy of the Spiegel lobe.

Effect of dietary inclusion of graded levels of distillers dried grains with solubles on the performance, blood profile and rumen microbiota of Najdi lambs

An experiment was conducted in a completely randomized design to evaluate the effect of including graded levels (0, 20, 30, 40 and 50% of diet) of dried distiller's grains with solubles (DDGS) on growth performance, slaughter parameters, blood serum metabolites and rumen microbiota in weaned Najdi male lambs. Thirty-five lambs, initial body weight of 33.45 ± 0.75 kg, and approximately three-month old were used in a 94-day feeding experiment. Performance measurements were conducted biweekly and blood samples were collected monthly. Inclusion of DDGS in the diets of growing Najdi lambs at levels up to 50% did not affect body weight gain (BWG) compared with the lambs fed the control diet (CON, 0% DDGS). Lambs fed the 50% DDGS diet consumed less feed compared with lambs in other groups (98 vs 112.5 kg DM) but had no adverse effect on BWG. Rumen pH values at 0, 6, 12 and 18 h post feeding and concentrations of blood serum total proteins, glucose, triglycerides, urea-N or albumin were similar across treatments. Slaughter parameters including slaughter weight, hot and cold carcass weights and dressing % (hot and cold carcass) were not affected by the treatments. There was no difference in the weights of full compartmental stomach and intestines, liver, omental fat, Kidney Knob and Channel Fat (KKCF) and tail fat between DDGS treatments and CON. The study concluded that the inclusion of DDGS in the diets of growing Najdi lambs had no adverse effects on growth performance and slaughter parameters. Rumen microbiota was not affected, however, our data suggest significant interactions between DDGS and selected bacterial groups and DDGS driven rearrangement of Prevotella species.

Effects of maternal and post-weaned rumen-protected folic acid supplementation on slaughter performance and meat quality in offspring lambs.

The present study was undertaken to evaluate the influence of rumen-protected folic acid (RPFA) on slaughter performance, visceral organ and gastrointestinal tract coefficients, and meat quality in lambs. Sixty-six lambs from 120 Hu ewes were selected based on body weight and maternal diets and then assigned to six groups using a randomised block experimental design in a 3 × 2 factorial arrangement. The first factor was folic acid (FA) as RPFA in the maternal diet (0 mg/kg (M0F), 16 mg/kg (M16F) or 32 mg/kg (M32F) on DM basis). The second factor was FA in the lambs' diet from weaning until slaughter (0 mg/kg (OC) or 4·0 mg/kg (OF)). The results indicated that the addition of 16 mg/kg FA to the maternal diet increased pre-slaughter weight (PSW), dressing and meat percentage, the reticulum and omasum coefficients, length of the jejunum and ileum, tail fat and perirenal fat coefficient and a* value of the meat colour. The addition of RPFA to the lambs' diet increased PSW, dressing and meat percentage, eye muscle area, abomasum weight, weight and length of the small intestine, but reduced the coefficients of tail fat. An M×O interaction was observed for the weights of heart, lungs, rumen and total stomach, weight and coefficient of omental fat and the girth rib value. Collectively, RPFA in the maternal and lambs' diet improved slaughter performance and meat quality by stimulating the morphological development of the gastrointestinal tract and the distribution of fat in the body.

Fatty acid profile of muscles and adipose tissues of fat-tail Barbarine lambs as affected by rosemary residue intake.

The rosemary distillation industry produces a considerable amount of rosemary distillation residues (RRs), which can be an alternative for feeding animals in harsh conditions and could enhance animal product quality. Given the meat quality is largely influenced by its fat content and fatty acid composition, the fatty acid (FA) profiles of longissimus thoracis et lumborum (LTL), semi-membranous (SM) muscles, and caudal (CFs) and omental fats (OFs) were determined using 21 Barbarine lambs fed with or without RRs. Diets contained 600 g of concentrate plus 600 g of forage. Forage represented oat hay, RR87 and RR60 pellets containing 87 % or 60 % of RR, respectively. At the end of the study, all lambs were slaughtered, and the fatty acid profile was studied.The inclusion of RR increased the polyunsaturated fatty acid (PUFA) contents and reduced saturated fatty acids (SFAs), and the thrombogenic and saturation indexes in all tissues. The SM muscle was the richest tissue in PUFAs, -3 and -6; however, both adipose tissues contained the highest proportions of SFAs. Especially the OF was the richest tissue in oleic acid and SFAs. Feeding RR to lambs enhanced meat quality.

Ultrasound measures of abdominal fat layers correlate with metabolic syndrome features in patients with obesity.

SummaryObjectiveAbdominal fat ultrasound (US) is a simple clinical tool that may allow measures of fat depots not visible using common dual‐energy X‐ray absorptiometry (DEXA) or computerized tomography (CT) imaging. The aim of this study was to validate the technique, give measures of superficial and profound subcutaneous, preperitoneal, omental and perirenal (retroperitoneal) fat and correlate them with MS markers.MethodsSequential US measures of these five abdominal fat layers were done at 397 adults. Blood pressure (BP), body mass index (BMI), waist, body fat %, HOMA‐IR index (homeostatic model assessment of insulin resistance), lipid profile and leptin were recorded. Metabolic syndrome (MS) was defined according to Cholesterol education programme adult treatment panel III (ATPIII) criteria.Results Subcutaneous and omental fat were increased among people with obesity, whereas preperitoneal and perirenal fat did not show any difference according to BMI or waist. Women showed thicker subcutaneous fat (both superficial and profound), whereas men had bigger omental fat. Both postmenopausal and diabetic patients had changes in omental fat only, whereas patients with fatty liver showed thicker preperitoneal and perirenal fat, as well. MS patients showed both thicker perirenal and omental fat. A cut‐off of 54 mm in male (M)/34 mm in female (F) of omental fat and 22.5 mm (M)/12.5 mm (F) of perirenal fat could be predictive of later MS onset.ConclusionsUS is a valid method to measure all different abdominal fat depots. Omental and perirenal fat measures may classify patients at risk for MS. Preperitoneal fat depot may also correlate with fatty liver disease.

S3576 Mesenteric Panniculitis: Case Report and Literature Review

INTRODUCTION: Mesenteric panniculitis, also known as sclerosing mesenteritis, belongs to a spectrum of rare diseases of the fatty (adipose) tissue of the mesentery. It is most commonly associated with abdominal surgery, autoimmune disorders and malignancy. Here we present a rare case of mesenteric panniculitis in a young woman who recently diagnosed with mesenteric panniculitis with no predisposing factors. CASE DESCRIPTION/METHODS: The patient is a 29-year-old female with a past medical history of nephrolithiasis who presented to our emergency department (ED) complaining of generalized nausea, fever, and generalized abdominal pain, which was more severe in the right flank region. Notable workup in the ED included a urinalysis with elevated white blood cell count and many bacteria present. The patient was then started on intravenous antibiotics and was admitted under impression of urinary tract infection. Upon admission a computed tomography (CT) scan of the abdomen was done which showed non-obstructing calculi in the lower pole of the right kidney. Additionally it showed lower abdominal mesenteric fat stranding consistent with mesenteric panniculitis (Figure 1, 2). These findings were most prominent in the lower abdomen and pelvis. The gastroenterology service was consulted and recommended no treatment given the patients abdominal pain being attributed to nephrolithiasis. During her hospitalization the patients abdominal pain resolved with intravenous fluid hydration and antibiotics. She was then discharged home with follow up appointments scheduled. DISCUSSION: Mesenteric panniculitis is a chronic and benign condition caused by fat degeneration and necrosis within mesentery. The exact mechanism of pathogenesis is not clear but a non-specific immune response to various stimuli has been suggested to trigger the inflammation of the adipose tissue. The disease has been associated with inflammatory conditions, autoimmune disorders, malignancies, tuberculosis and abdominal trauma or surgery. Patients can have a variety of symptoms including abdominal pain, nausea, vomiting, diarrhea, constipation, or intestinal obstruction. The main goal of treatment is the relief of symptoms by addressing inflammation. Corticosteroids are the treatment of choice, but colchicine, azathioprine, cyclophosphamide, infliximab have shown success. This case is unique as patient did not have any contributing factors such as abdominal surgeries, autoimmune disorders, family history of auto immune diseases and malignancy.Figure 1.: CT scan (axial view) showing omental fat stranding consistent with mesenteric panniculitis (blue arrow).Figure 2.: CT scan (coronal view) showing omental fat stranding consistent with mesenteric panniculitis (blue arrow).

Traumatic pericarditis in a dairy doe

A two‐year‐old pregnant Toggenberg doe presented for recumbency, anorexia and hypothermia. The owner noted that the doe had been experiencing anorexia for approximately 1 month's duration. Initial diagnostics revealed a leucocytosis with a left shift, ketonaemia, as well as decreased serum potassium and bicarbonate concentrations. Thoracic ultrasound identified moderate pericardial perfusion. The doe expired during an emergency caesarean section. Necropsy revealed a 2.5‐cm‐long hypodermic needle fragment that had migrated from the reticulum to the pericardial cavity and ultimately to the omental fat. While not commonly described in small ruminants, practitioners should be aware of the potential for traumatic pericarditis in goats and, as such, should consider hardware disease a differential for goats with pericardial effusion.

Specific macrophage subsets accumulate in human subcutaneous and omental fat depots during obesity.

Obesity is a chronic inflammatory disease associated with adipose tissue macrophage (ATM) activation. ATMs from lean mice contribute to tissue homeostasis by their M2-oriented polarization, whereas obesity leads to an increase of M1 inflammatory ATMs that underlies obesity-related metabolic disorders. In humans, studies characterizing ATMs and their functional status are limited. Here we investigated ATM phenotype in visceral (VAT) and subcutaneous (SAT) adipose tissue from healthy lean and obese individuals using two molecules previously identified as markers of M1-like and M2-like/tissue-resident macrophages, the C-type lectin CLEC5A and the scavenger receptor CD163L1, respectively. CD163L1 was expressed by the majority of ATMs, and CD163L1+ ATM density was greater with respect to cells expressing the pan-macrophage markers CD68 or CD11b. ATM counts in SAT, but not in VAT, increased in obese compared to lean individuals, measured with the three markers. Accordingly, CD163L1, CD68 and ITGAM gene expression was significantly enhanced in obese with respect to control individuals only in SAT. CLEC5A+ ATMs had a proinflammatory profile and were abundant in the lean VAT, but their density diminished in obesity. The only ATM subset that increased its counts in the obese VAT had a mixed M1-like (CD11c+ CD163- CD209- ) and M2-like (CLEC5A- CD206+ ) phenotype. ATM expansion was dominated by a subset of M2-like macrophages (CD11c- CLEC5A- CD163+ CD206+ CD209+ ) in the obese SAT, with a minor contribution of a CD11c+ CLEC5A- ATM subpopulation. Thus, both SAT and VAT seems to limit inflammation during obesity by differentially altering their ATM subset composition.

The Value of Morphometric Measurements in Risk Assessment for Donor-Site Complications after Microsurgical Breast Reconstruction.

Microsurgical abdominally-based reconstruction is considered the gold standard in autologous breast reconstruction. Despite refined surgical procedures, donor-site complications still occur, reducing patient satisfaction and quality of life. Recent work has outlined the potential of morphometric measurements in risk assessment for postoperative hernia development. With rising demand for personalised treatment, the goal of this study was to investigate their potential in risk assessment for any donor site complication. In this retrospective cohort study, 90 patients were included who each received microsurgical breast reconstruction at the hands of one surgeon between January 2015 and May 2017. Donor-site complications formed the primary outcome and were classified according to Clavien–Dindo. Morphometric measurements were taken on a routinely performed computed tomographic angiogram. Complications occurred in 13 of the 90 (14.4%) cases studied. All patients who developed any type of postoperative donor site complication had a history of abdominal surgery. The risk of postoperative complications increased by 3% with every square centimetre of omental fat tissue (OR 1.03, 95% CI 1.00–1.06, and p-value = 0.022). Morphometric measurements provide valuable information in risk assessment for donor-site complications in abdominally-based breast reconstruction. They may help identify personalised reconstructive options for maximal postoperative patient satisfaction and quality of life.

Abstract 537: Combination of Mitochondrial and Cytosolic Antioxidant Upregulated MSC Therapy Improves Non-Alcoholic Fatty Liver Disease (NAFLD)

Introduction: Diabetes and obesity are known to cause adipose inflammation, elevated oxidative stress by reactive oxygen species (ROS) accumulation. In this report we studied the effect of human adipose derived mesenchymal stroma cells (MSCs) overexpressing antioxidants both mitochondrial (Sod2) and cytosolic (Catalase) to reduce oxidative stress and systemic inflammation in DIO mouse model. Methods: C57BL/6J male mice (4–6 weeks old) were obtained from the Jackson Lab. Obesity, glucose intolerance, and insulin resistance were induced by feeding the mice a 60% fat high-fat diet (HFD) for 12 weeks. Mouse adipose-derived MSCs and adenovirus constructs containing GFP (Null, SOD2 and Catalase), were obtained. Liver and fat tissues gene expression, liver and fat depots H&amp; E staining and liver triglycerides (L-TG) were quantified. Results: Triglyceride assay confirmed reduced liver fat accumulation in animals that received combination -MSCs. The gene expression analysis by qPCR for liver and omental fat shows upregulation of Ucp1, Pgc1a and Prdm16 genes with concomitant increase in all antioxidant (Sod2, Sod3 and Catalase) mRNA expression. Further the systemic TNF-α levels were decreased in the mice received MSC-Sod2+catalase. Glucose tolerance showed a improvement trend with low area under curve (AUC) values for mice that received MSCs with both Sod2 and catalase upregulated compared to control null group. Discussion: The combination effect of both mitochondrial and cytosolic anti-oxidants reduced systemic inflammation and liver triglyceride levels in diet induced obesity mouse model compared to SOD2, Catalase and Null MSCs. An increase mRNA expression of genes associated with browning of white adipose tissue deposits might have contributed to improvement in NAFLD along with systemic reduction in TNF-α. Genetically modified MSC therapy can be a promising option for treating obesity and diabetes.

Tension pneumoperitoneum caused by intestinal perforation from underlying colon cancer: a case report

BackgroundTension pneumoperitoneum, a form of abdominal compartment syndrome, is an important clinical condition. Increased pressure in the intraperitoneal cavity leads to respiratory and circulatory instability. Most of the reported cases include complications due to active air infusion into the peritoneal cavity or trauma; however, few reports are available on tension pneumoperitoneum caused by perforation from colon cancer. We present a case of a patient with tension pneumoperitoneum caused by gastrointestinal perforation owing to colon cancer.Case presentationA 63-year-old Japanese man with altered mental state was brought to our emergency department. He was in shock, and an abdominal radiograph suggested gastrointestinal perforation. Despite rapid fluid infusion and inotropic support, his condition deteriorated. His abdomen was tensely distended; abdominal computed tomography showed significant intra-abdominal gas. Following immediate needle decompression, his circulatory status improved. Emergent laparotomy revealed an approximately 10-cm tumor (adenocarcinoma) in the colon, which caused the perforation.ConclusionsA perforated wall or the surrounding omental fat that acts as a one-way valve could lead to tension pneumoperitoneum without active air infusion. Although tension pneumoperitoneum is a life-threatening condition, it is reversible if prompt diagnosis and immediate decompression are performed. Physicians should always consider this condition as one of the causes of shock or cardiopulmonary arrest, even without an apparent medical history of active air infusion or trauma.

Paratesticular Liposarcoma Mimicking Inguinal Hernia: a Case Report

Paratesticular tumors account for approximately 5% of intrascrotal mass, and mostly they arise from the spermatic cord (75%). Here, we report a paratesticular mass having a misleading presentation of irreducible inguinal hernia. A 54-year-male patient presented with complaint of right inguino-scrotal swelling for 5 years. Serum tumor markers were within normal limits. Ultrasound of scrotum reveals inguino-scrotal hernia with omental fat and bowel loop herniating out. Patient underwent right inguinal exploration with high inguinal orchidectomy. Histopathology revealed paratesticular high-grade spindle cell sarcoma, and immunohistochemistry was suggestive of paratesticular liposarcoma.

Endoscopic management of symptomatic walled-off omental fat necrosis.

Endoscopic management of symptomatic walled-off omental fat necrosis.

Renal pelvis and ureteropelvic junction incarceration in a Grynfeltt-Lesshaft hernia: a case report and review of the literature

BackgroundGrynfeltt–Lesshaft hernia is a kind of lumbar abdominal wall hernia in which clinical presentations may vary from an asymptomatic bulge in the lumbar area to a symptomatic lumbar mass with back pain. It has been accepted to be a rare entity, and incarceration of the kidney through this hernia is shown to be very rare, and very few previous cases have been reported in this regard.We present a case of renal pelvic and ureteropelvic junction incarceration in a Grynfeltt-Lesshaft hernia and provide an overview of the existing literature on it.Case presentationA 76-year-old lady presented to the outpatient clinic with the chief complaint of right flank pain and swelling. Computed tomography (CT) scan of the abdomen was revealed a large herniated sac (60*30 mm) in the upper lumbar triangle with protrusion of retroperitoneal and omental fat, right renal pelvis, ureteropelvic junction and proximal ureter with consecutive hydronephrosis. Herniated retroperitoneal and omental fat was reduced, and closure of the abdominal wall defect was done using retro-muscular Mesh and was fixed to the fascia. The patient was discharged 24 h after the surgery without any complications.ConclusionKidney herniation through the lumbar triangle is extremely rare, and the diagnosis requires careful clinical evaluation. CT scan is the modality of choice for the assessment. Management through surgery should be done in symptomatic patients.

Proteases Activate Pregnancy Neutrophils by a Protease-Activated Receptor 1 Pathway: Epigenetic Implications for Preeclampsia.

We tested a novel hypothesis that elevated levels of proteases in the maternal circulation of preeclamptic women activate neutrophils due to their pregnancy-specific expression of protease-activated receptor 1 (PAR-1). Plasma was collected longitudinally from normal pregnant and preeclamptic women and analyzed for MMP-1 and neutrophil elastase. Neutrophils were isolated for culture and confocal microscopy. Omental fat was collected for immunohistochemistry. Circulating proteases were significantly elevated in preeclampsia. Confocal microscopy revealed that tet methylcytosine dioxygenase 2 (TET2), a DNA de-methylase, and p65 subunit of NF-κB were strongly localized to the nucleus of untreated neutrophils of preeclamptic women, but in untreated neutrophils of normal pregnant women they were restricted to the cytosol. Treatment of normal pregnancy neutrophils with proteases activated PAR-1, leading to activation of RhoA kinase (ROCK), which triggered translocation of TET2 and p65 from the cytosol into the nucleus, mimicking the nuclear localization in neutrophils of preeclamptic women. IL-8, an NF-κB-regulated gene, increased in association with TET2 and p65 nuclear localization. Co-treatment with inhibitors of PAR-1 or ROCK prevented nuclear translocation and IL-8 did not increase. Treatment of preeclamptic pregnancy neutrophils with inhibitors emptied the nucleus of TET2 and p65, mimicking the cytosolic localization of normal pregnancy neutrophils. Expression of PAR-1 and TET2 were markedly increased in omental fat vessels and neutrophils of preeclamptic women. We conclude that elevated levels of circulating proteases in preeclamptic women activate neutrophils due to their pregnancy-specific expression of PAR-1 and speculate that TET2 DNA de-methylation plays a role in the inflammatory response.

Feedlot growth, carcass characteristics and meat quality of hair breed male lambs exposed to seasonal heat stress (winter vs. summer) in an arid climate

Twenty Dorper × Katahdin male lambs (body weight = 33.9 ± 0.4 kg and age = 4.5 months) were individually housed for a 30-d feeding period to evaluate the effects of seasonal heat stress (winter [n = 10] vs. summer [n = 10]) on feedlot performance, carcass traits, wholesale cut yields and meat quality. Heat stress environmental conditions prevailed in summer and mostly thermoneutral in winter. Overall growth rate and feed efficiency, as well as empty body weight at slaughter, cold carcass weight, omental fat percentage, and loin yield were lower in summer than in winter. Kidney-pelvic-heart fat deposition and yields of hot carcass, neck and shoulder increased during summer. Postmortem aging of meat during 14 d exhibited higher lightness, redness, yellowness and toughness in summer. In conclusion, summer heat stress decreased growth and feed efficiency without affecting feed intake of hair male lambs. Additionally, heat stress improved carcass yield with no detrimental changes on meat quality.

Metastatic behavior of mixed invasive ductal lobular carcinoma (mIDC/ILC).

1085 Background: Mixed invasive ductal lobular carcinoma (mIDC/ILC) is a poorly described subtype of invasive breast cancer, characterized by its composition of both ductal and lobular histopathology. It is unclear if individual or both components drive metastasis. Literature is sparse regarding sites of metastatic spread of this elusive subtype of invasive breast cancer. Methods: Cohorts of patients with mIDC/ILC, invasive ductal carcinoma (IDC), and invasive lobular carcinoma (ILC) were identified from the UPMC Network Cancer Registry. Among these, 46 patients with mIDC/ILC, 1,131 patients with IDC, and 145 patients with ILC seen at UPMC Magee Women’s Hospital from 1990 – 2017 were found to have developed distant metastasis during the course of their disease. The metastatic pattern of spread was compared between the cohorts. Formalin-fixed, paraffin-embedded patient samples from the metastatic sites of a portion of the mIDC/ILC cases (n = 19) was acquired and evaluated by H&amp;E staining. Results: Patients with IDC were more likely than patients with ILC to have metastasis to the liver (p = 0.001) and lung (p &lt; 0.001), and less likely to have metastasis to the peritoneum (p &lt; 0.001). Patients with mIDC/ILC were more likely than patients with IDC to have peritoneal metastasis (p = 0.01), similar to patients with ILC. Compared to patients with ILC, patients with mIDC/ILC were more likely to have liver metastasis (p = 0.001), similar to patients with IDC. Evaluation of the metastatic lesions originating from mIDC/ILC displayed a spectrum of histopathology including mixed histology (n = 3), pure IDC (n = 3), pure ILC (n = 5), and indeterminate lesions with features of both IDC and ILC (n = 6). Two cases were uninterpretable due to significant crush artifact. Metastatic mIDC/ILC lesions with retained mIDC/ILC histology were found in vertebral, pleural, and skin tissues. Metastatic mIDC/ILC lesions with IDC histology were found in a cerebellar, liver, and chest wall lesion; whereas, those with ILC histology were found in bowel, omental fat, ovary, bone, and sacrum. Indeterminate histology metastatic lesions were found at liver, chest wall, cerebellar, and bone sites. Conclusions: mIDC/ILC metastasizes to a range of distant sites with a higher preference to the liver and peritoneum as compared to ILC and IDC, respectively. Metastatic lesions arising from mIDC/ILC tumors showed a spectrum of histologies, including mIDC/ILC, IDC, ILC and indeterminate lesions with features of both IDC and ILC. Ongoing genomics studies will provide further insight into development of metastases from mIDC/ILC tumors.

SAT-352 Severe Primary Hyperparathyroidism, Hypercalcemic Crisis, Acute Pancreatitis and Fatality: Complications of Atypical Parathyroid Adenoma, a Case Report

BACKGROUND: Atypical parathyroid adenomas (APAs) are a controversial and rare entity. These tumors show some features of carcinomas including adherence to adjacent structures, banding fibrosis, mitotic activity, and tumor cells trapped within capsule; however, they lack definitive capsular, vascular, or perineural invasion. Patients are often asymptomatic, or have vague symptoms such as fatigue. Studies and literature have reported that the elevation in parathyroid hormone (PTH) and calcium levels in APAs are intermediate between those of adenomas and carcinomas, and that the clinical course is generally benign. Clinical Case: A 41-year old woman with diabetes mellitus, Hashimoto’s thyroiditis, and obesity was noted to have mild asymptomatic hypercalcemia during routine tests performed at an outside hospital several months prior to presentation. A few weeks prior to presentation, she started complaining of anorexia, nausea, vomiting and abdominal pain. At the time of presentation, she was critically-ill with a picture of severe acute pancreatitis. Laboratory tests showed hypercalcemia (13.9 mg/dL, normal 8.5-10.6 mg/dL) and elevated lipase (1134 U/L, normal 13-60 U/L); however, a magnetic resonance cholangiopancreatography showed no biliary obstruction. Further testing revealed markedly elevated PTH (>5000 pg/ml, normal 15-65 pg/ml), and subsequent neck ultrasound showed a solitary mass on the left side of the neck. Despite maximum medical treatment, the patient continued to rapidly decompensate and passed away rapidly. Autopsy examination revealed a picture of severe acute pancreatitis including a markedly enlarged necrotic pancreas (360 grams, normal: 60-100 grams), extensive omental fat necrosis, ascites, and dusky discoloration of the abdominal organs. A well-circumscribed mass (6.6 x 3.5 x 1.5 cm) was found on the superior aspect of the left thyroid lobe. The tumor showed parathyroid cell proliferation admixed with banding fibrosis, no unequivocal invasion into the surrounding capsule, blood vessels or perineural spaces, and no evidence of lymph node involvement or distant metastasis, consistent with a diagnosis of APA. Her cause of death was the left neck APA and its associated sequelae of significant hypercalcemia and acute pancreatitis. Conclusion: This patient had asymptomatic hypercalcemia for months prior to presentation with PTH/hypercalcemic crisis, highlighting the importance of ruling out primary hyperparathyroidism in the assessment of patients with asymptomatic hypercalcemia. While it’s generally appreciated that parathyroid carcinomas usually cause more profound hypercalcemia and are more likely to cause fatality from metabolic complications, and that APAs follow a generally more benign course, this case shows that APAs can grow into significantly large lesions and could follow a severe and abrupt clinical course if not surgically removed.