Pericardial fat necrosis is an infrequent cause of acute chest pain and this can mimic acute myocardial infarction and acute pericarditis. We describe here a patient with the magnetic resonance imaging (MRI) findings of pericardial fat necrosis and this was correlated with the computed tomography (CT) findings. The MRI findings may be helpful for distinguishing pericardial fat necrosis from other causes of acute chest pain and from the fat-containing tumors in the cardiophrenic space of the anterior mediastinum.
Adult ; Contrast Media/diagnostic use ; Diagnosis, Differential ; Fat Necrosis/*diagnosis ; Humans ; Magnetic Resonance Imaging/*methods ; Male ; Pericardium/*pathology

Pancreas acinar cell carcinoma (ACC) accounts for only 1-2% of pancreatic exocrine malignant tumor. The symptoms of patients with ACC are usually non-specific, for example the anorexia and weight loss. Patients may develop Schmid's triad including subcutaneous fat necrosis, polyarthritis, and eosinophilia. We reported a case of ACC which was manifested by subcutaneous nodule as initial clinical symptom. To our knowledge, this is the first reported case of ACC presenting as subcutaneous fat necrosis in Korea.
Carcinoma, Acinar Cell/*diagnosis/surgery/ultrasonography ; Fat Necrosis/pathology ; Humans ; Keratins/metabolism ; Male ; Middle Aged ; Pancreatic Neoplasms/*diagnosis/surgery/ultrasonography ; Subcutaneous Fat/*pathology ; Synaptophysin/metabolism ; Tomography, X-Ray Computed

OBJECTIVETo explore the risk factors of fat necrosis in pectoralis major myocutaneous flaps.

METHODSFrom May 1998 to December 2005, 82 patients underwent reconstruction of oral and maxillofacial defects with pectoralis major myocutaneous flaps in our hospital. Postoperative fat necrosis of the flaps was occurred in 10 cases. Logistic regression analysis was used to investigate the risk factors.

RESULTS(1) Logistic univariate regression analysis indicated that there was a significant correlation between fat necrosis of pectoralis major myocutaneous flap and the following risk facoars: obesity, subcutaneous tissues dissection performed by electrotome, the design of skin island beyond the seventh costal cartilage and smoking. (2) Logistic multivariate regression analysis suggested that there was a significant correlation between fat necrosis of pectoralis major myocutaneous flap and obesity, subcutaneous tissues dissection performed by electrotome, the design of skin island beyond the seventh costal cartilage, whereas there was no significant correlation between fat necrosis of flap and smoking.

CONCLUSIONSObesity, subcutaneous tissues dissection performed by electrotome and the design of skin island beyond the seventh costal cartilage were the risk factors of fat necrosis in pectoralis major myocutaneous flap.

Fat Necrosis ; etiology ; Female ; Humans ; Logistic Models ; Male ; Pectoralis Muscles ; pathology ; Postoperative Complications ; Reconstructive Surgical Procedures ; Risk Factors ; Surgical Flaps ; pathology

Computed body tomography has become useful in the diagnosis of pancreatic disease. It was found to be are liable, often specific, and noninvasive method for detecting pancreatitis and extra-pancreatic extension of the pathology. Of eight hundred and seventy-two cases studied for abdominal pathology with EMI-CT 5005 whole body scanner form Oct. 1977 to August 1980, 21 cases were confirmed to be pancreatitis clinically or operatively. The authors reviewed the CT findings of the above cases and the results were as follows; 1. Among twenty-one cases, the acute pancreatitis was 12 cases and the chronic pancreatitis was 9 cases. The sex ratio as 17 males to females. 2. In acute pancreatitis, diffuse enlargement of pancreas (11/12), focal enlargement (1/12), loss of peripancreatic fat plane (9/12), thickening of anterior of pararenal fascia (6/12), and smooth margin ofpancreas (5/12) were observed. 3. In chronic pancreatitis, parenchymal atrophy (7/9), normal size (2/9), loss of peripancreatic fat plane (3/9), thickening of anterior pararenal fascia (1/9), calcification (1/9), smooth margin (2/9), and serrated margin (6/9) were observed. 4. The complications were associated with 7 cases of acute pancreatitis and 1 case of chronic pancreatitis; pseudocyst (6), abscess (2), and fat necrosis (3), The sites of the pseudocyst were lesser sac (2), anterior pararenal space (2), posterior pararenal space (1), subhepatic region (1), greater omentum (1), and intrapancreatic region (2). All of them were associated with acute pancreatitis except one in chronic pancreatitis.
Abscess ; Atrophy ; Diagnosis ; Fascia ; Fat Necrosis ; Female ; Humans ; Male ; Methods ; Omentum ; Pancreas ; Pancreatic Diseases ; Pancreatitis ; Pancreatitis, Chronic ; Pathology ; Peritoneal Cavity ; Sex Ratio

BACKGROUND: Membranocystic change represents a distinctive form of pathology in adipose tissue. It has been observed in a variety of inflammatory and noninflammatory dermatoses. OBJECTIVE: Our purpose was to find the clinical and histopathological features of membranocystic change in the panniculitis and we attempted to review the pathogenesis. METHODS: We reviewed medical records, clinical photographs, and histopatologic findings of 14 patients having membranocystic changes in biopsy specimen. RESULTS: (1) There was a female predominance (79%). (2) The most common primary lesions were the subcutaneous nodules and the most predilection sites were the lower legs. (3) The underlying diseases were variable such as erythema nodosum, lipoatrophy, sparganosis, sporotrichosis, accelerated nodulosis, necrobiosis lipoidica, periarteritis nodosa, tibial artery stenosis, dermatomyositis, lupus erythematosus profundus, oil granuloma and nodulocystic fat necrosis. (4)The membranes of cyst were positive with periodic acid-Schiff stain with diastase and sudan black B. Fluorescence examination gave a yellow autofluorescence. These findings indicated the lining materials were ceroid. CONCLUSION: Membranocystic change appears to be entirely nonspecific and may be seen in many types of the subcutaneous inflammatory process. Although ischemic insult has received the most attention in dermatologic literature as the primary cause, it is likely that this change results from various insults to adipose tissue, including infectious, autoimmune, and physical processes.
Adipose Tissue ; Amylases ; Biopsy ; Ceroid ; Constriction, Pathologic ; Dermatomyositis ; Erythema Nodosum ; Fat Necrosis ; Female ; Fluorescence ; Granuloma ; Humans ; Leg ; Medical Records ; Membranes ; Necrobiosis Lipoidica ; Panniculitis* ; Panniculitis, Lupus Erythematosus ; Pathology ; Physical Processes ; Polyarteritis Nodosa ; Skin Diseases ; Sparganosis ; Sporotrichosis ; Sudan ; Tibial Arteries

OBJECTIVE: To evaluate the effect of Shilajit, a medicine of Ayurveda, on the serum changes in cytokines and adipokines caused by non-alcoholic fatty liver disease (NAFLD). METHODS: After establishing fatty liver models by feeding a high-fat diet (HFD) for 12 weeks, 35 Wistar male rats were randomly divided into 5 groups, including control (standard diet), Veh (HFD + vehicle), high-dose Shilajit [H-Sh, HFD + 250 mg/(kg·d) Shilajit], low-dose Shilajit [L-Sh, HFD + 150 mg/(kg·d) Shilajit], and pioglitazone [HFD + 10 mg/(kg·d) pioglitazone] groups, 7 rats in each group. After 2-week of gavage administration, serum levels of glucose, insulin, interleukin 1beta (IL-1β), IL-6, IL-10, tumor necrosis factor-alpha (TNF-α), adiponectin, and resistin were measured, and insulin resistance index (HOMA-IR) was calculated. RESULTS: After NAFLD induction, the serum level of IL-10 significantly increased and serum IL-1β, TNF-α levels significantly decreased by injection of both doses of Shilajit and pioglitazone (P<0.05). Increases in serum glucose level and homeostasis model of HOMA-IR were reduced by L-Sh and H-Sh treatment in NAFLD rats (P<0.05). Both doses of Shilajit increased adiponectin and decreased serum resistin levels (P<0.05). CONCLUSION The probable protective role of Shilajit in NAFLD model rats may be via modulating the serum levels of IL-1β, TNF-α, IL-10, adipokine and resistin, and reducing of HOMA-IR.
Adiponectin ; Animals ; Cytokines ; Diet, High-Fat ; Glucose ; Insulin Resistance ; Interleukin-10 ; Liver ; Male ; Minerals ; Non-alcoholic Fatty Liver Disease/pathology* ; Pioglitazone/therapeutic use* ; Rats ; Rats, Wistar ; Resins, Plant ; Resistin/therapeutic use* ; Tumor Necrosis Factor-alpha

This study is to observe anti-lipotoxic effect of sesamin on renovascular hypertensive rats fed with a high-fat, high-sucrose diet. Thirty-four complex model rats were induced by two-kidney, one-clip method and on high-fat and refined-carbohydrate diet for thirteen weeks. From the fifth week, intragastric administration of sesamin (120, 60 and 30 mg x kg(-1) x d(-1)) lasted for eight weeks. Blood pressure (BP), blood fat (BF), blood glucose (BG), free fatty acids (FFA), insulin (Ins), tumor necrosis factor (TNF)-alpha and interleukin (IL)-6 were determined. Pathological changes of pancreas, perirenal fat and liver were semiquantitatively analyzed. In sesamin (120 and 60 mg x kg(-1) x d(-1)) group, it was found that there were decrease of levels of BP, BF, BG, TNF-alpha, IL-6 and FFA, improvement of insulin resistance and glucose tolerance, alleviation of body weight, humid weight of fat, liver and pancreas and their organ index, and reduction of islet cell hyperplasia and amount of lipid droplet vacuoles in lipocyte and hepatocyte. It is implied that sesamin had anti-lipotoxic effect and its mechanism may be closely associated with the amelioration of insulin resistance via reducing lipidoses in hepatocyte and inflammatory adipokines such as TNF-alpha and IL-6.
Adipocytes ; drug effects ; Animals ; Anticholesteremic Agents ; administration & dosage ; pharmacology ; Antihypertensive Agents ; administration & dosage ; pharmacology ; Blood Glucose ; metabolism ; Blood Pressure ; drug effects ; Body Weight ; drug effects ; Cholesterol ; blood ; Diet, High-Fat ; Dioxoles ; administration & dosage ; pharmacology ; Dose-Response Relationship, Drug ; Fatty Acids, Nonesterified ; blood ; Glucose Tolerance Test ; Hypertension, Renovascular ; blood ; pathology ; Insulin ; blood ; Insulin Resistance ; Interleukin-6 ; blood ; Islets of Langerhans ; pathology ; Lignans ; administration & dosage ; pharmacology ; Liver ; pathology ; Male ; Pancreas ; pathology ; Rats ; Rats, Sprague-Dawley ; Sucrose ; Triglycerides ; blood ; Tumor Necrosis Factor-alpha ; blood