We report the case of a 70-year-old man with an asymptomatic large patent ductus arteriosus (PDA) incidentally detected on triple-rule-out computed tomography (CT). CT clearly demonstrated a vascular structure connecting the descending thoracic aorta to the roof of the proximal left pulmonary artery, consistent with a PDA. Secondary pulmonary arterial hypertension was also evident on CT. The patient was eventually diagnosed with acute coronary syndrome and was successfully treated with coronary artery bypass graft surgery and concomitant patch closure of the PDA. This article aims to outline the imaging features of PDA and highlight the information provided by CT, which is crucial to treatment planning. The pathophysiology, clinical manifestations and closure options of PDA are also briefly discussed.
Aged ; Aorta, Thoracic ; diagnostic imaging ; Ductus Arteriosus, Patent ; complications ; diagnostic imaging ; Echocardiography ; Heart Diseases ; congenital ; diagnostic imaging ; Humans ; Hypertension, Pulmonary ; complications ; diagnostic imaging ; Infant ; Male ; Obesity ; complications ; Pulmonary Artery ; pathology ; Radiography, Thoracic ; Tomography, X-Ray Computed ; Treatment Outcome ; Young Adult

OBJECTIVETo explore the relationship between abdominal fat volume and obstructive sleep apnea hypopnea syndrome in obesity people.

METHODSFrom July 2009 to July 2010, 50 patients with BMI > 25 were prospectively selected for study from the patients who complained of snoring in the Respiratory department. The patients were divided into OSAHS group and non-OSAHS group according to the result of sleep apnea monitoring. All the patients also received full abdominal CT and the whole abdominal fat volume was measured by 3-D CT reconstruction system. SPSS 13.0 was used for statistical analysis.

RESULTSThe whole abdominal fat volume in the two groups was analyzed by T- test, which was significantly different between the two groups (P < 0.01). It showed that there was a statistical relationship between OSAHS and abdominal fat in obesity people.

CONCLUSIONIn obesity people, OSAHS has a close relationship with abdominal fat volume. The abdominal fat volume is markedly higher in OSAHS patients than that in non-OSAHS people.

Abdominal Fat ; diagnostic imaging ; Adult ; Case-Control Studies ; Female ; Humans ; Male ; Middle Aged ; Obesity ; diagnostic imaging ; Prospective Studies ; Radiography ; Sleep Apnea, Obstructive ; epidemiology

OBJECTIVETo observe the relationship between abdominal obesity and left ventricular weight/function.

METHODSA total of 495 patients [265 males, mean age (55 +/- 12) years] with hypertension (139), diabetes (65), metabolic syndrome (285), diabetes complicated with hypertension (11) were enrolled in this study. Visceral adipose area (VA), the subcutaneous adipose (SA), the total abdominal adipose (TA) were measured by computerized tomography (CT) and left ventricular weight and function were obtained by echocardiography. Patients were divided into three groups according to the VA (I. VA<75 cm(2), n=173, II. VA>75 and < 110 cm(2), n=153, III. VA >or= 110 cm(2), n=169).

RESULTSLeft ventricular mass (LVM) and LVM index (LVMI) increased and LVEF and E/A decreased in proportion to increasing VA. Left ventricular hypertrophy (LVH) rate was significantly higher in group II and III compared to group I and LVEF was significantly reduced in group III compared to group I and II. There are significant correlation between LVMI and VA, SA, TA as well as between LVEF and VA after adjusting gender, age and blood pressure. Logistic regression analysis showed that VA is an independent predictor for LVH.

CONCLUSIONThe abdominal adipose accumulation is closely related to the left ventricular weight and function.

Abdominal Fat ; physiology ; physiopathology ; Adult ; Aged ; Aged, 80 and over ; Diabetes Mellitus ; diagnostic imaging ; Female ; Humans ; Hypertension ; diagnostic imaging ; Inpatients ; Male ; Metabolic Syndrome ; diagnostic imaging ; Middle Aged ; Obesity ; physiopathology ; Radiography ; Ultrasonography ; Ventricular Function, Left ; Ventricular Remodeling

OBJECTIVETo evaluate the sensitivity and specificity of hepatic ultrasonography (US) for the diagnosis of hepatic steatosis in obese children, using ¹H magnetic resonance spectroscopy (¹H MRS) as the reference standard.

METHODSA total of 162 obese children with age of 10.5 ± 2.2 years and BMI of 28 ± 4 were enrolled in this study. They accepted hepatic US and (1)H MRS examinations. The sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of US were calculated for the overall presence of hepatic steatosis by comparison with ¹H MRS results.

RESULTSUsing quantitative criteria of liver fat content (LFC) >5% determined by (1)H MRS, 95 children(58.6%)were diagnosed as having hepatic steatosis. The sensitivity and specificity of US in diagnosing steatosis were 91.6% (87/95) and 50.7% (34/67) respectively, with PPV of 72.5% (87/120), and NPV of 81.0% (34/42). Considerable overlap in LFC measured by ¹H MRS was observed between different grades from US findings: absent (LFC interquartile range: 1.3%-3.9%), mild (2.4%-10.7%), moderate (7.1%-20.2%) and severe (7.6%-28.8%) steatosis.

CONCLUSIONSThe US can yield a high sensitivity and low specificity in the diagnosis of hepatic steatosis in obese children, suggesting it can be used as a screening tool for hepatic steatosis. To improve diagnostics, ¹H MRS is needed to determine LFC.

Adolescent ; Child ; Child, Preschool ; Fatty Liver ; diagnostic imaging ; Female ; Humans ; Magnetic Resonance Spectroscopy ; Male ; Obesity ; complications ; Predictive Value of Tests ; Ultrasonography

INTRODUCTIONNon-alcoholic fatty liver disease (NAFLD) is garnering increasing interest and acceptance as one of the most important causes of chronic liver disease. The aim of this study was to investigate the risk factors for NAFLD among selected adolescent students in Hualien City, Taiwan.

MATERIALS AND METHODSA stratified random sampling scheme was carried out among 1724 adolescent students aged 12 or 13 years old in Hualien City. In total, 220 students (normal: overweight: obese = 97:48:75) agreed to join the study. They underwent physical examination, laboratory tests and ultrasonography examination of the liver. Diagnosis of NAFLD in this study was based on sonographic evidence of a fatty liver and testing negative for serum HBsAg and anti- HCV antibody.

RESULTSOf the 220 participants, 4 were excluded because they tested positive for HBsAg or anti-HCV antibody. NAFLD was detected in 86 (39.8%) out of the 216 subjects. The rate of NAFLD in the adolescents increased progressively from 16.0% in the normal group to 50.5% in the overweight group, and 63.5% among the obese subjects. Compared to their normal counterparts, adolescents with NAFLD had a significantly higher weight, body mass index (BMI), waist circumference, levels of alanine aminotransferase (ALT), triglyceride and nonhigh- density-lipoprotein (non-HDL) cholesterol. However, among the participants with NAFLD, only 20 (23.3%) showed ALT abnormality but there was an increasing trend of ALT abnormality as the severity of fatty liver increased. In addition, the higher ALT, Homeostasis model assessment- insulin resistance (HOMA-IR), cholesterol, triglyceride, and non-HDL levels and lower HDL-C as the severity of fatty liver increased. In a stepwise logistic regression analysis, the most significant factor associated with the presence of NAFLD was weight category. When compared with their normal counterparts, overweight and obese adolescents had a 4.14 and 5.98 times the risk of having NAFLD, respectively. Elevated ALT was the second most important factor as adolescents with elevated ALT were more likely to have NAFLD (odds ratio = 3.32, 95% CI: 1.16 to 9.50). Non-HDL cholesterol level was the third most important factor associated with NAFLD with a 3.81-fold increase in risk incurred for every l n (1 mg/dL) increment.

CONCLUSIONSObesity, ALT abnormality and elevated non-HDL-cholesterol are risk factors for NAFLD in adolescents. However, only 23.3% of the adolescents with NAFLD showed an abnormality for ALT. Therefore, ALT alone is not a sufficient indicator; and it is recommended that ultrasonography of the liver should be part of the routine health examination of obese adolescents.

Adolescent ; Alanine Transaminase ; blood ; Child ; Cholesterol ; blood ; Fatty Liver ; blood ; diagnostic imaging ; etiology ; Humans ; Obesity ; complications ; Risk Factors ; Taiwan ; Ultrasonography

OBJECTIVETo investigate the whole body fat distribution in severe obese patients with multi-slice spiral CT, and to explore the correlation between adipose volume parameters and anthropometric data.

METHODSTotally 14 severe obese patients were enrolled and examined with multi-slice spiral CT. Total adipose tissue (TAT) volume and visceral adipose tissue (VAT) volume were measured using Volume software. The total, subcutaneous, and visceral adipose tissue volumes on umbilical level were also determined. The correlations between these parameters and anthropometric data including body weight, body mass index (BMI), and waist circumference were analyzed.

RESULTSAll scans were performed successfully. TAT was significantly correlated with body weight (r=0.7185ìP =0.004), BMI (r=0.8079ìP=0.004), and waist circumference (r=0.7627, P=0.002). VAT was mildly correlated with body weight (r=0.5727ìP=0.032) and strongly correlated with waist circumference (r=0.6707ìP =0.001). There was highly significant correlation between subcutaneous adipose tissue volume on umbilical level with TAT (r=0.8926ìP=0.000), and mild correlation between visceral adipose tissue volume on umbilical level with VAT (r=0.5949ìP=0.025).

CONCLUSIONSMulti-slice spiral CT can be applied to evaluate whole body fat distribution in severe obese patients. Waist circumference is highly relevant with VAT and therefore can be used as a simple parameter for evaluating adipose tissue inside the abdomen.

Adipose Tissue ; diagnostic imaging ; pathology ; Adult ; Body Fat Distribution ; Body Mass Index ; Body Weight ; Female ; Humans ; Male ; Middle Aged ; Obesity ; diagnostic imaging ; pathology ; Tomography, Spiral Computed ; Waist Circumference ; Young Adult

PURPOSE: To investigate anterior segment parameters in obese patients in comparison to healthy individuals. METHODS: Thirty-four obese subjects and 34 age-sex-matched healthy subjects were enrolled in this prospective cross-sectional study. Ophthalmological examinations including intraocular pressure (IOP), central corneal thickness (CCT), anterior chamber depth (ACD), anterior chamber volume (ACV), anterior chamber angle (ACA), and axial length (AL) measurements were performed on each subject. Height and weight of all subjects were recorded and body mass index (BMI) was calculated. RESULTS: IOP was significantly higher in the obese group (p = 0.003). The mean ACD in obese subjects was significantly lower than that in control subjects (p = 0.036). AL, ACV, ACA and CCT were not significantly different between the groups. There was a positive correlation between BMI and IOP (r = 0.404, p < 0.001). ACD and ACA were negatively correlated with BMI. CONCLUSIONS: IOP was significantly higher and ACD was significantly lower in obese subjects. AL, ACV, ACA and CCT were not significantly different between the groups. The impact of obesity on anterior chamber parameters should be further investigated.
Adult ; Aged ; Anterior Chamber/*pathology/physiopathology ; Cross-Sectional Studies ; Female ; Humans ; Intraocular Pressure/*physiology ; Male ; Middle Aged ; Obesity/*diagnostic imaging ; Prospective Studies ; Tomography, Optical Coherence/*methods ; Tonometry, Ocular

OBJECTIVETo explore the influence of obesity on surgical procedure and short-term surgical outcome in patients with gastric carcinoma.

METHODSA total of 426 patients with gastric carcinoma underwent laparotomy in our hospital during January 2006 and June 2008. All the patients were divided into obesity group and non-obesity group according to body mass index (BMI). The thickness of subcutaneous fat (SCF), abdominal anterior-posterior diameter (APD) and transverse diameter (TD) at the umbilicus level were measured by abdominal CT. Furthermore, the surgical data and postoperative conditions including short-term outcome were reviewed and compared between two groups.

RESULTSThe incidence of obesity was 29.8% in gastric carcinoma patients. Mean values of SCF thickness, APD and TD in obesity group and non-obesity group were (21.8+/-7.1) mm vs (14.4+/-7.5) mm, (223.2+/-24.6) mm vs (181.8+/-23.5) mm and (323.6+/-23.8) mm vs (285.8+/-24.4) mm (P=0.000). Longer operative time (P=0.007) and less amount of dissected lymph nodes were found in obesity group as compared to non-obesity group (P=0.000). Also, obesity group lasted a longer postoperative period of fever (P=0.000) and experienced more post-operative complications (P=0.005) than non-obesity group did.

CONCLUSIONSAbdominal CT scan may display the abdominal shape of gastric carcinoma patients, hence, it is useful to evaluate the difficulty of surgical procedure. These patients may involve in complicated surgical procedure and worse short-term outcome due to obese abdominal shape. Therefore, perioperative management should be emphasized for these patients.

Abdomen ; surgery ; Adult ; Aged ; Aged, 80 and over ; Body Mass Index ; Female ; Gastroplasty ; Humans ; Male ; Middle Aged ; Obesity ; Stomach Neoplasms ; diagnostic imaging ; surgery ; Tomography, X-Ray Computed ; Treatment Outcome

Female ; Gastrectomy ; Humans ; Hyperpigmentation ; diagnosis ; Middle Aged ; Nerve Compression Syndromes ; diagnosis ; Obesity ; surgery ; Peripheral Nervous System Diseases ; diagnosis ; Postoperative Complications ; diagnostic imaging ; Pruritus ; diagnosis ; Weight Gain ; Weight Loss

No abstract available.
Dyspepsia/physiopathology/*radionuclide imaging ; Fundoplication ; Human ; Obesity/physiopathology/*radionuclide imaging ; Observer Variation ; Postprandial Period/*physiology ; Sodium Pertechnetate Tc 99m/diagnostic use ; Stomach/physiopathology/*radionuclide imaging/surgery ; Support, Non-U.S. Gov't ; Support, U.S. Gov't, P.H.S. ; Tomography, Emission-Computed, Single-Photon/*methods