Insulin sensitivity in Familial Multiple Lipomatosis.

BACKGROUND: Familial Multiple Lipomatosis (FML) is a mainly autosomal dominant rare benign condition. Excessive fat storage (obesity), as well as the inability to store fat (lipodystrophy), is associated with insulin resistance. AIM: Our study aimed to document if also patients affected by regional excess of subcutaneous adipose tissue as in FML show this feature. PATIENTS AND METHODS: Metabolic studies were performed in four brothers. A standard 75 g oral glucose tolerance test (OGTT) was submitted to each patient, with blood sampling at 0, 30, 60, 90, 120 and 180 min. Insulin sensitivity was calculated from the OGTT as the oral glucose insulin sensitivity index (OGIS), using the 2-h OGIS equation. Eight obese, non-diabetic subjects matched for BMI, age and sex, were used as controls. RESULTS: All the patients revealed a normal glucose tolerance and a normal HBA1c. CONCLUSIONS: Isolated subcutaneous fat accumulation is not necessarily associated with insulin resistance, on the contrary it may even allow a relatively high degree of insulin sensitivity.

Acral melanoma of the hallux.

OBJECTIVE: A case of misdiagnosed acral melanoma of the hallux and its diagnostic challenge are herein presented. Acral melanoma is insidious and subtle. A methodic approach to any suspicious lesions is mandatory. A case of misdiagnosed acral melanoma of the hallux is herein reported in a 66-year-old healthy man. Suggestions concerning similar non-healing lesions are herein presented. MATERIALS AND METHODS: It was firstly clinically diagnosed and treated as a micosis at another centre. The absence of any amelioration after three years pushed us to perform a biopsy. RESULTS: An acral melanoma was revealed, treated by amputation. CONCLUSIONS: In case of a non-healing ulcer of the lower extremities, melanoma should be taken into consideration. Even in absence of any suggestive risk factors or clear signs of melanoma, the lack of any improvement after treatment should raise doubts about diagnosis. In particular, biopsy is advisable as a first attempt to guide the management.

Chest and breast MRI: the added value of a fast imaging for a new diagnostic approach in the planning of augmentation surgery in patients with thoracic asymmetries.

OBJECTIVE: In breast augmentation surgery, breast symmetry depends on the breast tissue, implants and chest wall. Any asymmetry of the anterior thoracic wall can influence the breast shape. If breast asymmetry is detected in the preoperative evaluation, a chest wall deformity should be suspected. Until now, very few reports describe the use of MRI to objectively assess breast and chest measurements with the aim of providing customized augmentation. This study describes the use of MRI to evaluate breast and chest wall asymmetry, and considers the feasibility of preoperative measurements which are useful for performing an objective preoperative evaluation. PATIENTS AND METHODS: Between April 2012 and February 2013, 13 patients underwent chest/breast MRI scan. Scans were performed on a 1.5 T scanner using a single T1 FSE non-suppressed axial sequence, without contrast administration. Acquisitions included the breast and chest wall. Specific measurements were obtained to assess the overall shape of the chest wall and breast, as well as any asymmetry. RESULTS: All patients showed some degree of left-right side asymmetry on specific thoracic, breast and implant measurements. MRI provided detailed and objective data. CONCLUSIONS: Preliminary findings revealed the value of breast/chest wall MRI in the planning of augmentation surgery. MRI is a valuable technique in young women because there is no use of ionizing radiation. Scans allow surgeons to determine the best surgical approach and obtain reproducible and better aesthetic results.

Multiple lipomatosis after stem cell trasplant and chemotherapy: a case report.

BACKGROUND: Lipomas are the most common type of soft tissue benign tumor. They can be either isolated entities or involved in a multiple lipomatosis, which may have a familial basis or be an acquired condition. AIM: Chemotherapy and/or blood stem cell transplantation may be plausible causes of multiple lipomatosis. MATERIALS AND METHODS: A 28 year-old patient was diagnosed with non-seminomatous germ cell left testicular cancer. The patient was addressed to chemotherapy and peripheral blood stem cell chemomobilization. After stem cells collection, the patient underwent autologous peripheral blood stem cell transplant. RESULTS: A subsequent de novo multiple lipomatosis onset developed. CONCLUSIONS: Although this is a preliminary study and further elaborations are needed, dermatologists and surgeons facing with multiple lipomatosis should consider previous chemotherapy and peripheral blood stem cell mobilization/transplant as possible causes of its onset.

Estudo citogenético em bovinos da raça Holandesa Preta e Branca infectados pelo vírus da leucose enzoótica bovina / Cytogenetic study of Holstein cattle infected with Bovine Leukemia Virus

Este estudo citogenético envolveu 49 animais, fêmeas da raça Holandesa Preta e Branca, sendo 24 soropositivas e 25 soronegativas para o Vírus da Leucose Enzoótica Bovina (VLB), no teste de imunodifusäo em gel de ágar (IDGA). Näo foi encontrada diferença significativa na relaçäo entre quebras, poliploidias e infecçäo pelo VLB. No entanto, foi verificada uma elevada freqüência de células poliplóides nos animais näo infectados (aumento de 65,4 por cento) em comparaçäo com os animais infectados pelo VLB