[To the question of laboratory diagnostics of fat droplets.]

This study aims to compare of study of blood plasma for the presence of fat globules using the method of V.A. Cherkasov and the method what we developed in 60 patients with severe combined trauma. The use of the developed method increases the accuracy of qualitative and quantitative analysis by reducing the emulsifying action of the ethyl alcohol of Sudan IV, preventing uneven coloring and destruction of the preparation within 3 minutes after preparation. A classification of fat globules has been developed, capillary-hazardous globules of ≥ 8 µm in size and arterioles-hazardous globules ≥ 50 µm.

Pituitary adenoma with adipose tissue: A new metaplastic variant.

Pituitary adenomas are benign tumors representing approximately 15-20% of intracranial neoplasms. There have been few reports of metaplastic osseous transformation and about 60 cases of neuronal metaplasia in pituitary adenoma but adipose metaplasia has not been previously described in the English literature. Here we report a case of pituitary adenoma with metaplastic adipose tissue in a 58-year-old male patient. Histologically this case fulfilled the criteria of a non-functioning pituitary adenoma, and moreover a central area of adipose tissue, made by mature adipocytes, and many tumor cells, containing fat droplet were evident. Lipomatous transformation of tumor cells in the CNS has been previously observed but, to the best of our knowledge, our case is the first pituitary adenoma with such change. The histogenesis of the adipose element in pituitary adenoma is not well understood, and could be a result of a metaplastic change or divergent differentiation from a common progenitor cell.

Traumatic rupture of intracranial dermoid cyst with continuous fat droplet migration.

Background: The intracranial dermoid cyst (ICD) can be complicated by rupture and spilling of its contents with potentially dreadful consequences. Head trauma as a predisposing element for this phenomenon is extremely rare. Few reports address the diagnosis and management of trauma-related rupture of ICD. However, there is a pronounced knowledge gap related to the long-term follow-up and the fate of the leaking contents. Here, we present a unique case of traumatic rupture of ICD complicated by continuous fat particle migration within the subarachnoid space with its surgical implications and outcome. Case Description: A 14-year-old girl had an ICD rupture following a vehicle collision. The cyst was located near the foramen ovale with intra and extradural extensions. Initially, we opted to follow the patient clinically and radiologically as she had no symptoms, and the imaging showed no red flags. Over the next 24 months, the patient remained asymptomatic. However, the sequential brain magnetic resonance imaging revealed significant continuous migration of the fat within the subarachnoid space, with the droplets noticed to increase in the third ventricle. That is considered an alarming sign of potentially serious complications impacting the patient's outcome. Based on the above, the ICD was completely resected through an uncomplicated microsurgical procedure. On follow-up, the patient is well, with no new radiological findings. Conclusion: Trauma-related ruptured ICD may have critical consequences. Persistent migration of dermoid fat can be managed with surgical evacuation as a viable option to prevent those potential complications such as obstructive hydrocephalus, seizures, and meningitis.

CT features of feline lipiduria and renal cortical lipid deposition.

OBJECTIVES: The aims of this study were to document the presence and prevalence of feline lipiduria and renal lipid deposition on CT, and to search for associations between the presence of lipiduria and sex, urinary tract abnormalities and urolithiasis. METHODS: The CT examinations of 252 cats were reviewed for the presence of an antigravitational hypodense bubble in the urinary bladder with density values between -180 Hounsfield units (HU) and -20 HU. To identify associations between lipiduria and sex, urinary tract abnormalities and urolithiasis, Fisher's exact test was used. Renal cortical density measurement was performed in all cats. The Mann-Whitney test was performed to compare renal cortical density between lipiduric and unaffected cats. RESULTS: A total of 27 domestic cats (10.7%) had CT evidence of lipiduria. Lipiduric cats had a significantly lower renal cortical density than unaffected cats (P <0.01). Male neutered cats had a significantly higher frequency of lipiduria and lower renal cortical density compared with female neutered cats (P <0.01). There was no significant difference between the groups regarding renal, ureteral or urethral abnormalities. CONCLUSIONS AND RELEVANCE: Lipiduria is a common physiological phenomenon in cats that can be detected on routine CT examinations. Decreased renal cortical density is associated with lipiduria. This may aid in the diagnosis of feline lipiduria and help to differentiate its presence from other pathological depositions and excretions.

Ruptured, Intracranial Dermoid Cyst - A Visual Diagnosis?

Dermoid cysts are a very rare entity of intracranial tumours. The traumatic or non-traumatic rupture of the cyst wall is a serious complication that can be treated surgically or conservatively depending on the clinical symptoms. However, more common entities have to be considered as a differential diagnosis. We report on a female patient who was admitted with complaints of significant, prolonged headache and diffuse pain. Analysis of her blood and cerebrospinal fluid indicated no clear pathology. A CT examination of the head revealed a ruptured dermoid cyst adjacent to the left sphenoidal bone. An additional MRI was conducted to confirm the CT findings and rule out an intracranial ischemia or vasospasms. A conservative therapy was scheduled and the patient recovered well. Using current imaging techniques, especially magnetic resonance imaging, it is possible to identify a ruptured dermoid cyst by its pathognomonic signal behavior and rule out potentially life threatening complications.

Ultrasonographic features of normal human parathyroids and related validating strategies / 第二军医大学学报

Objective To screen for and validate the principal ultrasonographic features of normal human parathyroid glands, so as to provide guidance for diagnostic ultrasound in parathyroid pathologies and protection of normal parathyroid during total thyroidectomy. Methods From Apr. 2008 to Dec. 2012, the neck ultrasonograms focusing on the thyroids and adjacent structures were obtained from 600 healthy subjects. One-by-one identification and exclusion was performed based on anatomical evidences, and the most probable parathyroid images (termed as presumed parathyroid sonogram) of normal human parathyroid were obtained. Based on those presumed parathyroid sonograms, we compared the detection rates of parathyroid in subjects with or without hypoparathyroidism following total thyroidectomy, and we also analyzed the ultrasonic features of patients with hyperparathyroidism. Moreover, we assessed the influence of intraoperative ultrasonography on the occurrence of hypoparathyroidism following total thyroidectomy. The accuracy and reliability of the presumed parathyroid sonogram were discussed. Results It was verified that the normal parathyroid appeared as a small well-circumscribed nodule with fine and homogenous internal hyperechoes. Their configuration varied, with oval shape as the commonest one; the texture was softer than that of adjacent thyroid parenchyma, with the quantitative strain ratio below 1 on elastography. About 62. 5% of the normal parathyroids were filled with color Doppler flow signals. The gland was small, with the mean length, width, and thickness being (6.38 + 1.46), (3.76 + 1.02), and (2.75 + 1.99) mm, respectively, and the mean volume was (0.13 + 0.06)mL by VOCAL method. The inferior glands were much better displayed than the superior ones. As for the patients who had experienced a total thyroidectomy, among five cases complicated with postoperative hypoparathyroidism, 4 (80%) developed the absence of parathyroid on ultrasonography, which was not seen in 35 patients with normal parathyroid function. As for the patients with hyperparathyroidism, normal parathyroid glands were invisible in the area of adenomatous or hyperplastic parathyroids. One patient (3. 3%) with intraoperative ultrasonography and six patients (20%) without intraoperative ultrasonography developed postoperative hypoparathyroidism (P<0. 01). Two patients with thyroid agenesis showed 2 normal ipsilateral normal parathyroids. Conclusion In the present study we have successfully obtained the ultrasonic features of normal parathyroids using non-invasive research strategies, which have been preliminarily validated in clinical application.

Distribution of Fat Droplets in Liver Tissue of Rats Fed a Diet with Different Fatty Acid Compositions / 日本補完代替医療学会誌

Objectives: We examined the effect of oil intake differing in fatty acid composition on fat accumulation amount, concentration of serum and fat droplets adipocytes of liver tissue in rats. Methods: Young male rats were fed a high cholesterol diet containing either lard, soybean oil, perilla oil or fish oil for 4wk. The control diet contained a lard component. Results: Posterior abdominal wall fat and testicle peripheral fat weights were significantly lower in the fish oil group compared with the control and the soybean oil group. The number of fat droplets was significantly higher in the liver tissue of rats in the perilla oil group compared with the other groups, and many fat droplets with small diameters were observed. The proportion of fat droplets to the total area was significantly lower in the perilla oil group and the fish oil group compared with the control and the soybean oil group. Conclusion: The results suggested that oil intake differing in fatty acid composition correlates with fat accumulation amount and lipid droplet area in the liver tissue. Fish oil intake correlated with reduced visceral fat accumulation and is expected to be useful in the prevention and improvement of obesity.