Correlation between Pancreatic Fat Deposition and Metabolic Syndrome: Relationships with Location in the Pancreas and Sex.

Objective To investigate the correlation between pancreatic fat deposition and metabolic syndrome (MetS) parameters, focusing on the locations of fat deposition in the pancreas and sex differences. Methods Degrees of fat deposition in the head, body, and tail of the pancreas were evaluated using computed tomography (CT). We examined the relationships between pancreatic fat deposition and the age, body mass index (BMI), visceral and subcutaneous fat, serum lipid profiles, hepatic steatosis, diabetes mellitus (DM), and hypertension (HTN). Results In this retrospective study, greater fat deposition was associated with a higher BMI, visceral and subcutaneous fat accumulation, and hepatic steatosis, with the pancreatic head showing the strongest correlation. Correlations of pancreatic fat deposition with the BMI and visceral and subcutaneous fat accumulation were stronger in females than in males, while correlations with hepatic steatosis were stronger in males than in females. In addition, a multivariate analysis did not suggest a direct causal relationship between pancreatic fat deposition and DM and HTN, but there was a significant correlation between pancreatic fat deposition in the pancreatic head and visceral fat area. Conclusion Pancreatic fat deposition, as evaluated by CT, especially in the part of the pancreatic head adjacent to the ampulla of Vater, is a sensitive indicator of MetS. The correlations between pancreatic fat deposition and MetS parameters tended to be stronger in females than in males. These results may help further elucidate the pathophysiology of MetS and provide opportunities for its diagnosis.

Visual assessment of pancreatic fat deposition: useful grading system and the relation to BMI and diabetes.

PURPOSE: To establish a simple and clinically useful method for the visual assessment of pancreatic fat deposition using computed tomography (CT) images, and to evaluate the relationship of the pancreatic fat deposition with body mass index (BMI) and type 2 diabetes mellitus (DM). MATERIALS AND METHODS: We used a four-scale grading system as the visual assessment criteria for pancreatic fat deposition using CT images. Pancreatic fat deposition was assessed for 200 patients and the results were compared with the CT attenuation-based assessment. In addition, the relationships of pancreatic fat deposition with BMI and type 2 DM were investigated. RESULTS: The visual and CT attenuation-based assessments were considered consistent. The results of the visual assessment suggested that mild and moderate pancreatic fat deposition correlated with BMI and presence of type 2 DM while severe fat deposition did not correlate with them. No correlation between pancreatic fat deposition and HbA1c level was found. CONCLUSION: The visual assessment criteria we used were consistent with CT attenuation-based assessment and may be useful for clinical application of pancreatic fat deposition. According to the visually assessment, mild or moderate pancreatic fat deposition correlated with BMI and the presence of type 2 DM, but severe fat deposition did not correlate with them.

Inferior mesenteric venous thrombosis that required operations: report of two cases.

Inferior mesenteric venous thrombosis (IMVT) is a very rare disease of colon ischemia. We experienced two cases of IMVT that required operations. The first patient was a 74-year-old male, who was admitted to our hospital because of melena and diarrhea. He was diagnosed with IMVT by angiography. As no improvement was seen after the conservative therapy for a month, left colectomy and transverse colostomy were performed. There was a small ulcer in the resected colon mucosa. The findings of histopathological examination revealed that mild and repeated ischemia of the colon had been caused. The second patient was a 70-year-old male, who was admitted to our hospital with the chief complaint of constipation, lower abdominal pain and nausea. He was diagnosed as IMVT by angiography. As no improvement was seen after the conservative therapy for a month, an operation was performed. The operative findings confirmed severe swelling of mesenteric fatty tissue and vascular ectasia of mesocolon. Left colectomy and transverse colostomy were performed. Histopathological examination of surgical specimens disclosed the multiple thrombi and almost complete occlusion of the inferior mesenteric vein, the invasion of lipid-filled macrophages as mesenteric panniculitis, and ischemic change in the sigmoid colon mucosa.

Diffusion-weighted magnetic resonance imaging of a severe heat stroke patient complicated with severe cerebellar ataxia.

A 78-year-old woman was admitted for severe heat stroke with brain damage. She was unconscious on arrival at the emergency room. Her armpit temperature was 42.0 degrees C and blood pressure was 76/25 mmHg. She was rapidly cooled and given intensive treatment. On magnetic resonance imaging, T1- and T2-weighted images showed no significant signals, but diffusion-weighted images demonstrated localized symmetrical injuries of the cerebellum and thalami. She gradually became conscious, but severe cerebellar ataxia persisted.