Abstract 14521: Association of Serum Leptin and Abdominal Aortic Inflammation in Rheumatoid Arthritis

Introduction: Rheumatoid arthritis (RA) is an autoimmune disease associated with increased risk of atherosclerosis. Leptin may indirectly contribute to atherogenesis, but its role in RA is not clear. Hypothesis: We aimed to study the correlation between leptin and inflammation in the abdominal aorta (AA) assessed by 18F-FDG PET/CT in RA patients. Methods: We retrospectively analyzed the data of 18 RA patients (mean age 56.0±11.9, 14 male). All patients were administered 18F-FDG intravenously, and full-body PET/CT scans were acquired 180 minutes later. Regions of interest were delineated around the wall of the AA, with a superior border at the aortic hiatus of the diaphragm and an inferior border at the bifurcation of iliac arteries. Mean standard uptake values per axial slice were averaged to calculate the average SUVmean (aSUVmean). BMI, visceral fat area (VFA), and serum logarithmically transformed leptin (ln-leptin) were obtained. Patients were divided into low- and high-BMI groups, with a cutoff of 25 kg/m2. Results: Mean BMI (kg/m2) and VFA (cm2) between the low- and high-BMI groups were 21.7 vs. 31.4 (p<0.001) and 72.3 vs. 157.0 (p=0.002), respectively. Serum ln-leptin and aSUVmean were significantly increased in the high-BMI group (7.2±0.9 vs. 9.8±1.1, p<0.001; 1.4 vs. 1.7, p=0.04). On regression analysis, serum ln-leptin correlated positively with aSUVmean (r=0.59, p=0.01). Conclusion: In our study, higher serum leptin levels moderately correlated with 18F-FDG uptake in the AA, which reflects inflammation and atherogenic activity. Future studies are warranted to further elucidate the role of leptin in co-morbid atherosclerosis in patients with RA.

Pseudopancreatic Cyst Extending into the Mediastinum in a 7-Year-Old Child

Mediastinal pseudopancreatic cyst (MPP) is the extension of a pancreatic pseudocyst through esophageal or aortic hiatus into the posterior mediastinum. It can produce a range of manifestations caused by compression by the cyst, for instance, odynophagia, dysphagia, pericardial, or pleural effusion. Here we report a case of MPP in a 7-year-old child who was presented with repeated chest infections and left pleural effusion. It was successfully drained by cystogastrostomy.

The Distance Between the Diafragm and the Origin of the Collateral Branches of the Abdominal Aorta

The Abdominal Aorta represents the terminal portion or the fourth portion of the artery, continuing the diaphragmatic portion, stretching from the aortic hiatus (at the level of the twelfth thoracic vertebra) up to the fourth lumbar vertebra, the level at which ends by bifurcation in the two common iliac artery, left and right. The survey was carried out on the computed tomography angiography’s executed on a computer tomography GE LightSpeed 16 slice CT in Medimar Imagistic Clinic located in the County Clinical Emergency Hospital “Sf. Andrei” Constanta, on healthy subjects and on the basis of sex. The distance between the origins of the collateral branches of the aorta are highly variable, causing differences in relation to sex, generally being higher in male, exceptions being due to the fact that these distances are proportional with the morphological type of the individual in question. Frequently, the maximum and minimum values of the distances have not been encountered only in one event. Like other morfometric data, the distances between the collateral arteries of the abdominal aorta firstly depend on the number of cases which it has been worked, which explains the differences between authors who are working on the same grounds and at close intervals of time, but differs on the number of cases which are working.

Anatomic variation of the thoracic duct and absence of accessory hemiazygos and hemiazygos veins: case report

The thoracic duct is a lymph vessel extending from the abdomen to the base of the neck where it drains to one of the large veins in the region. Many cases are described in the scientific literature, regarding anatomical variations of the thoracic duct, from its origin, path, until its end, and the vast majority intended to relate variations in the last part of the duct. The reports related to variations of its path are very scarce. In a male cadaver dissection in the anatomy laboratory of the Faculdade de Ciências Médicas of Minas Gerais (FCMMG), an anatomical variation of the position of the thoracic duct was found. The thoracic duct was presented to the left of the aorta and spine, from its entry in the aortic hiatus of the diaphragm and chest throughout its length. There were also anatomical variations of interest in the venous circulatory system, such as the absence of the veins: hemiazygos and accessory hemiazygos, and the different location of the azygos vein, which was located to the left of the aorta. These variations have no relation to each other. The study of this variation is important because the knowledge of variations in the thoracic duct path allows lower rates of trauma and iatrogenic lesions in thoracic surgery, with possible serious complications, such as a chylothorax.

Patient with Syphilitic Thoracic and Abdominal Aortic Aneurysms

Patient with Syphilitic Thoracic and Abdominal Aortic AneurysmsWe are presenting a rare case of patient with two syphilitic aneurysms localized in thoracic and abdominal aorta. Routine lung computer tomography (CT) for the patient with complains about irritating and unclear ethiology cough revealed 10 cm diameter aneurysm of descending thoracic aorta (TAA) and additionally 4.8 cm aneurysm of abdominal aorta (AAA) just below the aortic hiatus. As there was no evidence of previous trauma, Marfan syndrome or connective tissue disease patient was screened for syphilis. Diagnosis of tertiary syphilis was confirmed and specific treatment started. As complains of irritating cough intensified - patients TAA was successfully treated endovascularly with thoracic stent graft (Valiant®Captivia, Medtronic Ltd.) on emergency basis. On control CT angiography 3 month after treatment there was no evidence of graft migration, endoleaks and aneurysmal sac was thrombosed. AAA has not increased in size, and open repair is planned.