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Journal of Veterinary Diagnostic... Jul 2024A 7-y-old, castrated male, leucistic sugar glider () was presented because of a progressive history of lethargy, ataxia, diarrhea, and anorexia. Abdominal ultrasound...
A 7-y-old, castrated male, leucistic sugar glider () was presented because of a progressive history of lethargy, ataxia, diarrhea, and anorexia. Abdominal ultrasound revealed fluid in the abdomen and an infiltrative mass in the liver. Due to a poor prognosis, euthanasia was performed. Postmortem examination revealed a focally extensive, infiltrative, off-white, firm mass in the liver with adhesion to the omentum, mesentery, gastric serosa, and diaphragm. The remaining hepatic parenchyma was diffusely yellow. Histologically, the hepatic mass was consistent with metastatic cholangiocarcinoma (cholangiocellular carcinoma) with proliferation of neoplastic epithelial cells surrounded by marked desmoplasia. Neoplastic cells expanded and infiltrated the adjacent omentum, mesentery, and the serosal surfaces of the stomach, kidney, and small and large intestines. To our knowledge, cholangiocarcinoma has not been reported previously in a sugar glider.
Topics: Cholangiocarcinoma; Male; Animals; Bile Duct Neoplasms; Marsupialia; Liver Neoplasms; Fatal Outcome
PubMed: 38721887
DOI: 10.1177/10406387241252815 -
Journal of Surgical Case Reports May 2024Meckel's diverticula are one of the most common gastrointestinal anomalies, yet mesodiverticular bands are rare. The treatment of these bands commonly requires surgery....
Meckel's diverticula are one of the most common gastrointestinal anomalies, yet mesodiverticular bands are rare. The treatment of these bands commonly requires surgery. A healthy patient in his 20s presented to the emergency department with a 1 day history of acute onset abdominal pain. Computed tomography imaging was consistent with volvulus of the large intestine. In the operating room, the patient was noted to have a band between the ileal mesentery and tip of a Meckel's diverticulum, consistent with a mesodivertiular band, through which cecum had volvulized. The patient underwent resection. The patient recovered without major complications. Mesodiverticular bands are rare, but may present as hemoperitoneum, small bowel obstruction, or volvulus. Pre-operative diagnosis of a mesodiverticular band is often difficult and they are most commonly diagnosed intraoperatively. Treatment should include surgery and may include simple lysis of the band, bowel resection, or more extensive resection if other pathology is present.
PubMed: 38721257
DOI: 10.1093/jscr/rjae296 -
Journal of Surgical Case Reports May 2024We present a case of spontaneous abdominal hemoperitoneum secondary to ruptured splenosis in a 35-year-old patient with a history of splenectomy secondary to trauma...
We present a case of spontaneous abdominal hemoperitoneum secondary to ruptured splenosis in a 35-year-old patient with a history of splenectomy secondary to trauma 23 years prior. Computed tomography imaging demonstrated a large amorphous mass-like structure in the mesentery of the left hemiabdomen with active extravasation and hemoperitoneum. The patient also had a separate focus of hyper-enhancing mass adjacent to the bladder representing a mass versus splenule. The patient's radiographic and clinical presentation prompted management with exploratory laparotomy, hematoma evacuation, and resection of two splenules. With only a few cases of spontaneous abdominal hemoperitoneum from splenosis reported, this case describes successful management with surgical intervention.
PubMed: 38721255
DOI: 10.1093/jscr/rjae284 -
Inflammation Research : Official... Jul 2024Lymphatic abnormalities are essential for pathophysiologic changes of creeping fat (CrF) in Crohn's disease (CD). Anti-tumor necrosis factor (TNF) therapy has been...
BACKGROUND
Lymphatic abnormalities are essential for pathophysiologic changes of creeping fat (CrF) in Crohn's disease (CD). Anti-tumor necrosis factor (TNF) therapy has been proved to alleviate CrF lesions, however, whether it achieves these by remodeling lymphatics is unknown.
METHODS
CD74 expression was detected in CrF and uninvolved mesentery of CD patients. Lymphatic functions in vitro were evaluated and lymphatic endothelium barrier were checked by transendothelial electrical resistance (TEER) and FITC-Dextran permeability. Protein level of tight junction and signaling pathways were detected by western blotting.
RESULTS
CD74 was upregulated in LECs of CrF and positively correlated with TNF-α synthesis. This was suppressed by IFX administration. In vitro, TNF-α stimulated LECs to express CD74 through NF-κB signaling pathway, and this was rescued by IFX. CD74 downregulation suppressed the abilities of LECs in proliferation, migration and tube formation. Interaction of CD74-MIF impaired LECs' barrier via reducing tight junction proteins in an ERK1/2-dependent manner, which was reversed by CD74 downregulation. Consistently, the CD patients receiving IFX therapy displayed decreased lymphangiogenesis and improved mesenteric lymphatic endothelium barrier, companied with reduced adipocyte size and adipokine levels in CrF.
CONCLUSIONS
Anti-TNF therapy could modify pathological changes in CrF by alleviating CD74-mediated lymphatic abnormalities.
Topics: Crohn Disease; Humans; Antigens, Differentiation, B-Lymphocyte; Infliximab; Adipose Tissue; Tumor Necrosis Factor-alpha; Male; Female; Adult; Histocompatibility Antigens Class II; Endothelial Cells; Cells, Cultured; Young Adult; Middle Aged; Gastrointestinal Agents; NF-kappa B; Lymphangiogenesis; Cell Movement
PubMed: 38713235
DOI: 10.1007/s00011-024-01889-2 -
Cancer Diagnosis & Prognosis 2024Intestinal malrotation (IM) often remains undetected until adulthood, being discovered during testing or surgery for other comorbidities. Preoperative understanding of...
BACKGROUND/AIM
Intestinal malrotation (IM) often remains undetected until adulthood, being discovered during testing or surgery for other comorbidities. Preoperative understanding of this anatomical abnormality is crucial.
CASE REPORT
An 80-year-old woman presented with cecal cancer. Three-dimensional computed tomography (CT) revealed that the cecum was located at the midline of the abdominal cavity, the duodenum did not cross the midline, and the ileocolic vein ran to the left. Clinically diagnosed with stage IVc cecal cancer complicated by IM, the patient underwent laparoscopic surgery. The ascending colon and cecum were not fixed to the retroperitoneum. The duodenum lacked the second, third, and fourth portions and the small bowel was distributed on the left and right sides of the abdominal cavity. Adhesions had shortened the mesentery, which were released close to their normal positions.
CONCLUSION
Although laparoscopic surgery is superior to open surgery in terms of securing the field of view in a narrow space, providing a magnifying effect, and minimal invasiveness, it has a limited field of view and is inferior in terms of grasping the overall anatomy, which may be disadvantageous in cases of anatomical abnormalities. Colorectal cancer with IM is rare; however, the rate of preoperative diagnosis seems to be increasing thanks to improvements in diagnostic imaging, such as three-dimensional CT scans. In this study, we also reviewed 49 cases of colorectal cancer associated with IM.
PubMed: 38707722
DOI: 10.21873/cdp.10318 -
International Journal of Surgery Case... Jun 2024Lymphangioma is a benign tumor, containing thin-walled lymphatic spaces. The most affected sites are head, neck, axilla, and parenchymal organs. Mesentery lymphangioma...
INTRODUCTION
Lymphangioma is a benign tumor, containing thin-walled lymphatic spaces. The most affected sites are head, neck, axilla, and parenchymal organs. Mesentery lymphangioma is a rare case; it happens in <1 % of cases.
PRESENTATION OF CASE
A 25-year-old man came to the hospital, complaining of acute abdominal pain. The pain started in the morning and developed progressively. The physical examination was not helpful. The abdominal X-ray in the erect position was within normal. The ultrasound imaging findings were limited; they showed only a cystic mass in the pelvis. So, the investigatory laparotomy was indicated. During the laparotomy, we found a sizeable mass originating from the small bowel mesentery and pressed on it. The mass is located at a distance of 50 cm from the treitz ligament. We excised the mass and related intestinal loops. The histopathological examination showed that it was a cystic lymphangioma.
DISCUSSION
Lymphangioma is a benign tumor that forms when early lymphatic spaces fail to connect to the lymphatic system. The diagnosis of the lesion depends on radiological investigations because the manifestations and the laboratory investigations are not specific, but histopathology examination is still the only method to determine diagnosis. The treatment of lymphangioma depends on radical surgery.
CONCLUSION
Mesenteric lymphangioma is a rare condition with unspecific symptoms and radiological and laboratory findings, so we should keep it in mind when the patient comes with general abdominal manifestations and we cannot put a determined diagnosis. Laparotomy should be done rapidly in such cases to avoid life-threatening complications.
PubMed: 38703615
DOI: 10.1016/j.ijscr.2024.109730 -
Mayo Clinic Proceedings May 2024Sclerosing mesenteritis (SM), an idiopathic nonneoplastic condition affecting 0.18% to 3.14% of the population, is characterized by chronic fat necrosis, inflammation,... (Review)
Review
Sclerosing mesenteritis (SM), an idiopathic nonneoplastic condition affecting 0.18% to 3.14% of the population, is characterized by chronic fat necrosis, inflammation, and fibrosis most commonly of the mesentery of the small intestine. Sclerosing mesenteritis typically presents in the fifth or sixth decade of life, where patients with a history of abdominal surgery and/or autoimmune disease may be at higher risk. While many patients are asymptomatic, clinical features and complications are related to the mass effect resulting from the inflammation and fibrosis involved in the pathogenesis of SM. When present, common signs, symptoms, and complications include abdominal pain, weight loss, diarrhea, palpable abdominal mass on examination, bowel obstruction, chylous ascites, and mesenteric vessel thrombosis. Although SM was historically diagnosed predominantly by biopsy, current practice has shifted away from this to computed tomography imaging of the abdomen, given the invasive nature of biopsy. However, certain conditions, including mesenteric neoplasia (lymphoma, metastatic carcinoid tumor, desmoid tumor, mesenteric carcinomatosis), can mimic SM on imaging, and if clinical suspicion is equivocal, a biopsy may be warranted for definitive diagnosis. Asymptomatic patients do not require treatment. For patients with pronounced symptoms or complicated SM, the combination of tamoxifen 10 mg twice daily and prednisone 40 mg daily is the first-line pharmacotherapy; no randomized controlled trial of this regimen has been performed. Rarely, surgery may be necessary in cases of persistent bowel obstruction refractory to medical management. Sclerosing mesenteritis has an overall benign course in most cases, but disease progression and fatal outcomes have been reported.
Topics: Humans; Panniculitis, Peritoneal; Diagnosis, Differential
PubMed: 38702129
DOI: 10.1016/j.mayocp.2024.01.019 -
International Braz J Urol : Official... 2024Robotic-assisted radical cystectomy (RARC) with intracorporeal urinary diversion (ICUD) is associated with significant morbidity and mortality. We present an alternative...
BACKGROUND
Robotic-assisted radical cystectomy (RARC) with intracorporeal urinary diversion (ICUD) is associated with significant morbidity and mortality. We present an alternative technique that preserves the complete mesenteric vascularization during the isolation of the intestinal segment used in ICUD, including distal vessels. This approach aims to minimize the risk of ischemia in both the ileal anastomosis and the isolated loop at the diversion site.
METHODS
This cohort study included 31 patients, both male and female, who underwent RARC with ICUD from February 2018 to November 2023, performed by a single surgeon. Intraoperative and postoperative complications data were retrieved for analysis, employing our proposed mesentery-sparing technique in all cases. The primary endpoint was the incidence of intraoperative and postoperative complications directly attributable to the mesentery-sparing approach in ICUD. Secondary endpoints included other postoperative variables not directly related to mesentery preservation, such as the incidence of postoperative ileus requiring parenteral nutrition and the duration of hospitalization.
RESULTS
None of the patients experienced intraoperative or postoperative complications directly related to mesentery-sparing, such as intestinal fistulae or internal hernias. The median duration of hospitalization was 6 days, and postoperative ileus necessitating total parenteral nutrition occurred in 19% of the patients. Minor complications (Clavien-Dindo grades I-II) accounted for 27.6% of the cases and major complications (grades III-V) accounted for 20.6%.
CONCLUSION
The mesentery-sparing technique outlined herein offers an alternative method for preserving the vascularization of intestinal segments and reducing the risk of intestinal complications in ICUD during RARC.
Topics: Humans; Cystectomy; Female; Male; Robotic Surgical Procedures; Urinary Diversion; Middle Aged; Aged; Postoperative Complications; Mesentery; Urinary Bladder Neoplasms; Organ Sparing Treatments; Treatment Outcome; Intraoperative Complications; Retrospective Studies; Reproducibility of Results; Cohort Studies
PubMed: 38701184
DOI: 10.1590/S1677-5538.IBJU.2024.0153 -
Journal of Hypertension Aug 2024Proliferation and migration of vascular smooth muscle cells (VSMCs) contribute to vascular remodeling. Asprosin, a newly discovered protein hormone, is involved in...
OBJECTIVE
Proliferation and migration of vascular smooth muscle cells (VSMCs) contribute to vascular remodeling. Asprosin, a newly discovered protein hormone, is involved in metabolic diseases. Little is known about the roles of asprosin in cardiovascular diseases. This study focused on the role and mechanism of asprosin on VSMC proliferation and migration, and vascular remodeling in a rat model of hypertension.
METHODS AND RESULTS
VSMCs were obtained from the aortic media of 8-week-old male Wistar-Kyoto rats (WKY) and spontaneously hypertensive rats (SHR). Asprosin was upregulated in the VSMCs of SHR. For in vitro studies, asprosin promoted VSMC proliferation and migration of WKY and SHR, and increased Nicotinamide adenine dinucleotide phosphate (NADPH) oxidase (NOX) activity, NOX1/2/4 protein expressions and superoxide production. Knockdown of asprosin inhibited the proliferation, migration, NOX activity, NOX1/2 expressions and superoxide production in the VSMCs of SHR. The roles of asprosin in promoting VSMC proliferation and migration were not affected by hydrogen peroxide scavenger, but attenuated by superoxide scavenger, selective NOX1 or NOX2 inhibitor. Toll-like receptor 4 (TLR4) was upregulated in SHR, TLR4 knockdown inhibited asprosin overexpression-induced proliferation, migration and oxidative stress in VSMCs of WKY and SHR. Asprosin was upregulated in arteries of SHR, and knockdown of asprosin in vivo not only attenuated oxidative stress and vascular remodeling in aorta and mesentery artery, but also caused a subsequent persistent antihypertensive effect in SHR.
CONCLUSIONS
Asprosin promotes VSMC proliferation and migration via NOX-mediated superoxide production. Inhibition of endogenous asprosin expression attenuates VSMC proliferation and migration, and vascular remodeling of SHR.
Topics: Animals; Vascular Remodeling; Male; Rats, Inbred SHR; Superoxides; Rats, Inbred WKY; Rats; Hypertension; Muscle, Smooth, Vascular; Signal Transduction; Cell Proliferation; Cell Movement; Myocytes, Smooth Muscle; NADPH Oxidases; Peptide Hormones; Fibrillin-1; Toll-Like Receptor 4
PubMed: 38690935
DOI: 10.1097/HJH.0000000000003751 -
In Vivo (Athens, Greece) 2024Since acute myeloid leukemias still represent the most aggressive type of adult acute leukemias, the profound understanding of disease pathology is of paramount...
BACKGROUND/AIM
Since acute myeloid leukemias still represent the most aggressive type of adult acute leukemias, the profound understanding of disease pathology is of paramount importance for diagnostic and therapeutic purposes. Hence, this study aimed to explore the real-time disease fate with the establishment of an experimental myelomonoblastic leukemia (My1/De) rat model using preclinical positron emission tomography (PET) and whole-body autoradiography.
MATERIALS AND METHODS
In vitro [F]F-FDG uptake studies were performed to compare the tracer accumulation in the newly cultured My1/De tumor cell line (blasts) with that in healthy control and My1/De bone marrow suspensions. Post transplantation of My1/De cells under the left renal capsule of Long-Evans rats, primary My1/De tumorigenesis, and metastatic propagation were investigated using [F]F-FDG PET imaging, whole-body autoradiography and phosphorimage analyses. To assess the organ uptake profile of the tumor-carrying animals we accomplished ex vivo biodistribution studies.
RESULTS
The tracer accumulation in the My1/De culture cells exceeded that of both the tumorous and the healthy bone marrow suspensions (p<0.01). Based on in vivo imaging, the subrenally transplanted My1/De cells resulted in the development of leukemia in the abdominal organs, and metastasized to the mesenterial and thoracic parathymic lymph nodes (PTLNs). The lymphatic spread of metastasis was further confirmed by the significantly higher %ID/g values of the metastatic PTLNs (4.25±0.28) compared to the control (0.94±0.34). Cytochemical staining of the peripheral blood, autopsy findings, and wright-Giemsa-stained post-mortem histological sections proved the leukemic involvement of the assessed tissues/organs.
CONCLUSION
The currently established My1/De model appears to be well-suited for further leukemia-related therapeutic and diagnostic investigations.
Topics: Animals; Rats; Disease Models, Animal; Fluorodeoxyglucose F18; Autoradiography; Positron-Emission Tomography; Cell Line, Tumor; Tissue Distribution; Leukemia, Myeloid, Acute; Radiopharmaceuticals; Male; Humans
PubMed: 38688644
DOI: 10.21873/invivo.13540