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Protective effect of curcumin on acute lung injury induced by intestinal ischaemia/reperfusion

The aim of this study is to evaluate the role of curcumin on acute lung injury induced by intestinal ischaemia/reperfusion (I/R). A total of 30 male Wistar albino rats were divided into 3 groups: sham, I/R, and I/R + curcumin; each group contains 10 animals. Sham group animals underwent laparotomy without I/R injury. After I/R groups animals underwent laparotomy, 1 h of superior mesenteric artery ligation were followed by 1 h of reperfusion. In the curcumin group, 3 days before I/R, curcumin (100 mg/kg) was administered by gastric gavage. All animals were killed at the end of reperfusion and lung tissue samples were obtained for biochemical and histopathological investigation in all groups. To date, no more biochemical and histopathological changes on intestinal I/R injury in rats by curcumin treatment have been reported. Curcumin treatment significantly decreased the elevated tissue malondialdehyde levels and increased reduced superoxide dismutase, and glutathione peroxidase enzyme activities in lung tissue samples. Intestinal I/R caused severe histopathological injury including oedema, haemorrhage, increased thickness of the alveolar wall, and infiltration of inflammatory cells into alveolar spaces. Curcumin treatment significantly attenuated the severity of intestinal I/R injury. Furthermore, there is a significant reduction in the activity of inducible nitric oxide synthase and increase in the expression of surfactant protein D in lung tissue of acute lung injury induced by intestinal I/R with curcumin therapy. It was concluded that curcumin treatment may have beneficial effects in acute lung injury, and therefore has potential for clinical use.

Anti-inflammatory and antioxidant effects of infliximab in a rat model of intestinal ischemia/reperfusion injury.

The aim of this study was to investigate the possible protective effects of infliximab on oxidative stress, cell proliferation and apoptosis in the rat intestinal mucosa after ischemia/reperfusion (I/R). A total of 30 male Wistar albino rats were divided into three groups: sham, I/R and I/R+ infliximab; each group comprised 10 animals. Sham group animals underwent laparotomy without I/R injury. I/R groups after undergoing laparotomy, 1 hour of superior mesenteric artery ligation occurred, which was followed by 1 hour of reperfusion. In the infliximab group, 3 days before I/R, infliximab (3 mg/kg) was administered intravenously. All animals were killed at the end of reperfusion and intestinal tissues samples were obtained for biochemical and histopathological investigation in all groups. To date, no biochemical and histopathological changes have been reported regarding intestinal I/R injury in rats due to infliximab treatment. Infliximab treatment significantly decreased the elevated tissue malondialdehyde levels and increased reduced superoxide dismutase and glutathione peroxidase enzyme activities in intestinal tissues samples. I/R caused severe histopathological injury including mucosal erosions, inflammatory cell infiltration, necrosis, hemorrhage, and villous congestion. Infliximab treatment significantly attenuated the severity of intestinal I/R injury, inhibiting I/R-induced apoptosis, and cell proliferation. Because of its anti-inflammatory and antioxidant effects, infliximab pretreatment may have protective effects on the experimental intestinal I/R model of rats.

A giant abdominal mass: fecaloma.

r t a d p w t f i o a a t p h s A man was admitted to our hospital for 2-month constipation, nausea, and abdominal pain. Abominal distention had been added to his list of complaints for bout 2 weeks. He was not able to pass stool but did have ischarge of gas. The patient had no history of serious illness, ospitalization, or major surgery, but he had been smoking igarettes and cannabis and using various kinds of laxatives for any years. On initial evaluation, he had a temperature of 7.8°C, a heart rate of 106 beats per minute, respiratory rate of 6 breaths per minute, and blood pressure of 95/60 mm Hg. He as found to be in an agitated condition; on physical examiation, his skin was wet and the patient seemed anxious. Bowel ounds were hypoactive, especially in the left quadrant. Palpaion revealed a hard, nonmobile, tender abdominal mass filling he mid and left abdominal quadrants (Figure A). Digital rectal xamination revealed hard stool impaction. Blood tests reealed: hemoglobin, 15 g/dL; hematocrit, 42; white blood cells, 6.800/mL; sedimentation rate, 61 mm per hour; blood glucose, 48 mg/dL; urea, 58; creatinine, 0.6; Na, 135; protein, 5.5; and lbumin, 3.1 g/dL. Carcino-embryonic antigen, CA 19 –9, and lpha-fetoprotein levels were normal. Abdominal tomography howed a giant fecaloma in the pelvis and left side of the bdomen causing displacement of visceral structures to the ight side (Figure B; b, bladder; f, fecaloma). A hard mass of feces hat could not be fragmented was noted on sigmoidoscopic exmination. Repeated enemas and laxatives were used to stimulate efecation, but they were all unsuccessful. It was decided that the atient required abdominal surgery. Laparotomy was performed ith a midline incision. During the exploration, we discovered that he descending and sigmoid colons were filled with a giant ecaloma. To extract the colon from the abdomen, a midline ncision was made, extending from the xiphoid process to the level f the pubic symphysis. The diameter of the sigmoid colon was pproximately 20 cm (Figure C). Resection of the descending nd sigmoid colons, manual extraction of the remainder of he fecalomas from the rectum, and terminal colostomy were erformed following Hartmann’s technique (Figure D). The istopathologic study revealed atrophy of the mucosa and ubmucosa (Figure E), and pigmented macrophages in the

A therapeutic and diagnostic dilemma: granular cell tumor of the breast.

Six to eight percent of granular cell tumors are seen in the breast. Although mostly benign, they rarely have malignant features clinically and radiologically reminding of breast cancer. This may lead to a potential misdiagnosis of breast carcinoma and overtreatment of patients. The final diagnosis is made by immunohistochemical examination. We performed excisional biopsy on a patient who was diagnosed to have a breast mass. The histopathological examination of the mass revealed granular cell tumor.

Testosterone- and Cortisol-Secreting Adrenocortical Oncocytoma: An Unusual Cause of Hirsutism

Objective. Oncocytomas of the adrenal cortex are usually benign and nonfunctional. They are rarely seen as the cause of hirsutism. Therefore, we aimed to report a case of adrenocortical oncocytoma presenting with hirsutism. Methods. We report a testosterone- and cortisol-secreting adrenal oncocytoma in a 23-year-old female patient presenting with hirsutism. Results. The patient had the complaint of hirsutism for the last year. Laboratory tests revealed total testosterone level of 4.2 ng/mL, free testosterone of >100 pg/mL, and DHEAS level of 574 µg/dL. There was no suppression in cortisol levels with 2 mg dexamethasone suppression test (5.4 µg/dL). Adrenal MRI revealed a 27 × 25 mm isointense solid mass lesion in the left adrenal gland and the patient underwent laparoscopic left adrenalectomy. Pathological examination confirmed the diagnosis of benign adrenocortical oncoyctoma. Conclusion. This well-characterized case describes a testosterone- and cortisol-secreting adrenocortical oncocytoma as a possible cause of hirsutism. To our knowledge, this is the second report in the literature. Adrenal oncocytomas should always be considered in the differential diagnosis of hirsutism.

A rare cause of acute abdomen: jejunal diverticulosis with perforation.

Jejunal diverticulosis is generally asymptomatic and is associated with high morbidity and mortality secondary to complications, especially in elderly patients. We present a case report of a 74-year-old female patient with jejunal diverticulosis and perforation due to diverticulitis.

Adalimumab Ameliorates Abdominal Aorta Cross Clamping Which Induced Liver Injury in Rats

The aim of this study was to investigate the possible protective effects of adalimumab (ADA) on cell damage in rat liver tissue during ischemia/reperfusion (I/R) injury of infrarenal abdominal aorta. Thirty male Wistar-albino rats were divided into three groups: control, I/R, and I/R+ADA, each group containing 10 animals. Laparotomy without I/R injury was performed in the control group animals. Laparotomy in the I/R group was followed by two hours of infrarenal abdominal aortic cross ligation and then two hours of reperfusion. ADA (50 mg/kg) was administered intraperitoneally as a single dose, to the I/R+ADA group, five days before I/R. The tumor necrosis factor-alpha (TNF-α) (pg/mg protein) and nitric oxide (NO) (µmol/g protein) levels in the I/R group (430.8 ± 70.1, 8.0 ± 1.1, resp.) were significantly higher than those in the I/R+ADA group (338.0 ± 71.6, P = 0.006; 6.3 ± 1.2, P = 0.008) and the control group (345.5 ± 53.3, P = 0.008; 6.5 ± 1.5, P = 0.010, resp.). I/R causes severe histopathological injury to the liver tissue, but ADA leads to much less histopathological changes. ADA treatment significantly decreased the severity of liver I/R injury. ADA pretreatment may have protective effects on experimental liver injury.

Paratesticular Liposarcoma: A Radiologic Pathologic Correlation

Spermatic cord liposarcoma is an uncommon paratesticular tumor. Patients usually present with a painless scrotal or inguinal mass, mimicking inguinal hernia. Clinical examination suggested an inguinal hernia. Computed tomography demonstrated a fat-containing mass in the right inguinal region. The mass was surgically removed, along with the right testis and spermatic cord. Histopathological examination revealed a well-differentiated liposarcoma. No evidence of recurrence or metastases has been noted during the two-year follow-up with postoperative adjuvant therapy.

Gastric Necrosis due to Acute Massive Gastric Dilatation

Gastric necrosis due to acute massive gastric dilatation is relatively rare. Vascular reasons, herniation, volvulus, acute gastric dilatation, anorexia, and bulimia nervosa play a role in the etiology of the disease. Early diagnosis and treatment are highly important as the associated morbidity and mortality rates are high. In this case report, we present a case of gastric necrosis due to acute gastric dilatation accompanied with the relevant literature.

Laparoscopic treatment of a phytobezoar in the duodenal diverticulum – Report of a case

INTRODUCTION Primer small intestine bezoar is seen rarely. It frequently arises from underlying small intestine pathologies (diverticle, tumor, stricture etc.). We report a very rare case of disopyrobezoar in the duodenal diverticulum, a kind of phytobezoar caused by persimmons, which was treated laparoscopically. PRESENTATION OF CASE The 47-year-old patient applied to polyclinic with complaints of epigastric tenderness, occasional distension, and acid regurgitation. In endoscopical examination, impacted bezoar was determined in the diverticulum in the duodenum. Because it is too hard, it was unable to remove endoscopically. On the abdominal tomography, a smooth-bounded non-homogeneous mass including gas and soft tissue areas in the 2nd portion of the duodenum was detected. A barium meal confirmed the presence of a 5cm diameter diverticulum on the lateral wall of the second portion of the duodenum. It also showed an intraluminalfilling defect as well as the mottled appearance of the bezoar. Learned from history of the patient, that the patient consumed over persimmon in childhood. DISCUSSION Generally, duodenal diverticles are asymptomatic. Surgical treatment is rarely necessary because of complications such as bleeding, perforation, abdominal pain, bezoar formation. As well as using methods such as gastric lavage, enzymatic dissolution, endoscopical fragmentation in the treatment of phytobezoar, their chances of success are low because its structure is rigid. Usually, surgical intervention is required. CONCLUSION For the treatments of bezoar cases located in the small intestine, laparoscopic surgical method is a safe and feasible method in selected cases.