Effect of Ozone on Apelin and APJ Expressions in Rat Peritonitis-Constituted With Colon Anastomosis

Background: Analyze the effect of ozone therapy on Apelin and APJ expressions in peritonitis constituted colon anastomosis.Methods: Eighteen male Wistar albino rats weighing 250-300 g were used in this study. The rats were randomly assigned into three groups. In the colonic tissue samples Hematoxylin-Eosin staining (HE) and the Apelin and APJ immunostaining was applied. Also, Apelin and APJ protein levels between groups were determined with the Western-Blot method.Results: In the ozone therapy group, Apelin and APJ immunoreactivity was decreased compared to the anastomosis group. The protein levels of Apelin and APJ according to Western-Blot analysis are consistent with immunostaining. Conclusion: As a result, increased levels of Apelin and APJ in cecal punctuation and colonic anastomosis process can be deduced and said to contribute to worsening of tissue while it may be involved in return to normal of with treatment.

Inflammatory Myofibroblastic Tumor of the Sigmoid Colon in an Infant: A Case Report

Background: Inflammatory myofibroblastic tumor (IMT), an infrequent mesenchymal lesion composed of myofibroblastic and fibroblastic spindle cells with inflammatory infiltration, mostly occurred in pediatric patients. IMT has been reported in a number of locations throughout the body. However, the cases occurred in the gastrointestinal tract, especially those involving the sigmoid colon in pediatric patients, are very rare and even have not been reported. Here we present a case of a large IMT originating from the sigmoid colon and invading the omentum and the surrounding tissues in an 11-month-old boy. Case presentation: The patient is an 11-month-old boy initially presenting with symptoms of fever and vomiting. Abdominal ultrasound revealed an inhomogeneous echo with a size of 9.9*4.6 cm in the left lower abdomen. Abdomen computed tomography (CT) scanning confirmed that a mass with a size of 10*8*6 cm located in the left middle and lower abdomen. Post-operative pathological examination confirmed the histopathologic diagnosis of IMT. Complete resection of the tumor along with the involved colon segments were performed and followed by end-to-end colon anastomosis. The boy recovered well without postoperative complications or recurrence during one-year follow-up. Conclusions: Colon IMT is extremely rare; its etiology and pathogeny are unclear. Imaging examination may provide reliable evidence for determining IMT. However, postoperative histopathologic examination is also important for the final diagnosis. Complete tumor excision, accompanied by rare recurrence and satisfying survival, is the best therapeutic approach at present. This case report may complete the clinical presentation of IMT by reminding physicians not to ignore the possibility of IMT in the colon.

Caudal Duplication Syndrome Systematic Review—A Need for Better Multidisciplinary Surgical Approach and Follow-Up

Background and Objectives: Caudal duplication syndrome is a rare association of anatomical anomalies describing duplication of the hindgut, spine, and uro-genital structures, leading to varied clinical presentations. The current literature focuses on case reports which describe the embryological etiology and anatomical spectrum of the condition giving little attention to the surgical preparation, the need for a well-structured follow-up program, or the transition into adult healthcare of these complex patients. No reviews have been published regarding this complex pathology. Materials and Methods: A review of caudal duplication syndrome cases was done to assess the range of the clinical malformations, timing, and types of surgical interventions. Inconsistencies in multidisciplinary care, follow-up, and risk events were described. Results: Hindgut duplication always involved the anorectal region. Anorectal malformations were evenly distributed as unilateral and bilateral. Colon duplication extended from the anal region to the transverse colon or ascending colon in most of the cases and less to terminal. In females, genital duplication was present in all cases. The follow-up period varied between 3 months and 12 years. In all adult females, the motive of presentation was related to pregnancy (complications after successful delivery, fertility evaluation) or late complications (fecalith obstruction of the end-to-side colon anastomosis, repeated UTIs with renal scarring). Conclusions: Complex malformations affecting multiple caudal organs may have a strong impact in many aspects of the long-term quality of life; therefore, patients with caudal duplication syndrome need increased awareness and joined multidisciplinary treatment.