[Giant caseoma of the mesentery of the small intestine].
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Desmoid tumors are rare lesions with a local invasive potential and a risk of recurrence considered as benign due to the absence of metastases. They are included in fibromatoses and may be associated with Gardner's syndrome. The authors report an unusual case, in a 26 year old man, of a desmoid tumor invading ileon, right colon, appendix and the right ureter and responsible of a ureteral obstruction. Etiologic factors (traumatic, hormonal, auto-immune, ... ) are discussed. The treatment of choice to lower the risk of recurrence is the complete surgical removal of the tumor.
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The authors possess experience in surgical treatment of 12 cases. Benign tumor of the mesenterium is among diseases which are recognized with great difficulty in the early and preoperative period. This is mainly due to the vague signs of the disease and the limited possibilities of applying auxiliary methods of examination because of the specificity of the organ in which the neoplasm is situated. To make the correct diagnosis in the early stages of the disease it is necessary in this case to conduct differential diagnosis with other diseases of the abdominal organs. The most typical clinical signs characteristic only of a benign tumor of the mesenterium can be distinguished as a result. When used in a complex with other methods of examination, differential diagnosis makes it possible to increase the number of correct preoperative diagnoses.
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In the isolated perfused rat mesenteric vascular bed pretreated with guanethidine and precontracted with methoxamine, periarterial nerve stimulation elicited a frequency-dependent and endothelium-independent vasodilation. The sustained vasodilation was slow-onset and reversible. It was resistant to propranolol or atropine but sensitive to tetrodotoxin and capsaicin suggesting that this is a nonadrenergic-noncholinergic vasodilation and is a neurogenic response. The vasodilation was abolished by anti-serum against calcitonin-gene related peptide (CGRP) in a concentration-dependent manner. These data suggest that the non-adrenergic-noncholinergic vasodilation is mediated by endogenous CGRP released from the primary sensory nerve terminals upon electrical stimulation. In addition to the vasodilator action, CGRP also inhibited nerve stimulation-induced and norepinephrine-induced vasoconstriction at extremely low concentrations. The inhibitory action of CGRP appeared to be mediated by postsynaptic mechanisms inasmuch as evoked norepinephrine release was not affected by CGRP when the vasoconstriction produced by norepinephrine or periarterial nerve stimulation was attenuated greatly by CGRP. These observations suggest that the vascular tone of the resistance vessels can be regulated by primary sensory nerve-derived CGRP.
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The article presents a case of a rare tumor, mesenteric fibromatosis, unassociated with Gardner's syndrome and without previously abdominal surgery. The author reviews symptoms, diagnostic features and treatment, and discusses some of the possible differential diagnoses.
Ultrastructural changes of endothelial cells of the mesenteric microcirculatory bed were morphometrically and statistically examined on a total of 32 male R-rats 15, 30, 60, and 120 min after a traumatic-haemorrhagic shock (THS). Significant changes of various parameters were observed at all times after shock compared with a control group (8 animals). The findings can be divided into 2 main forms of reaction, namely activation and injury. At all times overlapping occurred and endothelial cells were considerably heteromorphic. Severe, possible irreversible injuries were rare.
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