ABSTRACT
BACKGROUND: Median arcuate ligament syndrome (MALS) is a rare disease caused by compression of the celiac trunk artery by the median arcuate ligament (MAL). It can cause symptoms of postprandial abdominal pain, weight loss, and nausea and vomiting. CASE SUMMARY: A 55-year-old woman was admitted due to abdominal pain, nausea and vomiting. On admission, the patient presented with epigastric pain that worsened after eating, without signs of peritoneal irritation. Computed tomography angiography of the upper abdomen showed compression of the proximal segment of the abdominal trunk, local luminal stenosis with angular "fishhook" changes, which changed significantly during forceful inspiration and expiration; gallbladder stones; and multiple cysts in the liver. Abdominal duplex ultrasonography showed that peak systolic velocity was 352 cm/s. After diagnosis of MALS was confirmed, an arch ligament release procedure was performed. MALS has no specific symptoms and can be misdiagnosed as other abdominal diseases. Awareness of MALS should be improved to avoid misdiagnosis. The commonly used treatment option is MAL release and resection of the peripheral ganglion of the celiac trunk artery. CONCLUSION: The diagnosis and treatment of MALS must be individualized, and MAL release is effective and provides immediate symptomatic relief.
ABSTRACT
Globally, gastric cancer is one of the leading cause of death. Surgical and chemotherapy constitute an important treatment regimen. Unfortunately, less than 20 persons out of 100 patients are live on almost 5 years. Hence, a nontoxic, effective and significantly enhancing novel therapeutic agent is required. d-Carvone is a natural terpenoid present in the essential oils and abundant in the seeds of caraway, as well as known folk medication for diarrhea, acidity, and other gastric disorders. Nevertheless, the role of d-carvone on gastric cancer and its underlying molecular mechanism resides enigmatic. Cells were treated with d-carvone to find out the IC50 by MTT assay. This study shows that 20 and 25 µM d-carvone has induced the reactive oxygen species production and mitochondrial membrane potential in gastric cancer AGS cells, which were evaluated by 2,7-dichlorofluoresceindiacetate and Rh123 staining methods, respectively. The effect of d-carvone against the Janus kinase 2 (JAK2)/signal transducer and activator of transcription 3 (STAT3) pathway was studied through immunoblotting. Then, we found that it effectively inhibited the proliferation of cell, and the induction of cell apoptosis was scrutinized by dual, 4',6-diamidino-2-phenylindole, and also propidium iodide staining methods. We also explored the fundamental molecular signaling mechanism of the d-carvone and our data depicts that d-carvone induced apoptosis cell death by mitochondrial reactive oxygen species production and downregulation of the and JAK and STAT3 signaling molecules. These overall findings support that the d-carvone inhibits the JAK/STAT3 signaling pathway and induces cell death in the gastric cancer AGS cells.
