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Sample records for baff mediates splenic

  1. Molecular and functional characterization of BAFF from the Yangtze alligator (Alligator sinensis, Alligatoridae).

    Science.gov (United States)

    Zhang, Jia-Xin; Song, Ren; Sang, Ming; Sun, Si-Qing; Ma, Lei; Zhang, Jie; Zhang, Shuang-Quan

    2015-10-01

    B-cell activating factor (BAFF) from the TNF family is critical for B-cell survival and maturation. In this study, we identified a Yangtze alligator (Alligator sinensis, Alligatoridae) BAFF cDNA, designated as asBAFF, using reverse transcription polymerase chain reaction (RT-PCR) and rapid amplification of cDNA ends (RACE). The open reading frame of this cDNA encodes a 287-amino acid protein containing a predicted transmembrane domain and a furin protease cleavage site, similar to mammalian and avian BAFF. The amino acid identity between biologically soluble asBAFF (assBAFF) and csBAFF, hsBAFF, and msBAFF is 94, 76, and 71%, respectively. Real-time quantitative PCR analysis showed that the asBAFF gene is strongly expressed in the spleen. Since BAFF is always expressed as inclusion bodies in bacteria, it is difficult to purify. To enhance the soluble expression of assBAFF in Escherichia coli, we fused the extracellular region of the asBAFF gene to a small ubiquitin-related modifier gene (SUMO). Purified assBAFF was able to promote the survival of splenic lymphocytes and co-stimulate the proliferation of mouse B cells with anti-mouse IgM. These findings suggest that asBAFF plays an important role in the survival and proliferation of Yangtze alligator B cells, and because it is evolutionarily highly conserved, functional cross-reactivity exists between mammalian and Yangtze alligator BAFF. PMID:26116474

  2. Molecular structure, distribution, and immunology function of TNFSF13B (BAFF) in Nile tilapia (Oreochromis niloticus).

    Science.gov (United States)

    Liu, Hongzhen; Zhang, Jiaxin; Li, Jianfeng; Song, Jinyun; Zhang, Shuangquan

    2016-04-01

    B cell-activating factor (BAFF)is a member of the tumor necrosis factor (TNF) family and plays roles in B cell survival and maturation. In this study, the full-length cDNA of Nile tilapia (Oreochromis niloticus) BAFF (tBAFF) was amplified from the spleen by reverse transcription PCR (RT-PCR). The open reading frame of this cDNA encodes a protein of 261 amino acids containing a predicted transmembrane domain and a furin protease cleavage site, similar to mammalian, avian, and reptile BAFF. Real-time quantitative PCR (qPCR) analysis revealed that tBAFF is present in various tissues and is predominantly expressed in the spleen. The predicted three-dimensional (3D) structure of the Nile tilapia (Oreochromis niloticus) soluble BAFF (tsBAFF) monomer was determined by (3D) structure modeling monomeranalyzed by (3D) structure mouse counterpart. Both tsBAFF and EGFP/tsBAFF were efficiently expressed in Escherichia coli BL21 (DE3), as confirmed by SDS-PAGE and Western blot analysis. After purification, the EGFP/tsBAFF fusion protein showed a fluorescence spectrum similar to that of EGFP. Laser scanning confocal microscopy showed that EGFP/tsBAFF bound to its receptor. In vitro, tsBAFF promoted the proliferation of Nile tilapia and mouse splenic B cells together with/without a priming agent (Staphylococcus aureus Cowan 1, SAC) or anti-mouse IgM. Furthermore, tsBAFF showed a similar proliferation-stimulating effect on mouse B cells compared to msBAFF. These findings indicate that tsBAFF plays an important role in the proliferation of Nile tilapia B cells and has functional cross-reactivity among Nile tilapia and mammals. Therefore, BAFF may represent a useful factor for enhancing immunological efficacy in animals. PMID:26915306

  3. First BAFF gene cloned from an aquatic mammal.

    Science.gov (United States)

    You, Fengtao; Ren, Wenhua; Gu, Shasha; Wang, Wenqian; Zhou, Lidan; Zhang, Yijun; Gan, Weifeng; Chen, Mingxing

    2012-08-01

    The finless porpoise (Neophocaena phocaenoides) is one of the smallest cetacean species. Research into the immune system of the finless porpoise is essential to the protection of this species, but, to date, no genes coding for proteins from the tumor necrosis factor family (TNF family) have yet been reported from finless porpoises. The TNF B cell activating factor (BAFF) is critical to B cell survival, proliferation, maturation, and immunoglobulin secretion and to T cell activation. It acts through its three receptors, BAFF-R, BCMA, and TACI. In the present study, the full-length cDNA of BAFF (designated NpBAFF) from the finless porpoise was cloned using RT-PCR and rapid amplification of cDNA ends (RACE) techniques, and its biological activities have been characterized. To our knowledge, this is the first report of any BAFF gene being cloned from an aquatic mammal. The full-length cDNA of NpBAFF consists of 1502 bases including an 852 bp open reading frame encoding 283 amino acids. This protein was found to contain a predicted transmembrane domain, a putative furin protease cleavage site, and a typical TNF homology domain corresponding to other, known BAFF homologues. Sequence comparison indicated that the amino acid sequence of NpBAFF was very similar to its bovine (87.68%), porcine (76.33%), hircine (87.68%) and canine (82.19%) counterparts. The predicted three-dimensional (3D) structure of the NpsBAFF monomer, analyzed by comparative protein modeling, revealed that it was very similar to its human counterpart. Phylogenetic analysis indicated that NpBAFF showed a notable homology with Artiodactyla BAFFs. The SUMO-NpsBAFF was efficiently expressed in Escherichia coli BL21 (DE3) and confirmed by SDS-PAGE and Western blot analysis. Laser scanning confocal microscopy analysis showed that NpsBAFF could bind to its receptors on B cells. In vitro, MTT assays indicated that SUMO-NpsBAFF could promote the survival or proliferation of mouse splenic B cells grown with anti

  4. Changes in Blood B Cell-Activating Factor (BAFF Levels in Multiple Sclerosis: A Sign of Treatment Outcome.

    Directory of Open Access Journals (Sweden)

    Karin Kannel

    Full Text Available Multiple sclerosis (MS is mediated primarily by autoreactive T cells. However, evidence suggesting the involvement of humoral immunity in brain diseases has increased interest in the role of B cells and their products during MS pathogenesis. The major survival factor for B cells, BAFF has been shown to play a role in several autoimmune conditions. Elevated BAFF levels have been reported in MS animal model and during MS relapse in patients. Moreover, disease-modifying treatments (DMT reportedly influence blood BAFF levels in MS patients, but the significance of these changes remains unclear. The present study addresses how blood BAFF levels are associated with the clinical course of relapsing-remitting MS and the effectiveness of DMT and short-term steroid treatment. During a prospective longitudinal follow-up of 2.3 years, BAFF was measured in the blood of 170 MS patients in the stable phase and within 186 relapses. BAFF levels were significantly higher in MS patients compared to healthy controls. However, stable MS patients without relapses exhibited significantly higher BAFF levels than relapsing patients. Treatment with interferon-β and immunosuppressants raised BAFF blood levels. Interestingly, a similar effect was not seen in patients treated with glatiramer acetate. Short-term treatment with high doses of intravenous methylprednisolone did not significantly alter plasma BAFF levels in 65% of relapsing-remitting MS patients. BAFF were correlated weakly but significantly with monocyte and basophil counts, but not with other blood cell types (neutrophils, lymphocytes, or eosinophils or inflammatory biomarkers. To our knowledge, this is the first report demonstrating that higher blood BAFF levels may reflect a more stable and effective MS treatment outcome. These results challenge hypotheses suggesting that elevated blood BAFF levels are associated with more severe disease presentation and could explain the recent failure of pharmaceutical

  5. IP-10-mediated T cell homing promotes cerebral inflammation over splenic immunity to malaria infection.

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    Catherine Q Nie

    2009-04-01

    Full Text Available Plasmodium falciparum malaria causes 660 million clinical cases with over 2 million deaths each year. Acquired host immunity limits the clinical impact of malaria infection and provides protection against parasite replication. Experimental evidence indicates that cell-mediated immune responses also result in detrimental inflammation and contribute to severe disease induction. In both humans and mice, the spleen is a crucial organ involved in blood stage malaria clearance, while organ-specific disease appears to be associated with sequestration of parasitized erythrocytes in vascular beds and subsequent recruitment of inflammatory leukocytes. Using a rodent model of cerebral malaria, we have previously found that the majority of T lymphocytes in intravascular infiltrates of cerebral malaria-affected mice express the chemokine receptor CXCR3. Here we investigated the effect of IP-10 blockade in the development of experimental cerebral malaria and the induction of splenic anti-parasite immunity. We found that specific neutralization of IP-10 over the course of infection and genetic deletion of this chemokine in knockout mice reduces cerebral intravascular inflammation and is sufficient to protect P. berghei ANKA-infected mice from fatality. Furthermore, our results demonstrate that lack of IP-10 during infection significantly reduces peripheral parasitemia. The increased resistance to infection observed in the absence of IP-10-mediated cell trafficking was associated with retention and subsequent expansion of parasite-specific T cells in spleens of infected animals, which appears to be advantageous for the control of parasite burden. Thus, our results demonstrate that modulating homing of cellular immune responses to malaria is critical for reaching a balance between protective immunity and immunopathogenesis.

  6. Genetic variation in BAFF and asthma exacerbations among African American individuals

    Science.gov (United States)

    Kumar, Rajesh; Williams, L. Keoki; Kato, Atsushi; Peterson, Edward L.; Favoreto, Silvio; Hulse, Katie; Wang, Deli; Beckman, Kenneth; Thyne, Shannon; LeNoir, Michael; Meade, Kelley; Lanfear, David E.; Levin, Albert M.; Favro, David; Yang, James J.; Weiss, Kevin; Boushey, Homer A.; Grammer, Leslie; Avila, Pedro C; Burchard, Esteban G.; Schleimer, Robert

    2012-01-01

    Capsule Summary A BAFF polymorphism is associated with asthma exacerbations and serum BAFF levels. BAFF expression in vivo increases in natural rhinovirus infection. BAFF may play a role in airway antiviral immunity and impact asthma exacerbation rates. PMID:22728080

  7. H1-histamine receptors may mediate the contractile response of guinea-pig ileum to 'histamine-free' splenic extracts.

    OpenAIRE

    Ainz, L. F.; Casis, E.; de Gandarias, J. M.; Gil-Rodrigo, C. E.; Goiriena de Gandarias, J. J.

    1983-01-01

    A water-soluble splenic factor, which produces a contractile response of the guinea-pig ileum, that is resistant to cholinoceptor and adrenoceptor antagonists is described. The ileal contractions elicited by the splenic extract showed some significant differences from those elicited by 5-hydroxytryptamine. The responses to splenic extract were not affected by the D-tryptamine-receptor antagonist, methysergide. The effect of the splenic extract on the guinea-pig ileum was similar to that of hi...

  8. Splenic dendritic cell involvement in FXR-mediated amelioration of DSS colitis.

    Science.gov (United States)

    Massafra, Vittoria; Ijssennagger, Noortje; Plantinga, Maud; Milona, Alexandra; Ramos Pittol, José M; Boes, Marianne; van Mil, Saskia W C

    2016-02-01

    Inflammatory Bowel Disease (IBD) is a multifactorial disorder involving dysregulation of the immune response and bacterial translocation through the intestinal mucosal barrier. Previously, we have shown that activation of the bile acid sensor Farnesoid X Receptor (FXR), which belongs to the family of nuclear receptors, improves experimental intestinal inflammation, decreasing expression of pro-inflammatory cytokines and protecting the intestinal barrier. Here, we aimed to investigate the immunological mechanisms that ameliorate colitis when FXR is activated. We analyzed by FACS immune cell populations in mesenteric lymph nodes (MLN) and in the spleen to understand whether FXR activation alters the systemic immune response. We show that FXR activation by obeticholic acid (OCA) has systemic anti-inflammatory effects that include increased levels of plasma IL-10, inhibition of both DSS-colitis associated decrease in splenic dendritic cells (DCs) and increase in Tregs. Impact of OCA on DC relative abundance was seen in spleen but not MLN, possibly related to the increased FXR expression in splenic DCs compared to MLN DCs. Moreover, FXR activation modulates the chemotactic environment in the colonic site of inflammation, as Madcam1 expression is decreased, while Ccl25 is upregulated. Together, our data suggest that OCA treatment elicits an anti-inflammatory immune status including retention of DCs in the spleen, which is associated with decreased colonic inflammation. Pharmacological FXR activation is therefore an attractive new drug target for treatment of IBD. PMID:26554605

  9. BAFF induces spleen CD4+ T cell proliferation by down-regulating phosphorylation of FOXO3A and activates cyclin D2 and D3 expression

    International Nuclear Information System (INIS)

    Highlights: ► Firstly analyze the mechanism of BAFF and anti-CD3 co-stimulation on purified mouse splenic CD4+ T cells. ► Carrying out siRNA technology to study FOXO3A protein function. ► Helpful to understand the T cell especially CD4+ T cell‘s role in immunological reaction. -- Abstract: The TNF ligand family member “B cell-activating factor belonging to the TNF family” (BAFF, also called BLyS, TALL-1, zTNF-4, and THANK) is an important survival factor for B and T cells. In this study, we show that BAFF is able to induce CD4+ spleen T cell proliferation when co-stimulated with anti-CD3. Expression of phosphorylated FOXO3A was notably down-regulated and cyclins D2 and D3 were up-regulated and higher in the CD4+ T cells when treated with BAFF and anti-CD3, as assessed by Western blotting. Furthermore, after FOXO3A was knocked down, expression of cyclin D1 was unchanged, compared with control group levels, but the expression of cyclins D2 and D3 increased, compared with the control group. In conclusion, our results suggest that BAFF induced CD4+ spleen T cell proliferation by down-regulating the phosphorylation of FOXO3A and then activating cyclin D2 and D3 expression, leading to CD4+ T cell proliferation.

  10. BAFF induces spleen CD4{sup +} T cell proliferation by down-regulating phosphorylation of FOXO3A and activates cyclin D2 and D3 expression

    Energy Technology Data Exchange (ETDEWEB)

    Ji, Fang; Chen, Rongjing [Department of Orthodontics, Ninth People' s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Stomatology, Shanghai (China); Liu, Baojun [Laboratory of Lung, Inflammation and Cancers, Huashan Hospital, Fudan University, Shanghai (China); Zhang, Xiaoping [Department of Nuclear Medicine, Shanghai 10th People' s Hospital, Tongji University School of Medicine, Shanghai 200072 (China); Han, Junli; Wang, Haining [Department of General Dentistry, Ninth People' s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Stomatology, Shanghai (China); Shen, Gang [Department of Orthodontics, Ninth People' s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Stomatology, Shanghai (China); Tao, Jiang, E-mail: taojiang2012@yahoo.cn [Department of General Dentistry, Ninth People' s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Stomatology, Shanghai (China)

    2012-09-07

    Highlights: Black-Right-Pointing-Pointer Firstly analyze the mechanism of BAFF and anti-CD3 co-stimulation on purified mouse splenic CD4{sup +} T cells. Black-Right-Pointing-Pointer Carrying out siRNA technology to study FOXO3A protein function. Black-Right-Pointing-Pointer Helpful to understand the T cell especially CD4{sup +} T cell's role in immunological reaction. -- Abstract: The TNF ligand family member 'B cell-activating factor belonging to the TNF family' (BAFF, also called BLyS, TALL-1, zTNF-4, and THANK) is an important survival factor for B and T cells. In this study, we show that BAFF is able to induce CD4{sup +} spleen T cell proliferation when co-stimulated with anti-CD3. Expression of phosphorylated FOXO3A was notably down-regulated and cyclins D2 and D3 were up-regulated and higher in the CD4{sup +} T cells when treated with BAFF and anti-CD3, as assessed by Western blotting. Furthermore, after FOXO3A was knocked down, expression of cyclin D1 was unchanged, compared with control group levels, but the expression of cyclins D2 and D3 increased, compared with the control group. In conclusion, our results suggest that BAFF induced CD4{sup +} spleen T cell proliferation by down-regulating the phosphorylation of FOXO3A and then activating cyclin D2 and D3 expression, leading to CD4{sup +} T cell proliferation.

  11. Innate lymphoid cells integrate stromal and immunological signals to enhance antibody production by splenic marginal zone B cells

    OpenAIRE

    Magri, Giuliana; Miyajima, Michio; Bascones, Sabrina; Mortha, Arthur; Puga, Irene; Cassis, Linda; Barra, Carolina M; Comerma, Laura; Chudnovskiy, Aleksey; Gentile, Maurizio; Llige, David; Cols, Montserrat; Serrano, Sergi; Aróstegui, Juan Ignacio; Juan, Manel

    2014-01-01

    Innate lymphoid cells (ILCs) regulate stromal, epithelial and immune cells, but their impact on B cells remains unclear. We identified RORγt+ ILCs nearby the marginal zone (MZ), a splenic compartment containing innate-like B cells that respond to circulating T cell-independent (TI) antigens. Spenic ILCs established a bidirectional crosstalk with MAdCAM-1+ marginal reticular cells by providing tumor necrosis factor (TNF) and lymphotoxin, and activated MZ B cells via BAFF, CD40 ligand and the N...

  12. Expression of BAFF and BR3 in patients with systemic lupus erythematosus

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    J.H. Duan

    2016-03-01

    Full Text Available The objective of this study was to examine the relationship between the expression of B cell activating factor (BAFF and BAFF receptor in patients with disease activity of systemic lupus erythematosus (SLE. Real-time RT-PCR was used to examine BAFF mRNA expression in peripheral blood monocytes of active and stable SLE patients and healthy controls. The percentage of BAFF receptor 3 (BR3 on B lymphocytes was measured by flow cytometry. Soluble BAFF levels in serum were assayed by ELISA. Microalbumin levels were assayed by an automatic immune analysis machine. BAFF mRNA and soluble BAFF levels were highest in the active SLE group, followed by the stable SLE group, and controls (P<0.01. The percentage of BR3 on B lymphocytes was downregulated in the active SLE group compared with the stable SLE group and controls (P<0.01. BAFF mRNA levels and soluble BAFF levels were higher in patients who were positive for proteinuria than in those who were negative (P<0.01. The percentage of BR3 on B lymphocytes was lower in patients who were positive for proteinuria than in those who were negative (P<0.01. The BAFF/BR3 axis may be over-activated in SLE patients. BAFF and BR3 levels may be useful parameters for evaluating treatment.

  13. Therapeutic Effects of PADRE-BAFF Autovaccine on Rat Adjuvant Arthritis

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    Guo-dong Feng

    2014-01-01

    Full Text Available B cell activating factor (BAFF is a cytokine of tumor necrosis factor family mainly produced by monocytes and dendritic cells. BAFF can regulate the proliferation, differentiation, and survival of B lymphocytes by binding with BAFF-R on B cell membrane. Accumulating evidences showed that BAFF played crucial roles and was overexpressed in various autoimmune diseases such as systemic lupus erythematous (SLE and rheumatoid arthritis (RA. This suggests that BAFF may be a therapeutic target for these diseases. In the present study, we developed a BAFF therapeutic vaccine by coupling a T helper cell epitope AKFVAAWTLKAA (PADRE to the N terminus of BAFF extracellular domains (PADRE-BAFF and expressed this fusion protein in Escherichia coli. The purified vaccine can induce high titer of neutralizing BAFF antibodies and ameliorate the syndrome of complete Freund’s adjuvant (CFA induced rheumatoid arthritis in rats. Our data indicated that the BAFF autovaccine may be a useful candidate for the treatment of some autoimmune diseases associated with high level of BAFF.

  14. Splenic injury diagnosis & splenic salvage after trauma

    NARCIS (Netherlands)

    D.C. Olthof

    2014-01-01

    Non-operative management (NOM) has replaced surgery as the treatment of choice for hemodynamically stable patients with splenic injury after trauma. The growing use of NOM for blunt abdominal organ injury has been made possible by the progress in the quality and availability of the multidetector CT

  15. Interferon-beta increases systemic BAFF levels in multiple sclerosis without increasing autoantibody production

    DEFF Research Database (Denmark)

    Hedegaard, Chris J; Sellebjerg, Finn; Krakauer, Martin; Hesse, Dan; Bendtzen, Klaus; Nielsen, Claus H

    2011-01-01

    -associated autoantibodies. Objective: To investigate whether BAFF levels are associated with disease severity/activity in untreated MS patients, and to assess the effect of IFN-beta therapy on circulating BAFF and anti-myelin basic protein (MBP) autoantibody levels. Results: Twenty-three patients with relapsing......-remitting MS (RRMS) were followed longitudinally from initiation of IFN-beta therapy. Their blood levels of BAFF correlated positively at baseline with the expanded disability status scale (p <0.009) and MS severity score (p <0.05), but not with disease activity as determined by the number of gadolinium......-enhanced lesions. The patients were followed for up to 26 months, during which the BAFF levels remained elevated without association to increased disease activity. IFN-beta therapy caused an increase in plasma BAFF levels after both 3 and 6 months of therapy (p <0.002). However, an 11% decrease in IgM and a 33...

  16. The strength of the antibody response to the nematode Ascaris lumbricoides inversely correlates with levels of B-Cell Activating Factor (BAFF)

    OpenAIRE

    Bornacelly, Adriana; Mercado, Dilia; Acevedo, Nathalie; Caraballo, Luis

    2014-01-01

    Background B-Cell Activating Factor (BAFF) is a cytokine regulating antibody production. Polymorphisms in the gene encoding BAFF were associated with the antibody response to Ascaris but not to mite allergens. In the present study we evaluated the relationship between BAFF and specific antibodies against Ascaris and mites in 448 controls and 448 asthmatics. Soluble BAFF was measured by ELISA and BAFF mRNA by qPCR. Surface expression of BAFF and its receptor (BAFF-R) was analyzed by flow cytom...

  17. BAFF is decreased in the cerebrospinal fluid of multiple sclerosis at clinical onset.

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    Puthenparampil, M; Miante, S; Federle, L; Zanetta, C; Toffanin, E; Ruggero, S; Rinaldi, F; Gallo, P

    2016-08-15

    B-cells are thought to play a relevant role in multiple sclerosis (MS) pathology. BAFF (B cell activating factor of the TNF family) is a B-cell survival factor constitutively produced inside the CNS by astrocytes. We studied the intrathecal synthesis of BAFF in MS at clinical onset. Paired serum and cerebrospinal fluid (CSF) specimens from 40 clinically isolated syndromes (CIS) suggestive of MS or early relapse-onset MS (eRRMS) and from 18 healthy controls (HC) were analysed. Patients were classified based on the detection of oligoclonal IgG bands in the CSF (IgGOB+ and IgGOB-). BAFF was detected by highly sensitive ELISA and its ratio (CSF-BAFF/serum-BAFF, QBAFF) and Index (QBAFF/QAlb, BAFF-Index) were calculated. IgGOB+ presented lower CSF concentrations of BAFF compared to both HC and IgGOB- (p<0.05). BAFF Index was significantly lower in IgGOB+ compared to both HC and IgGOB- (p<0.01). A significant inverse correlation between QIgG and QBAFF (r: -0.4, p<0.05) and between BAFF index and IgGIF (r: -0.4, p<0.05) or IgG Index (r: -0.4, p=0.05) was found in IgGOB+. The decreased CSF levels of BAFF in IgGOB+ at clinical onset suggest the absorption of this factor by intrathecally recruited B cells since the early disease phases. PMID:27397077

  18. Ultrasonography of splenic abnormalities

    Institute of Scientific and Technical Information of China (English)

    Ming-Jen Chen; Ming-Jer Huang; Wen-Hsiung Chang; Tsang-En Wang; Horng-Yuan Wang; Cheng-Hsin Chu; Shee-Chan Lin; Shou-Chuan Shih

    2005-01-01

    AIM: This report gives a comprehensive overview of ultrasonography of splenic abnormalities. Certain ultrasonic features are also discussed with pathologic correlation.METHODS: We review the typical ultrasonic characteristics of a wide range of splenic lesions, illustrating them with images obtained in our institution from 2000 to 2003.One hundred and three patients (47 men, 56 women),with a mean age of 54 years (range 9-92 years), were found to have an abnormal ultrasonic pattern of spleen.RESULTS: We describe the ultrasonic features of various splenic lesions such as accessory spleen, splenomegaly,cysts, cavernous hemangiomas, lymphomas, abscesses,metastatic tumors, splenic infarctions, hematomas, and rupture, based on traditional gray-scale and color Doppler sonography.CONCLUSION: Ultrasound is a widely available, noninvasive,and useful means of diagnosing splenic abnormalities. A combination of ultrasonic characteristics and clinical data may provide an accurate diagnosis. If the US appearance alone is not enough, US may also be used to guide biopsy of suspicious lesions.

  19. Splenic rupture following colonoscopy

    Institute of Scientific and Technical Information of China (English)

    Juan Francisco Guerra; Ignacio San Francisco; Fernando Pimentel; Luis Ibanez

    2008-01-01

    Colonoscopy is a safe and routinely performed diagnostic and therapeutic procedure for different colorectal diseases. Although the most common complications are bleeding and perforation, extracolonic or visceral injuries have also been described. Splenic rupture is a rare complication following colonoscopy, with few cases reported. We report a 60-year-old female who presented to surgical consultation 8 h after a diagnostic colonoscopy. Clinical, laboratory and imaging findings were suggestive for a massive hemoperitoneum. At surgery, an almost complete splenic disruption was evident, and an urgent splenectomy was performed. After an uneventful postoperative period, she was discharged home. Splenic injury following colonoscopy is considered infrequent. Direct trauma and excessive traction of the splenocolic ligament can explain the occurrence of this complication. Many times the diagnosis is delayed because the symptoms are due to colonic insufflation, so the most frequent treatment is an urgent splenectomy. A high index of suspicion needs an early diagnosis and adequate therapy.

  20. The Early Protective Thymus-Independent Antibody Response to Foot-and-Mouth Disease Virus Is Mediated by Splenic CD9+ B Lymphocytes▿

    OpenAIRE

    Ostrowski, Matias; Vermeulen, Monica; Zabal, Osvaldo; Zamorano, Patricia I; Sadir, Ana M; Jorge R. Geffner; Lopez, Osvaldo J.

    2007-01-01

    Infection of mice with cytopathic foot-and-mouth disease virus (FMDV) induces a rapid and specific thymus-independent (TI) neutralizing antibody response that promptly clears the virus. Herein, it is shown that FMDV-infected dendritic cells (DCs) directly stimulate splenic innate-like CD9+ B lymphocytes to rapidly (3 days) produce neutralizing anti-FMDV immunoglobulin M antibodies without T-lymphocyte collaboration. In contrast, neither follicular (CD9−) B lymphocytes from the spleen nor B ly...

  1. Expression of BAFF in the trophoblast and decidua of normal early pregnant women and patients with recurrent spontaneous miscarriage

    Institute of Scientific and Technical Information of China (English)

    2008-01-01

    Background BAFF,the B cell activation factor,is a member of the tumor necrosis factor(TNF)ligand family that binds to BCMA,TACI,and BAFF-R.Previous studies have shown that members of the TNF family are detected in human placental trophoblast cells,but the expression patterns of BAFF involved in human decidua and the differential expression of BAFF between normal pregnancy and miscarriage are still incompletely documented or unknown.This study was designed to investigate the expression of BAFF and BAFF-R in the trophoblast and decidua of normal early pregnant women and recurrent spontaneous abortion(RSA)patients.Methods Forty-five patients with RSA and 45 normal pregnant women were included in this study.By reverse transcriptase-polymerase chain reaction(RT-PCR),Western blotting and immunohistochemical experiments,we explored the expression of BAFF and BAFF-R in the maternal-fetal interface of normal early pregnant women and RSA patients.Results Analysis by RT-PCR and Western blotting revealed that BAFF was detected in both trophoblast and decidua of all the samples,and the expression level was higher in the tissues of normal early pregnant women(P<0.05)than that of recurrent spontaneous abortion patients under the same gestational weeks.Messages for BAFF-R were absent.Immunohistochemical experiments showed that expression of BAFF was cell-specific which was localized to villous cytotrophoblast and syncytiotrophoblast cells in trophoblast and to stromal cells in decidua.Whereas BAFF was prominent on the trophoblast and decidua of normal early pregnant women,it was decreased in the tissues of RSA patients.Conclusions BAFF might steer maternal leukocytes away from a harmful immune response and toward a favorable one and play a potentially vital role for successful pregnancy.

  2. BAFF Blockade Prevents Anti-Drug Antibody Formation in a Mouse Model of Pompe Disease

    OpenAIRE

    Doerfler, Phillip A.; Nayak, Sushrusha; Herzog, Roland W; Morel, Laurence; Barry J Byrne

    2015-01-01

    Antibodies formed against the therapeutic protein are a life-threatening complication that arises during enzyme replacement therapy for Pompe disease (acid α-glucosidase deficiency; GAA). To provide an effective alternative to current practices, we investigated the capacity of anti-B-cell activating factor (BAFF) as a novel drug candidate to prevent antibody formation in a Pompe disease mouse model. A BAFF-neutralizing antibody was administered prophylactically and with maintenance doses in a...

  3. Stimulation of prostaglandin E2-synthesis by noradrenaline in primary cell cultures from rabbit splenic pulpa is mediated by atypical alpha-adrenoceptors.

    Science.gov (United States)

    Brückner-Schmidt, R; Jackisch, R; Hertting, G

    1981-02-01

    In primary cell cultures originating from rabbit splenic pulpa the effects of various adrenoceptor agonists on prostaglandin (PG)-synthesis were studied. The cells - microscopically identified as fibroblasts - released PGs into the medium: especially PGE2 besides small amounts of PGF2alpha and PGD2. Noradrenaline increased dose-dependently the amount of PGs released into the medium. Besides noradrenaline, only the catecholamines adrenaline and alpha-methylnoradrenaline strongly activated PG-synthesis. Other alpha-adrenoceptor agonists like the phenylethylamine and imidazoline derivatives were only weak agonists or completely ineffective. All adrenoceptor agonists without intrinsic activity in these cells antagonized the noradrenaline effect on PG-synthesis, the imidazolines being more potent antagonists than the phenylethylamines. The beta-adrenoceptor agonist isoprenaline stimulated PG-synthesis at high concentration only. The effects of both noradrenaline and isoprenaline were inhibited by low concentrations of phentolamine phenoxybenzamine, but not by propranolol. The preferential alpha2-adrenoceptor antagonists yohimbine and rauwolscine were about 50 times more potent in blocking the noradrenaline effect on PG-synthesis than the more alpha1-specific antagonist corynanthine. However, prazosin, another alpha1-adrenoceptor antagonist, was about equipotent with yohimbine. It is concluded that noradrenaline elicits PG-synthesis in rabbit splenic fibroblasts via alpha-adrenoceptor stimulation. The alpha-adrenoceptor involved has properties which are different from those reported so far for alpha1- or alpha2-adrenoceptors. PMID:6268994

  4. Serum BAFF levels, Methypredsinolone therapy, Epstein-Barr Virus and Mycobacterium avium subsp. paratuberculosis infection in Multiple Sclerosis patients.

    Science.gov (United States)

    Mameli, Giuseppe; Cocco, Eleonora; Frau, Jessica; Arru, Giannina; Caggiu, Elisa; Marrosu, Maria Giovanna; Sechi, Leonardo A

    2016-01-01

    Elevated B lymphocyte activating factor BAFF levels have been reported in multiple sclerosis (MS) patients; moreover, disease-modifying treatments (DMT) have shown to influence blood BAFF levels in MS patients, although the significance of these changes is still controversial. In addition, BAFF levels were reported increased during infectious diseases. In our study, we wanted to investigate on the serum BAFF concentrations correlated to the antibody response against Mycobacterium avium subspecies paratuberculosis (MAP), Epstein-Barr virus (EBV) and their human homologous epitopes in MS and in patients affected with other neurological diseases (OND), divided in Inflammatory Neurological Diseases (IND), Non Inflammatory Neurological Diseases (NIND) and Undetermined Neurological Diseases (UND), in comparison to healthy controls (HCs). Our results confirmed a statistically significant high BAFF levels in MS and IND patients in comparison to HCs but not NIND and UND patients. Interestingly, BAFF levels were inversely proportional to antibodies level against EBV and MAP peptides and the BAFF levels significantly decreased in MS patients after methylprednisolone therapy. These results implicate that lower circulating BAFF concentrations were present in MS patients with humoral response against MAP and EBV. In conclusion MS patients with no IgGs against EBV and MAP may support the hypothesis that elevated blood BAFF levels could be associated with a more stable disease. PMID:27383531

  5. Investigations of a rabbit (Oryctolagus cuniculus model of systemic lupus erythematosus (SLE, BAFF and its receptors.

    Directory of Open Access Journals (Sweden)

    Jiahui Yang

    Full Text Available B-cell activation factor belonging to the tumor necrosis factor family (BAFF is a major contributor to survival of B lymphocytes during development and maturation. A relationship between circulating BAFF levels and disease activity has been reported in patients with the autoimmune disease Systemic Lupus Erythematosus (SLE. Clinical trials targeting BAFF or its receptors are currently in progress. In order to further characterize a rabbit (Oryctolagus cuniculus model of SLE, we investigated the expression of BAFF and its receptors in non-inbred, pedigreed rabbits derived from breeding and selection based on autoantibody responses. We immunized rabbits related to previous groups that developed autoantibodies and inflammatory responses after immunizations with peptides synthesized on multiple antigen-branched polylysine backbones. Blood and sera collected before immunization and after boosts were used for health monitoring, analyses of serum autoantibody responses by ELISA and immunofluorescence. Peripheral blood mononuclear cells (PBMC were studied by flow cytometry and were the source of mRNA for quantitative PCR analyses. We hypothesized that BAFF mRNA expression and serum BAFF levels measured indirectly through BAFF receptor binding might increase in autoantibody-producing rabbits. Immunized rabbits developed elevated levels of leucocyte populations, anti-nuclear, anti-dsDNA and other autoantibodies. BR3 mRNA levels in total PBMC decreased and BAFF levels remained low and unchanged in most immunized rabbits. By flow cytometry, percentages of BAFF positive cells decreased. Percentages of transmembrane activator and CAML interactor (TACI decreased in most rabbits from all the immunized groups. The rabbit is an important model for human autoimmune and infectious diseases, and a high quality draft rabbit genome assembly was recently completed. Human disease models developed in non-inbred pedigreed animals are better able to reflect the complexities

  6. BAFF promotes regulatory T-cell apoptosis and blocks cytokine production by activating B cells in primary biliary cirrhosis

    International Nuclear Information System (INIS)

    Primary biliary cirrhosis (PBC) is a chronic and slowly progressive cholestatic liver disease of autoimmune etiology. A number of questions regarding its etiology are unclear. CD4+CD25+ regulatory T cells (Tregs) play a critical role in self-tolerance and, for unknown reasons, their relative number is reduced in PBC patients. B-cell-activating factor (BAFF) is a key survival factor during B-cell maturation and its concentration is increased in peripheral blood of PBC patients. It has been reported that activated B cells inhibit Treg cell proliferation and there are no BAFF receptors on Tregs. Therefore, we speculated that excessive BAFF may result in Treg reduction via B cells. To prove our hypothesis, we isolated Tregs and B cells from PBC and healthy donors. BAFF and IgM concentrations were then analyzed by ELISA and CD40, CD80, CD86, IL-10, and TGF-β expression in B cells and Tregs were measured by flow cytometry. BAFF up-regulated CD40, CD80, CD86, and IgM expression in B cells. However, BAFF had no direct effect on Treg cell apoptosis and cytokine secretion. Nonetheless, we observed that BAFF-activated B cells could induce Treg cell apoptosis and reduce IL-10 and TGF-β expression. We also showed that BAFF-activated CD4+ T cells had no effect on Treg apoptosis. Furthermore, we verified that bezafibrate, a hypolipidemic drug, can inhibit BAFF-induced Treg cell apoptosis. In conclusion, BAFF promotes Treg cell apoptosis and inhibits cytokine production by activating B cells in PBC patients. The results of this study suggest that inhibition of BAFF activation is a strategy for PBC treatment

  7. BAFF promotes regulatory T-cell apoptosis and blocks cytokine production by activating B cells in primary biliary cirrhosis

    Directory of Open Access Journals (Sweden)

    Bo Zhang

    2013-10-01

    Full Text Available Primary biliary cirrhosis (PBC is a chronic and slowly progressive cholestatic liver disease of autoimmune etiology. A number of questions regarding its etiology are unclear. CD4+CD25+ regulatory T cells (Tregs play a critical role in self-tolerance and, for unknown reasons, their relative number is reduced in PBC patients. B-cell-activating factor (BAFF is a key survival factor during B-cell maturation and its concentration is increased in peripheral blood of PBC patients. It has been reported that activated B cells inhibit Treg cell proliferation and there are no BAFF receptors on Tregs. Therefore, we speculated that excessive BAFF may result in Treg reduction via B cells. To prove our hypothesis, we isolated Tregs and B cells from PBC and healthy donors. BAFF and IgM concentrations were then analyzed by ELISA and CD40, CD80, CD86, IL-10, and TGF-β expression in B cells and Tregs were measured by flow cytometry. BAFF up-regulated CD40, CD80, CD86, and IgM expression in B cells. However, BAFF had no direct effect on Treg cell apoptosis and cytokine secretion. Nonetheless, we observed that BAFF-activated B cells could induce Treg cell apoptosis and reduce IL-10 and TGF-β expression. We also showed that BAFF-activated CD4+ T cells had no effect on Treg apoptosis. Furthermore, we verified that bezafibrate, a hypolipidemic drug, can inhibit BAFF-induced Treg cell apoptosis. In conclusion, BAFF promotes Treg cell apoptosis and inhibits cytokine production by activating B cells in PBC patients. The results of this study suggest that inhibition of BAFF activation is a strategy for PBC treatment.

  8. BAFF promotes regulatory T-cell apoptosis and blocks cytokine production by activating B cells in primary biliary cirrhosis

    Energy Technology Data Exchange (ETDEWEB)

    Zhang, Bo; Hu, Mintao [Department of Hepatology, Wuxi Infectious Diseases Hospital, Wuxi, Jiangsu (China); Zhang, Peng [Nanjing Medical University, Nanjing, Jiangsu (China); Cao, Hong [Department of Hepatology, Wuxi Infectious Diseases Hospital, Wuxi, Jiangsu (China); Wang, Yongzhen [The Second Hospital of Nanjing, Nanjing, Jiangsu (China); Wang, Zheng; Su, Tingting [Department of Hepatology, Wuxi Infectious Diseases Hospital, Wuxi, Jiangsu (China)

    2013-05-10

    Primary biliary cirrhosis (PBC) is a chronic and slowly progressive cholestatic liver disease of autoimmune etiology. A number of questions regarding its etiology are unclear. CD4+CD25+ regulatory T cells (Tregs) play a critical role in self-tolerance and, for unknown reasons, their relative number is reduced in PBC patients. B-cell-activating factor (BAFF) is a key survival factor during B-cell maturation and its concentration is increased in peripheral blood of PBC patients. It has been reported that activated B cells inhibit Treg cell proliferation and there are no BAFF receptors on Tregs. Therefore, we speculated that excessive BAFF may result in Treg reduction via B cells. To prove our hypothesis, we isolated Tregs and B cells from PBC and healthy donors. BAFF and IgM concentrations were then analyzed by ELISA and CD40, CD80, CD86, IL-10, and TGF-β expression in B cells and Tregs were measured by flow cytometry. BAFF up-regulated CD40, CD80, CD86, and IgM expression in B cells. However, BAFF had no direct effect on Treg cell apoptosis and cytokine secretion. Nonetheless, we observed that BAFF-activated B cells could induce Treg cell apoptosis and reduce IL-10 and TGF-β expression. We also showed that BAFF-activated CD4+ T cells had no effect on Treg apoptosis. Furthermore, we verified that bezafibrate, a hypolipidemic drug, can inhibit BAFF-induced Treg cell apoptosis. In conclusion, BAFF promotes Treg cell apoptosis and inhibits cytokine production by activating B cells in PBC patients. The results of this study suggest that inhibition of BAFF activation is a strategy for PBC treatment.

  9. BAFF promotes regulatory T-cell apoptosis and blocks cytokine production by activating B cells in primary biliary cirrhosis

    Directory of Open Access Journals (Sweden)

    Bo Zhang

    2013-05-01

    Full Text Available Primary biliary cirrhosis (PBC is a chronic and slowly progressive cholestatic liver disease of autoimmune etiology. A number of questions regarding its etiology are unclear. CD4+CD25+ regulatory T cells (Tregs play a critical role in self-tolerance and, for unknown reasons, their relative number is reduced in PBC patients. B-cell-activating factor (BAFF is a key survival factor during B-cell maturation and its concentration is increased in peripheral blood of PBC patients. It has been reported that activated B cells inhibit Treg cell proliferation and there are no BAFF receptors on Tregs. Therefore, we speculated that excessive BAFF may result in Treg reduction via B cells. To prove our hypothesis, we isolated Tregs and B cells from PBC and healthy donors. BAFF and IgM concentrations were then analyzed by ELISA and CD40, CD80, CD86, IL-10, and TGF-β expression in B cells and Tregs were measured by flow cytometry. BAFF up-regulated CD40, CD80, CD86, and IgM expression in B cells. However, BAFF had no direct effect on Treg cell apoptosis and cytokine secretion. Nonetheless, we observed that BAFF-activated B cells could induce Treg cell apoptosis and reduce IL-10 and TGF-β expression. We also showed that BAFF-activated CD4+ T cells had no effect on Treg apoptosis. Furthermore, we verified that bezafibrate, a hypolipidemic drug, can inhibit BAFF-induced Treg cell apoptosis. In conclusion, BAFF promotes Treg cell apoptosis and inhibits cytokine production by activating B cells in PBC patients. The results of this study suggest that inhibition of BAFF activation is a strategy for PBC treatment.

  10. Splenic injury after colonoscopy

    DEFF Research Database (Denmark)

    Petersen, C.R.; Adamsen, S.; Gocht-Jensen, P.;

    2008-01-01

    Splenic injury is a rare and serious complication of colonoscopy. The most likely mechanism is tension on the splenocolic ligament and adhesions. Eight cases were identified among claims for compensation submitted to the Danish Patient Insurance Association during the period 1992-2006, seven of...... potentially lethal complication might be more common than was previously assumed, and it is possibly under-reported. Preventive measures include good colonoscopic technique to avoid loop formation and the use of excessive force; and it is possible that emerging endoscopic technologies will lead to a reduced...

  11. Splenic abscess: a rare presentation

    Directory of Open Access Journals (Sweden)

    Mohit Bhatia

    2015-01-01

    Full Text Available Splenic abscess is a rare clinical entity with an incidence of 0.2-0.7% in autopsy-based studies. When untreated, splenic abscess is associated with nearly 100% mortality; in treated patients, the mortality rate is 16.6% during the first 90 days. It mostly occurs in patients with neoplasia, immunodeficiency, trauma, diabetes or splenic infarct. The incidence of splenic abscess is thought to be growing because of the increase in the number of immunocompromised patients who are particularly at risk for this disease and also because of the widespread use of diagnostic modalities. However, the optimal treatment for this remains unclear. We present a case of a 42-year-old man diagnosed with multiloculated splenic abscess and was subjected to splenectomy.

  12. Splenic hydatid cyst attacking retroperitoneum.

    Science.gov (United States)

    Kaya, Bülent; Uçtum, Yalım; Kutanış, Rıza

    2010-01-01

    Hydatid disease most commonly affects the liver and lungs but no organ is immune. Splenic hydatid cyst is a rare clinical entity. Although the patients are usually asymptomatic, the disease may present with secondary infection, adhesion to adjacent organs with fistulisation or rupture into abdominal cavity. We present a 67 year old women with splenic hydatid cyst. Severe adhesions and tumorlike growth were found in the retroperitoneal region. To our knowledge, retroperitoneal invasion with a splenic hydatid cyst is a very rare clinical condition. Total splenectomy was performed without complication. PMID:21391192

  13. Imaging findings of splenic hamartoma

    Institute of Scientific and Technical Information of China (English)

    Ri-Sheng Yu; Shi-Zheng Zhang; Jian-Ming Hua

    2004-01-01

    AIM: To assess CT and MR manifestations and their diagnostic value in splenic hamartoma with review of literatures.METHODS: We described a woman who was accidentally found to have a splenic tumor by ultrasound of the abdomen.CT and MR findings of this splenic hamartoma were proved by pathology retrospectively.RESULTS: The CT and MR findings in this case included a ball-like mass with homogeneous mild-hypodensity lesions on non-enhanced CT scans or isointensity on T1-weighted images and mild hypointensity on T2-weighted images,progressive homogeneous enhancement on multiple-phase spiral CT and MR enhanced scans, and isodense enhancement on delayed post-contrast CT scans and obvious hyperintensity relative to the spleen on delayed MR images.CONCLUSION: Splenic hamartoma has some specific radiological features. However, the diagnosis of this disease must be based on dinical features and confirmed by pathology.

  14. Serum BAFF and APRIL levels in patients with IgG4-related disease and their clinical significance

    OpenAIRE

    Kiyama, Kazuhiro; Kawabata, Daisuke; Hosono, Yuji; Kitagori, Koji; Yukawa, Naoichiro; Yoshifuji, Hajime; Omura, Koichiro; Fujii, Takao; Mimori, Tsuneyo

    2012-01-01

    Introduction B cell-activating factor of the tumor necrosis factor family (BAFF) and a proliferation-inducing ligand (APRIL) play a crucial role in B cell development, survival, and antibody production. Here we analyzed the serum levels of BAFF and APRIL and their respective clinical associations in patients with an immunoglobulin (Ig) G4-related disease (IgG4-RD). Methods We measured serum levels of BAFF and APRIL in patients with IgG4-RD, primary Sjögren's syndrome (pSS), and healthy indivi...

  15. B-Cell Activating Factor (BAFF) is elevated in Chronic Granulomatous Disease

    OpenAIRE

    Matharu, Kabir; Zarember, Kol A.; Marciano, Beatriz E.; Kuhns, Douglas B; Spalding, Christine; Garofalo, Mary; DiMaggio, Thomas; Estwick, Tyra; Huang, Chiung-yu; Fink, Danielle; Priel, Debra L.; Fleisher, Thomas A.; Holland, Steven M.; Malech, Harry L.; Gallin, John I.

    2013-01-01

    Chronic Granulomatous Disease (CGD) is an inherited defect in superoxide production leading to life-threatening infections, granulomas, and, possibly, abnormal immunoglobulin concentrations. We investigated whether factors controlling antibody production, such as B-cell activating factor (BAFF), were altered in CGD. CGD subjects had significantly increased mean (2.3-fold, p

  16. Large primary splenic cyst: A laparoscopic technique.

    LENUS (Irish Health Repository)

    Geraghty, M

    2009-01-01

    Splenic cysts are rare lesions with around 800 cases reported in the world literature. Traditionally splenectomy was the treatment of choice. However, with the recognition of the important immunological function of the spleen, new techniques to preserve splenic function have been developed. This case emphasizes that in selected cases splenic preservation is appropriate.

  17. Splenic Hydatid Cysts: 17 Cases.

    Science.gov (United States)

    Ozogul, Bunyami; Kisaoglu, Abdullah; Atamanalp, Sabri Selcuk; Ozturk, Gurkan; Aydinli, Bulent; Yıldırgan, Mehmet İlhan; Kantarcı, A Mecit

    2015-12-01

    Hydatid cyst disease, which is endemically observed and an important health problem in our country, involves the spleen at a frequency ranking third following the liver and the lungs. In this study, we aimed to evaluate the efficacy and results of management in splenic hydatid cysts. The demographic data, localization, diagnosis, treatment methods, and the length of postoperative hospital stay of patients with splenic hydatid cysts in a 12-year period were evaluated retrospectively. Seventeen cases were evaluated. Among these, 13 were females and four were males. Seven had solitary splenic involvement, eight had involvement of both the spleen and the liver, and two had multiple organ involvement. Ten had undergone splenectomy, one had undergone distal splenectomy, and the remaining cases had undergone different surgical procedures. The patients had received albendazole treatment in the pre- and postoperative period. One patient had died secondary to hypernatremia on the first postoperative day. The clinical picture in splenic hydatid cysts, which is seen rarely, is usually asymptomatic. The diagnosis is established by ultrasonography and abdominal CT. Although splenectomy is the standard mode of treatment, spleen-preserving methods may be used. PMID:26730005

  18. Splenic contraction in patients with various disorders

    International Nuclear Information System (INIS)

    To investigate the pathophysiology of human spleen, splenic contraction following subcutaneous injection of epinephrine was measured in 45 patients with various disorders using single photon emission computed tomography (SPECT). The splenic contraction rates and percent decreases in splenic counts (ejection rates) in 5 controls were 34.5 +- 10.0 percent (mean +- SD) and 16.4 +- 6.9 percent respectively. With regard to non-Hodgkin lymphoma, the splenic contraction and ejection rates in 8 patients with no splenic involvement diagnosed by CT and/or 67Ga scintigraphy were 27.3 +- 7.0 percent and 9.4 +- 7.0 percent respectively, while these values in 6 patients with splenic involvement diagnosed by presence of splenomegaly, CT and/or 67Ga scintigraphy were 12.8 +- 5.8 percent and 2.5 +- 1.6 percent respectively. Both the values in the patients with splenic involvement were low (p < 0.01, p < 0.1) compared with those in the patients without splenic involvement. The splenic contraction and ejection rates in 7 patients with splenomegaly due to portal hypertension were averaged 33.5 +- 6.7 percent and 13.8 +- 4.5 percent respectively. These values were comparable to those in controls. All 3 patients with leukemia and splenomegaly showed exceedingly low values of the splenic contraction and ejection rates. The values were also remarkably low in a patient with splenic metastasis of unknown origin. (author)

  19. Serum B cell–activating factor (BAFF) level in connective tissue disease associated interstitial lung disease

    OpenAIRE

    Hamada, Tsutomu; Samukawa, Takuya; Kumamoto, Tomohiro; Hatanaka, Kazuhito; Tsukuya, Go; Yamamoto, Masuki; Machida, Kentaro; Watanabe, Masaki; Mizuno, Keiko; Higashimoto, Ikkou; Inoue, Yoshikazu; Inoue, Hiromasa

    2015-01-01

    Background Interstitial lung diseases (ILDs) are common in patients with connective tissue diseases (CTDs). Although the diagnosis of an underlying CTD in ILD (CTD-ILD) affects both prognosis and treatment, it is sometimes difficult to distinguish CTD-ILD from chronic fibrosing interstitial pneumonia (CFIP). B cell–activating factor belonging to the tumour necrosis factor family (BAFF) plays a crucial role in B cell development, survival, and antibody production. Methods We examined serum lev...

  20. Increased serum concentration of BAFF/APRIL and IgA2 subclass in patients with mixed connective tissue disease complicated by interstitial lung disease.

    Science.gov (United States)

    Kaneko, Toshiyuki; Amano, Hirofumi; Kawano, Shinya; Minowa, Kentaro; Ando, Seiichiro; Watanabe, Takashi; Nakano, Soichiro; Suzuki, Jun; Morimoto, Shinji; Tokano, Yoshiaki; Takasaki, Yoshinari

    2014-03-01

    B cell activating factor (BAFF) and a proliferation-inducing ligand (APRIL) are known to be crucial for B cell maturation and survival, and increased expression of these factors in various autoimmune diseases has been reported. Human B cells produce two IgA subclasses: IgA1 and IgA2, the latter being abundant in the distal intestine, saliva, colostrum and bronchial fluid. We investigated these parameters in patients with mixed connective tissue disease (MCTD) complicated by interstitial lung disease (ILD+), and compared them with those in MCTD patients without ILD (ILD-). Sixty-three MCTD patients were divided into two groups: 21 ILD+ patients and 42 ILD- patients. In each patient group we analyzed soluble BAFF/APRIL using ELISA, and IgA1 and IgA2 using double immunodiffusion. Furthermore, we analyzed BAFF-APRIL receptors, BCMA, BAFF-R and TACI, using flow cytometry. The ILD+ patients had significantly higher levels of BAFF/APRIL than the ILD- patients. There were significant correlations between BAFF/APRIL, BAFF/KL-6 and APRIL/KL-6. Although there was no significant inter-group difference in the serum IgA1 level, ILD+ patients had a significantly elevated IgA2 level in comparison with ILD- patients. Moreover, although there were no significant inter-group differences in the expression of BCMA, BAFF-R and TACI on B cells, the expression of BAFF-R was significantly decreased in the ILD+ patients. In recent years, relationships between BAFF/APRIL and IgA subclass have been reported. Our results suggest that an elevated level of BAFF/APRIL drives the maturation of B cells, subsequently leading to IgA2 class switching, and possibly to the development of ILD in patients with MCTD. PMID:24252051

  1. Radiologic viewpoint of splenic abscess

    International Nuclear Information System (INIS)

    Splenic abscess is not a common disease, and has been infrequently diagnosed during life because of vague symptom and presence of underlying disease. However, advent of newer diagnostic imaging and interventional technology have augmented our ability to diagnose and treat the abscess. Authors experienced eight cases of splenic abscess, which were confirmed by operation or aspiration and, herein, we describe the radiological viewpoint and clinical course. Summary is follows: 1. Radiological finding was well defined, noncontrast enhancing wedge or lentiform lower density lesion, either single or multiple, focal or massive, parenchymal or subcapsular in location. Prognosis was favorable in focal parenchymal lesion after medical treatment. 2. Pancreatitis is the most common combined disease and this made the localization delay. 3. High incidence of sterile culture suggests possibility of anaerobic of fungal infection. 4. Hypoechoic lesion suggesting splenic abscess should be aspirated under the guidance of ultrasound and The aspirate should be cultured including anaerobic and fungus. C.T. scan should be done for better evaluation of the lesion. 5. According to pathology, organism and loculation pattern, various treatment modalities can be considered rather than routine splenectomy.

  2. Radiologic viewpoint of splenic abscess

    Energy Technology Data Exchange (ETDEWEB)

    Chang, Jae Chun; Jung, Kyung Hwa; Byun, Woo Mok; Kim, Sun Yong; Hwang, Mi Soo; Park, Bok Hwan [Yeungnam University College of Medicine, Kyungsan (Korea, Republic of)

    1988-12-15

    Splenic abscess is not a common disease, and has been infrequently diagnosed during life because of vague symptom and presence of underlying disease. However, advent of newer diagnostic imaging and interventional technology have augmented our ability to diagnose and treat the abscess. Authors experienced eight cases of splenic abscess, which were confirmed by operation or aspiration and, herein, we describe the radiological viewpoint and clinical course. Summary is follows: 1. Radiological finding was well defined, noncontrast enhancing wedge or lentiform lower density lesion, either single or multiple, focal or massive, parenchymal or subcapsular in location. Prognosis was favorable in focal parenchymal lesion after medical treatment. 2. Pancreatitis is the most common combined disease and this made the localization delay. 3. High incidence of sterile culture suggests possibility of anaerobic of fungal infection. 4. Hypoechoic lesion suggesting splenic abscess should be aspirated under the guidance of ultrasound and The aspirate should be cultured including anaerobic and fungus. C.T. scan should be done for better evaluation of the lesion. 5. According to pathology, organism and loculation pattern, various treatment modalities can be considered rather than routine splenectomy.

  3. Abnormally High Expression of BAFF on T Lymphocytes from Lung Cancer-associated Pleural Effusions and Its Potent Anti-tumor Effect

    Institute of Scientific and Technical Information of China (English)

    Haiyan XU; Xiaozhou HE; Yibei ZHU; Tiangzan YAN; Hongbin MA; Xueguang ZHANG

    2007-01-01

    In the present study, the expressions of B cell activating factor belonging to the tumor necrosis factor family (BAFF) and its receptors (BAFF-R and TACI) on T lymphocytes from malignant pleural effusion (MPE) were examined by fluorescence-activated cell sorting (FACS) analysis, and compared with those on the T lymphocytes from non-malignant pleural effusion (NMPE) and healthy controls. It was found that CD3 positive T lymphocytes (including CD4, CD8, and part of CD25 and CD69 positive cells) of MPE in lung cancer highly and consistently expressed the BAFF molecule, while high expressions of BAFF could only be found in phytohemagglutinin (PHA) or interleukin 2 (IL-2) induced T lymphocytes from NMPE or healthy controls. These results were consistent with the results from BAFF mRNA detection by real-time PCR. In addition, T lymphocytes from MPE expressed significantly more BAFF-R than those from NMPE or healthy controls, while the expression of TACI was increased on CD4+ T cells but decreased on CD8+ T cells when compared with controls. The Annexin/PI assay suggested that recombinant human BAFF (rhBAFF) could promote the survival rate of T lymphocytes from MPE, while the decoy receptor TACI-Fc fusion protein could promote the apoptosis rate of T lymphocytes. Cytokines in the supernatant detected by ELISA assay showed that rhBAFF could significantly upregulate the secretion of IFN-γ in vitro,and the IFN-γ level in the TACI-Fc-treated group resembled that of the control groups. All of these results indicated that the abnormally high expression of BAFF on T lymphocytes from MPE may play a role of antitumor effect.

  4. Escherichia coli clearance after splenic autotransplants

    International Nuclear Information System (INIS)

    Background: Splenic autotransplantation seems to be the only alternative for preservation of splenic tissue, after total splenectomy. The present study was carried out to analyze Escherichia coli depuration by mononuclear phagocyte system organs after total splenectomy and splenic autotransplantation. Methods: We utilized an experimental model including young and adult Wistar rats, of both sexes, submitted to total splenectomy and splenic autotransplantation. The evaluation method was intravenous inoculation of a suspension of Escherichia coli labeled with technetium-99m. We analyzed bacteria uptake by mononuclear phagocyte system organs and bacteria remnant in the bloodstream. Results: There was no difference between young and adult animals in bacteria uptake by mononuclear phagocyte system organs. In the comparison of groups, it was found out that the mean percent uptake by spleen and liver of animals in the control group was higher than that observed for animals with splenic implants. However, bacteria uptake in the lung was higher in the splenic implant group than in the control group. Although spleen bacteria uptake in the control group animals has been higher than that of animals in the splenic implant group, the remnant bacteria in the bloodstream was similar. Animals submitted to isolated total splenectomy showed higher bacteria remnant in the bloodstream than animals of the control group or the group submitted to total splenectomy combined with splenic autotransplantation. Conclusion: Our results indicate that autogenous splenic implant is efficacious in bacteria depuration in rats, by means of their macrophages phagocytosis. In addition, it does not modify bacteria removal function of liver and lung

  5. Non-interventional management of splenic abscess

    Directory of Open Access Journals (Sweden)

    Saket Kumar

    2014-01-01

    Full Text Available Splenic abscess is not an uncommon entity in tropics. In Indian subcontinent, where the incidence of enteric fever is high, abscess formation in spleen is frequently seen in clinical practice. In view of immunological functions, splenic preservation is preferred over splenectomy, especially in children and young adults. Medical management with antibiotics alone is considered inadequate for management of splenic abscess. Hereby, we report an unusual case of complete resolution of a florid splenic abscess with antibiotics alone without the need for any invasive intervention.

  6. Unusual splenic metastasis from oesophageal cancer.

    OpenAIRE

    Murthy S; Prabhakaran P; Rao S; Kumar R

    1991-01-01

    The most common visceral metastasis from oesophageal carcinomas are lungs and liver. A case of splenic metastasis from a squamous carcinoma of oesophagus is reported. To our knowledge, splenic metastasis without any nodal disease has not been described previously. The pattern of reported metastasis is summarised.

  7. Embolization Therapy for Traumatic Splenic Lacerations

    Energy Technology Data Exchange (ETDEWEB)

    Dasgupta, Niloy; Matsumoto, Alan H., E-mail: ahm4d@virginia.edu; Arslan, Bulent; Turba, Ulku C.; Sabri, Saher; Angle, John F. [University of Virginia Health System, Division of Vascular and Interventional Radiology, Department of Radiology (United States)

    2012-08-15

    Purpose: This study was designed to evaluate the clinical success, complications, and transfusion requirements based on the location of and agents used for splenic artery embolization in patients with splenic trauma. Methods: A retrospective study was performed of patients with splenic trauma who underwent angiography and embolization from September 2000 to January 2010 at a level I trauma center. Electronic medical records were reviewed for demographics, imaging data, technical aspects of the procedure, and clinical outcomes. Results: Fifty patients were identified (34 men and 16 women), with an average age of 48 (range, 16-80) years. Extravasation was seen on initial angiography in 27 (54%) and was absent in 23 (46%). All 27 patients with extravasation were embolized, and 18 of 23 (78.2%) without extravasation were embolized empirically. Primary clinical success was similar (>75%) across all embolization locations, embolic agents, and grades of laceration treated. Of 45 patients treated, 9 patients (20%) were embolized in the main splenic artery, 34 (75.6%) in the splenic hilum, and 2 (4.4%) were embolized in both locations. Partial splenic infarctions developed in 47.3% treated in the splenic hilum compared with 12.5% treated in the main splenic artery. There were four (8.9%) mortalities: two occurred in patients with multiple critical injuries and two from nonbleeding etiologies. Conclusions: Embolization of traumatic splenic artery injuries is safe and effective, regardless of the location of treatment. Embolization in splenic hilar branches may have a higher incidence of infarction. The grade of laceration and agents used for embolotherapy did not impact the outcomes.

  8. Embolization Therapy for Traumatic Splenic Lacerations

    International Nuclear Information System (INIS)

    Purpose: This study was designed to evaluate the clinical success, complications, and transfusion requirements based on the location of and agents used for splenic artery embolization in patients with splenic trauma. Methods: A retrospective study was performed of patients with splenic trauma who underwent angiography and embolization from September 2000 to January 2010 at a level I trauma center. Electronic medical records were reviewed for demographics, imaging data, technical aspects of the procedure, and clinical outcomes. Results: Fifty patients were identified (34 men and 16 women), with an average age of 48 (range, 16–80) years. Extravasation was seen on initial angiography in 27 (54%) and was absent in 23 (46%). All 27 patients with extravasation were embolized, and 18 of 23 (78.2%) without extravasation were embolized empirically. Primary clinical success was similar (>75%) across all embolization locations, embolic agents, and grades of laceration treated. Of 45 patients treated, 9 patients (20%) were embolized in the main splenic artery, 34 (75.6%) in the splenic hilum, and 2 (4.4%) were embolized in both locations. Partial splenic infarctions developed in 47.3% treated in the splenic hilum compared with 12.5% treated in the main splenic artery. There were four (8.9%) mortalities: two occurred in patients with multiple critical injuries and two from nonbleeding etiologies. Conclusions: Embolization of traumatic splenic artery injuries is safe and effective, regardless of the location of treatment. Embolization in splenic hilar branches may have a higher incidence of infarction. The grade of laceration and agents used for embolotherapy did not impact the outcomes.

  9. Disruption of Splenic Lymphoid Tissue and Plasmacytosis in Canine Visceral Leishmaniasis: Changes in Homing and Survival of Plasma Cells

    Science.gov (United States)

    Silva-O’Hare, Joselli; de Oliveira, Isabela Silva; Klevorn, Thaís; Almeida, Valter A.; Oliveira, Geraldo G. S.; Atta, Ajax M.; de Freitas, Luiz Antonio R.; dos-Santos, Washington L. C.

    2016-01-01

    Visceral leishmaniasis (VL) is a disease caused by Leishmania infantum, which is transmitted by phlebotomine sandflies. Dogs are the main urban reservoir of this parasite and the disease presents similar characteristics in both humans and dogs. In this paper, we investigated the potential pathways involved in plasma cell replacement of normal cell populations in the spleen, with respect to disease severity in dogs from an endemic area for visceral leishmaniasis. To this end, canine spleen samples were grouped into three categories: TYPE1SC- (non-infected dogs or without active infection with organized white pulp), TYPE1SC+ (infected dogs with organized white pulp) or TYPE3SC+ (infected animals with disorganized white pulp). We analyzed the distribution of different plasma cell isotypes (IgA, IgG and IgM) in the spleen. The expression of cytokines and chemokines involved in plasma cell homing and survival were assessed by real time RT-PCR. Polyclonal B cell activation and hypergammaglobulinemia were also evaluated. The proportion of animals with moderate or intense plasmacytosis was higher in the TYPE3SC+ group than in the other groups (Fisher test, P<0.05). This was mainly due to a higher density of IgG+ plasma cells in the red pulp of this group. The albumin/globulin ratio was lower in the TYPE3SC+ animals than in the TYPE1SC- or TYPE1SC+ animals, which evidences VL-associated dysproteinemia. Interestingly, TYPE3SC+ animals showed increased expression of the BAFF and APRIL cytokines, as well as chemokine CXCL12. Aberrant expression of BAFF, APRIL and CXCL12, together with amplified extrafollicular B cell activation, lead to plasma cell homing and the extended survival of these cells in the splenic red pulp compartment. These changes in the distribution of immunocompetent cells in the spleen may contribute to the progression of VL, and impair the spleen’s ability to protect against blood borne pathogens. PMID:27243459

  10. Proximal Versus Distal Splenic Artery Embolisation for Blunt Splenic Trauma: What is the Impact on Splenic Immune Function?

    Energy Technology Data Exchange (ETDEWEB)

    Foley, P. T., E-mail: pfoley@doctors.org.uk [The Canberra Hospital, Department of Medical Imaging (Australia); Kavnoudias, H., E-mail: h.kavnoudias@alfred.org.au [The Alfred Hospital, Radiology Research Unit, Radiology Department (Australia); Cameron, P. U., E-mail: paul.cameron@unimelb.edu.au [The Alfred Hospital, Infectious Diseases Unit (Australia); Czarnecki, C., E-mail: caroline.czarnecki@gmail.com [Royal Melbourne Hospital, Radiology Department (Australia); Paul, E., E-mail: eldho.paul@monash.edu [Monash University, Department of Epidemiology & Preventive Medicine, School of Public Health and Preventive Medicine, Alfred Hospital (Australia); Lyon, S. M., E-mail: lyonsey@optusnet.com.au [Melbourne Endovascular (Australia)

    2015-10-15

    PurposeTo compare the impact of proximal or distal splenic artery embolisation versus that of splenectomy on splenic immune function as measured by IgM memory B cell levels.Materials and MethodsPatients with splenic trauma who were treated by splenic artery embolisation (SAE) were enrolled. After 6 months splenic volume was assessed by CT, and IgM memory B cells in peripheral blood were measured and compared to a local normal reference population and to a post-splenectomy population.ResultsOf the 71 patients who underwent embolisation, 38 underwent proximal embolisation, 11 underwent distal embolisation, 22 patients were excluded, 1 had both proximal and distal embolisation, 5 did not survive and 16 did not return for evaluation. There was a significant difference between splenectomy and proximal or distal embolisation and a trend towards greater preservation of IgM memory B cell number in those with distal embolisation—a difference that could not be attributed to differences in age, grade of injury or residual splenic volume.ConclusionIgM memory B cell levels are significantly higher in those treated with SAE compared to splenectomy. Our data provide evidence that splenic embolisation should reduce immunological complications of spleen trauma and suggest that distal embolisation may maintain better function.

  11. Proximal Versus Distal Splenic Artery Embolisation for Blunt Splenic Trauma: What is the Impact on Splenic Immune Function?

    International Nuclear Information System (INIS)

    PurposeTo compare the impact of proximal or distal splenic artery embolisation versus that of splenectomy on splenic immune function as measured by IgM memory B cell levels.Materials and MethodsPatients with splenic trauma who were treated by splenic artery embolisation (SAE) were enrolled. After 6 months splenic volume was assessed by CT, and IgM memory B cells in peripheral blood were measured and compared to a local normal reference population and to a post-splenectomy population.ResultsOf the 71 patients who underwent embolisation, 38 underwent proximal embolisation, 11 underwent distal embolisation, 22 patients were excluded, 1 had both proximal and distal embolisation, 5 did not survive and 16 did not return for evaluation. There was a significant difference between splenectomy and proximal or distal embolisation and a trend towards greater preservation of IgM memory B cell number in those with distal embolisation—a difference that could not be attributed to differences in age, grade of injury or residual splenic volume.ConclusionIgM memory B cell levels are significantly higher in those treated with SAE compared to splenectomy. Our data provide evidence that splenic embolisation should reduce immunological complications of spleen trauma and suggest that distal embolisation may maintain better function

  12. Expression of TNF-superfamily members BAFF and APRIL in breast cancer: Immunohistochemical study in 52 invasive ductal breast carcinomas

    International Nuclear Information System (INIS)

    Recent studies suggest an association between chronic inflammation, modulating the tissue microenvironment, and tumor biology. Tumor environment consists of tumor, stromal and endothelial cells and infiltrating macrophages, T lymphocytes, and dendritic cells, producing an array of cytokines, chemokines and growth factors, accounting for a complex cell interaction and regulation of differentiation, activation, function and survival of tumor and surrounding cells, responsible for tumor progression and spreading or induction of antitumor immune responses and rejection. Tumor Necrosis Factor (TNF) family members (19 ligands and 29 receptors) represent a pleiotropic family of agents, related to a plethora of cellular events from proliferation and differentiation to apoptosis and tumor reduction. Among these members, BAFF and APRIL (CD257 and CD256 respectively) gained an increased interest, in view of their role in cell protection, differentiation and growth, in a number of lymphocyte, epithelial and mesenchymal structures. We have assayed by immunohistochemistry 52 human breast cancer biopsies for the expression of BAFF and APRIL and correlated our findings with clinicopathological data and the evolution of the disease. BAFF was ubiquitely expressed in breast carcinoma cells, DCIS, normal-appearing glands and ducts and peritumoral adipocytes. In contrast, APRIL immunoreactive expression was higher in non-malignant as compared to malignant breast structures. APRIL but not BAFF immunoreactivity was higher in N+ tumors, and was inversely related with the grade of the tumors. Neither parameter was related to DFS or the OS of patients. Our data show, for the first time, an autocrine secretion of BAFF and APRIL from breast cancer cells, offering new perspectives for their role in neoplastic and normal breast cell biology and offering new perspectives for possible selective intervention in breast cancer

  13. Splenic tuberculosis. Report of twelve cases

    International Nuclear Information System (INIS)

    Tuberculosis of the spleen is not exceptional. The authors report ten cases which occurred with a predominance in young male adults. All patients had at least one other site of tuberculosis without any HIV infection. All patients had focal splenic lesions in the form of scattered hypo-echogenic and hypodense nodules. These nodules had a pseudo-tumor appearance in one case. CT-guided puncture was performed in one case. Splenic tuberculosis is not as rare as is sometimes thought. The CT-guided splenic puncture is now performed routinely and remains the ideal diagnostic approach. (authors). 9 refs., 5 figs

  14. Severe pneumococcal disease and temporary splenic dysfunction.

    OpenAIRE

    Pelly, M. D.; Huo, Z.; Henderson, D. C.; Soni, N.

    1997-01-01

    We report a patient presenting with pneumonia in whom temporary splenic dysfunction was diagnosed by counting pitted red blood cells. This under-recognised condition caused a transient immunosuppression which may have had serious implications for our patient's recovery.

  15. Splenic vasculopathy in portal hypertension patients

    Institute of Scientific and Technical Information of China (English)

    Tao Li; Ji-Yuan Ni; Yan-Wu Qi; Hai-Yang Li; Tong Zhang; Zhen Yang

    2006-01-01

    AIM: To investigate the interaction between portal hypertension, splanchnic hyperdynamic circulation and splanchnic vasculopathy by observing splenic arterial and venous pathological changes and the role of extracellular matrix in the pathogenesis of portal hypertensive vasculopathy by measuring the expression of type Ⅰ and type Ⅲ procollagen mRNA in splenic venous walls of portal hypertensive patients.METHODS: Morphological changes of splenic arteries and veins taken from portal hypertensive patients (n = 20)and normal controls (n = 10) were observed under optical and electron microscope. Total RNA was extracted and the expression of type Ⅰ and type Ⅲ procollagen mRNA in splenic venous walls of portal hypertensive patients (n = 20) was semi-quantitatively detected using reverse transcription-polymerase chain reaction (RT- PCR).RESULTS: Under optical microscope, splenic arterial intima was destroyed and internal elastic membrane and medial elastic fibers of the splenic arterial walls were degenerated and broken. Splenic venous intima became remarkably thick. Endothelial cells were not intact with formation of mural thrombus. The tunica media became thickened significantly due to hypertrophy of smooth muscles. Fibers and connective tissues were increased obviously. Under electron microscope, smooth muscle cells of the splenic arteries were degenerated and necrotized. Phenotypes of smooth muscle cells changed from constrictive into synthetic type. Red blood cells and platelets accumulated around the damaged endothelial cells. Synthetic smooth muscle cells were predominant in splenic veins and their cytoplasma had plentiful rough endoplasmic reticulum ribosomes and Golgi bodies. Along the vascular wall, a lot of collagen fibers were deposited,the intima was damaged and blood components accumulated. There was no significant difference in the expression of type Ⅰ procollagen mRNA in splenic venous wall between the patients with portal hypertension and those

  16. Splenic artery aneurysm rupture in pregnancy

    International Nuclear Information System (INIS)

    Rupture of a splenic artery aneurysm, commonly associated with pregnancy is a rare and catastrophic event. We report here a case of a patient in her second pregnancy who presented with a short history of left hypochondriac and epigastric pain, followed by collapse at 32 weeks gestation. Sudden fetal distress lead to emergency caesarean delivery when splenic artery aneurysm rupture was diagnosed. With timely involvement of multidisciplinary personnel both mother and baby survived and had an uneventful recovery. (author)

  17. Development of splenic surgery in China

    Institute of Scientific and Technical Information of China (English)

    JIANG Hongchi; ZHAO Xianqi; GAO Yue

    2007-01-01

    Splenic surgery has enjoyed rapid progress for the past decades in China.Based on continuously solidilying theories and clinical practice,many advanced concepts with applicable clinical frameworks have been established,thus making splenic surgery an indispensable division in modern surgery.In this study,the authors try to give an overview of the developments in this field.Spleen function is a key issue that generally guides advances in splenic surgery.The old knowledge of the"dispensable spleen"has been abandoned,while the exact role that it plays in the body continues to be unveiled.Now,standard grading for splenic injury and the respective guidelines for clinical management have been established,with the use of selective instead of indiscriminate splenectomy being accepted by most experts.Various spleen sparing operations have been developed,while many advanced techniques such as laparoscopy have been introduced to splenic surgery.Spleen transplantation has greatly advanced in China,even though there are still many unsolved mysteries in this field.Altogether,splenic surgery is a new and prosperous discipline,and it is a tremendous stage for young surgeons to be part of.

  18. Spontaneous Splenic Rupture in Melanoma

    Directory of Open Access Journals (Sweden)

    Hadi Mirfazaelian

    2014-01-01

    Full Text Available Spontaneous rupture of spleen due to malignant melanoma is a rare situation, with only a few case reports in the literature. This study reports a previously healthy, 30-year-old man who came with chief complaint of acute abdominal pain to emergency room. On physical examination, abdominal tenderness and guarding were detected to be coincident with hypotension. Ultrasonography revealed mild splenomegaly with moderate free fluid in abdominopelvic cavity. Considering acute abdominal pain and hemodynamic instability, he underwent splenectomy with splenic rupture as the source of bleeding. Histologic examination showed diffuse infiltration by tumor. Immunohistochemical study (positive for S100, HMB45, and vimentin and negative for CK, CD10, CK20, CK7, CD30, LCA, EMA, and chromogranin confirmed metastatic malignant melanoma. On further questioning, there was a past history of a nasal dark skin lesion which was removed two years ago with no pathologic examination. Spontaneous (nontraumatic rupture of spleen is an uncommon situation and it happens very rarely due to neoplastic metastasis. Metastasis of malignant melanoma is one of the rare causes of the spontaneous rupture of spleen.

  19. Hyperferritinemia in dogs with splenic hemangiosarcoma.

    Science.gov (United States)

    Chikazawa, Seishiro; Hori, Yasutomo; Hoshi, Fumio; Kanai, Kazutaka; Ito, Naoyuki; Higuchi, Seiichi

    2013-11-01

    Serum ferritin concentration increases in dogs in association with various diseases. In this study, we measured serum ferritin levels in dogs with splenic masses, using a sandwich ELISA assay. Eleven dogs with hemangiosarcoma (HSA), six with hematoma, 1 with hemangioma and 3 with lymphoma were enrolled. All dogs with HSA had serum ferritin concentrations above the normal limit (1,357 ng/ml, mean + 2× standard deviation of normal). Increased serum ferritin concentrations have also been observed in few cases of hematoma, hemangioma and lymphoma. Therefore, hyperferritinemia is not specific for splenic HSA, but may have clinical usefulness as a sensitive test for the disease. Further evaluation of serum ferritin concentrations in dogs with splenic HSA is needed. PMID:23803459

  20. Changing treatment of pediatric splenic trauma

    International Nuclear Information System (INIS)

    A review of splenic injuries at Cincinnati Children's Hospital Medical Center from July 1978 to June 1980 revealed this form of injury in 29 patients. Treatment without surgery was successful in 21 patients. Seven patients required operation. One patient died shortly after admission of severe associated injuries. All patients admitted with blunt abdominal trauma were initially treated conservatively. If the clinical state improved, after transfusions if necessary, or remained stable and there were no objective signs of further blood loss, conservative therapy was continued. Liver-spleen scans were obtained on an urgent basis to confirm the diagnosis of splenic injury in patients who did not undergo surgery. No complications of treatment without surgery were recognized. The satisfactory outcome in these patients suggests that there is a place for treatment without surgery in some children with splenic injury

  1. Splenic mass with remote trauma history: a management dilemma.

    LENUS (Irish Health Repository)

    McCarthy, C J

    2012-02-01

    BACKGROUND: Delayed presentation of splenic trauma is a well described entity. METHOD: We report two patients who presented with splenic abnormality found incidentally on imaging for other medical problems. A remote history of splenic trauma was elicited during clinical evaluation; 18 months in one patient and 11 years in the second patient. Both patients underwent surgical exploration. CONCLUSIONS: Radiological investigations could not reassure us that the splenic abnormalities were benign, and their management was the subject of some debate.

  2. Splenic mass with remote trauma history: a management dilemma.

    LENUS (Irish Health Repository)

    McCarthy, C J

    2011-03-02

    BACKGROUND: Delayed presentation of splenic trauma is a well described entity. METHOD: We report two patients who presented with splenic abnormality found incidentally on imaging for other medical problems. A remote history of splenic trauma was elicited during clinical evaluation; 18 months in one patient and 11 years in the second patient. Both patients underwent surgical exploration. CONCLUSIONS: Radiological investigations could not reassure us that the splenic abnormalities were benign, and their management was the subject of some debate.

  3. A benzenediamine derivate FC-99 attenuates lupus nephritis in MRL/lpr mice via inhibiting myeloid dendritic cell-secreted BAFF.

    Science.gov (United States)

    Ji, Jianjian; Xu, Jingjing; Li, Fanlin; Li, Xiaojing; Gong, Wei; Song, Yuxian; Dou, Huan; Hou, Yayi

    2016-05-01

    Myeloid dendritic cells (DCs) can produce B-cell-activating factor (BAFF) that modulates survival and differentiation of B cells and plays a pivotal role in the pathogenesis of systemic lupus erythematosus (SLE). Toll-like receptor 4 (TLR4) signaling has important functions in the process of BAFF production. Our previous study showed that a benzenediamine derivate FC-99 possesses anti-inflammation activity and directly interacts with interleukin-1 receptor-associated kinase 4 (IRAK4), which was a pivotal molecule in TLR4 signaling. In this study, we demonstrated that FC-99 attenuated lupus nephritis in the MRL/lpr mice. FC-99 also decreased the levels of total immunoglobulin G (IgG), total IgG2a and IgM in sera, as well as the activation of B cells in the spleens of MRL/lpr mice. Moreover, FC-99 inhibited abnormal activation of myeloid DCs in spleens and reduced the levels of BAFF in sera, spleens, and kidneys of MRL/lpr mice. Furthermore, upon TLR4 stimulation with lipopolysaccharide in vitro, FC-99 inhibited IRAK4 phosphorylation, as well as the activation and BAFF production in murine bone marrow-derived DCs. These data indicate that FC-99 attenuates lupus nephritis in MRL/lpr mice via inhibiting DC-secreted BAFF, suggesting that FC-99 may be a potential therapeutic candidate for the treatment of SLE. PMID:27121231

  4. Thrombosis of splenic artery pseudoaneurysm complicating pancreatitis.

    OpenAIRE

    De Ronde, Thierry; Van Beers, Bernard; De Canniere, Louis; Trigaux, Jean-Paul; Melange, Michel

    1993-01-01

    The natural history of pseudoaneurysms complicating pancreatitis is unknown. A patient with chronic pancreatitis is described in whom thrombosis of a splenic artery pseudoaneurysm occurred. Early diagnosis and radical treatment of a bleeding pseudoaneurysm are mandatory. When elective treatment is considered, however, contrast enhanced computed tomography may be useful just before surgery as thrombosis may occur.

  5. Radiological features of a symptomatic splenic hamartoma

    International Nuclear Information System (INIS)

    Symptomatic splenic hamartomas are rare in the pediatric age group, with only four previous reports in the literature. Splenic hamartoma has been reported as a solid homogeneous mass without calcification on CT and ultrasound (US), and only one previous report of the findings on MRI has been published. We report a case of a large symptomatic splenic hamartoma in a 14-year-old girl who presented with splenomegaly, pancytopenia and growth retardation. A solid mass with multiple punctate foci resembling calcifications was seen on US. The mass was heterogeneous and better demarcated on enhanced CT. Radiocolloid scintigraphy demonstrated uptake within the lesion, but less than that of normal spleen. The mass was isointense relative to normal splenic tissue on T1-weighted MRI (0.5 T) and of increased intensity with T2 weighting. At splenectomy, a red pulp hamartoma was identified, which contained nodules of hyalinization and necrosis thought to account for the punctate foci seen on US. (orig.). With 4 figs

  6. Partial splenic artery embolization in cirrhotic patients

    OpenAIRE

    Hadduck, Tyson A; McWilliams, Justin P.

    2014-01-01

    Splenomegaly is a common sequela of cirrhosis, and is frequently associated with decreased hematologic indices including thrombocytopenia and leukopenia. Partial splenic artery embolization (PSE) has been demonstrated to effectively increase hematologic indices in cirrhotic patients with splenomegaly. This is particularly valuable amongst those cirrhotic patients who are not viable candidates for splenectomy. Although PSE was originally developed decades ago, it has recently received increase...

  7. Puzzles in practice: splenic vein thrombosis.

    Science.gov (United States)

    McIntyre, Brittany; Marsh, Melanie; Walden, Jeffrey

    2016-06-01

    This report details a 58-year-old gentleman who presented to his outpatient primary care physician's clinic several times over four weeks for ongoing epigastric pain radiating into his left flank, dry heaving, and constipation. He was presumed to have gastritis at each visit and prescribed escalating doses of proton pump inhibitors. Due to the unrelenting pain, he eventually was admitted to the hospital and diagnosed with splenic vein thrombosis after computed tomography imaging of the abdomen. Our literature search revealed that pancreatic pathology is overwhelmingly the contributing factor to splenic vein thrombosis. Our patient had prominent collateral vasculature, suggesting that his splenic vein thrombosis was chronic in nature and likely the cause of his ongoing abdominal pain. Splenic vein thrombosis is an uncommon cause of abdominal pain, but one that should be included in the treating physician's differential diagnoses when abdominal pain is ongoing despite medical therapy. Although he had no evidence of initial findings on radiography, our patient was eventually diagnosed with biopsy-proven pancreatic cancer. Our case report demonstrates how patients presenting with persistent or worsening abdominal pain despite the use of proton pump inhibitors or other acid reducing agents and potential 'red flag' findings such as decreased appetite and weight loss should be worked up for other potential sources of abdominal pathology. PMID:27157637

  8. Splenic melanosis in agouti and black mice.

    Science.gov (United States)

    Michalczyk-Wetula, Dominika; Wieczorek, Justyna; Płonka, Przemysław M

    2015-01-01

    An interesting example of extradermal deposition of melanin in vertebrates, notably in mammals, is splenic melanosis. In particular, if the phenomenon of splenic melanosis is correlated with hair or skin pigmentation, it must reflect the amount and perhaps the quality of pigment produced in hair follicle melanocytes. The present paper is our first study on splenic pigmentation in mice of phenotype agouti. We used untreated mixed background mice C57BL/6;129/SvJ (black - a/a, agouti - A/a, A/A), and as a control - black C57BL/6 and agouti fur from 129/SvJ mice, Mongolian gerbils (Meriones unguiculatus) and golden hamsters (Mesocricetus auratus). After euthanasia skin and spleen was evaluated macroscopically, photographed and collected for further analysis using Fontana-Masson and hematoxylin-eosin staining and electron paramagnetic resonance (EPR) at X-band. Spleens of the agouti mice revealed splenic melanosis but were slightly weaker pigmented than their black counterparts, while the presence of pheomelanin was difficult to determine. The fur of both phenotypes was of similar melanin content, with the same tendency as in the spleens. The contribution of pheomelanin in the agouti fur was on the border of detectability by EPR. Histological and EPR analysis confirmed the presence of melanin in the melanotic spleens. The shape of the EPR signal showed a dominance of eumelanin in fur and in melanized spleens in both phenotypes of mice. Therefore, splenic melanosis does reflect the hair follicle pigmentation not only in black, but also in agouti mice. PMID:26291042

  9. CT assessment of normal splenic size in children

    International Nuclear Information System (INIS)

    The size of the normal spleen was estimated by CT in 153 children, examined with indication unrelated to splenic disease. In each patient the width, thickness, length and volume of the spleen were calculated. Measurements were also normalized to the transverse diameter of the body of the first lumbar vertebra. The spleen underwent significant growth during the first 4 years of life and reached maximum size at the age of 13. There were no differences in splenic volume between boys and girls. Splenic thickness correlated best with normal splenic volume. The strongest correlation was also found between splenic thickness and volume in a group of 45 children with clinically evident splenomegaly. Splenic thickness, an easy-to-use measurement, may be employed in everyday practice to represent splenic volume on CT. (orig.)

  10. Impact of Splenic Artery Embolization on the Success Rate of Nonoperative Management for Blunt Splenic Injury

    International Nuclear Information System (INIS)

    Introduction: Nonoperative management (NOM) has become the treatment of choice for hemodynamically stable patients with blunt splenic injury. Results of outcome after NOM are predominantly based on large-volume studies from level 1 trauma centers in the United States. This study was designed to assess the results of NOM in a relatively low-volume Dutch level 1 trauma center. Methods: An analysis of a prospective trauma registry was performed for a 6-year period before (period 1) and after the introduction and implementation of splenic artery embolization (SAE) (period 2). Primary outcome was the failure rate of initial treatment. Results: A total of 151 patients were reviewed. An increased use of SAE and a reduction of splenic operations during the second period was observed. Compared with period 1, the failure rate after observation in period 2 decreased from 25% to 10%. The failure rate after SAE in period 2 was 18%. The splenic salvage rate (SSR) after observation increased from 79% in the first period to 100% in the second period. During the second period, all patients with failure after observation were successfully treated with SAE. The SSR after SAE in periods 1 and 2 was respectively 100% and 86%. Conclusions: SAE of patients with blunt splenic injuries is associated with a reduction in splenic operations. The failure and splenic salvage rates in this current study were comparable with the results from large-volume studies of level 1 trauma centers. Nonoperative management also is feasible in a relatively low-volume level 1 trauma center outside the United States.

  11. Transcatheter Splenic Artery Occlusion for Treatment of Splenic Artery Steal Syndrome After Orthotopic Liver Transplantation

    International Nuclear Information System (INIS)

    Purpose: To review some aspects of the problem of splenic artery steal syndrome as cause of ischemia in transplanted livers and treatment by selective splenic artery occlusion. Materials and Methods: Eleven liver transplant patients from a group of 350 patients, nine men and two women,ranging in age from 40 years to 61 years (mean 52 years), presented with biochemical evidences of liver ischemia and failure, ranging from one to 60 days following orthotopic liver transplantation. Diagnosis of splenic artery steal syndrome was suspected by elevated enzymes, Doppler ultrasound and confirmed by celiac angiogram. Patients with confirmed hepatic artery thrombosis before angiography were excluded from the study. Embolization with Gianturco coils was performed. Results: All patients were treated by splenic artery embolization with Gianturco coils. The 11 patients improved clinically within 24 hours of the procedure with significant change in the biochemical and clinical parameters. Followup ranged from one month to two years. One of the 11 patient initially improved, but developed hepatic artery thrombosis within 24 hours of the embolic treatment,requiring surgical repair. Conclusion: Splenicartery steal syndrome following liver transplantation surgery can be diagnosed by celiac angiography, and effectively treated by splenic artery embolization with coils. Embolization is one of the treatments available, it is minimally invasive, and leads to immediate clinical improvement. Hepatic artery thrombosis is a possible complication of the procedure

  12. The (re)generation of splenic tissue

    OpenAIRE

    Hovius, J W R; H. J. Verberne; Bennink, R.J.; Blok, W L

    2010-01-01

    A 48-year-old man with a history of a traumatic splenic rupture followed by splenectomy at the age of 5 years was referred to the outpatient clinic with markedly elevated liver enzymes. He was diagnosed with alcoholic liver cirrhosis. Ultrasound of the upper abdomen revealed hepatomegaly and suggested a central mass in the liver. Subsequent MRI of the abdomen did not show a hepatic mass, but revealed multiple intraperitoneal and retroperitoneal ovoid structures with a maximum diameter of 3 cm...

  13. Hyperferritinemia in Dogs with Splenic Hemangiosarcoma

    OpenAIRE

    Chikazawa, Seishiro; HORI, Yasutomo; Hoshi, Fumio; KANAI, Kazutaka; Ito, Naoyuki; Higuchi, Seiichi

    2013-01-01

    ABSTRACT Serum ferritin concentration increases in dogs in association with various diseases. In this study, we measured serum ferritin levels in dogs with splenic masses, using a sandwich ELISA assay. Eleven dogs with hemangiosarcoma (HSA), six with hematoma, 1 with hemangioma and 3 with lymphoma were enrolled. All dogs with HSA had serum ferritin concentrations above the normal limit (1,357 ng/ml, mean + 2× standard deviation of normal). Increased serum ferritin concentrations have also bee...

  14. Pediatric blunt splenic trauma: a comprehensive review

    Energy Technology Data Exchange (ETDEWEB)

    Lynn, Karen N.; Werder, Gabriel M.; Callaghan, Rachel M.; Jafri, Zafar H. [William Beaumont Hospital, Department of Diagnostic Radiology, Royal Oak, MI (United States); Sullivan, Ashley N. [St. George' s University School of Medicine, Grenada, West Indies (Grenada); Bloom, David A. [William Beaumont Hospital, Department of Diagnostic Radiology, Royal Oak, MI (United States); William Beaumont Hospital, Section of Pediatric Radiology, Department of Radiology, Royal Oak, MI (United States)

    2009-09-15

    Abdominal trauma is a leading cause of death in children older than 1 year of age. The spleen is the most common organ injured following blunt abdominal trauma. Pediatric trauma patients present unique clinical challenges as compared to adults, including different mechanisms of injury, physiologic responses, and indications for operative versus nonoperative management. Splenic salvage techniques and nonoperative approaches are preferred to splenectomy in order to decrease perioperative risks, transfusion needs, duration/cost of hospitalization, and risk of overwhelming postsplenectomy infection. Early and accurate detection of splenic injury is critical in both adults and children; however, while imaging findings guide management in adults, hemodynamic stability is the primary determinant in pediatric patients. After initial diagnosis, the primary role of imaging in pediatric patients is to determine the level and duration of care. We present a comprehensive literature review regarding the mechanism of injury, imaging, management, and complications of traumatic splenic injury in pediatric patients. Multiple patients are presented with an emphasis on the American Association for the Surgery of Trauma organ injury grading system. Clinical practice guidelines from the American Pediatric Surgical Association are discussed and compared with our experience at a large community hospital, with recommendations for future practice guidelines. (orig.)

  15. Partial splenic artery embolization in cirrhotic patients

    Science.gov (United States)

    Hadduck, Tyson A; McWilliams, Justin P

    2014-01-01

    Splenomegaly is a common sequela of cirrhosis, and is frequently associated with decreased hematologic indices including thrombocytopenia and leukopenia. Partial splenic artery embolization (PSE) has been demonstrated to effectively increase hematologic indices in cirrhotic patients with splenomegaly. This is particularly valuable amongst those cirrhotic patients who are not viable candidates for splenectomy. Although PSE was originally developed decades ago, it has recently received increased attention. Presently, PSE is being utilized to address a number of clinical concerns in the setting of cirrhosis, including: decreased hematologic indices, portal hypertension and its associated sequela, and splenic artery steal syndrome. Following PSE patients demonstrate significant increases in platelets and leukocytes. Though progressive decline of hematologic indices occur following PSE, they remain improved as compared to pre-procedural values over long-term follow-up. PSE, however, is not without risk and complications of the procedure may occur. The most common complication of PSE is post-embolization syndrome, which involves a constellation of symptoms including fever, pain, and nausea/vomiting. The rate of complications has been shown to increase as the percent of total splenic volume embolized increases. The purpose of this review is to explore the current literature in regards to PSE in cirrhotic patients and to highlight their techniques, and statistically summarize their results and associated complications. PMID:24876920

  16. Symptomatic calcified splenic artery aneurysm: Case report

    Directory of Open Access Journals (Sweden)

    Čolović Radoje

    2010-01-01

    Full Text Available Introduction. Although the third most common aneurysm within the abdomen, after aneurysms of the aorta and iliac arteries, splenic artery aneurysms are rare, but not exceptionally. Owing to new imaging techniques, they have been discovered with increasing frequency. Case Outline. Authors present a 47-year-old woman, multipara, who presented with left upper abdominal pain in whom X-ray showed a calcified ring in the area of distal pancreas. Selective angiography confirmed a splenic artery aneurysm of its proximal part. During an open surgery the aneurysm was excised (aneurismectomy without immediate, early or late complications. The patient became symptom-free. Conclusion. In patients, particularly women, the multiparas who present with epigastric or left upper abdominal pain of unknown aetiology, splenic artery aneurysm has to be taken into account. Further diagnostic procedures such as plain X-ray and selective angiography in suspected cases should be performed. Surgery or other treatment modalities are to be seriously considered in all patients, particularly in those with increased risk of rupture.

  17. Treatment of Hypersplenism by Partial Splenic Embolization Through Gastric Collaterals.

    Science.gov (United States)

    Saddekni, Souheil; Moustafa, Amr Soliman; Tahoon, Hany A; Setita, Mostafa; Abdel-Aal, Ahmed Kamel

    2016-03-01

    We report a case of Chronic lymphocytic leukemia (CLL) with associated hypersplenism, that was referred to us for partial splenic embolization (PSE) as the patient was not a surgical candidate for splenectomy. Initially, we were not successful in catheterizing the splenic artery from the celiac trunk due to significant atherosclerotic disease. Therefore, we successfully managed to access the distal splenic artery through patent gastro-epiploic collateral circulation along the greater curvature of the stomach. Partial splenic embolization was successfully performed and resulted in improvement of the patient's peripheral blood cell count as well as 60-70% reduction in the size of the spleen on follow up. Our case highlights an alternative pathway for splenic artery embolization when catheterization of the splenic artery is not feasible. To our knowledge, the use of gastro-epiploic collaterals to embolize the spleen has not been previously reported in literature. PMID:27200164

  18. Endovascular treatment of splenic artery aneurysms

    International Nuclear Information System (INIS)

    Purpose. To assess the feasibility and effectiveness of endovascular treatment of splenic artery aneurysm (SAAs). Materials and methods. Between May 2000 and June 2003 we treated 11 true SAAs in 9 patients (7 females and 2 males; mean age 58 years), 8 saccular and 3 fusiform, 4 located at the middle tract of the splenic artery, 5 at the distal tract and 2 intra-parenchymal. The diagnosis was performed with colour-Doppler ultrasound and/or CT-angiography; 7 patients were symptomless, 1 had left hypochondriac pain, and 1 had acute abdomen caused by a ruptured SAA. Four SAAs were treated by micro coil embolisation of the aneurysmal sac with preservation of splenic artery patency; in 2 cases this was associated with transcatheter injection of N-butyl-2-cyanoacrylate. Four cases were treated by endovascular ligature, with sectoral spleen ischaemia. One ruptured SAA received emergency treatment with splenic artery cyanoacrylate embolisation. Two intra-parenchymal SAAs were excluded, one by cyanoacrylate embolisation of the afferent artery and the other by transcatheter thrombin injection in the aneurysmal sac. Results. Technical success was observed in all cases (in 10/11 at the end of the procedure; in 1/11 at CT performed 3 days after the procedure). The follow-up (mean 18 months; range 6-36) was performed by colour-Doppler ultrasound and/or CT-angiography 3, 6 and 12 months after the procedure and subsequently once a year; the complete exclusion of the aneurysms was confirmed in 11/11 cases. The complications were: 4 cases of mild pleuritis; fever and left hypochondriac pain 1 day after the procedure (in the same 4 patients and in one other case); 5 cases of sectorial spleen ischaemia and 1 case of diffuse spleen infarction with partial revascularization by collateral vessels. No alteration of the levels of pancreatic enzymes was found; a transitory increase in platelet count occurred only in the patient with diffuse spleen infarction. Conclusions. Using different

  19. Acute tumor lysis syndrome after proximal splenic artery embolization

    OpenAIRE

    Jason T. Salsamendi; Mehul H. Doshi; Francisco J. Gortes; Levi, Joe U; Govindarajan Narayanan

    2016-01-01

    Preoperative splenic artery embolization for massive splenomegaly has been shown to reduce intraoperative hemorrhage during splenectomy. We describe a case of tumor lysis syndrome after proximal splenic artery embolization in a patient with advanced mantle cell lymphoma and splenic involvement. The patient presented initially with hyperkalemia two days after embolization that worsened during splenectomy. He was stabilized, but developed laboratory tumor lysis syndrome with renal failure and e...

  20. Conservative management in infectious mononucleosis related spontaneous splenic rupture

    OpenAIRE

    EKINGEN, Gülşen; AZMAN, Bülent; ERKUŞ, Burak; GÜVENÇ, B. Haluk

    2010-01-01

    Spontaneous splenic rupture is a rare but potential lethal complication of infectious mononucleosis. Although splenectomy is still the treatment of choice for patients with spontaneous splenic rupture, non-surgical management should be considered in carefully selected patients. We describe the case of a 16-year-old girl with infectious mononucleosis and who had splenic rupture and who was treated by non-operative approach.

  1. Acute pancreatitis complicated with splenic rupture: A case report

    OpenAIRE

    Hernani, Bruno L; Silva, Pedro C; Nishio, Ricardo T; Mateus, Henrique C; Assef, José C; De Campos, Tercio

    2015-01-01

    Atraumatic splenic rupture is an uncommon complication of acute pancreatitis. This report describes the case of a 30-year-old man with acute pancreatitis and splenic vein thrombosis complicated by splenic rupture. The patient was admitted to the emergency department with pain in the upper abdomen that had been present for six hours and was associated with vomiting and sweating. He was diagnosed with acute pancreatitis of alcoholic etiology. Upon computed tomography (CT) of the abdomen, the pa...

  2. Isolated splenic calcifications in two patients with portal hypertension

    International Nuclear Information System (INIS)

    Calcification of the walls of the veins of the portal hypertension (PHT) (1-0), is uncommon. Calcification of the intra splenic vessels is exceptional. We report two cases of isolated calcification of intra splenic vessels, without calcification of the splenoportal venous axis, in patients with liver cirrhosis and PHT. The calcification was not clear. Computed tomography identified the calcification as linear tubular, branched structures located in the wall of intra splenic vessels. magnetic resonance imaging disclosed signs of cirrhosis and PHT but did not show the splenic classifications because of technical limitations. The cause of these calcifications was sustained PHT due to chronic liver disease. (Author) 15 refs

  3. Current and emerging treatment options for ANCA-associated vasculitis: potential role of belimumab and other BAFF/APRIL targeting agents

    Directory of Open Access Journals (Sweden)

    Lenert A

    2015-01-01

    Full Text Available Aleksander Lenert,1 Petar Lenert21Division of Rheumatology, University of Kentucky, Kentucky Clinic, Lexington, KY, USA; 2Division of Immunology, Department of Internal Medicine, The University of Iowa, Iowa City, IA, USAAbstract: Antineutrophil cytoplasmic antibody (ANCA-associated vasculitis (AAV comprises several clinical entities with diverse clinical presentations, outcomes, and nonunifying pathogenesis. AAV has a clear potential for relapses, and shows unpredictable response to treatment. Cyclophosphamide-based therapies have remained the hallmark of induction therapy protocols for more than four decades. Recently, B-cell depleting therapy with the anti-CD20 antibody rituximab has proved beneficial in AAV, leading to Food and Drug Administration approval of rituximab in combination with corticosteroids for the treatment of AAV in adults. Rituximab for ANCA-associated vasculitis and other clinical trials provided clear evidence that rituximab was not inferior to cyclophosphamide for remission induction, and rituximab appeared even more beneficial in patients with relapsing disease. This raised hopes that other B-cell-targeted therapies directed either against CD19, CD20, CD22, or B-cell survival factors, B-cell activating factor of the tumor necrosis factor family (BAFF and a proliferation-inducing ligand could also be beneficial for the management of AAV. BAFF neutralization with the fully humanized monoclonal antibody belimumab has already shown success in human systemic lupus erythematosus and, along with another anti-BAFF reagent blisibimod, is currently undergoing Phase II and III clinical trials in AAV. Local production of BAFF in granulomatous lesions and elevated levels of serum BAFF in AAV provide a rationale for BAFF-targeted therapies not only in AAV but also in other forms of vasculitis such as Behcet’s disease, large-vessel vasculitis, or cryoglobulinemic vasculitis secondary to chronic hepatitis C infection. BAFF

  4. Endovascular Management of Splenic Arteriovenous Fistula with Giant Venous Aneurysmal Dilatation

    OpenAIRE

    Hamed Ibrahim, Wael; M Bassurrah, Hana

    2012-01-01

    Although splenic artery aneurysm is the commonest visceral and third most common intra abdominal aneurysm after aorta and iliac artery, aneurysm of splenic artery along with aneurysm of splenic vein and arteriovenous fistula is a rare entity. Most of them are 10 cm have been reported. We report a case of 11 cm × 8 cm giant splenic vein aneurysm with splenic arteriovenous fistula as the 1st case of giant splenic venous aneurysm with arteriovenous fistula managed by endovascular treatment.

  5. Management of Giant Splenic Artery Aneurysm

    Science.gov (United States)

    Akbulut, Sami; Otan, Emrah

    2015-01-01

    Abstract To provide an overview of the medical literature on giant splenic artery aneurysm (SAA). The PubMed, Medline, Google Scholar, and Google databases were searched using keywords to identify articles related to SAA. Keywords used were splenic artery aneurysm, giant splenic artery aneuryms, huge splenic artery aneurysm, splenic artery aneurysm rupture, and visceral artery aneurysm. SAAs with a diameter ≥5 cm are considered as giant and included in this study. The language of the publication was not a limitation criterion, and publications dated before January 15, 2015 were considered. The literature review included 69 papers (62 fulltext, 6 abstract, 1 nonavailable) on giant SAA. A sum of 78 patients (50 males, 28 females) involved in the study with an age range of 27–87 years (mean ± SD: 55.8 ± 14.0 years). Age range for male was 30–87 (mean ± SD: 57.5 ± 12.0 years) and for female was 27–84 (mean ± SD: 52.7 ± 16.6 years). Most frequent predisposing factors were acute or chronic pancreatitis, atherosclerosis, hypertension, and cirrhosis. Aneurysm dimensions were obtained for 77 patients with a range of 50–300 mm (mean ± SD: 97.1 ± 46.0 mm). Aneurysm dimension range for females was 50–210 mm (mean ± SD: 97.5 ± 40.2 mm) and for males was 50–300 mm (mean ± SD: 96.9 ± 48.9 mm). Intraperitoneal/retroperitoneal rupture was present in 15, among which with a lesion dimension range of 50–180 mm (mean ± SD; 100 ± 49.3 mm) which was range of 50–300 mm (mean ± SD: 96.3 ± 45.2 mm) in cases without rupture. Mortality for rupture patients was 33.3%. Other frequent complications were gastrosplenic fistula (n = 3), colosplenic fistula (n = 1), pancreatic fistula (n = 1), splenic arteriovenous fistula (n = 3), and portosplenic fistula (n = 1). Eight of the patients died in early postoperative period while 67 survived. Survival status of the

  6. Splenic lymphoma with circulating villous lymphocytes.

    OpenAIRE

    Imbing, F; Kumar, D.; Kumar, S.; Yuoh, G; Gardner, F

    1995-01-01

    This report describes the occurrence of splenic lymphoma with villous lymphocytes (SLVL) in a 56 year old white female with a family history of chronic lymphocytic leukaemia. Other unusual features included a marked lymphocytosis with counts up to 224 x 10(9)/l and marked clumping of lymphocytes in EDTA anticoagulated blood. The neoplastic cells were CD19+, CD20+, CD22+, CD22+, IgM+, lambda+, kappa-, CD5-, and CD10-. The spleen had nodular infiltrates of B lymphocytes in the region of the whi...

  7. Pedunculated hepatocellular carcinoma and splenic metastasis

    Institute of Scientific and Technical Information of China (English)

    Mao-Lin Yan; Yao-Dong Wang; Zhi-De Lai; Yi-Feng Tian; Hong-Biao Chen; Fu-Nan Qiu; Song-Qiang Zhou

    2009-01-01

    Only a few cases of pedunculated hepatocellular carcinoma (P-HCC) have been reported in the literature. The common sites of extrahepatic metastases in patients with HCC are the lungs, regional lymph nodes,kidney, bone marrow and adrenals. Metastasis to spleen is mostly via hematogenous metastasis, direct metastasis to spleen was very rare. We report a case of P-HCC presenting as a left upper abdominal lesions which involved the spleen that was actually a P-HCC with splenic metastasis. This case is unique as P-HCC directly involved the spleen which is not via hematogenous metastasis.

  8. Radionuclide diagnosis of splenic rupture in infectious mononucleosis

    Energy Technology Data Exchange (ETDEWEB)

    Vezina, W.C.; Nicholson, R.L.; Cohen, P.; Chamberlain, M.J.

    1984-06-01

    Spontaneous splenic rupture is a rare but serious complication of infectious mononucleosis. Although radionuclide spleen imaging is a well accepted method for diagnosis of traumatic rupture, interpretation can be difficult in the setting of mononucleosis, as tears may be ill-defined and diagnosis hampered by inhomogeneous splenic uptake. Four proven cases of spontaneous rupture are presented, three of which illustrate these diagnostic problems.

  9. Radionuclide diagnosis of splenic rupture in infectious mononucleosis

    International Nuclear Information System (INIS)

    Spontaneous splenic rupture is a rare but serious complication of infectious mononucleosis. Although radionuclide spleen imaging is a well accepted method for diagnosis of traumatic rupture, interpretation can be difficult in the setting of mononucleosis, as tears may be ill-defined and diagnosis hampered by inhomogeneous splenic uptake. Four proven cases of spontaneous rupture are presented, three of which illustrate these diagnostic problems

  10. Splenic artery pseudoaneurysm complicating chronic pancreatitis: A cae report

    International Nuclear Information System (INIS)

    Splenic artery pseudoaneurysm is a relatively rare and potentially life-threatening complication of chronic pancreatitis. The authors present a case of splenic artery pseudoaneurysm complicating chronic pancreatitis. It was converting into a pseudoaneurysm by vessel ruptures. In this case report, color doppler US, CT, and MRI made the definite diagnosis

  11. Fatal splenic rupture in Ehlers-Danlos syndrome.

    OpenAIRE

    Harris, S. C.; Slater, D N; Austin, C. A.

    1985-01-01

    A fatal case of Ehlers-Danlos syndrome (Type IV) is described. Autopsy revealed splenic rupture that had resulted from spontaneous haemorrhage into the splenic parenchyma. This is a previously unrecorded complication of Ehlers-Danlos syndrome and should be considered in the differential diagnosis of chest and abdominal pain in patients with this condition.

  12. Spontaneous splenic rupture. Radiological findings in three cases

    International Nuclear Information System (INIS)

    Spontaneous splenic rupture not associated with previous trauma is an uncommon disease. It can appear in the course of multiple systemic diseases or over a normal splenic architecture, which is even more infrequent. An early diagnosis results mandatory, since it is a potentially fatal disease if it is not promptly diagnosed and managed. We present three cases of spontaneous splenic rupture (two sub capsular hematomas opened to peritoneum and a rupture of splenic parenchyma). One patient had infectious mononucleosis, other was in the acute phase of a chronic pancreatitis and the third one had a normal splenic architecture. We emphasize the importance of CT in the early diagnosis of this entity. (Author) 21 refs

  13. Systemic lupus erythematosus and splenic abscess

    International Nuclear Information System (INIS)

    Systemic lupus erythematosus is an autoimmune disease in which there is an increase risk of infections by common germ as by opportunistic germs. This fact is explained by the alterations in the humoral and cellular immunity, and phagocytic mononuclear system due to the disease and the immunosuppressive therapy use for its treatment. Multiple infectious processes have been describes in patients with SLE and within them, the splenic abscess, although in few cases. Usually its presence is associated with an underlying disease such as sepsis or peritonitis, with multiple outcomes. Due to its low frequency as well as the unusual presentation, we reported a case of a solitary splenic abscess documented by ultrasound in a teenager with SLE and immunosuppressive treatment, without any underlying infection, who presents with fever, abdominal pain, leucocytosis and elevation of acute phase reactants. He received antibiotic therapy with clindamycin and ceftriaxone and percutaneous drainage of the abscess guided by ultrasound and sent to culture in which grew non-typificable anaerobe germs, with a favorable evolution after 5 year of follow up

  14. Medical image of the week: splenic infarction

    Directory of Open Access Journals (Sweden)

    Casey DJ

    2016-08-01

    Full Text Available No abstract available. Article truncated after 150 words. A 52-year-old Hispanic woman with a past medical history significant for Type 1 Diabetes Mellitus, hypertension, and rheumatoid arthritis presented with left upper quadrant pain for one day. Her review of systems was positive for bloating, severe epigastric and left upper quadrant tenderness that radiated to the back and left shoulder, nausea with non-bilious emesis, and diarrhea for one day prior to admission. Physical exam only revealed epigastric and left upper quadrant tenderness to light palpation without rebound or guarding. Abdominal computed tomography of the abdomen demonstrated a new acute or subacute splenic infarct with no clear evidence of an embolic source in the abdomen or pelvis (Figure 1. Echocardiogram with bubble study and contrast did not demonstrate valve abnormalities, cardiac mass, vegetation, valve or wall motion abnormalities and no evidence of patent foramen ovale. Splenic infarction should be suspected when patients present with sharp, acute left upper quadrant pain ...

  15. Diagnostic imaging and nonoperative therapy for splenic injury

    International Nuclear Information System (INIS)

    Twenty-seven splenic injuries during the last six years were studied with regard to diagnosis by computed tomography (CT) and nonoperative therapy. CT is useful for the diagnosis of splenic injury. The majority of CT scans showed irregularity of the splenic margin and high and/or low area of attenuation in the splenic parenchyme. CT also showed five splenic fractures, one extravasation of contrast medium and one nonvisualization of spleen by contrast enhancement. Of 27 splenic injuries, operations were performed in 10 cases, and nonoperative therapies were initiated in the remaining 17. In the one case of delayed rupture, transcatheter embolization was added for hemostasis of active bleeding. Nonoperative therapy should be selecteded when the following conditions are fulfilled: 1) Stable vital signs and lack of signs of massive intraperitoneal hemorrhage, 2) correct diagnosis of splenic injury utilizing CT, 3) absence of ssociated abdominal injury that demands laparotomy, such as perforation of the alimentary tract, and 4) intensive care of the patient and lack of delay in shifting from nonoperative therapy to laparotomy. (author)

  16. Splenic hypofunction in the nephrotic syndrome of childhood

    Energy Technology Data Exchange (ETDEWEB)

    McVicar, M.I.; Chandra, M.; Margouleff, D.; Zanzi, I.

    1986-05-01

    The reticuloendothelial system, including the spleen, subserves important immunologic functions. Loss of splenic function results in an increased incidence of severe bacterial infections and is accompanied by thrombocytosis. Several nephrotic children were noted to have remarkably high platelet counts and predisposition to bacterial infection with encapsulated organisms. We, therefore, investigated the splenic function of nine children with primary nephrotic syndrome and measured the phagocytic function of the spleen by sequestration of Technetium-99-labelled heat-treated autologous RBC, administered intravenously. Four children had decreased splenic function. Repeat studies performed in two of these children after remission of the nephrotic syndrome gave normal results. There were six episodes of bacterial infection (3 peritonitis, 1 septic arthritis, 1 cellulitis, and 1 Escherichia coli urinary tract infection) among the four patients with decreased splenic function. There were no episodes of bacterial infection among the five nephrotic children with normal splenic function. Nephrotic patients with decreased splenic function had significantly increased platelet counts (921,000 +/- 196,000; mean +/- SEM) compared to those with normal function (435,000 +/- 46,000; P less than 0.001). Our findings suggest the possibility that some nephrotic children may have decreased splenic function in association with increased susceptibility to bacterial infections.

  17. Selective nonoperative management of high grade splenic trauma.

    Science.gov (United States)

    Branco, Bernardino C; Tang, Andrew L; Rhee, Peter; Fraga, Gustavo Pereira; Nascimento, Bartolomeu; Rizoli, Sandro; O'Keeffe, Terence

    2013-01-01

    The "Evidence-based Telemedicine - Trauma & Acute Care Surgery" (EBT-TACS) Journal Club performed a critical review of the literature and selected three up-to-date articles on the management of splenic trauma. Our focus was on high-grade splenic injuries, defined as AAST injury grade III-V. The first paper was an update of the 2003 Eastern Association for the Surgery of Trauma (EAST) practice management guidelines for nonoperative management of injury to the spleen. The second paper was an American Association for the Surgery of Trauma (AAST) 2012 plenary paper evaluating the predictive role of contrast blush on CT scan in AAST grade IV and V splenic injuries. Our last article was from Europe and investigates the effects of angioembolization of splenic artery on splenic function after high-grade splenic trauma (AAST grade III-V). The EBT-TACS Journal Club elaborated conclusions and recommendations for the management of high-grade splenic trauma. PMID:23912375

  18. Sonography after splenic embolization: the wedge-shaped acute infarct

    International Nuclear Information System (INIS)

    After undergoing therapeutic transcatheter embolization of the splenic artery for treatment of portal hypertension, 11 consecutive patients were evaluated with sulfur colloid scintigraphy and real-time sonography of the left upper quadrant to determine which method was better for follow-up evaluation of the spleen. Six splenic infarcts were documented by both imaging methods; sonography, however, demonstrated the characteristic wedge shape of the infarct in four of the six cases. There were no cases of splenic abscess formation. Sonography should be the primary method for evaluation of the spleen after transcatheter embolization and can help in planning treatment to avoid abscess formation

  19. Splenic angiosarcoma metastasis to small bowel presented with gastrointestinal bleeding

    Institute of Scientific and Technical Information of China (English)

    Jun-Te Hsu; Chin-Yew Lin; Ting-Jun Wu; Han-Ming Chen; Tsann-Long Hwang; Yi-Yin Jan

    2005-01-01

    Primary splenic angiosarcoma is a very rare,aggressive neoplasm with a high metastatic rate and dismal prognosis. This neoplasm usually presents with abdominal pain, splenomegaly, anemia, and thrombocytopenia. Splenic angiosarcoma with bleeding gastrointestinal metastases is extremely rare. The literature contains only two case reports. This study reported a 44-year-old male patient with splenic angiosarcoma with sustained repeated gastrointestinal bleeding due to small bowel metastases. Salvage surgery was performed by splenectomy and resection of the metastatic small bowel tumors. The post-operative course was uneventful; the patient survived with the disease and had no GI bleeding, 7 mo after surgery.

  20. Tubercular splenic abscess: Two case reports with review of literature

    Directory of Open Access Journals (Sweden)

    Subhra Mitra

    2015-01-01

    Full Text Available Tubercular splenic abscess is an extremely rare entity among immunocompetent individuals. Here we describe two cases of tubercular splenic abscess in immunocompetent individuals, the first had to undergo emergency splenectomy for pain abdomen. The second case presented with pyrexia of unknown origin where pus aspirated from spleen stained positive for acid fast bacilli. Both had favorable response to anti-tubercular therapy. Tuberculosis although uncommon should be kept as a differential diagnosis of splenic abscess presenting with pain abdomen or pyrexia of unknown origin with multiple hypodense lesions in spleen on imaging.

  1. Splenic tuberculosis. Report of twelve cases; La tuberculose splenique

    Energy Technology Data Exchange (ETDEWEB)

    Adil, A.; Chikhaoui, N.; Ousehal, A.; Kadiri, R. [Centre Hospitalier Universitaire Ibn Rochd, Casablanca (Morocco)

    1995-12-31

    Tuberculosis of the spleen is not exceptional. The authors report ten cases which occurred with a predominance in young male adults. All patients had at least one other site of tuberculosis without any HIV infection. All patients had focal splenic lesions in the form of scattered hypo-echogenic and hypodense nodules. These nodules had a pseudo-tumor appearance in one case. CT-guided puncture was performed in one case. Splenic tuberculosis is not as rare as is sometimes thought. The CT-guided splenic puncture is now performed routinely and remains the ideal diagnostic approach. (authors). 9 refs., 5 figs.

  2. Splenic torsion and ureteropelvic junction obstruction - a case report

    International Nuclear Information System (INIS)

    We report a case of a 13-year-old boy with a pedicle splenic torsion associated with ureteropelvic junction obstruction. The symptoms, clinical outcome and the imaging findings are presented. (author)

  3. Ectopic pancreatic islets in Splenic hilum and peripancreatic fat

    Directory of Open Access Journals (Sweden)

    Vasishta RK

    2008-01-01

    Full Text Available Abstract The presence of pancreatic islets alone in the peripancreatic region and splenic hilum is an uncommon occurrence. Herein, we describe their presence in this rare location.

  4. Embolization of a large, symptomatic splenic artery pseudoaneurysm

    International Nuclear Information System (INIS)

    Splenic artery aneurysm is the third most common abdominal aneurysm. Most often it is due to pancreatitis. There were only 19 cases of aneurysms larger than 5 cm in diameter described in the literature. Management of splenic artery aneurysms depends on the size and symptoms. Invasive treatment modalities involve open procedures and interventional radiology methods (endovascular). A 44-years-old male with chronic pancreatitis, in a gradually worsening general condition due to a large splenic artery aneurysm, was subjected to the procedure. Blood flow through the aneurysm was cut-off by implanting a covered stent between celiac trunk and common hepatic artery. Patient’s general condition rapidly improved, allowing discharge home in good state soon after the procedure. Percutaneous embolization appears to be the best method of treatment of large splenic artery aneurysms. Complications of such treatment are significantly less dangerous than those associated with surgery

  5. Nescient Aetiology of Splenic Laceration - An Enigma Unveiled.

    Science.gov (United States)

    Sreeram, Saraswathy; Sridevi, Hanaganahalli B; Khadilkar, Urmila N; Adiga, Deepa

    2016-03-01

    Malaria is a common endemic disease prevalent in developing countries like India that presents with wide spectrum of clinical symptoms and complications. Splenic rupture is an uncommon but life-threatening complication which can be either spontaneous or as a result of trauma. We present a case of 50-year-old man with left upper quadrant pain following a polytrauma. Based on the radiological evidence of laceration and rupture of markedly enlarged spleen, emergency splenectomy was performed. Postoperative haematological evaluation established the co-infection of Plasmodium falciparum and vivax with high parasitaemia and marked thrombocytosis. The incidences of splenic rupture due to malaria are under-reported. In endemic areas, the management of splenic rupture in malaria should be focused on splenic preservation, thereby reducing the risk of future attacks of malaria in those patients who are highly susceptible to Plasmodium species and also reducing the incidence of overwhelming sepsis. PMID:27134879

  6. Isolated splenic metastasis from colon cancer: Case report

    OpenAIRE

    Abdou, Jiddou; Omor, Youssef; Boutayeb, Saber; Elkhannoussi, Basma; Errihani, Hassan

    2016-01-01

    Isolated splenic metastases from colorectal cancer are very rare clinical entities and when they are present, they usually manifest widely disseminated disease. In this paper we report a case of metachronous solitary isolated splenic metastasis from colon cancer in a 64-year-old woman who was successfully treated by laparoscopic splenectomy. We discuss the pathological and clinical aspects of this condition. We furthermore comment on the diagnostic and therapeutic options of this rare entity ...

  7. [Animal experiments concerning the autoimplantation of splenic tissue (author's transl)].

    Science.gov (United States)

    Böhles, H; Willital, G H; Krebs, C; Kaduk, B; Herzog, K H

    1981-09-01

    15 male rabbits were divided into three groups. The animals in group 1 were splenectomized. In group 2 pulpa tissue from the cut surface of the spleen was left in the abdominal cavity. Group 3 was sham operated. After 15 months all animals from group 2 showed particles of histologically intact splenic tissue mainly on the parietal peritoneum of the abdominal wall. The implications of the autoimplantation of splenic tissue during splenectomy are discussed. PMID:7314957

  8. Splenic Tuberculosis Presenting as Ascites in Immunocompetant Patient

    OpenAIRE

    Lonkar, Y; Parikh, S; S. Kumar; Diwan, SK; A Bhake

    2013-01-01

    Tuberculosis can involve any part of the gastrointestinal tract from mouth to anus, the peritoneum and the pancreatobiliary system. Here we report a case of splenic tuberculosis in a 60-year-old man who presented with ascitis. Splenic tuberculosis is an unusual clinical presentation, especially in immunocompetent patients. No primary focus of infection was detected in the lungs or any other organs. The postulated mechanisms by which the tubercule bacilli reach the peritoneum is through direct...

  9. Splenic arteriovenous fistula treated with percutaneous transarterial embolization

    DEFF Research Database (Denmark)

    Madsen, M.A.; Frevert, S.; Madsen, P.L.; Eiberg, J.P.

    2008-01-01

    Splenic arteriovenous fistula is a rare complication following splenectomy. We report a case of a large splenic arteriovenous fistula 23 years after splenectomy in a 50-year old male with abdominal pain, gastro-intestinal bleeding, ascites, diarrhoea, dyspnoea, portal hypertension and heart failure....... The arteriovenous fistula was successfully treated with percutaneous transarterial embolization and the patient gained almost complete recovery. This case demonstrates the usefulness of embolization of an otherwise surgical demanding arteriovenous fistula Udgivelsesdato: 2008/11...

  10. Non-operative management of adult blunt splenic injuries

    Institute of Scientific and Technical Information of China (English)

    YANG Jun; GAO Jin-mou; Jean-Claude Baste

    2006-01-01

    Objective: To investigate the indication of nonoperative management of adult blunt splenic injuries.Methods: A retrospective review was performed on all adult patients (age > 15 years ) with blunt splenic injuries admitted to the department of vascular surgery of Pellegrin hospital in France from 1999 to 2003. We managed splenic injuries non-operatively in all appropriate patients without regard to age.Results: During the 4 years, 54 consecutive adult patients with blunt splenic injuries were treated in the hospital. A total of 27 patients with stable hemodynamic status were treated non-operatively at first, of which 2 patients were failed to non-operative treatment. The successful percentage of non-operative management was 92.6 %. In the 54 patients, 7 of 8 patients older than 55 years were treated with non-operative management. Two cases developing postoperatively subphrenic infection were healed by proper treatment. In the series, there was no death.Conclusions: Non-operative management of low-grade splenic injuries can be accomplished with an acceptable low-failure rate. If the clinical and laboratory parameters difficult for surgeons to make decisions, they can depend on Resciniti' s CT (computed tomography)scoring system to select a subset of adults with splenic trauma who are excellent candidates for a trial of nonoperative management. The patients older than 55 years are not absolutely inhibited to receive non-operative management.

  11. Radiological diagnosis of splenic metastasis and its prevalence at autopsy

    International Nuclear Information System (INIS)

    CT and US findings of 7 cases of splenic metastases are described and the prevalence of splenic metastases at autopsy in 641 cases of malignant tumors were evaluated. Metastatic foci in spleen appeared mostly as poorly-defined low density masses on CT. Iodinated contrast material was administered in 2 cases, but no contrast enhancement was observed. US showed both hypoechoic and hyperechoic patterns. These appearances were nonspecific, but were similar to those of metastatic lesions in the liver which were often visible on CT associated with splenic metastases. At autopsy splenic metastases were found in 34 of 641 cases (5.3%). Gastric, colon, lung and ovarian cancers were most common primary tumors. However, the rate of splenic metastasis per tumor was highest in ovarian cancer (50.0%), followed by malignant melanoma (33.3%), colon cancer (16.2%), and gastric cancer (8.2%). Hepatoma which had the largest number of autopsy cases in this series showed the lowest rate of splenic metastases (0.8%). (author)

  12. Comparison of murine hepatic accessory cells and splenic dendritic cells

    International Nuclear Information System (INIS)

    Accessory cells are required for proliferation and antibody synthesis of B lymphocytes and proliferation of T lymphocytes in primary immune responses in vitro. The obligatory cells derived from the spleen are referred to as dendritic cells. Accessory cells were isolated from normal adult livers which were functionally interchangeable with splenic DC. Both hepatic accessory cells (AC) and splenic DC adhere firmly to plastic culture dishes or wells within 2 hr; but hepatic AC, unlike splenic DC, do not detach during 22 hr additional incubation. Hepatic AC, unlike splenic DC, are not lysed or inactivated by monoclonal antibody 33D1 and C'. Hepatic AC and splenic DC are similarly sensitive to irradiation in vivo and insensitive to irradiation in vitro. Hepatic AC are separated with cells which are predominantly phagocytic and FcR+ and contain nonspecific esterase. Both hepatic AC and splenic DC are suppressed or eliminated by activation of NK cells in vivo, a phenomenon prevented by prior elimination of NK cells

  13. Acute pancreatitis complicated with splenic rupture: A case report

    Institute of Scientific and Technical Information of China (English)

    Bruno; L; Hernani; Pedro; C; Silva; Ricardo; T; Nishio; Henrique; C; Mateus; José; C; Assef; Tercio; De; Campos

    2015-01-01

    Atraumatic splenic rupture is an uncommon complication of acute pancreatitis. This report describes the case of a 30-year-old man with acute pancreatitis and splenic vein thrombosis complicated by splenic rupture. The patient was admitted to the emergency department with pain in the upper abdomen that had been present for six hours and was associated with vomiting and sweating. He was diagnosed with acute pancreatitis of alcoholic etiology. Upon computed tomography(CT) of the abdomen, the pancreatitis was scored as Balthazar C grade, and a suspicious area of necrosis affecting 30% of the pancreas with splenic vein thrombosis was revealed. Seventytwo hours after admission, the patient had significant improvement in symptoms. However, he showed clinical worsening on the sixth day of hospitalization, with increasing abdominal distension and reduced hemoglobin levels. A CT angiography showed a large amount of free fluid in the abdominal cavity, along with a large splenic hematoma and contrast extravasation along the spleen artery. The patient subsequently underwent laparotomy, which showed hemoperitoneum due to rupture of the splenic parenchyma. A splenectomy was then performed, followed by ultrasound-guided percutaneous drainage.

  14. Isolated retroperitoneal hydatid cyst invading splenic hilum.

    Science.gov (United States)

    Ozturk, Safak; Unver, Mutlu; Kibar Ozturk, Burcin; Kebapci, Eyup; Bozbiyik, Osman; Erol, Varlık; Zalluhoglu, Nihat; Olmez, Mustafa

    2014-01-01

    Introduction. Hydatid disease (HD) is an infestation that is caused by the larval stage of Echinococcus granulosus. The liver is affected in approximately two-thirds of patients, the lungs in 25%, and other organs in a small proportion. Primary retroperitoneal hydatid cyst is extremely rare. The most common complaint is abdominal pain; however, the clinical features of HD may be generally dependent on the location of the cyst. Case Presentation. A 43-year-old female was admitted with the complaint of abdominal pain. Her physical examination was normal. Computed tomography (CT) revealed a 17 × 11 cm cystic lesion, with a thick and smooth wall that is located among the left liver lobe, diaphragm, spleen, tail of the pancreas, and transverse colon and invading the splenic hilum. Total cystectomy and splenectomy were performed. Pathological examination was reported as cyst hydatid. Discussion. Cysts in the peritoneal cavity are mainly the result of the spontaneous or traumatic rupture of concomitant hepatic cysts or surgical inoculation of a hepatic cyst. Serological tests contribute to diagnosis. In symptomatic and large hydatid peritoneal cysts, surgical resection is the only curative treatment. Total cystectomy is the gold standard. Albendazole or praziquantel is indicated for inoperable and disseminated cases. Percutaneous aspiration, injection, and reaspiration (PAIR) technique is another nonsurgical option. PMID:24790764

  15. Isolated Retroperitoneal Hydatid Cyst Invading Splenic Hilum

    Directory of Open Access Journals (Sweden)

    Safak Ozturk

    2014-01-01

    Full Text Available Introduction. Hydatid disease (HD is an infestation that is caused by the larval stage of Echinococcus granulosus. The liver is affected in approximately two-thirds of patients, the lungs in 25%, and other organs in a small proportion. Primary retroperitoneal hydatid cyst is extremely rare. The most common complaint is abdominal pain; however, the clinical features of HD may be generally dependent on the location of the cyst. Case Presentation. A 43-year-old female was admitted with the complaint of abdominal pain. Her physical examination was normal. Computed tomography (CT revealed a 17 × 11 cm cystic lesion, with a thick and smooth wall that is located among the left liver lobe, diaphragm, spleen, tail of the pancreas, and transverse colon and invading the splenic hilum. Total cystectomy and splenectomy were performed. Pathological examination was reported as cyst hydatid. Discussion. Cysts in the peritoneal cavity are mainly the result of the spontaneous or traumatic rupture of concomitant hepatic cysts or surgical inoculation of a hepatic cyst. Serological tests contribute to diagnosis. In symptomatic and large hydatid peritoneal cysts, surgical resection is the only curative treatment. Total cystectomy is the gold standard. Albendazole or praziquantel is indicated for inoperable and disseminated cases. Percutaneous aspiration, injection, and reaspiration (PAIR technique is another nonsurgical option.

  16. Impact of developmental lead exposure on splenic factors

    International Nuclear Information System (INIS)

    Lead (Pb) is known to alter the functions of numerous organ systems, including the hematopoietic and immune systems. Pb can induce anemia and can lower host resistance to bacterial and viral infections. The anemia is due to Pb's inhibition of hemoglobin synthesis and Pb's induction of membrane changes, leading to early erythrocyte senescence. Pb also increases B-cell activation/proliferation and skews T-cell help (Th) toward Th2 subset generation. The specific mechanisms for many of the Pb effects are, as yet, not completely understood. Therefore, we performed gene expression analysis, via microarray, on RNA from the spleens of developmentally Pb-exposed mice, in order to gain further insight into these Pb effects. Splenic RNA microarray analysis indicated strong up-regulation of genes coding for proteolytic enzymes, lipases, amylase, and RNaseA. The data also showed that Pb affected the expression of many genes associated with innate immunity. Analysis of the microarray results via GeneSifter software indicated that Pb increased apoptosis, B-cell differentiation, and Th2 development. Direct up-regulation by Pb of expression of the gene encoding the heme-regulated inhibitor (HRI) suggested that Pb can decrease erythropoiesis by blocking globin mRNA translation. Pb's high elevation of digestive/catabolizing enzymes could generate immunogenic self peptides. With Pb's potential to induce new self-peptides and to enhance the expression of caspases, cytokines, and other immunomodulators, further evaluation of Pb's involvement in autoimmune phenomena, especially Th2-mediated autoantibody production, and alteration of organ system activities is warranted.

  17. Spontaneous splenic rupture in Waldenstrom's macroglobulinemia: a case report

    Directory of Open Access Journals (Sweden)

    Charakidis Michail

    2010-09-01

    Full Text Available Abstract Introduction We report the case of a patient with Waldenstrom's macroglobulinemia complicated by spontaneous splenic rupture. Case presentation A 49-year-old Caucasian woman was referred to our emergency department by her general practitioner following a three-week history of malaise, night sweats, six kilograms of weight loss, intermittent nausea and vomiting, progressive upper abdominal pain and easy bruising. On the fourth day following her admission, she had a rapid clinical deterioration, with subsequent radiological investigations revealing a splenic rupture. Her morphology, biochemistry, flow cytometry and histology were strongly suggestive of Waldenstrom's macroglobulinemia. Conclusions Spontaneous splenic rupture is not an expected complication of low-grade lymphoplasmacytic lymphomas, such as Waldenstrom's macroglobulinemia. To the best of our knowledge, this is the only reported case of early spontaneous splenic rupture due to Waldenstrom's macroglobulinemia. Our case highlights that despite the typical disease course of low-grade hematological malignancies, signs and symptoms of imminent splenic rupture should be considered when formulating a clinical assessment.

  18. [VARIANT ANATOMY OF SPLENIC LIGAMENTS AND ARTERIES PASSING THROUGH THEM].

    Science.gov (United States)

    Gaivoronskiy, I V; Kotiv, B N; Alekseyev, V S; Nichiporuk, G I

    2015-01-01

    The research was performed on 15 non embalmed bodies and 32 abdominal complexes of adult individuals. The comparative study of variant anatomy of splenic ligaments and architectonics of arteries passing through them was carried out to substantiate the mobilization of splenopancreatic complex. Anatomical and angiographic restudied were carried out using preparation, morphometry, injection of gastric, pancreatic and splenic vascular bed with red lead suspension. It was established that the form and sizes of splenic ligaments and their interrelation with the branches of the splenic artery were variable. The minimal and maximal sizes of gastrolienal, phrenicosplenic and splenocolic ligaments differed 2-3 times. In most cases, spleen was fixed in abdominal cavity by many short ligaments. It was shown that architectonics and topography of main branches of spleen artery were determined by morphometric characteristics of the spleen proper and its ligaments. The knowledge of splenic ligament variant anatomy allows a new perspective to approach to substantiate different methods of the mobilization of spleno-pancreatic complex during surgical operations on organs of the upper part of the peritoneal cavity and organ-preserving surgery of the spleen. PMID:26234038

  19. Splenic Artery Pseudoaneurysm Presenting as Massive Hematemesis: A Diagnostic Dilemma

    Directory of Open Access Journals (Sweden)

    Peeyush Varshney

    2014-01-01

    Full Text Available Introduction. Splenic artery Pseudoaneurysm, a complication of chronic pancreatitis, presenting as massive hematemesis is a rare presentation. Case Report. We present a case of 38-year-old male admitted with chief complaints of pain in the upper abdomen and massive hematemesis for the last 15 days. On examination there was severe pallor. On investigating the patient, Hb was 4.0 gm/dL, upper GI endoscopy revealed a leiomyoma in fundus of stomach, and EUS Doppler also supported the UGI findings. On further investigation of the patient, CECT of the abdomen revealed a possibility of distal pancreatic carcinoma encasing splenic vessels and infiltrating the adjacent structure. FNA taken at the time of EUS was consistent with inflammatory pathology. Triple phase CT of the abdomen revealed a splenic artery pseudoaneurysm with multiple splenic infarcts. After resuscitation we planned an emergency laparotomy; splenic artery pseudoaneurysm densely adherent to adjacent structures and associated with distal pancreatic necrosis was found. We performed splenectomy with repair of the defect in the stomach wall and necrosectomy. Postoperative course was uneventful and patient was discharged on day 8. Conclusion. Pseudoaneurysm can be at times a very difficult situation to manage; options available are either catheter embolisation if patient is vitally stable, or otherwise, exploration.

  20. Percutaneous Treatment of Splenic Cystic Echinococcosis: Results of 12 Cases

    Energy Technology Data Exchange (ETDEWEB)

    Akhan, Okan, E-mail: akhano@tr.net; Akkaya, Selçuk, E-mail: selcuk.akkaya85@gmail.com [Hacettepe University, Department of Radiology, School of Medicine (Turkey); Dağoğlu, Merve Gülbiz, E-mail: drmgkartal@gmail.com [Istanbul University, Department of Radiology, Istanbul School of Medicine (Turkey); Akpınar, Burcu, E-mail: burcu-akpinar@yahoo.com [Hacettepe University, Department of Radiology, School of Medicine (Turkey); Erbahçeci, Aysun, E-mail: aysunerbahceci@yahoo.com [Istanbul Bakirkoy Dr. Sadi Konuk Education and Research Hospital, Department of Radiology (Turkey); Çiftçi, Türkmen, E-mail: turkmenciftci@yahoo.com [Hacettepe University, Department of Radiology, School of Medicine (Turkey); Köroğlu, Mert, E-mail: mertkoroglu@hotmail.com [Antalya Education and Research Hospital, Department of Radiology (Turkey); Akıncı, Devrim, E-mail: akincid@hotmail.com [Hacettepe University, Department of Radiology, School of Medicine (Turkey)

    2016-03-15

    PurposeCystic echinococcosis (CE) in the spleen is a rare disease even in endemic regions. The aim of this study was to examine the efficacy of percutaneous treatment for splenic CE.Materials and MethodsTwelve patients (four men, eight women) with splenic CE were included in this study. For percutaneous treatment, CE1 and CE3A splenic hydatid cysts were treated with either the PAIR (puncture, aspiration, injection, respiration) technique or the catheterization technique.ResultsEight of the hydatid cysts were treated with the PAIR technique and four were treated with catheterization. The volume of all cysts decreased significantly during the follow-up period. No complication occurred in seven of 12 patients. Abscess developed in four patients. Two patients underwent splenectomy due to cavity infection developed after percutaneous treatment, while the spleen was preserved in 10 of 12 patients. Total hospital stay was between 1 and 18 days. Hospital stay was longer and the rate of infection was higher in the catheterization group. Follow-up period was 5–117 months (mean, 44.8 months), with no recurrence observed.ConclusionThe advantages of the percutaneous treatment are its minimal invasive nature, short hospitalization duration, and its ability to preserve splenic tissue and function. As the catheterization technique is associated with higher abscess risk, we suggest that the PAIR procedure should be the first percutaneous treatment option for splenic CE.

  1. Percutaneous Treatment of Splenic Cystic Echinococcosis: Results of 12 Cases

    International Nuclear Information System (INIS)

    PurposeCystic echinococcosis (CE) in the spleen is a rare disease even in endemic regions. The aim of this study was to examine the efficacy of percutaneous treatment for splenic CE.Materials and MethodsTwelve patients (four men, eight women) with splenic CE were included in this study. For percutaneous treatment, CE1 and CE3A splenic hydatid cysts were treated with either the PAIR (puncture, aspiration, injection, respiration) technique or the catheterization technique.ResultsEight of the hydatid cysts were treated with the PAIR technique and four were treated with catheterization. The volume of all cysts decreased significantly during the follow-up period. No complication occurred in seven of 12 patients. Abscess developed in four patients. Two patients underwent splenectomy due to cavity infection developed after percutaneous treatment, while the spleen was preserved in 10 of 12 patients. Total hospital stay was between 1 and 18 days. Hospital stay was longer and the rate of infection was higher in the catheterization group. Follow-up period was 5–117 months (mean, 44.8 months), with no recurrence observed.ConclusionThe advantages of the percutaneous treatment are its minimal invasive nature, short hospitalization duration, and its ability to preserve splenic tissue and function. As the catheterization technique is associated with higher abscess risk, we suggest that the PAIR procedure should be the first percutaneous treatment option for splenic CE

  2. Unusual long-term complications of a splenic cyst.

    LENUS (Irish Health Repository)

    Ward, E V M

    2010-01-01

    Splenic cysts are relatively uncommon, and are usually asymptomatic. They are benign, typically treated conservatively and followed up with ultrasound examination, with few reported complications. We report a case of a simple splenic cyst that was followed up on imaging over a seven-year period. During that time, the cyst gradually enlarged from 5 cm to 12 cm in diameter, however the patient remained asymptomatic. After seven years, the patient was admitted with abdominal pain and a pelvic mass. The spleen was located within the pelvis, which was felt to be due to the weight of the cyst which caused the spleen to migrate out of its normal position. This case illustrates an extremely unusual complication, and suggests that while most splenic cysts may be managed conservatively, enlarging cysts may be prone to gravitational effects and prophylactic treatment should be considered.

  3. Unusual long-term complications of a splenic cyst.

    LENUS (Irish Health Repository)

    Ward, E V M

    2012-02-01

    Splenic cysts are relatively uncommon, and are usually asymptomatic. They are benign, typically treated conservatively and followed up with ultrasound examination, with few reported complications. We report a case of a simple splenic cyst that was followed up on imaging over a seven-year period. During that time, the cyst gradually enlarged from 5 cm to 12 cm in diameter, however the patient remained asymptomatic. After seven years, the patient was admitted with abdominal pain and a pelvic mass. The spleen was located within the pelvis, which was felt to be due to the weight of the cyst which caused the spleen to migrate out of its normal position. This case illustrates an extremely unusual complication, and suggests that while most splenic cysts may be managed conservatively, enlarging cysts may be prone to gravitational effects and prophylactic treatment should be considered.

  4. Fatal splenic sequestration crisis in adult sickle cell-beta thalassaemia.

    OpenAIRE

    van Rhee, F; Balsitis, M.; French, E. A.

    1991-01-01

    Fatal acute splenic sequestration crisis in an adult patient with sickle cell-beta+ thalassaemia is described. To our knowledge fatal splenic sequestration in adult sickle cell-beta thalassaemia has not been previously reported.

  5. Splenic irradiation before bone marrow transplantation for chronic myeloid leukaemia

    International Nuclear Information System (INIS)

    A total of 229 patients with chronic myeloid leukaemia (CML) in chronic phase were randomized between 1986 and 1990 to receive or not receive additional splenic irradiation as part of their conditioning prior to bone marrow transplantation (BMT). Both groups, 115 patients with and 114 patients without splenic irradiation, were very similar regarding distribution of age, sex, donor/recipient sex combination, conditioning, graft-versus-host disease (GvHD) prevention method and blood counts at diagnosis or prior to transplant. 135 patients (59%) are alive as of October 1995 with a minimum follow-up of 5 years. 52 patients have relapsed (23%), 26 patients in the irradiated, 26 patients in the non-irradiated group (n.s.) with a relapse incident at 6 years of 28%. The main risk factor for relapse was T-cell depletion as the method for GvHD prevention, and an elevated basophil count in the peripheral blood prior to transplant. Relapse incidence between patients with or without splenic irradiation was no different in patients at high risk for relapse, e.g. patients transplanted with T-cell-depleted marrows (P = n.s.) and in patients with low risk for relapse, e.g. patients transplanted with non-T-cell-depleted transplants and basophil counts 3% basophils in peripheral blood). In this patient group, relapse incidence was 11% at 6 years with splenic irradiation but 32% in the non-irradiated group (P = 0.05). Transplant-related mortality was similar whether patients received splenic irradiation or not. This study suggests an advantage in splenic irradiation prior to transplantation for CML in this subgroup of patients and illustrates the need for tailored therapy. (Author)

  6. Spontaneous splenic rupture during the recovery phase of dengue fever

    OpenAIRE

    de Silva, W T T; Gunasekera, M

    2015-01-01

    Background Spontaneous splenic rupture is a rare but known complication of dengue fever. Previously reported cases have occurred early during the course of the disease and most cases have led to a fatal outcome. Here we report a case of spontaneous splenic rupture in a patient with dengue fever, which occurred during the recovery phase of the illness. Case presentation A 28-year-old Sinhalese, Sri Lankan man presented with a history of fever, myalgia and vomiting of 4 days duration. Investiga...

  7. Dynamic alteration in splenic function during acute falciparum malaria

    Energy Technology Data Exchange (ETDEWEB)

    Looareesuwan, S.; Ho, M.; Wattanagoon, Y.; White, N.J.; Warrell, D.A.; Bunnag, D.; Harinasuta, T.; Wyler, D.J.

    1987-09-10

    Plasmodium-infected erythrocytes lose their normal deformability and become susceptible to splenic filtration. In animal models, this is one mechanism of antimalarial defense. To assess the effect of acute falciparum malaria on splenic filtration, we measured the clearance of heated /sup 51/Cr-labeled autologous erythrocytes in 25 patients with acute falciparum malaria and in 10 uninfected controls. Two groups of patients could be distinguished. Sixteen patients had splenomegaly, markedly accelerated clearance of the labeled erythrocytes (clearance half-time, 8.4 +/- 4.4 minutes (mean +/- SD) vs. 62.5 +/- 36.5 minutes in controls; P less than 0.001), and a lower mean hematocrit than did the patients without splenomegaly (P less than 0.001). In the nine patients without splenomegaly, clearance was normal. After institution of antimalarial chemotherapy, however, the clearance in this group accelerated to supernormal rates similar to those in the patients with splenomegaly, but without the development of detectable splenomegaly. Clearance was not significantly altered by treatment in the group with splenomegaly. Six weeks later, normal clearance rates were reestablished in most patients in both groups. We conclude that splenic clearance of labeled erythrocytes is enhanced in patients with malaria if splenomegaly is present and is enhanced only after treatment if splenomegaly is absent. Whether this enhanced splenic function applies to parasite-infected erythrocytes in patients with malaria and has any clinical benefit will require further studies.

  8. Dynamic alteration in splenic function during acute falciparum malaria

    International Nuclear Information System (INIS)

    Plasmodium-infected erythrocytes lose their normal deformability and become susceptible to splenic filtration. In animal models, this is one mechanism of antimalarial defense. To assess the effect of acute falciparum malaria on splenic filtration, we measured the clearance of heated 51Cr-labeled autologous erythrocytes in 25 patients with acute falciparum malaria and in 10 uninfected controls. Two groups of patients could be distinguished. Sixteen patients had splenomegaly, markedly accelerated clearance of the labeled erythrocytes (clearance half-time, 8.4 +/- 4.4 minutes [mean +/- SD] vs. 62.5 +/- 36.5 minutes in controls; P less than 0.001), and a lower mean hematocrit than did the patients without splenomegaly (P less than 0.001). In the nine patients without splenomegaly, clearance was normal. After institution of antimalarial chemotherapy, however, the clearance in this group accelerated to supernormal rates similar to those in the patients with splenomegaly, but without the development of detectable splenomegaly. Clearance was not significantly altered by treatment in the group with splenomegaly. Six weeks later, normal clearance rates were reestablished in most patients in both groups. We conclude that splenic clearance of labeled erythrocytes is enhanced in patients with malaria if splenomegaly is present and is enhanced only after treatment if splenomegaly is absent. Whether this enhanced splenic function applies to parasite-infected erythrocytes in patients with malaria and has any clinical benefit will require further studies

  9. Primary Giant Splenic Echinococcal Cyst Treated by Laparoscopy.

    Science.gov (United States)

    Arce, Maira A; Limaylla, Himerón; Valcarcel, Maria; Garcia, Hector H; Santivañez, Saul J

    2016-01-01

    Cystic echinococcosis (CE) is a zoonosis caused by the larval stage of the dog tapeworm Echinococcus granulosus. Liver and lungs are the most commonly affected organs whereas splenic infection is rarer and its primary involvement occurs in less than 2% of abdominal CE. We report a case of primary giant splenic hydatid cyst in a 75-year-old Peruvian woman that was laparoscopically removed without any complications, perioperative prophylactic chemotherapy with albendazole 400 mg twice a day 5 days before, and 7 days after the surgical procedure was administered, postoperative recovery was uneventful, and; at her 3-month follow-up the patient remains asymptomatic and an abdominal computed tomography scan demonstrated a cystic cavity of 15 cm diameter with no daughter vesicles, neither other abdominal organ involvement. This case is in line with the existing literature on laparoscopical treatment of splenic cystic hydatid disease, suggesting that laparoscopical treatment is a safe and effective approach for large splenic hydatid cysts to be preferred to open surgical techniques. PMID:26556833

  10. Giant splenic hematoma can be a hidden condition

    DEFF Research Database (Denmark)

    Jensen, Kristian Kiim; Hangaard, Stine

    2014-01-01

    An otherwise healthy 28-year old male presented to his general practitioner with dyspnoea in the morning and abdominal discomfort through months. Four months earlier, he had experienced a blunt trauma to the left side of his abdomen. Abdominal ultrasonography revealed a splenic hematoma and the p...

  11. TLR3 Ligand-Induced Accumulation of Activated Splenic Natural Killer Cells into Liver

    Institute of Scientific and Technical Information of China (English)

    Jing Wang; Jiawei Xu; Weici Zhang; Haiming Wei; Zhigang Tian

    2005-01-01

    It has been revealed that poly Ⅰ:C is a potent stimulator for NK cells, which can induce NK cell rapid activation and preferential accumulation into liver. However, the process mediating the influx of NK cells remains obscure. In this study, we found that poly Ⅰ:C administration increased the portion and absolute number of NK cells in liver,but largely decreased those in spleen. There were no obvious changes of these lymphocytes in other immune organs.The results from splenic adoptive transfer and splenectomy showed that the recruited spleen NK cells contributed to the accumulation of NK cells in liver, and this process was regulated by the production of chemokines and the presence of T cells. This investigation will help to understand the enhanced immune cell recruitment in liver upon viral infection.

  12. SPLENIC VOLUME CHANGE AND THERAPUETIC RESPONSE IN PATIENTS TREATED WITH RADIOMMUNOCONJUGATES

    Energy Technology Data Exchange (ETDEWEB)

    Shen, S; DeNardo, G L; Yuan, A; Siantar, C H; O' Donnell, R T; DeNardo, S J

    2005-04-06

    Splenomegaly is frequently found in non-Hodgkin's lymphoma (NHL) patients. This study evaluated the implications of splenic volume change in response to radioimmunotherapy (RIT). Twenty-nine NHL patients treated with radiolabeled-Lym-1 and 9 breast cancer patients (reference group) treated with radiolabeled-ChL6, BrE-3 or m170 were analyzed using CT splenic images obtained before and after RIT. Patient-specific radiation doses to spleen were determined using actual splenic volume determined by CT and body weight. In 13 of 29 NHL patients who had splenic volume {le} 310 ml, there was no or small change (-23 to 15 mL) in splenic volume, despite splenic doses as high as 14.4 Gy. Similarly, in a reference group of 9 breast cancer patients, there was no or small change (-5 to 13 mL), despite splenic doses as high as 11.4 Gy. In contrast, 13 of 29 NHL patients who had splenic volume 380-1400 mL, splenic volume decreased by 68 to 548 mL despite splenic doses as low as 1.40 Gy. Ten of 29 NHL patients with greater than a 15% decrease in splenic volume after RIT had nodal tumor regression (5 CR, 5 PR). In the remaining 19 NHL patients with less than a 15% decrease in splenic volume after RIT, there were 7 non-responders (5 CR and 7 PR). Splenic volume changes were found in NHL patients with splenomegaly. These splenic volume changes is likely due to therapeutic effect on malignant lymphocytes associated with splenomegaly. Nodal tumor response was more likely when splenomegaly decreased after RIT.

  13. Treatment of a Celiac Trunk Aneurysm Close to the Hepato-splenic Bifurcation by Using Hepatic Stent-graft Implantation and Splenic Artery Embolization

    International Nuclear Information System (INIS)

    We present a case of a 73-year-old man in whom a celiac trunk aneurysm close to the hepato-splenic bifurcation was discovered and treated by using celiac-hepatic stent-grafts implantation and splenic artery embolization

  14. Splenic imaging in a patient with functional asplenia

    International Nuclear Information System (INIS)

    A 65-year-old woman presented with right upper extremity paralysis and left cerebrovascular accident. A routine complete blood count (CBC) demonstrated Howell-Jolly bodies on peripheral smear, and a liver-spleen scan showed absent splenic sulfur colloid uptake suggesting functional asplenia. A subsequent heat damaged red blood cell study demonstrated a normal sized spleen with preserved sequestering function, thereby excluding anatomic asplenia, vascular alterations, or congenital anomalies in the differential diagnosis of functional asplenia. This case illustrates the use of Tc-99m heat damaged red blood cells as a unique and useful diagnostic aid in identifying the presence and size of a spleen in patients with functional asplenia. It also demonstrates an apparent qualitative separation of splenic functions in processing sulfur colloid and heat damaged red blood cells

  15. Splenic infarct as a diagnostic pitfall in radiology

    Directory of Open Access Journals (Sweden)

    Joshi Sanjeev

    2008-01-01

    Full Text Available Follow-up of colorectal carcinoma after therapy is based on symptoms, tumor markers, and imaging studies. Clinicians sometimes face diagnostic dilemmas because of unusual presentations on the imaging modalities coupled with rising serum markers. We report a case of colorectal carcinoma that presented with gastrointestinal symptoms 14 months after completion of treatment. Investigations showed rise in carcinoembryonic antigen (CEA. Suspecting disease recurrence, complete radioimaging workup was performed; the only abnormality detected was a smooth, hypodense area in the posterior third of the spleen on contrast-enhanced computed tomography abdomen. In view of the previous diagnosis of carcinoma colon, the symptoms reported by the patient, the elevated CEA, and the atypical CECT appearance, a diagnosis of splenic metastasis was made. The patient was subjected to splenectomy as a curative treatment. However, the histopathological report revealed it to be a splenic infarct. The present case reemphasizes the limitations of radiological studies in the follow-up of carcinoma colon.

  16. Inflammatory pseudotumour of the spleen associated with splenic tuberculosis

    Institute of Scientific and Technical Information of China (English)

    Maria; Isabel; Prieto-Nieto; Juan; Pedro; Pérez-Robledo; Beatriz; Díaz-San; Andrés; Manuel; Nistal; José; Antonio; Rodríguez-Montes

    2014-01-01

    Inflammatory pseudotumor(IPT) of the spleen is an uncommon entity with an uncertain aetiology. Inflammatory pseudotumors present diagnostic difficulties because the clinical and radiological findings tend to suggest a malignancy. The symptoms include weight loss, fever, and abdominal pain. Most cases of splenic IPT present solitary relatively large well circumscribed masses on imaging. The diagnosis in the majority of the cases is made after histopathologic study of splenectomy specimens. The IPTs that occur in the spleen and liver are typically associated with Epstein-Barr virus. Thirtyseven percent of all new cases of active tuberculosis infection are extrapulmonary tuberculosis and tuberculous lymphadenitis the most commonly occurring form of extrapulmonary tuberculosis. We report the case of an inflammatory pseudotumor of the spleen associated with splenic tuberculous lymphadenitis in a 50-year-old female patient who was preoperatively diagnosed with a malignant spleen tumour based on her history of breast of carcinoma.

  17. Spontaneous splenic rupture: A rare presentation of dengue fever

    OpenAIRE

    Mainak Mukhopadhyay; Nandini Chatterjee; Pranab Maity; Kartik Patar

    2014-01-01

    Spontaneous rupture of the spleen with hemoperitoneum is a very rare, but serious manifestation of dengue fever (DF). We report a case of a young female who was presented with atraumatic abdominal pain, hypovolemic shock, anemia, ascites and hepatosplenomegaly with a recent history of a febrile illness. Subsequent investigations proved the presence of hemoperitoneum with spontaneous splenic rupture with seropositivity for DF. Early diagnosis and conservative management in this case resulted i...

  18. Spontaneous splenic rupture: A rare presentation of dengue fever.

    Science.gov (United States)

    Mukhopadhyay, Mainak; Chatterjee, Nandini; Maity, Pranab; Patar, Kartik

    2014-02-01

    Spontaneous rupture of the spleen with hemoperitoneum is a very rare, but serious manifestation of dengue fever (DF). We report a case of a young female who was presented with atraumatic abdominal pain, hypovolemic shock, anemia, ascites and hepatosplenomegaly with a recent history of a febrile illness. Subsequent investigations proved the presence of hemoperitoneum with spontaneous splenic rupture with seropositivity for DF. Early diagnosis and conservative management in this case resulted in a favorable outcome. PMID:24678156

  19. Spontaneous splenic rupture: A rare presentation of dengue fever

    Directory of Open Access Journals (Sweden)

    Mainak Mukhopadhyay

    2014-01-01

    Full Text Available Spontaneous rupture of the spleen with hemoperitoneum is a very rare, but serious manifestation of dengue fever (DF. We report a case of a young female who was presented with atraumatic abdominal pain, hypovolemic shock, anemia, ascites and hepatosplenomegaly with a recent history of a febrile illness. Subsequent investigations proved the presence of hemoperitoneum with spontaneous splenic rupture with seropositivity for DF. Early diagnosis and conservative management in this case resulted in a favorable outcome.

  20. Splenic hemangiosarcoma with abdominal dissemination in a dog

    OpenAIRE

    GÜLBAHAR, M. Yavuz

    1998-01-01

    A case of spontaneosly ruptured splenic hemangiosarcoma with abdominal dissemination in a 12-year-old male German shepherd dog is described. At necropsy, a ruptured tumor mass was seen in the ventral region of the visceral surface of the spleen, and disseminated tumor masses were seen throughout the peritoneal cavity. Histologically, in both the primary tumor mass and dis-seminated tumor masses, atypical endothelial cells lining vascular spaces as small clefts or as cavernous channels were...

  1. Specific receptor binding of staphylococcal enterotoxins by murine splenic lymphocytes.

    OpenAIRE

    Buxser, S; Bonventre, P F; Archer, D L

    1981-01-01

    We describe a reliable assay to measure the specific binding of 125I-labeled staphylococcal enterotoxin A (SEA) by murine spleen cells. Toxin binding by lymphocytes was specific in that it was inhibited by unlabeled SEA but not by unrelated proteins. The biological activity of SEA (T-lymphocyte mitogenesis) correlated with toxin binding to splenic lymphocytes. In the presence of high concentrations of [125I]SEA, specific binding increased rapidly and approached saturation after 2 h. Toxin bin...

  2. Isolated metachronous splenic metastasis from synchronous colon cancer

    Directory of Open Access Journals (Sweden)

    Aker Fugen

    2006-07-01

    Full Text Available Abstract Background Isolated splenic metastases from colorectal cancer are very rare and there are only 13 cases reported in the English literature so far. Most cases are asymptomatic and the diagnosis is usually made by imaging studies during the evaluation of rising CEA level postoperatively. Case presentation A 76-year-old man underwent an extended left hemicolectomy for synchronous colon cancers located at the left flexure and the sigmoid colon. The tumors were staged as IIIC (T3N2M0 clinically and the patient received adjuvant chemotherapy. During the first year follow-up period, the patient remained asymptomatic with normal levels of laboratory tests including CEA measurement. However, a gradually rising CEA level after the 14th postoperative month necessitated further imaging studies including computed tomography of the abdomen which revealed a mass in the spleen that was subsequently confirmed by 18FDG- PET scanning to be an isolated metastasis. The patient underwent splenectomy 17 months after his previous cancer surgery. Histological diagnosis confirmed a metastatic adenocarcinoma with no capsule invasion. After an uneventful postoperative period, the patient has been symptom-free during the one-year of follow-up with normal blood CEA levels, although he did not accept to receive any further adjuvant therapy. To the best of our knowledge, this 14th case of isolated splenic metastasis from colorectal carcinoma is also the first reported case of splenic metastasis demonstrated preoperatively by 18FDG PET-CT fusion scanning which revealed its solitary nature as well. Conclusion Isolated splenic metastasis is a rare finding in the follow-up of colorectal cancer patients and long-term survival can be achieved with splenectomy.

  3. Laparoscopic Marsupialization of a Giant Posttraumatic Splenic Cyst

    OpenAIRE

    Sierra, Rafael; Brunner, William C.; Murphy, Joseph T.; Dunne, J Bruce; Scott, Daniel J

    2004-01-01

    Background and Objective: Nonparasitic cysts are rare clinical lesions of the spleen. Causes include congenital malformations and trauma. Historically, management has entailed partial or total splenectomy using an open approach. Recently, laparoscopic approaches have been developed. In this report, we describe laparoscopic marsupialization of a giant splenic cyst (diameter > 15 cm). Methods: A 25-year-old African-American man presented with a 9-month history of early satiety, constipation, an...

  4. Autoimmune Pancreatitis Complicated by Spontaneous Subcapsular Splenic Haemorrhage

    Directory of Open Access Journals (Sweden)

    Mina S Hanna

    2013-09-01

    Full Text Available Context Autoimmune pancreatitis is a rare but increasingly reco gnised condition with unique clinical, immunologica l and histological features. We report the first case of auto immune pancreatitis associated with spontaneous sple nic haemorrhage. Case report A 75-year-old man presented with severe epigastric pa in radiating to the back associated with nausea and vomiting. A CT-scan of his abdomen showed a large ps eudocyst within the pancreatic tail as well as a sub capsular splenic haemorrhage. His IgG4 levels were elevated and clinica l history and investigations were consistent with se vere acute pancreatitis, but were negative for other known causes of pancreatic disease. The patient was started on ste roid therapy and improved dramatically clinically, immunologically and radiologically thus confirming the diagnosis of auto immune pancreatitis. His splenic haemorrhage was managed cons ervatively in view of his haemodynamic stablity and eventually self- resolved. Conclusion Autoimmune pancreatitis should not be overlooked in cases of acute pancreatitis without other obvious etiology. Furthermore, superimposed splenic hae morrhage is a rare but important complication of autoimm une pancreatitis.

  5. CT imaging of splenic sequestration in sickle cell disease

    International Nuclear Information System (INIS)

    Pooling of blood in the spleen is a frequent occurrence in children with sickle cell diseases, particularly in the first few years of life, resulting in what is termed ''splenic sequestration crisis.'' The spectrum of severity in this syndrome is wide, ranging from mild splenomegaly to massive enlargement, circulatory collapse, and even death. The diagnosis is usually clinical, based on the enlargement of the spleen with a drop in hemoglobin level by >2 g/dl, and it is rare that imaging studies are ordered. However, in the patient who presents to the emergency department with non-specific findings of an acute abdomen, it is important to recognize the appearance of sequestration on imaging studies. We studied seven patients utilizing contrast-enhanced CT scans and found two distinct patterns - multiple, peripheral, non-enhancing low-density areas or large, diffuse areas of low density in the majority of the splenic tissue. Although radiological imaging is not always necessary to diagnose splenic sequestration, in those situations where this diagnosis is not immediately obvious, it makes an important clarifying contribution. (orig.)

  6. Splenic irradiation in myelofibrosis. Clinical findings and ferrokinetics

    Energy Technology Data Exchange (ETDEWEB)

    Parmentier, C.; Charbord, P.; Tibi, M.; Tubiana, M.

    1977-01-01

    Nine patients were submitted to splenic or, in two cases, hepatosplenic irradiation; these patients presented a primary myelofibrosis or a spent polycythemia vera characterized by splenomegaly, anemia, and occasionally leucocytosis and thrombocytopenia. The hematological condition returned to normal in 2 patients. This improvement lasted 4 years after a first series of irradiation. The recurrence of splenomegaly and anemia indicated a second series of irradiation, the results of which were as good as those of the first series. Ineffective medullary and splenic erythropoiesis without preeminent aplasia appeared to be correlated with a beneficial effect of splenic irradiation. Absence of hepatomegaly and marked leucocytosis were less important prognostic factors. The modee of action of radiotherapy and the way in which it differs from splenectomy are discussed. The irradiation delivered moderate doses (450 rad in 18 sessions of 25 rad). Hepatic irradiation did not appear to be essential even in cases of intense hepatic myeloid metaplasia: in 2 patients liver erythropoiesis regressed when the spleen alone was irradiated.

  7. Nonoperative treatment of splenic trauma: usefulness of computed tomography

    International Nuclear Information System (INIS)

    Objective: to report the results of use of conservative treatment in patients with splenic trauma and to emphasize the usefulness of computed tomography in these cases. Material and method: sixty-nine cases of pediatric patients with blunt abdominal trauma seen from from January 2001 to June 2004 at the level I trauma center were retrospectively studied. Forty-four of these patients were submitted to nonoperative treatment and the clinical follow-up was performed by computerized tomography. All patients had been diagnosed with splenic injury by computerized tomography.Results: the causes of the injuries were motor vehicle accident in 12 (27.2%) patients, bicycle accident in nine (20.4%) patients, and falls in 23 (52.2%) patients. Two (3.7%) patients died from associated injuries. The mean duration of hospital stay was six days. The mean age of the patients was nine years. Conclusion: conservative treatment for blunt splenic trauma is performed with the aim of reducing costs and risks for the patients, and computerized tomography should be routinely used. No posterior complications were observed in this approach. (author)

  8. CT imaging of splenic sequestration in sickle cell disease

    Energy Technology Data Exchange (ETDEWEB)

    Sheth, S.; Piomelli, S. [Columbia Univ., New York, NY (United States). Dept. of Pediatrics; Ruzal-Shapiro, C.; Berdon, W.E. [Columbia Univ., New York, NY (United States). Div. of Pediatric Radiology

    2000-12-01

    Pooling of blood in the spleen is a frequent occurrence in children with sickle cell diseases, particularly in the first few years of life, resulting in what is termed ''splenic sequestration crisis.'' The spectrum of severity in this syndrome is wide, ranging from mild splenomegaly to massive enlargement, circulatory collapse, and even death. The diagnosis is usually clinical, based on the enlargement of the spleen with a drop in hemoglobin level by >2 g/dl, and it is rare that imaging studies are ordered. However, in the patient who presents to the emergency department with non-specific findings of an acute abdomen, it is important to recognize the appearance of sequestration on imaging studies. We studied seven patients utilizing contrast-enhanced CT scans and found two distinct patterns - multiple, peripheral, non-enhancing low-density areas or large, diffuse areas of low density in the majority of the splenic tissue. Although radiological imaging is not always necessary to diagnose splenic sequestration, in those situations where this diagnosis is not immediately obvious, it makes an important clarifying contribution. (orig.)

  9. Giant Splenic Artery Pseudoaneurysm: A Case Report and Literature Review.

    Science.gov (United States)

    Yagmur, Yusuf; Akbulut, Sami; Gumus, Serdar; Demircan, Firat

    2015-07-01

    Splenic artery aneurysms (SAAs) are the third most frequent intra-abdominal aneurysm, following abdominal aorta and iliac artery aneurysms. SAAs are classified according to their involvement of arterial wall layers: true aneurysms involve all 3 layers (intima, media, and adventitia), and pseudoaneurysms involve only one or two. Herein we present a new case of giant pseudo SAA. A 65-year-old female patient with a pancreatic mass and iron deficiency was referred to our clinic for further investigation. Abdominal ultrasonography, contrast-enhanced CT and magnetic resonance imaging showed a lesion resembling a subcapsular hemangioma in the spleen, and aneurysmatic dilation of the splenic artery with a diameter of >5 cm. The large size of the aneurysm and the clinical findings were indications for surgical treatment. The patient underwent en bloc resection of the spleen, distal pancreas, and aneurysmatic segment of the splenic artery. The patient remains complication-free 2 months after the operation. Spontaneous rupture is the most important life-threatening complications of giant SAAs. Therefore, all symptomatic patients with SAA should be treated, as well as asymptomatic patients with lesions ≥2 cm, who are pregnant or fertile, have portal hypertension, or are candidates for liver transplantation. Despite advances in endovascular techniques, conventional abdominal surgery remains the gold standard for treatment. PMID:26595501

  10. Salmonella sepsis following posttraumatic splenectomy and implantation of autologous splenic tissue

    DEFF Research Database (Denmark)

    Schrøder, H M; Hovendal, C

    1985-01-01

    A severe complication following implantation of autologous splenic tissue occurred in a 51-year-old man. Indirect injury to abdomen resulted in a lesion of the splenic artery. Following splenectomy and reimplantation of splenic tissue into three pouches, a severe Salmonella sepsis developed withi...... 24 hours. At second look laparotomy two pouches were infected. Recently there had been moderate signs of gastroenteritis and the same bacteria was cultivated from feces. Modifications of the implantation procedure are discussed....

  11. Acute Brucellosis with Splenic Infarcts: A Case Report from a Tertiary Care Hospital in Saudi Arabia

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    Mishal Alyousef

    2015-01-01

    Full Text Available Splenic infarction is an extremely rare and unique presentation of brucellosis. Only few cases have been reported worldwide. We here report a case of a young man, presenting with acute onset of fever, left hypochondial pain, and vomiting. Further evaluation revealed multiple splenic infarcts and positive blood culture for brucellosis despite negative transesophageal echocardiography for endocarditis. Significant improvement in clinical symptoms and splenic lesions was achieved after six weeks of combination therapy against brucellosis.

  12. The efficacy of transcatheter arterial embolization (TAE) in children with blunt splenic injury

    International Nuclear Information System (INIS)

    The purpose of this study is to evaluate the efficacy of transcatheter arterial embolization (TAE) in children with blunt splenic injury. The results of transcatheter splenic arterial embolization in nine children who suffered splenic injury after blunt abdominal trauma were retrospectively studied. This injury was demonstrated by CT, and the findings were evaluated according to the classification of Mirvis et al.; two patients were grade 3 and seven were grade 4. All were carefully observed in intensive care before embolization. TAE was performed if a patient satisfied the following criteria : (1) transfusion and/or fluid replacement required to maintain hemodynamic stability; or (2) rapid Hb/Hct decrease; or (3) both. Splenic function was subsequently estimated according to the results of 09mTc-sulfur colloid scintigraphy and/or CT scanning. TAE was successful in all nine children. Two were embolized with a coil only, three with gelfoam, and four with gelfoam and a coil. Seven were embolized in the main trunk of the splenic artery and others in both the main trunk and its branches. Splenic function was preserved in all nine children, during follow-up, none suffered rebleeding. TAE of the splenic artery can be a safe and effective nonsurgical approach to the management of blunt splenic injury in children, and can preserve splenic function. (author). 18 refs., 2 tabs., 3 figs

  13. Polyvinyl alcohol and gelatin sponge particle embolization of splenic artery pseudoaneurysm complicating chronic alcoholic pancreatitis

    OpenAIRE

    Guan, Yong-Song; Sun, Long; Zhou, Xiang-Ping; Li, Xiao; Fei, Ze-Jun; Zheng, Xiao-Hua; He, Qing

    2005-01-01

    AIM: To assess the effectiveness of and complications associated with polyvinyl alcohol (PVA) and gelatin sponge particles embolization of splenic artery pseudoaneurysm complicating chronic alcoholic pancreatitis.

  14. Tc-99m sulfur colloid spleen imaging following splenic artery and vein resection for pancreas organ donation

    International Nuclear Information System (INIS)

    The authors retrospectively studied the records and Tc-99m sulfur colloid (TSC) splenic artery and vein resection for donation to HLA-compatible relatives. Of 37 patients with postoperative TSC studies, four had no postoperative splenic abnormalities. Nineteen of the abnormal TSC studies were followed with TSC studies 2 weeks to 14 months later; three showed no change, seven showed improvements,and ten became normal. One patient required splenectomy 2 days after pancreatectomy for splenic infarction; her TSC study showed no uptake. These data suggest that the spleen usually survives splenic artery and vein resection. Absent splenic TSC uptake raises the possibility of splenic infarction but usually improves

  15. Management of Giant Splenic Artery Aneurysm: Comprehensive Literature Review.

    Science.gov (United States)

    Akbulut, Sami; Otan, Emrah

    2015-07-01

    To provide an overview of the medical literature on giant splenic artery aneurysm (SAA).The PubMed, Medline, Google Scholar, and Google databases were searched using keywords to identify articles related to SAA. Keywords used were splenic artery aneurysm, giant splenic artery aneuryms, huge splenic artery aneurysm, splenic artery aneurysm rupture, and visceral artery aneurysm. SAAs with a diameter ≥5 cm are considered as giant and included in this study. The language of the publication was not a limitation criterion, and publications dated before January 15, 2015 were considered.The literature review included 69 papers (62 fulltext, 6 abstract, 1 nonavailable) on giant SAA. A sum of 78 patients (50 males, 28 females) involved in the study with an age range of 27-87 years (mean ± SD: 55.8 ± 14.0 years). Age range for male was 30-87 (mean ± SD: 57.5 ± 12.0 years) and for female was 27-84 (mean ± SD: 52.7 ± 16.6 years). Most frequent predisposing factors were acute or chronic pancreatitis, atherosclerosis, hypertension, and cirrhosis. Aneurysm dimensions were obtained for 77 patients with a range of 50-300 mm (mean ± SD: 97.1 ± 46.0 mm). Aneurysm dimension range for females was 50-210 mm (mean ± SD: 97.5 ± 40.2 mm) and for males was 50-300 mm (mean ± SD: 96.9 ± 48.9 mm). Intraperitoneal/retroperitoneal rupture was present in 15, among which with a lesion dimension range of 50-180 mm (mean ± SD; 100 ± 49.3 mm) which was range of 50-300 mm (mean ± SD: 96.3 ± 45.2 mm) in cases without rupture. Mortality for rupture patients was 33.3%. Other frequent complications were gastrosplenic fistula (n = 3), colosplenic fistula (n = 1), pancreatic fistula (n = 1), splenic arteriovenous fistula (n = 3), and portosplenic fistula (n = 1). Eight of the patients died in early postoperative period while 67 survived. Survival status of the remaining 3 patients is

  16. Transjugular Endovascular Recanalization of Splenic Vein in Patients with Regional Portal Hypertension Complicated by Gastrointestinal Bleeding

    Energy Technology Data Exchange (ETDEWEB)

    Luo, Xuefeng; Nie, Ling; Wang, Zhu; Tsauo, Jiaywei; Tang, Chengwei; Li, Xiao, E-mail: simonlixiao@126.com [West China Hospital, Sichuan University, Department of Gastroenterology (China)

    2013-05-02

    PurposeRegional portal hypertension (RPH) is an uncommon clinical syndrome resulting from splenic vein stenosis/occlusion, which may cause gastrointestinal (GI) bleeding from the esophagogastric varices. The present study evaluated the safety and efficacy of transjugular endovascular recanalization of splenic vein in patients with GI bleeding secondary to RPH.MethodsFrom December 2008 to May 2011, 11 patients who were diagnosed with RPH complicated by GI bleeding and had undergone transjugular endovascular recanalization of splenic vein were reviewed retrospectively. Contrast-enhanced computed tomography revealed splenic vein stenosis in six cases and splenic vein occlusion in five. Etiology of RPH was chronic pancreatitis (n = 7), acute pancreatitis with pancreatic pseudocyst (n = 2), pancreatic injury (n = 1), and isolated pancreatic tuberculosis (n = 1).ResultsTechnical success was achieved in 8 of 11 patients via the transjugular approach, including six patients with splenic vein stenosis and two patients with splenic vein occlusion. Two patients underwent splenic vein venoplasty only, whereas four patients underwent bare stents deployment and two covered stents. Splenic vein pressure gradient (SPG) was reduced from 21.5 ± 7.3 to 2.9 ± 1.4 mmHg after the procedure (P < 0.01). For the remaining three patients who had technical failures, splenic artery embolization and subsequent splenectomy was performed. During a median follow-up time of 17.5 (range, 3–34) months, no recurrence of GI bleeding was observed.ConclusionsTransjugular endovascular recanalization of splenic vein is a safe and effective therapeutic option in patients with RPH complicated by GI bleeding and is not associated with an increased risk of procedure-related complications.

  17. Clinical indications and biological mechanisms of splenic irradiation in autoimmune diseases

    International Nuclear Information System (INIS)

    Background: Splenic irradiation (SI) is a fairly unknown treatment modality in autoimmune disorders like autoimmune thrombocytopenia (AIT) or autoimmune hemolytic anemia (AIHA), which may provide an effective, low toxic and cost-effective treatment for selected patients. Patients, Materials and Methods: This article reviews the limited experiences on splenic irradiation in autoimmune thrombocytopenia by analyzing the current studies including 71 patients and some preliminary reports on splenic irradiation in autoimmune hemolytic anemia. Results: In autoimmune thrombocytopenia between 40 and 90% of all patients responded, but most of them relapsed within 4 to 6 months after splenic irradiation. Between 10 and 20% of all patients had a sustained response. The efficacy of splenic irradiation in HIV-associated cases of thrombocytopenia is probably lower than in other forms of autoimmune thrombocytopenia, but especially in this group immunosuppressive drug treatment of autoimmune thrombocytopenia exposes some problems. In autoimmune hemolytic anemia there are some case reports about efficacy of splenic irradiation. Toxicity of splenic irradiation in both diseases was very moderate. Conclusions: For HIV patients, for elderly patients or patients at high risk for complications following splenectomy splenic irradiation might be a treatment option. Splenic irradiation as preoperative treatment in patients not responding to or not suitable for immunosuppressive drugs prior to splenectomy may be a promising new application of splenic irradiation to reduce adverse effects of splenectomy in thrombocytopenic patients. A further analysis of the biological mechanisms underlying splenic irradiation may help to improve patient selection, to optimize dose concepts and treatment schedules and will improve understanding of radiotherapy as an immunomodulatory treatment modality. (orig.)

  18. Primary splenic torsion in dogs: 102 cases (1992-2014).

    Science.gov (United States)

    DeGroot, Whitney; Giuffrida, Michelle A; Rubin, Jacob; Runge, Jeffrey J; Zide, Amy; Mayhew, Philipp D; Culp, William T N; Mankin, Kelley Thieman; Amsellem, Pierre M; Petrukovich, Brandi; Ringwood, P Brendon; Case, J Brad; Singh, Ameet

    2016-03-15

    OBJECTIVE To determine the percentage of dogs surviving to hospital discharge and identify factors associated with death prior to hospital discharge among dogs undergoing surgery because of primary splenic torsion (PST). DESIGN Retrospective case series. ANIMALS 102 client-owned dogs. PROCEDURES Medical records of dogs with a confirmed diagnosis of PST that underwent surgery between August 1992 and May 2014 were reviewed. History, signalment, results of physical examination and preoperative bloodwork, method of splenectomy, concurrent surgical procedures, perioperative complications, duration of hospital stay, splenic histopathologic findings, and details of follow-up were recorded. Best-fit multivariate logistic regression was performed to identify perioperative factors associated with survival to hospital discharge. RESULTS 93 of the 102 (91.2%) dogs survived to hospital discharge. German Shepherd Dogs (24/102 [23.5%]), Great Danes (15/102 [14.7%]), and English Bulldogs (12/102 [11.8%]) accounted for 50% of cases. Risk factors significantly associated with death prior to hospital discharge included septic peritonitis at initial examination (OR, 32.4; 95% confidence interval [CI], 2.1 to 502.0), intraoperative hemorrhage (OR, 22.6; 95% CI, 1.8 to 289.8), and postoperative development of respiratory distress (OR, 35.7; 95% CI, 2.7 to 466.0). Histopathologic evidence of splenic neoplasia was not found in any case. CONCLUSIONS AND CLINICAL RELEVANCE Results suggested that the prognosis for dogs undergoing splenectomy because of PST was favorable. Several risk factors for death prior to discharge were identified, including preexisting septic peritonitis, intraoperative hemorrhage, and postoperative development of respiratory distress. PMID:26953920

  19. Spontaneous Splenic Rupture in Vascular Ehlers-Danlos Syndrome.

    Science.gov (United States)

    Batagini, Nayara Cioffi; Gornik, Heather; Kirksey, Lee

    2015-01-01

    Vascular Ehlers-Danlos Syndrome (VEDS) is a rare autosomal dominant collagen vascular disorder. Different from other Ehler-Danlos Syndrome subtypes, VEDS has poor prognosis due to severe fragility of connective tissues and association with life-threatening vascular and gastrointestinal complications. Spontaneous splenic rupture is a rare but hazardous complication related to this syndrome. To date, only 2 cases have been reported in the literature. Here we present another case of this uncommon complication, occurring in a 54-year-old woman in clinical follow-up for VEDS who presented with sudden onset of abdominal pain and hypotension. PMID:26323967

  20. Ultrasonic Measurement of Normal Splenic Size in Infants and Children in Paediatric Indian Population

    Directory of Open Access Journals (Sweden)

    Tanna Nita A, Ambiye MV, Tanna Vilpa A, Joshi Himanshu A

    2012-09-01

    Full Text Available Background: No two individuals are alike in this world, not even identical twins. In children, knowledge of normal splenic size (splenic length in relation to age and other biometric parameters (height and weight of physical growth is of paramount importance for the determination of mild splenomegaly. Objectives: The purpose of this study is to measure normal splenic size in infants & children in Indian population by ultrasonography; to establish correlation of splenic size with age, height and weight. Methods: The present study was conducted in the departments of Anatomy, Radiology and Paediatrics at a General Public Charitable Hospital, Mumbai. The study group consisted of 80 children of both sexes, who were referred to the Radiology department for ultrasonography for abdominal and/or pelvic problems unrelated to the spleen. The splenic length was measured by a radiologist using a commercially available real time ultrasound system with a TOSHIBA ECOCEE USG SYSTEM particularly by using the convex probe. Results: In the present study, p value is less than 0.001 for all - age with splenic size, splenic size with height, splenic size with weight indicate significant correlation of slenic size with age, height and weight. Conclusion: I believe this study shall stand as a good reference to Radiologists and Paediatricians in early diagnosis as well as undiagnosed and complicated disorders involving the spleen.

  1. Meningoencephalitis, pancytopenia, pulmonary insufficiency and splenic abscess in a patient with brucellosis

    International Nuclear Information System (INIS)

    A complicated case of brucellosis with some rare features is reported. Brucellosis is a multisystematic disease. However, disseminated brucellosis with cerebral, pulmonary, hematopoietic and splenic involvement in an otherwise healthy patient is a rare event. In this article, we report a case of disseminated brucellosis who was initially diagnosed as myeldoplastic syndrome (MDS) and meningoencephalitis, pulmonary symptoms, and splenic abscess formation occurred thereafter. (author)

  2. Ultrasonographic features of splenic hemangiosarcoma in dogs: 18 cases (1980-1986)

    International Nuclear Information System (INIS)

    The medical records of 18 dogs in which ultrasonography was useful in making a diagnosis of splenic hemangiosarcoma were reviewed. Splenic ultrasonography revealed masses with echo patterns that ranged from anechoic fluid to hyperechoic tissue. In 7 dogs, metastasis was detected ultrasonographically as anechoic to hypoechoic lesions in the liver

  3. Clinical Findings in Patients with Splenic Injuries: Are Injuries to the Left Lower Chest Important?

    Directory of Open Access Journals (Sweden)

    Schneir, Aaron

    2001-07-01

    Full Text Available The purpose of this study was to describe the clinical findings in patients with splenic injury and to determine if isolated left lower chest injury may be the single clinical indicator of splenic injury. The medical records of all adult blunt trauma patients with splenic injury over a 14 month period were reviewed. Significant left lower chest injury was considered present if the patient had left sided pleuritic chest pain with tenderness to ribs 7-12 or if these ribs were visualized as fractured on any imaging study. Patients were considered to have clinical findings suggestive of splenic injury if they had pre-hospital or emergency department hypotension, abdominal pain or tenderness, a Glasgow coma scale < 15, or gross hematuria. Ninety patients had splenic injury. Thirty-nine (43%. 95% CI 33, 54% patients had significant left lower chest injury. In five (6%. 95% CI 2, 12% patients, injury to this portion of the chest was the single indicator of splenic injury. Nearly half the patients with splenic injury will have significant injury to the left lower chest and this finding may be the only indicator of splenic injury.

  4. CT finding of ruptured splenic artery aneurysm after cesarean section : a case report

    Energy Technology Data Exchange (ETDEWEB)

    Ryu, Chang Woo; Kim, Hee Jin [CHA Medical College, Pundang CHA Gerneral Hospital Sungnam, (Korea, Republic of)

    2000-03-01

    Spontaneous rupture of a splenic artery aneurysm during puerperium is rare and is due to the non-specific clinical appearance, diagnosis is difficult. We describe a case of spontaneous rupture of splenic artery aneurysm after a Cesarean section. CT showed high-density ascites localized in the lesser sac and left retroperitoneum.

  5. Non-surgical management of spontaneous splenic rupture in infectious mononucleosis

    Directory of Open Access Journals (Sweden)

    Gerardo Dessì

    2014-09-01

    Full Text Available Spontaneous rupture of the spleen is a rare, but serious complication of infectious mononucleosis with no clear consensus on appropriate management. Although management of traumatic splenic rupture has largely moved to non-operative treatment, splenectomy is still frequently used in dealing with rupture of the diseased spleen. Here we report the case of a 27-year-old boy with splenic rupture secondary to laboratory-confirmed infectious mononucleosis in the absence of trauma. Our management included an endovascular treatment (embolization of the splenic artery, serial ultrasound scans, activity limitation, and a computed tomography low-dose scan before discharge. Our experience, along with a review of the literature, has led us to conclude that splenic preservation can be a safe alternative to splenectomy in hemodynamically stable patients with spontaneous splenic rupture. This is of particular importance in the young population, which is at higher risk for postsplenectomy sepsis.

  6. Polyvinyl alcohol and gelatin sponge particle embolization of splenic artery pseudoaneurysm complicating chronic alcoholic pancreatitis

    Institute of Scientific and Technical Information of China (English)

    Yong-Song Guan; Long Sun; Xiang-Ping Zhou; Xiao Li; Ze-Jun Fei; Xiao-Hua Zheng; Qing He

    2005-01-01

    AIM: To assess the effectiveness of and complications associated with polyvinyl alcohol (PVA) and gelatin sponge particles embolization of splenic artery pseudoaneurysm complicating chronic alcoholic pancreatitis.METHODS: A 42-year-old man with splenic artery pseudoaneurysm formation secondary to chronic alcoholic pancreatitis was admitted. We used PVA and gelatin sponge partides embo lization of splenic artery pseudoaneurysm by superselective embolization techniques.RESULTS: The splenic artery pseudoaneurysm was successfully controlled with splenic embolization. The patient was discharged in 9 d with complete recovery. CONCLUSION: This case confirms that superselective transcatheter embolization by PVA and gelatin sponge particles may represent an effective treatment for pseudoaneurysm caused by chronic alcoholic pancreatitis in the absence of other therapeutic alternatives.

  7. Elevated serum thymidine kinase activity in canine splenic hemangiosarcoma*.

    Science.gov (United States)

    Thamm, D H; Kamstock, D A; Sharp, C R; Johnson, S I; Mazzaferro, E; Herold, L V; Barnes, S M; Winkler, K; Selting, K A

    2012-12-01

    Thymidine kinase 1 (TK1) is a soluble biomarker associated with DNA synthesis. This prospective study evaluated serum TK1 activity in dogs presenting with hemoabdomen and a splenic mass. An ELISA using azidothymidine as a substrate was used to evaluate TK1 activity. Sixty-two dogs with hemoabdomen and 15 normal controls were studied. Serum TK1 activity was significantly higher in dogs with hemangiosarcoma (HSA) than in normal dogs (mean ± SEM = 17.0 ± 5.0 and 2.01 ± 0.6, respectively), but not dogs with benign disease (mean ± SEM = 10.0 ± 3.3). Using a cut-off of 6.55 U/L, TK activity demonstrated a sensitivity of 0.52, specificity of 0.93, positive predictive value of 0.94 and negative predictive value of 0.48 for distinguishing HSA versus normal. When interval thresholds of 7.95 U/L were used together, diagnostic utility was increased. Serum TK1 evaluation may help to discriminate between benign disease and HSA in dogs with hemoabdomen and a splenic mass. PMID:22236280

  8. Splenic artery pseudoaneurysm as a complication of pancreatic pseudocyst

    Directory of Open Access Journals (Sweden)

    Micković Saša

    2011-01-01

    Full Text Available Introduction. Pancreatic pseudocyst presented as pseudoaneurysm of the splenic artery is a potential serious complication in patients with chronic pancreatitis. Case report. A 42-year-old male patient with a long-standing evolution of chronic pancreatitis and 8-year long evolution of pancreas pseudocyst was referred to the Military Medical Academy, Belgrade due to worsening of the general condition. At admission, the patient was cachectic, febrile, and had the increased values of amylases in urine and sedimentation (SE. After clinical and diagnostic examination: laboratory assessment, esophagogastroduodenoscopy (EGDS, ultrasonography (US, endoscopic ultrasonography (EUS, multislice computed scanner (MSCT angiography, pseudoaneurysm was found caused by the conversion of pseudocyst on the basis of chronic pancreatitis. The patient was operated on after founding pancreatic pseudocyst, which caused erosion of the splenic artery and their mutual communication. Postoperative course was duly preceded without complications with one year follow-up. Conclusion. Angiography is the most reliable and the safest method for diagnosing hemorrhagic pseudocysts when they clinically present as pseudoaneurysms. A potentially dangerous complication in the presented case was treated surgically with excellent postoperative results.

  9. Rituximab-Induced Splenic Rupture and Cytokine Release

    Science.gov (United States)

    Nair, Ranjit; Gheith, Shereen; Lamparella, Nicholas

    2016-01-01

    Patient: Female, 55 Final Diagnosis: Mantle cell lymphoma Symptoms: Cytokine release syndrome • hypoglycemia • hypotension • splenic rupture • splenomegaly • vision loss Medication: — Clinical Procedure: Case Report Specialty: Oncology Objective: Unusual clinical course Background: Rituximab is a therapeutic monoclonal antibody that is used for many different lymphomas. Post-marketing surveillance has revealed that the risk of fatal reaction with rituximab use is extremely low. Splenic rupture and cytokine release syndrome are rare fatal adverse events related to the use of therapeutic monoclonal antibodies, especially in aggressive malignancies with high tumor burden. Case Report: A 55-year-old woman presented with abdominal pain and type B symptoms and was diagnosed with mantle cell lymphoma. Initial peripheral blood flow cytometry showed findings that mimicked features of chronic lymphocytic leukemia. Further treatment with rituximab led to catastrophic treatment complications that proved to be fatal for the patient. Conclusions: Severe cytokine release syndrome associated with biologics carries a very high morbidity and case fatality rate. With this case report we aim to present the diagnostic challenge with small B-cell neoplasms, especially mantle cell lymphoma and chronic lymphocytic lymphomas, and underscore the importance of thorough risk assessment for reactions prior to treatment initiation. PMID:26972227

  10. On the mechanism of noradrenaline-induced prostaglandin E2-Synthesis in primary cell cultures from rabbit splenic pulpa.

    Science.gov (United States)

    Brückner-Schmidt, R; Jackisch, R; Hertting, G

    1981-10-01

    The role of Ca2+ and phospholipase A2 in alpha-adrenoceptor mediated stimulation of prostaglandin (PG)E2-release was investigated in primary cell cultures of rabbit splenic pulpa. Noradrenaline enhanced PGE2-release only in the presence of extracellular Ca2+. In contrast, PGE2-release induced by arachidonic acid was unchanged when Ca2+ was omitted. In the presence of Ca2+, the ionophore A 23187 increased PGE2-release concentration-dependently. During incubation in Ca2+-free medium, the ionophore was ineffective. Inhibitors of phospholipase A2 (mepacrine, p-bromophenacyl bromide) abolished the noradrenaline-induced PGE2-release and reduced the effect of A 23187; the stimulation of PGE2-release by arachidonic acid was not affected. Addition of exogenous phospholipase A2 enhances release of PGE2. From these results we suggest that noradrenaline-induced PGE2-release in rabbit splenic fibroblasts via alpha-adrenoceptors involves the following steps: influx of Ca2+, activation of a Ca2+-dependent phospholipase and liberation of arachidonic acid which is transformed into PGs. PMID:6798947

  11. Coexistence of splenic marginal zone lymphoma with hepatocellular carcinoma: a case report

    Directory of Open Access Journals (Sweden)

    Zheng Jian-Ming

    2007-02-01

    Full Text Available Abstract Background Coexistence of splenic marginal zone lymphoma with hepatocellular carcinoma is rare. Although some reports have suggested the possible pathogenic role of HBV, HCV, chronic and persistent antigenic stimulation in lymphoma, their role in causing lymphomas is still unclear. Case presentation We describe a hepatocellular carcinoma with concomitant splenic marginal zone lymphoma in a 64-year-old Chinese man with cirrhosis. Serum hepatitis B virus surface antigen was positive and antihepatitis C virus antibody was negative. The resected liver mass measuring 4 × 3 × 3 cm was grey and soft with a small area of bleeding, necrosis and intact capsule. Cut surface of the spleen was red-purple and had a diffuse reticulonodular appearance indicative of prominent white pulp. On histologic sections, the liver mass was well and moderately differentiated hepatocellular carcinoma, and the splenic tumor was a specific low-grade small B-cell lymphoma. Immunohistochemical staining and gene rearrangement studies supported that the splenic tumor represents a clonal B-cell lymphoma. Therefore, the diagnosis of SMZL was made from the splenic specimen. Conclusion To our knowledge, this is the second case report describing coexistence of hepatocellular carcinoma and splenic marginal zone lymphoma in the course of chronic HBV infection. However, we cannot assert at present that hepatitis B virus is directly involved in splenic lymphomagenesis until more information is collected from more cases in the future.

  12. Tortuosity and calcification of the splenic artery. More than an additional finding

    International Nuclear Information System (INIS)

    Tortuosity of the splenic artery and calcification of the vessel wall are typical additional findings on plain abdominal x-ray. The combination of both anomalies is common in elderly persons presenting without symptoms of splenic ischemia. Its pathogenesis is thought to be multifactorial. In infancy and childhood, the splenic artery is stretched in its entire course. A growing difference between the length of the vessel and the distance between its origin and the splenic hilum gives rise to tortuosity. The artery's proximal segment is involved more frequently and more severely than the distal one. The tortuous route of the vessel is accentuated by the direction of its major branches, which is roughly perpendicular to the main trajectory. Neither tortuosity nor calcification should be taken to be risk factors for the comparatively common splenic artery aneurysm. Calcific deposits are not confined to the media but are also detected in the intima of the vascular wall. Critical narrowings of the lumen arising on the calcium deposits are not observed. Calcifying atherosclerosis of the splenic artery is comparable to medial sclerosis of the peripheral arteries frequently noticed in diabetics and dialysis patients. Only the less important calcification of the intima may be attributed to mechanisms of the hydrohemodynamic theory of atherosclerosis. The spleen's blood storage capacity may contribute to the characteristic age-dependent alterations of the shape and course of the splenic artery. (orig.)

  13. Chemoembolization Via Branches from the Splenic Artery in Patients with Hepatocellular Carcinoma

    International Nuclear Information System (INIS)

    Purpose: This study was designed to evaluate the radiologic findings and imaging response of chemoembolization via branches of the splenic artery in patients with hepatocellular carcinoma (HCC). Methods: From January 2001 to July 2010, we observed tumor staining supplied by branches of the splenic artery in 34 (0.6%) of 5,413 patients with HCC. Computed tomography (CT) scans and digital subtraction angiograms of these patients were retrospectively reviewed in consensus by two investigators. Results: A total of 39 tumor feeding-vessels in 34 patients were identified: omental branches from the left gastroepiploic artery (n = 5), branches from the short gastric artery (n = 9), and omental branches directly from the splenic artery (n = 25). Branches of the splenic artery that supplied tumors were revealed on the celiac angiogram in 29 (85%) of 34 patients and were detected on pre-procedure CT images in 27 (79%) of 34 patients. Selective chemoembolization was achieved in 38 of 39 tumor-feeding vessels. Complete or partial response of the tumor fed by branches of the splenic artery, as depicted on follow-up CT scans, was achieved in 21 (62%) patients. No patient developed severe complications directly related to chemoembolization via branches of the splenic artery. Conclusions: Omental branches directly from the splenic artery are common tumor-feeding vessels of the splenic artery in cases of advanced HCC with multiple previous chemoembolizations. Tumor-feeding vessels of the splenic artery are usually visualized on the celiac angiogram or CT scan, and chemoembolization through them can be safely performed in most patients.

  14. A rare case of occult splenic rupture after left pneumonectomy.

    Science.gov (United States)

    Acharya, Metesh N; George, Robert S; Loubani, Mahmoud

    2016-01-01

    Cardiopulmonary resuscitation (CPR) techniques are now well-established and play a crucial role in improving survival in cardiac arrest. Recognized complications associated with CPR include injury to the upper abdominal viscera, including the liver, stomach and spleen. We present a rare case of occult splenic rupture following cardiac arrest in a 63-year-old male immediately after left pneumonectomy. We discuss potential mechanisms predisposing the spleen to injury in this case, and highlight the difficulty of promptly identifying such a traumatic injury within the confines of a cardiac arrest scenario. Clinicians should be aware that anatomical changes following thoracic surgery may render the intra-abdominal viscera at increased risk of injury following CPR. PMID:27190201

  15. The splenomegaly of myeloproliferative and lymphoproliferative disorders: splenic cellularity and vascularity

    Energy Technology Data Exchange (ETDEWEB)

    Zhang, B (Capital Hospital, Peking University Medical College, Beijing (China)); Lewis, S.M. (Department of Haematology, Royal Postgraduate Medical School, London (UK))

    1989-01-01

    Employing radionuclide scanning, the volume of the spleen, its red cell pool and plasma pool have been measured in vivo, and the relative proportions of cellularity and vascularity of the spleen have been calcualted in 51 patients with myeloproliferactive and lymphoproliferative disorders. In primary proliferative polycythaemia (polycythaemia vera), the increase of spleen size was attributed mainly to the increase of splenic vascularity; in myelofibrosis and in hairy cell leukaemia, the increase of spleen size was associated with increase in both splenic vascularity and cellularity, whilst in size was associated with increase in both splenic vascularity and cellularity, whilst in CGL and CLL the increase was attributed more to cellularity than to vascularity. (author).

  16. FDG PET/CT Findings in Multiple Splenic Amebomas (Amebic Granulomas).

    Science.gov (United States)

    Dong, Aisheng; Wang, Yang; Zuo, Changjing; Zhu, Huaimin

    2016-05-01

    Splenic ameboma (amebic granuloma) is rare. A 38-year-old man with a severe pneumonia due to inhalation of swimming pool water 18 months ago complained of night sweat, tiredness, and anorexia for 1 month. Abdominal ultrasound showed multiple nodules in the spleen. These nodules showed slight enhancement on enhanced CT and intense FDG uptake on PET/CT. Splenectomy was performed. Multiple splenic amebomas were confirmed by pathology. Free-living amoebae were also detected in samples of pleural effusion and blood. Splenic ameboma, although rare, should be included in the differential diagnosis with isolated focally increased FDG activity in the spleen. PMID:26505858

  17. The multidetector computed tomography angiography (MDCTA) in the diagnosis of splenic artery aneurysm and pseudoaneurysm

    Energy Technology Data Exchange (ETDEWEB)

    Saba, Luca; Mallarini, Giorgio (Dept. of Radiology, Azienda Ospedaliero Universitaria (AOU), Cagliari (Italy)), email: lucasaba@tiscali.it; Anzidei, Michele; Lucatelli, Pierleone (Dept. of Radiological Sciences, Univ. of Rome La Sapienza, Rome (Italy))

    2011-06-15

    Splenic artery aneurysm is the most frequent visceral artery aneurysm and rupture of the aneurysm is associated with a high mortality rate. It is important to discriminate between a true aneurysm and a pseudoaneurysm that may be caused by pancreatitis, iatrogenic and postoperative causes, trauma and peptic ulcer disease. Multidetector-row CT angiography (MDCTA) allows detailed visualization of the vascular anatomy and may allow identification of aneurysms and pseudoaneurysms that affect the splenic artery. The objective of this article is to provide a review of the general characteristics of splenic artery aneurysms and pseudoaneurysms and to describe the findings of MDCTA

  18. Subtotal resection and omentoplasty of the epidermoid splenic cyst: a case report

    Science.gov (United States)

    Spahija, Gazmend S; Hashani, Shemsedin I; Osmani, Eshref A; Hoxha, Sejdullah A; Hamza, Astrit H; Gashi-Luci, Lumturije H

    2009-01-01

    Introduction Nonparasitic splenic cysts are uncommon clinical entity and because of it, there is no information regarding their optimal surgical treatment. Case presentation A 41-years-old female with incidentally diagnosed nonparasitic splenic cyst which initially was asymptomatic. After two years of follow up, the patient underwent surgery; subtotal cystectomy and omentoplasty as an additional procedure. Postoperative course was uneventful. Conclusion Short and mid term results showed that near total cystectomy with omentoplasty was a safe successful procedure for treatment of epidermoid splenic cyst. PMID:19829799

  19. Surgical repair of an aberrant splenic artery aneurysm: report of a case.

    Science.gov (United States)

    Illuminati, Giulio; LaMuraglia, Glenn; Nigri, Giuseppe; Vietri, Francesco

    2007-03-01

    Aneurysms of the splenic artery are the most common splanchnic aneurysms. Aneurysms of a splenic artery with an anomalous origin from the superior mesenteric artery are however rare, with eight previously reported cases. Their indications for treatment are superposable to those of aneurysms affecting an orthotopic artery. Methods of treatment of this condition include endovascular, minimally invasive techniques and surgical resection. We report one more case of aneurysm of an aberrant splenic artery, treated with surgical resection, and preservation of the spleen. PMID:17349366

  20. Visualizing early splenic memory CD8+ T cells reactivation against intracellular bacteria in the mouse.

    Directory of Open Access Journals (Sweden)

    Marc Bajénoff

    Full Text Available Memory CD8(+ T cells represent an important effector arm of the immune response in maintaining long-lived protective immunity against viruses and some intracellular bacteria such as Listeria monocytogenes (L.m. Memory CD8(+ T cells are endowed with enhanced antimicrobial effector functions that perfectly tail them to rapidly eradicate invading pathogens. It is largely accepted that these functions are sufficient to explain how memory CD8(+ T cells can mediate rapid protection. However, it is important to point out that such improved functional features would be useless if memory cells were unable to rapidly find the pathogen loaded/infected cells within the infected organ. Growing evidences suggest that the anatomy of secondary lymphoid organs (SLOs fosters the cellular interactions required to initiate naive adaptive immune responses. However, very little is known on how the SLOs structures regulate memory immune responses. Using Listeria monocytogenes (L.m as a murine infection model and imaging techniques, we have investigated if and how the architecture of the spleen plays a role in the reactivation of memory CD8(+ T cells and the subsequent control of L.m growth. We observed that in the mouse, memory CD8(+ T cells start to control L.m burden 6 hours after the challenge infection. At this very early time point, L.m-specific and non-specific memory CD8(+ T cells localize in the splenic red pulp and form clusters around L.m infected cells while naïve CD8(+ T cells remain in the white pulp. Within these clusters that only last few hours, memory CD8(+ T produce inflammatory cytokines such as IFN-gamma and CCL3 nearby infected myeloid cells known to be crucial for L.m killing. Altogether, we describe how memory CD8(+ T cells trafficking properties and the splenic micro-anatomy conjugate to create a spatio-temporal window during which memory CD8(+ T cells provide a local response by secreting effector molecules around infected cells.

  1. Splenic abscess diagnosed with the aid of abdominal computerized tomography: report of 2 cases

    International Nuclear Information System (INIS)

    Two patients with splenic abscess successfully diagnosed and treated are described. The first case, a diabetic, developed a pyogenic abscess caused by klebsiella, while the other suffered a splenic infarct complicated by splenic abscess. Although relatively easy to treat, solitary abscess of the spleen is a potentially lethal condition due to diagnostic difficulties. In both present instances the final diagnosis was easily achieved before surgery by the aid of computerized tomography (CT). This investigation seems to be more accurate than 99Tcsup(m)-sulphur colloid scan and ultrasound scan, which failed in both cases to diagnose splenic abscess clearly. The use of this investigation is suggested in every suspected case and will no doubt, confirm the diagnosis at an early stage of the disease. Splenectomy with antibiotic cover will usually result in cure. (author)

  2. Splenic infarction associated with sorafenib use in a hepatocellular carcinoma patient

    Institute of Scientific and Technical Information of China (English)

    Sang Ock Kim; Sang Young Han; Yang Hyun Baek; Sung Wook Lee; Ji Sun Han; Byung Geun Kim; Jin Han Cho; Kyung Jin Nam

    2011-01-01

    Sorafenib, a multitargeted tyrosine kinase inhibitor, has been shown to improve survival in patients with advanced hepatocellular carcinoma (HCC). As the clinical use of sorafenib increases, many adverse effects have been reported, such as hand-foot skin reaction, diarrhea,anorexia, asthenia, alopecia, weight loss, hypertension and arterial thromboembolism. However, there are no prior reports of splenic infarction as an adverse effect of sorafenib. Here, a case of splenic infarction in a patient with HCC who was treated with sorafenib is reported.The patient had no other predisposing factors to explain the splenic infarction except for the administration of sorafenib. The splenic infarction improved after sorafenib was discontinued; however, the HCC progressed.

  3. Weber-Christian disease producing splenic vein occlusion and bleeding gastric varices: successful treatment with sclerotherapy.

    OpenAIRE

    Heseltine, D.; Bramble, M.; Cole, A.; Clarke, D; Castle, W

    1990-01-01

    A 48 year old woman with intra-abdominal Weber-Christian disease presented with bleeding gastric varices and evidence of splenic vein occlusion. We describe the problems encountered in making this diagnosis and subsequent treatment.

  4. Ruptured Aneurysm of the Splenic Artery: A Rare Cause of Abdominal Pain after Blunt Trauma

    Directory of Open Access Journals (Sweden)

    Jalalludin Khoshnevis

    2013-01-01

    Full Text Available Introduction: Splenic artery aneurysms (SAAs are rare (0.2-10.4%; however, they are the most common form of visceral artery aneurysms. Splenic artery aneurysms are important to identify, because up to 25% of the cases are complicated by rupture. Post- rupture mortality rate is 25% -70% based on the underlying cause. Herein we present a young patient with abdominal pain after blunt abdominal trauma due to rupture of an SAA.Case Presentation: A 27-year-old male, without a remarkable medical history, who suffered from abdominal pain for 2 days after falling was admitted to the emergency department with hypovolemic shock. Upon performing emergency laparotomy a ruptured splenic artery aneurysm was found.Conclusions: It is important to consider rupture of a splenic artery aneurysm in patients with abdominal pain and hypovolemic shock.

  5. [Chronic recurrent volvulus of the colonic splenic flexure associated with the eventration of left diaphragm].

    Science.gov (United States)

    Kim, Hee Sun; Yoo, Jeong Seon; Han, Seok Joo; Park, Hyojin

    2007-01-01

    The eventration of diaphragm is usually found incidentally on chest X-ray or sometimes presented as acute gastric volvulus. However, colonic volvulus on splenic flexure area complicated by diaphragmatic eventration is extremely rare. A 25 year old man complained of upper abdominal pain for three days. He had a history of brain injury during infant period, and had epilepsy and mental retardation. Plain chest X-ray showed left diaphragmatic eventration and marked dilatation of colon on splenic flexure area which had not been changed for last three years. Barium enema showed bird beak appearance on distal colon near the splenic flexure. Colonoscopic reduction failed. After decompression with rectal and nasogastric tubes, colonic volvulus was relieved. To prevent the recurrence of volvulus, we performed segmental resection of left colon including splenic flexure area and repaired the left diaphragmatic eventration. After the operation, the patient had no further recurrent episode of volvulus although ileus persisted. PMID:18167432

  6. A colonic splenic flexure tumour presenting as an empyema thoracis: a case report.

    LENUS (Irish Health Repository)

    Murphy, K

    2009-01-01

    The case report describes the rare presentation of a 79-year-old patient with a locally perforated splenic flexure tumour of the colon presenting with an apparent empyema thoracis in the absence of abdominal signs or symptoms.

  7. Haemosuccus pancreaticus due to true splenic artery aneurysm: a rare cause of massive upper gastrointestinal bleeding

    Directory of Open Access Journals (Sweden)

    MK Roy

    2010-07-01

    Full Text Available “Haemosuccus pancreaticus” is an unusual cause of severe upper gastrointestinal bleeding and results from rupture of splenic artery aneurysm into the pancreatic duct. More commonly, it is a pseudoaneurysm of the splenic artery which develops as sequelae of pancreatitis. However, true aneurysm of the splenic artery without pancreatitis has rarely been incriminated as the etiologic factor of this condition. Owing to the paucity of cases and limited knowledge about the disease, diagnosis as well as treatment become challenging. Here we describe a 60-year-old male presenting with severe recurrent upper gastrointestinal bleeding and abdominal pain, which, after considerable delay, was diagnosed to be due to splenic artery aneurysm. Following an unsuccessful endovascular embolisation, the patient was cured by distal pancreatectomy and ligation of aneurysm.

  8. Splenic infarction associated with sorafenib use in a hepatocellular carcinoma patient

    OpenAIRE

    Kim, Sang Ock; Han, Sang Young; Baek, Yang Hyun; Lee, Sung Wook; Han, Ji Sun; Kim, Byung Geun; Cho, Jin Han; Nam, Kyung Jin

    2011-01-01

    Sorafenib, a multitargeted tyrosine kinase inhibitor, has been shown to improve survival in patients with advanced hepatocellular carcinoma (HCC). As the clinical use of sorafenib increases, many adverse effects have been reported, such as hand-foot skin reaction, diarrhea, anorexia, asthenia, alopecia, weight loss, hypertension and arterial thromboembolism. However, there are no prior reports of splenic infarction as an adverse effect of sorafenib. Here, a case of splenic infarction in a pat...

  9. Splenic red pulp macrophages are intrinsically superparamagnetic and contaminate magnetic cell isolates

    OpenAIRE

    Lars Franken; Marika Klein; Marina Spasova; Anna Elsukova; Ulf Wiedwald; Meike Welz; Percy Knolle; Michael Farle; Andreas Limmer; Christian Kurts

    2015-01-01

    A main function of splenic red pulp macrophages is the degradation of damaged or aged erythrocytes. Here we show that these macrophages accumulate ferrimagnetic iron oxides that render them intrinsically superparamagnetic. Consequently, these cells routinely contaminate splenic cell isolates obtained with the use of MCS, a technique that has been widely used in immunological research for decades. These contaminations can profoundly alter experimental results. In mice deficient for the transcr...

  10. Sub capsular splenectomy for delayed spontaneous splenic rupture in a case of sickle cell anemia

    OpenAIRE

    Sharma Dhananjaya

    2009-01-01

    Abstract Splenic ruptures are mostly due to trauma and manifest at the moment of injury with symptoms of acute intraperitoneal hemorrhage and shock. Spontaneous/pathological and delayed rupture of the spleen is not unknown. A case of delayed spontaneous splenic rupture in a case of sickle cell anemia is being reported, which was treated with sub capsular splenectomy (from within the pseudo capsule formed due to inflammation).

  11. Melena-associated regional portal hypertension caused by splenic arteriovenous fistula

    OpenAIRE

    2012-01-01

    Regional portal hypertension is a rare cause of upper gastrointestinal bleeding. We reported an extremely rare case in which regional portal hypertension was associated with both the splenic arteriovenous fistula and chronic pancreatitis. In June 2010, our patient, a 41-year-old man, was admitted to a local hospital due to a sudden melena and dizziness without haematemesis and jaundice. The splenic arteriovenous fistula in this patient was successfully occluded through transcatheter arterial ...

  12. Intractable oesophageal variceal bleeding caused by splenic arteriovenous fistula: treatment by transcatheter arterial embolization

    OpenAIRE

    Hung, C; Tseng, J.; Lui, K; Wan, Y.; Tsai, C.; Shem, C; Wu, C.

    1999-01-01

    We describe a rare case of splenic arteriovenous fistula and venous aneurysm which developed after splenectomy in a 40-year-old woman who presented with epigastralgia, watery diarrhoea, repeated haematemesis and melaena caused by hyperkinetic status of the portal system and bleeding of oesophageal varices. It was diagnosed by computed tomography and angiography, and obliterated with giant Gianturco steel coils.


Keywords: splenic arteriovenous fistula; gastrointestinal bleeding; transcathete...

  13. Asymptomatic Partial Splenic Infarction In Laparoscopic Floppy Nissen Fundoplication And Brief Literature Review

    OpenAIRE

    Odabasi, Mehmet; Abuoglu, Haci Hasan; Arslan, Cem; Gunay, Emre; Yildiz, Mehmet Kamil; Eris, Cengiz; Ozkan, Erkan; Aktekin, Ali; Muftuoglu, Tolga

    2014-01-01

    Short gastric vessels are divided during the laparoscopic Nissen fundoplication resulting in splenic infarct in some cases. We report a case of laparoscopic floppy Nissen fundoplication with splenic infarct that was recognized during the procedure and provide a brief literature review. The patient underwent a laparoscopic floppy Nissen fundoplication. We observed a partial infarction of the spleen. She reported no pain. A follow-up computed tomography scan showed an infarct, and a 3-month abd...

  14. Treatment of splenic artery aneurysm with double overlapping bare stents: case report

    Energy Technology Data Exchange (ETDEWEB)

    Kwak, Hyo Sung; Han, Young Min; Jin, Gong Yong [School of Medicine, Chonbuk National Univ., Chonju (Korea, Republic of)

    2004-09-01

    The traditional treatment of splenic artery aneurysm (SAA) is generally surgery and/or transcatheter arterial embolization, but recently, the treatment of SAA using a stent graft has been reported. However, the acute angle of the celiac axis, as well as the tortuous path of the splenic artery makes the use of stent graft difficult for treatment of aneurysma. We report here a case of SAA treated with the technique of double overlapping metallic stents.

  15. Subtotal resection and omentoplasty of the epidermoid splenic cyst: a case report

    OpenAIRE

    Krasniqi, Avdyl S.; Spahija, Gazmend S; Hashani, Shemsedin I; Osmani, Eshref A; Hoxha, Sejdullah A; Hamza, Astrit H; Gashi-Luci, Lumturije H

    2009-01-01

    Introduction Nonparasitic splenic cysts are uncommon clinical entity and because of it, there is no information regarding their optimal surgical treatment. Case presentation A 41-years-old female with incidentally diagnosed nonparasitic splenic cyst which initially was asymptomatic. After two years of follow up, the patient underwent surgery; subtotal cystectomy and omentoplasty as an additional procedure. Postoperative course was uneventful. Conclusion Short and mid term results showed that ...

  16. Splenic artery aneurysm: a diagnostic challenge in the setting of extensive portal venous collaterals

    Energy Technology Data Exchange (ETDEWEB)

    Phillips, Grace S.; Vo, Nghia J.; Ishak, Gisele E.; Swanson, Jonathan O.; Otto, Randolph K. [University of Washington, Seattle Children' s Hospital, Department of Radiology, Seattle, WA (United States)

    2010-07-15

    We present a 16-year-old boy with autoimmune liver disease and longstanding portal hypertension in whom a CT arteriogram demonstrated a large aneurysm arising from the distal, extra-parenchymal portion of the splenic artery. Because of its location adjacent to multiple venous collaterals, the aneurysm was indistinguishable from splenic varices on initial imaging with Doppler sonography and on portal venous-phase CT. There is an increased risk of rupture of splenic artery aneurysms in the post-liver transplant period, with high associated mortality, and therefore diagnosis of splenic artery aneurysm prior to liver transplantation is clinically important. It is quite possible that the diagnosis of splenic artery aneurysm in this case would have been missed in the absence of dedicated arterial-phase imaging. As radiologists strive to reduce radiation exposure in children, this case highlights a potential diagnostic pitfall of both Doppler sonography and venous or single-acquisition arterial/venous-phase CT angiogram in children with venous collaterals and an undiagnosed splenic artery aneurysm. (orig.)

  17. Unusual case of pancreatic inflammatory myofibroblastic tumor associated with spontaneous splenic rupture

    Directory of Open Access Journals (Sweden)

    Hassan Fadi K

    2010-11-01

    Full Text Available Abstract Background Spontaneous splenic rupture considered a relatively rare but life threatening. The three commonest causes of spontaneous splenic rupture are malignant hematological diseases, viral infections and local inflammatory and neoplastic disorders. We describe a unique and unusual case of inflammatory myofibroblastic tumor of the tail of pancreas presented with massively enlarged spleen and spontaneous splenic rupture. Case presentation A 19 years old male patient with no significant past medical history presented to emergency room with abdominal pain and fatigue. Massively enlarged spleen was detected. Hypotension and rapid reduction of hemoglobin level necessitated urgent laparatomy. About 1.75 liters of blood were found in abdominal cavity. A large tumor arising from the tail of pancreas and local rupture of an enlarged spleen adjacent to the tumor were detected. Distal pancreatectomy and splenectomy were performed. To our knowledge, we report the first case of massively enlarged spleen that was complicated with spontaneous splenic rupture as a result of splenic congestion due to mechanical obstruction caused by an inflammatory myofibroblastic tumor of the tail of pancreas. A review of the literature is also presented. Conclusion Inflammatory myofibroblastic tumor of the tail of pancreas should be included in the differential diagnosis of the etiological causes of massively enlarged spleen and spontaneous splenic rupture.

  18. Splenic artery aneurysm: a diagnostic challenge in the setting of extensive portal venous collaterals

    International Nuclear Information System (INIS)

    We present a 16-year-old boy with autoimmune liver disease and longstanding portal hypertension in whom a CT arteriogram demonstrated a large aneurysm arising from the distal, extra-parenchymal portion of the splenic artery. Because of its location adjacent to multiple venous collaterals, the aneurysm was indistinguishable from splenic varices on initial imaging with Doppler sonography and on portal venous-phase CT. There is an increased risk of rupture of splenic artery aneurysms in the post-liver transplant period, with high associated mortality, and therefore diagnosis of splenic artery aneurysm prior to liver transplantation is clinically important. It is quite possible that the diagnosis of splenic artery aneurysm in this case would have been missed in the absence of dedicated arterial-phase imaging. As radiologists strive to reduce radiation exposure in children, this case highlights a potential diagnostic pitfall of both Doppler sonography and venous or single-acquisition arterial/venous-phase CT angiogram in children with venous collaterals and an undiagnosed splenic artery aneurysm. (orig.)

  19. Aberrant Expression of Functional BAFF-System Receptors by Malignant B-Cell Precursors Impacts Leukemia Cell Survival

    OpenAIRE

    Maia, Sara; Pelletier, Marc; Ding, Jixin; Hsu, Yen-Ming; Rao, Sambasiva P.; Cardoso, Angelo A.; Sallan, Stephen Earl; Nadler, Lee Marshall

    2011-01-01

    Despite exhibiting oncogenic events, patient's leukemia cells are responsive and dependent on signals from their malignant bone marrow (BM) microenvironment, which modulate their survival, cell cycle progression, trafficking and resistance to chemotherapy. Identification of the signaling pathways mediating this leukemia/microenvironment interplay is critical for the development of novel molecular targeted therapies. We observed that primary leukemia B-cell precursors aberrantly express recept...

  20. Splenic Tuberculosis –A rare case report

    Directory of Open Access Journals (Sweden)

    Prof. Mrudula Phadke

    2007-07-01

    Full Text Available Tuberculosis of spleen is an extremely rare clinical entity. It often poses diagnostic difficulties as microbiological confirmation of diagnosis is not easy. We came across a case of middle aged immunocompetent female from good socioeconomic background who presented with weight loss and pain in left hypochondriac region. Ultrasonography of abdomen revealed multiple hypo echoic lesions in the spleen. Splenectomy was performed and sample was sent for histopathological examination and also microbiological analysis. Gross examination of the specimen showed multiple nodules coalescing to form large yellowish white colored mass of firm consistency. Histopathological examination showed large areas of caseation surrounded by multiple granulomas of epitheloid cells and Langhan’s type of giant cells throughout the splenic pulp. PCR was done by using IS6110 primers. This was consistent with the diagnosis of Mycobacterial infection. Mycobacterium tuberculosis grew on culture from the tissue after 5 weeks. No primary focus of infection was detected in the lungs or any other organ. Diagnosis within just a few hours was made possible because of PCR.

  1. Hepatic or splenic targeting of carrier erythrocytes: a murine model

    International Nuclear Information System (INIS)

    Carrier mouse erythrocytes, i.e., red cells, subjected to a dialysis technique involving transient hypotonic hemolysis and isotonic resealing were treated in vitro in three different ways: (a) energy depletion by exposure for 90 min at 42 degrees C; (b) desialylation by incubation with neuroaminidase; and (c) oxidative stress by incubation with H2O2 and NaN3. Procedure (c) afforded maximal damage, as shown by analysis of biochemical properties of the treated erythrocytes. Reinfusion in mice of the variously manipulated erythrocytes following their 51Cr labeling showed extensive fragilization as indicated by rapid clearance of radioactivity from the circulation. Moreover, both the energy-depleted and the neuraminidase-treated erythrocytes showed a preferential liver uptake, reaching 50 and 75%, respectively, within 2 h. On the other hand, exposure of erythrocytes to the oxidant stress triggered a largely splenic removal, accounting for almost 40% of the reinjected cells within 4 h. Transmission electron microscopy of liver from mice receiving energy-depleted erythrocytes demonstrated remarkable erythrocyte congestion within the sinusoids, followed by hyperactivity of Kupffer cells and by subsequent thickening of the perisinusoidal Disse space. Concomitantly, levels of serum transaminase activities were moderately increased. Each of the three procedures of manipulation of carrier erythrocytes may prove applicable under conditions where selective targeting of erythrocyte-encapsulated chemicals and drugs to either the liver or the spleen has to be achieved

  2. Cystic angiomatosis with splenic involvement: unusual MRI findings

    Energy Technology Data Exchange (ETDEWEB)

    Vanhoenacker, F.M. [Dept. of Radiology, Univ. Hospital Antwerp, Edegem (Belgium); Dept. of Radiology, AZ St-Maarten, Campus Duffel, Duffel (Belgium); Schepper, A.M. [Dept. of Radiology, Univ. Hospital Antwerp, Edegem (Belgium); Raeve, H. [Dept. of Pathology, Univ. Hospital Antwerp, Edegem (Belgium); Berneman, Z. [Dept. of Hematology, Univ. Hospital Antwerp, Edegem (Belgium)

    2003-12-01

    Cystic angiomatosis is a rare disorder with a poor prognosis. We describe a case of a 33-year-old woman who presented with longstanding bone pain, hemolytic anemia, and an enlarged spleen. Radiologically, multiple osseous lesions with a mixed pattern of lytic and sclerotic areas were seen within the shoulders, spine, and pelvis. On CT and MRI of the abdomen, the spleen was markedly enlarged, with internal hyperdense foci on non-contrast CT scan, corresponding to low signal intensity areas on all MR pulse sequences. After administration of contrast, a mottled enhancement pattern throughout the entire spleen was seen both on CT and MRI. Cystic angiomatosis was proven by histological analysis of a biopsy specimen of an involved vertebra and histopathological examination of the spleen after subsequent splenectomy. This is the first report of a patient with disseminated cystic angiomatosis with splenic involvement in which the MRI features differ from the previous reports. Instead of the usual pattern consisting of multiple well-defined cystic lesions, a diffuse involvement replacing the entire spleen, with heterogeneous signal intensities on T2-weighted images and heterogeneous enhancement pattern, was seen in our patient. (orig.)

  3. Cystic angiomatosis with splenic involvement: unusual MRI findings

    International Nuclear Information System (INIS)

    Cystic angiomatosis is a rare disorder with a poor prognosis. We describe a case of a 33-year-old woman who presented with longstanding bone pain, hemolytic anemia, and an enlarged spleen. Radiologically, multiple osseous lesions with a mixed pattern of lytic and sclerotic areas were seen within the shoulders, spine, and pelvis. On CT and MRI of the abdomen, the spleen was markedly enlarged, with internal hyperdense foci on non-contrast CT scan, corresponding to low signal intensity areas on all MR pulse sequences. After administration of contrast, a mottled enhancement pattern throughout the entire spleen was seen both on CT and MRI. Cystic angiomatosis was proven by histological analysis of a biopsy specimen of an involved vertebra and histopathological examination of the spleen after subsequent splenectomy. This is the first report of a patient with disseminated cystic angiomatosis with splenic involvement in which the MRI features differ from the previous reports. Instead of the usual pattern consisting of multiple well-defined cystic lesions, a diffuse involvement replacing the entire spleen, with heterogeneous signal intensities on T2-weighted images and heterogeneous enhancement pattern, was seen in our patient. (orig.)

  4. Blood B Lymphocyte Stimulator (BLyS)/BAFF levels may reflect natural immunity to HIV in highly exposed uninfected Beninese Commercial Sex Workers

    Science.gov (United States)

    Sabourin-Poirier, Catherine; Fourcade, Lyvia; Chagnon-Choquet, Josiane; Labbé, Annie-Claude; Alary, Michel; Guédou, Fernand; Poudrier, Johanne; Roger, Michel

    2016-01-01

    We have previously shown that excess B lymphocyte Stimulator (BLyS)/BAFF in plasma and on surface of blood dendritic cells (DC) of HIV-infected progressors coincides with B-cell dysregulations and increased frequencies of “precursor” innate marginal zone (MZ)-like B-cells. In contrast, both blood BLyS levels and frequencies of this population remained unaltered in HIV elite-controllers. Based on these observations, we hypothesized that control of BLyS and innate B-cell status could be associated with natural immunity against HIV infection. Therefore, we assessed blood BLyS levels and B-cell status in HIV highly-exposed commercial sex workers (CSWs) from Benin. We found blood BLyS levels of HIV-uninfected CSWs were lower than those observed in both HIV-infected CSW and HIV-uninfected non-CSW groups. Furthermore, levels of BLyS expression on blood T-cells and monocytes were lower in HIV-uninfected CSWs when compared to HIV-infected CSWs, but higher than those observed for HIV-uninfected non-CSWs. Concomitantly, HIV-infected CSWs presented a dysregulated blood B-cell compartment, characterized by increased total IgG1, increased frequencies of populations presenting immature and/or innate profiles and a higher ratio of IgG+/IgA+ plasmablasts. In contrast, relatively low levels of BLyS in the blood of HIV-uninfected CSWs coincided with a rather preserved B-cell compartment. PMID:27561453

  5. Blood B Lymphocyte Stimulator (BLyS)/BAFF levels may reflect natural immunity to HIV in highly exposed uninfected Beninese Commercial Sex Workers.

    Science.gov (United States)

    Sabourin-Poirier, Catherine; Fourcade, Lyvia; Chagnon-Choquet, Josiane; Labbé, Annie-Claude; Alary, Michel; Guédou, Fernand; Poudrier, Johanne; Roger, Michel

    2016-01-01

    We have previously shown that excess B lymphocyte Stimulator (BLyS)/BAFF in plasma and on surface of blood dendritic cells (DC) of HIV-infected progressors coincides with B-cell dysregulations and increased frequencies of "precursor" innate marginal zone (MZ)-like B-cells. In contrast, both blood BLyS levels and frequencies of this population remained unaltered in HIV elite-controllers. Based on these observations, we hypothesized that control of BLyS and innate B-cell status could be associated with natural immunity against HIV infection. Therefore, we assessed blood BLyS levels and B-cell status in HIV highly-exposed commercial sex workers (CSWs) from Benin. We found blood BLyS levels of HIV-uninfected CSWs were lower than those observed in both HIV-infected CSW and HIV-uninfected non-CSW groups. Furthermore, levels of BLyS expression on blood T-cells and monocytes were lower in HIV-uninfected CSWs when compared to HIV-infected CSWs, but higher than those observed for HIV-uninfected non-CSWs. Concomitantly, HIV-infected CSWs presented a dysregulated blood B-cell compartment, characterized by increased total IgG1, increased frequencies of populations presenting immature and/or innate profiles and a higher ratio of IgG(+)/IgA(+) plasmablasts. In contrast, relatively low levels of BLyS in the blood of HIV-uninfected CSWs coincided with a rather preserved B-cell compartment. PMID:27561453

  6. Splenic scintigraphy for further differentiation of unclear (68) Ga-DOTATOC-PET/CT findings: Strengths and limitations.

    Science.gov (United States)

    Werner, Christoph; Winkens, Thomas; Freesmeyer, Martin

    2016-06-01

    Splenic scintigraphy has been described to be a powerful tool in unclear (68 ) Ga-DOTATOC-PET/CT findings, allowing differentiation between somatostatin receptor (Sst)-positive tissue deriving from neuroendocrine tumour (NET) and functioning splenic tissue. However, our own experiences sometimes show a lack of identification on splenic scintigraphy, especially in small lesions, leading to uncertainties regarding the safe identification of NET or splenic tissue. Here, we report on 10 cases with (68) Ga-DOTATOC-PET/CT and (99m) Tc-heat-denaturated red blood cell (HDRBC) scintigraphy and we illustrate the strengths and limitations of (99m) Tc-HDRBC scintigraphy in this context. PMID:27188232

  7. ASSOCIATIONS BETWEEN DUAL-PHASE COMPUTED TOMOGRAPHY FEATURES AND HISTOPATHOLOGIC DIAGNOSES IN 52 DOGS WITH HEPATIC OR SPLENIC MASSES.

    Science.gov (United States)

    Jones, Ian D; Lamb, Christopher R; Drees, Randi; Priestnall, Simon L; Mantis, Panagiotis

    2016-03-01

    Ability to noninvasively differentiate malignant from nonmalignant abdominal masses would aid clinical decision making. The aim of this retrospective, cross-sectional study was to identify features in dual-phase computed tomographic (CT) studies that could be used to distinguish malignant from nonmalignant hepatic and splenic masses in dogs. Medical records were searched for dogs that had an abdominal dual-phase CT examination, a hepatic or splenic mass, and subsequent histopathologic diagnosis. Computed tomographic images for all included dogs were acquired prior to and 60 s (delayed phase) after intravenous contrast administration. Fifty-two dogs with 55 masses were studied: 24 hepatic, including 14 (58%) malignant and 10 (42%) non-malignant; 31 splenic, including 18 (58%) malignant and 13 (42%) nonmalignant. There was substantial overlap in the pre- and postcontrast CT features of malignant and nonmalignant hepatic and splenic masses. Regardless of histologic diagnosis, hepatic masses most frequently showed marked, generalized enhancement in early phase images that persisted in the delayed phase. Splenic hemangiosarcoma and nodular hyperplastic lesions most frequently showed marked, generalized enhancement in early phase images that persisted in delayed images whereas most splenic hematomas had slight enhancement in early phase images. All splenic hematomas and 77% of the hemangiosarcomas had contrast accumulation compatible with active hemorrhage. There were no other significant differences in quantitative or categorical CT data between malignant and nonmalignant hepatic or splenic masses. Dual-phase CT of dogs with hepatic or splenic masses provides limited specific diagnostic information. PMID:26763951

  8. Splenotoxicity associated with splenic sarcomas in rats fed high doses of D & C Red No. 9 or aniline hydrochloride.

    Science.gov (United States)

    Weinberger, M A; Albert, R H; Montgomery, S B

    1985-10-01

    A histopathologic review of F344 rat spleens from the National Toxicology Program-National Cancer Institute bioassays of barium salt of 5-chloro-2-(2-hydroxy-1-naphthalenyl)-azo-4-methylbenzenesulfonic acid [(D & C Red No. 9) CAS: 516-00-21] and aniline HCI (CAS: 142-04-1) was conducted to assess splenotoxic changes associated with splenic sarcomas induced by these aromatic amines. Four splenic changes--fatty metamorphosis (FM), splenic fibrosis (FIB), capsule hyperplasia (CH), and hemorrhage--were markedly increased in incidence and severity in males treated with high doses of either D & C Red No. 9 or aniline HCI. Females treated with high doses of either of these compounds showed similar but less severe changes. FIB and FM showed strong group correlations with tumor incidence (r greater than or equal to 0.87). All groups that demonstrated FM also demonstrated splenic sarcomas; groups without the FM lesions did not exhibit splenic tumors. The morphologic similarity of the FIB and CH lesions to the induced splenic sarcomas suggests that these lesions are preneoplastic. Moreover, the treatment-related splenic lesions appear to be precursors of the induced splenic sarcomas. Carcinogenicity studies with serial sacrifices at varying intervals will be required for experimental verification of these conclusions. A schema, based on the findings of the study, suggests a hypothetical pathway for the progression of the treatment-related splenic lesions from onset to tumor formation. PMID:3862900

  9. Isolated splenic calcifications in two patients with portal hypertension; Calcificaciones esplenicas aisladas en dos pacientes con hipertension portal

    Energy Technology Data Exchange (ETDEWEB)

    Aleixandre, A.; Cugat, A. [Hospital de la Malvarrosa. Valencia (Spain); Ruiz, A.; Marti-Bonmati, L. [Hosptial Universitario Dr. Peset. Valencia (Spain); Tardaguila, F. [Clinica Provisa. Vigo (Spain)

    2002-07-01

    Calcification of the walls of the veins of the portal hypertension (PHT) (1-0), is uncommon. Calcification of the intra splenic vessels is exceptional. We report two cases of isolated calcification of intra splenic vessels, without calcification of the splenoportal venous axis, in patients with liver cirrhosis and PHT. The calcification was not clear. Computed tomography identified the calcification as linear tubular, branched structures located in the wall of intra splenic vessels. magnetic resonance imaging disclosed signs of cirrhosis and PHT but did not show the splenic classifications because of technical limitations. The cause of these calcifications was sustained PHT due to chronic liver disease. (Author) 15 refs.

  10. Infarto esplénico secundario a pancreatitis aguda Splenic infarction secondary to acute pancreatitis

    Directory of Open Access Journals (Sweden)

    J. J. Arenal Vera

    2008-05-01

    Full Text Available Fundamento y objetivo: la estrecha relación anatómica del páncreas con los vasos esplénicos y el bazo es responsable de complicaciones esplénicas en el curso de la pancreatitis aguda. El objetivo es presentar dos casos clínicos de pancreatitis aguda grave que sufrieron infarto esplénico como complicación de la enfermedad pancreática. Pacientes, participantes: en un periodo de tres meses, dos pacientes fueron diagnosticados de infarto esplénico secundario a pancreatitis aguda. En ambos casos el diagnóstico y seguimiento evolutivo del infarto esplénico se hizo a través de tomografía axial computerizada. Resultados: en el primer paciente, las imágenes muestran de forma inequívoca la afectación de la arteria esplénica por el proceso inflamatorio pancreático. En el segundo, no se pudo demostrar afectación de los vasos esplénicos, por lo que la única posible explicación etiológica es un incremento de coagulabilidad intravascular. Conclusiones: sería recomendable añadir las complicaciones esplénicas al conjunto de complicaciones graves extrapancreáticas de la pancreatitis aguda. La tomografía axial computerizada es de gran utilidad para la detección y seguimiento de las complicaciones esplénicas de la pancreatitis aguda.Background and objective: the close anatomic relationship of the pancreas with the splenic vessels and the spleen is responsible for splenic complications in the course of acute pancreatitis. Our objective was to report two cases of severe acute pancreatitis complicated by splenic infarction. Patients: in a three-month period of time two patients were diagnosed with splenic infarction secondary to acute pancreatitis. In both cases splenic infarction diagnosis and follow-up were carried out using computed tomography. Results: in the first case images clearly showed a narrowing of the splenic artery due to the inflammatory pancreatic condition. In the second case no involvement of the splenic vessels could

  11. Factors Associated with Diffusely Increased Splenic F-18 FDG Uptake in Patients with Cholangiocarcinoma

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Keunyoung; Kim, Seongjang; Kim, Injoo; Kim, Dong Uk; Kim, Heeyoung; Kim, Sojung; Ahn, Sang Hyun [Pusan National Univ. Hospital, Busan (Korea, Republic of)

    2014-06-15

    Although diffuse splenic {sup 18}F-fluorodeoxyglucose (F-18 FDG) uptake exceeding hepatic activity, is considered abnormal, its clinical significance is rarely discussed in the literature. The aim of this study was to determine the contributing factors causing diffusely increased splenic FDG uptake in patients with cholangiocarcinoma. From January 2010 to March 2013, 140 patients (84 men, 56 women) were enrolled in this study. All patients had been diagnosed with cholangiocarcinoma and underwent F-18 FDG positron emission tomography/computed tomography (PET/CT) for the pretreatment staging work up. Clinical records were reviewed retrospectively. Various hematological parameters, C-reactive protein (CRP) level, CEA, CA19-9, pancreatic enzymes and liver function tests were conducted within 2 days after the F-18 FDG PET/CT study. Diffuse splenic uptake was observed in 23 patients (16.4%). Of those, 19 patients (82.6%) underwent endoscopic retrograde cholangiopancreastography (ERCP) 7 days before F-18 FDG PET/CT. The CRP level (p <0.001) and white blood cell count (p =0.023) were significantly higher in the group of patients with diffuse splenic FDG uptake. The hemoglobin (p <0.001) and the hematocrit (p <0.001) were significantly lower in patients with diffuse splenic FDG uptake. Pancreatic enzymes, liver function test results, and tumor markers were not significantly different between the patients who did or did not have diffusely increased splenic FDG uptake. The significant factors for diffuse splenic F-18 FDG uptake exceeding hepatic F-18 FDG uptake on multivariate analysis included: performing ERCP before F-18 FDG PET-CT (odds ratio [OR], 77.510; 95% CI, 7.624-132.105), and the presence of leukocytosis (OR, 12.436; 95% CI, 2.438-63.445) or anemia (OR, 1.211; 95% CI, 1.051-1.871). In conclusion, our study demonstrated that concurrent inflammation could be associated with diffusely increased splenic FDG uptake. We suggest that performing ERCP before F-18 FDG PET

  12. A case of splenic abscess diagnosed by computed tomography

    International Nuclear Information System (INIS)

    A 71-year-old man became febrile with transient pain of left upper quadrant for one or two days and admitted to prior hospital. He was treated with various antibiotics during about two months in prior hospital, but his fever continued and small amount of left pleural effusions were occasionally observed at his chest X-ray film. He was removed to Suibarago Hospital on July 17, 1980 introduced by prior hospital. On admission his temperature was 38.7 0C, abdominal pain and jaundice were not present, liver, spleen and kidneys were not palpable. The WBC count was 19800/mm3 with 76 % neutrophils and CRP reaction was 6+. No abnormality was found in his hepatic- and renal-function. Blood cultures were negative. A computed tomography (CT) of upper abdominal region showed irregular shaped multiple (maximum size: 2.5 x 3.5 cm in diameter) low density areas in enlarged spleen at the left upper side of left kidney. The diagnosis of multiple spleenic abscess was made and chemotherapy was instituted with clindamycin, dibekacin and cefotetan. Clinical symptomes were not changed and CT findings after three weeks were stationary. Splenectomy was performed on August 21. The spleen was covered with adherent surroundings organs namely stomach, diaphragm, colon and omentum. Abscesses were present in various sized yellowish granulomatous lesions. Aerobic and anaerobic culture of purulent materials yielded no growth. The patient recovered and discharged on November 9. CT is a non-invasive and valuable technique in diagnosis of splenic abscess. (author)

  13. Macrophages support splenic erythropoiesis in 4T1 tumor-bearing mice.

    Directory of Open Access Journals (Sweden)

    Min Liu

    Full Text Available Anemia is a common complication of cancer; a role of spleen in tumor-stress erythropoiesis has been suggested. However, the molecular mechanisms involved in the splenic erythropoiesis following tumor maintenance remain poorly understood. Here we show that tumor development blocks medullar erythropoiesis by granulocyte colony-stimulating factor (G-CSF and then causes anemia in murine 4T1 breast tumor-bearing mice. Meanwhile, tumor-stress promotes splenic erythropoiesis. Splenectomy worsened tumor-induced anemia, and reduced tumor volume and tumor weight, indicating the essential role of spleen in tumor-stress erythropoiesis and tumor growth. Tumor progression of these mice led to increased amounts of bone morphogenetic protein 4 (BMP4 in spleen. The in vivo role of macrophages in splenic erythropoiesis under tumor-stress conditions was investigated. Macrophage depletion by injecting liposomal clodronate decreased the expression of BMP4, inhibited splenic erythropoiesis, aggravated the tumor-induced anemia and suppressed tumor growth. Our results provide insight that macrophages and BMP4 are positive regulators of splenic erythropoiesis in tumor pathological situations. These findings reveal that during the tumor-stress period, the microenvironment of the spleen is undergoing changes, which contributes to adopt a stress erythropoietic fate and supports the expansion and differentiation of stress erythroid progenitors, thereby replenishing red blood cells and promoting tumor growth.

  14. An unusual presentation of non pathological delayed splenic rupture: a case report.

    LENUS (Irish Health Repository)

    Khan, Suhail Aslam

    2009-01-01

    The diagnosis of Delayed Splenic Rupture poses a major challenge to even the most astute clinician, as it can mimic other medical emergencies. We present a case of an unusual presentation of delayed splenic rupture in a 23-year-old Caucasian man, who presented to the emergency department with a 2 day history of left upper quadrant pain. He initially denied any history of trauma. There were no signs of generalized peritonisim on examination but his haemoglobin level was low (8.9 gm\\/dl) for which there was no obvious cause identified. He was resuscitated and a computed tomography of the abdomen was performed. This revealed complete rupture of the splenic capsule with haemorrhagic fluid in the abdomen. With the computed tomography abdomen findings and further questioning of the patient, the only potential precipitating event that he could remember was a minor kick to the left upper quadrant more than 2 weeks ago while playing football. An urgent splenectomy was performed and histology confirmed complete rupture of the splenic capsule with a large adherent haematoma to the capsule. This case illustrates the difficulty in diagnosing delayed splenic rupture especially when accurate history is not available. A high index of suspicion is essential as delay in diagnosis can be fatal. Early diagnosis in suspected cases can be achieved by performing computed tomography of the abdomen.

  15. Partial splenic artery embolization with gelatin sponge or with lipiodol for hypersplenism: a comparative study

    International Nuclear Information System (INIS)

    Objective: To discuss the effects and the complications of partial splenic artery embolization with gelatin sponge or with lipiodol for hypersplenism, to provide scientific information helpful for the selection of embolization materials in clinical practice. Methods: Partial splenic artery embolization with gelatin sponge was performed in forty patients with hypersplenism due to cirrhosis (gelatin sponge group) and partial splenic artery embolization with lipiodol was carried out in another thirty-nine patients (lipiodol group). The clinical data were retrospectively analyzed. The laboratory studies, complications and recurrence were observed and compared between two groups. Results: No significant difference in the reduction of splenic size, in the hemoglobin levels and in the thrombocyte and leucocyte counts existed between two groups (P > 0.05). However, the platelet count in lipiodol group was obviously decreased three months after the treatment. The occurrence of complications in gelatin sponge group was much higher than that in lipiodol group (P < 0.05). The toxic reaction of the liver and gastrointestinal tract in lipiodol group was significantly slighter than that in gelatin sponge group. Conclusion: Partial splenic artery embolization with lipiodol should be employed for the treatment of hypersplenism when the patient is elder and the disease is accompanied by poor liver function, massive ascites, severe dysfunction of blood coagulation and serious portal hypertension. (authors)

  16. Asymptomatic Partial Splenic Infarction In Laparoscopic Floppy Nissen Fundoplication And Brief Literature Review

    Science.gov (United States)

    Odabasi, Mehmet; Abuoglu, Haci Hasan; Arslan, Cem; Gunay, Emre; Yildiz, Mehmet Kamil; Eris, Cengiz; Ozkan, Erkan; Aktekin, Ali; Muftuoglu, Tolga

    2014-01-01

    Short gastric vessels are divided during the laparoscopic Nissen fundoplication resulting in splenic infarct in some cases. We report a case of laparoscopic floppy Nissen fundoplication with splenic infarct that was recognized during the procedure and provide a brief literature review. The patient underwent a laparoscopic floppy Nissen fundoplication. We observed a partial infarction of the spleen. She reported no pain. A follow-up computed tomography scan showed an infarct, and a 3-month abdominal ultrasound showed complete resolution. Peripheral splenic arterial branches have very little collateral circulation. When these vessels are occluded or injured, an area of infarction will occur immediately. Management strategies included a trial of conservative management and splenectomy for persistent symptoms or complications resulting from splenic infarct. In conclusion, we believe that the real incidence is probably much higher because many cases of SI may have gone undiagnosed during or following an operation, because some patients are asymptomatic. We propose to check spleen carefully for the possibility of splenic infarct. PMID:24833155

  17. Functional hyposplenia after splenic irradiation for Hodgkins's disease

    Energy Technology Data Exchange (ETDEWEB)

    Coleman, C.N.; McDougall, I.R.; Dailey, M.O.; Ager, P.; Bush, S.; Kaplan, H.S.

    1982-01-01

    We previously reported a patient who developed fulminant pneumococcal sepsis 12 years after successful treatment for Hodgkin's disease, which included splenic irradiation. We have since evaluated splenic size and function in 25 patients who had received splenic irradiation 5 to 16 years previously either for Hodgkin's disease (n = 19) or non-Hodgkin's lymphoma (n = 6). Mean maximum splenic diameter as measured on a /sup 99//sup m/Tc-sulfur colloid liver-spleen scan was 6.2 cm in the irradiated group and 9.7 cm in a control group (p < 0.001). The mean percentage of erythrocytes containing pits when observed with interference phase microscopy was 13.0% in the irradiated group, which was significantly different (p < 0.001) from the levels found in each of the control groups: normal subjects, 0.9%; unstaged and untreated lymphoma patients, 0.6%; and patients after splenectomy, 33.7%. Patients who have had splenic irradiation should be considered at risk of developing overwhelming pneumococcal sepsis.

  18. Functional hyposplenia after splenic irradiation for Hodgkin's disease

    Energy Technology Data Exchange (ETDEWEB)

    Coleman, C.N.; McDougall, I.R.; Dailey, M.O.; Ager, P.; Bush, S.; Kaplan, H.S.

    1982-01-01

    We previously reported a patients who developed fulminant pneumococcal sepsis 12 years after successful treatment for Hodgkin's disease, which included splenic irradiation. We have since evaluated splenic size and function in 25 patients who had received splenic irradiation 5 to 16 years previously either for Hodgkin's disease (n . 19) or non-Hodgkin's lymphoma (n . 6). Mean maximum splenic diameter as measured on a 99mTc-sulfur colloid liver-spleen scan was 6.2 cm in the irradiated group and 9.7 cm in a control group (p less than 0.001). The mean percentage of erythrocytes containing pits when observed with interference phase microscopy was 13.0% in the irradiated group, which was significantly different (p less than 0.001) from the levels found in each of the control groups: normal subjects, 0.9%; unstaged and untreated lymphoma patients, 0.6%; and patients after splenectomy, 33.7%. Patients who have had splenic irradiation should be considered at risk of developing overwhelming pneumococcal sepsis.

  19. Recanalization of Splenic Artery Aneurysm After Transcatheter Arterial Embolization Using N-Butyl Cyanoacrylate

    International Nuclear Information System (INIS)

    A 65-year-old woman who had been diagnosed as having microscopic polyangiitis developed sudden abdominal pain and entered a state of shock. Abdominal CT showed massive hemoperitoneum, and emergent angiography revealed a ruptured splenic artery aneurysm. After direct catheterization attempts failed due to tortuous vessels and angiospasm, transcatheter arterial embolization using an n-butyl cyanoacrylate (NBCA)-lipiodol mixture was successfully performed. Fifty days later, the patient developed sudden abdominal pain again. Repeated angiography demonstrated recanalization of the splenic artery and splenic artery aneurysm. This time, the recanalized aneurysm was embolized using metallic coils with the isolation method. Physicians should keep in mind that recanalization can occur after transcatheter arterial embolization using N-butyl cyanoacrylate, which has been used as a permanent embolic agent.

  20. Laparoscopic Management of a Giant Congenital Splenic Cyst in a Child

    Institute of Scientific and Technical Information of China (English)

    Hualei Cui; Gang Li; Jiqing Gu; Xiaoli Hu; Xiaoye Wang; Liang Dong; Hong Yang

    2008-01-01

    @@ Introduction Splenic cysts are rare in pediatric surgery. They can be classified as"true" cysts or pseudocysts on the basis of the presence or absence of an epithelial lining. Congenital cysts represent 10% of splenic cysts,most of which are epidermoid lesions[1]. Splenectomy was initially the surgical treatment employed due to size, risk of operative compli-cations, and fear of postoperative bleeding[2]. With the introduction of minimally invasive surgery, several cases have been documented where laparoscopy has been used safely and with good results[2]. The use of laparoscopy is less aggressive, resulting in less postoperative discomfort, and requires a shorter stay in the hospital and with the same results as with the open approach[3-5]. We report a new case of congenital splenic cyst handled successfully by laparoscopy include-ing a follow-up period of more than 2 years.

  1. Blastomycosis Presenting as Multiple Splenic Abscesses: Case Report and Review of the Literature

    Directory of Open Access Journals (Sweden)

    Sami Al-Nassar

    2010-01-01

    Full Text Available A 31-year-old Canadian Aboriginal man from northwestern Ontario presented with left upper quadrant pain and a tender left upper quadrant mass. Evaluation with a computed tomography scan showed multiple lesions within the spleen, a collection between the splenic tip and splenic flexure of the colon, and several small adrenal lesions. Computed tomographic-guided needle biopsy showed necrotizing granulomatous inflammation and multinucleated giant cells. Gomori’s methenamine silver stain showed broad-based budding yeast consistent with Blastomyces dermatitidis. Abdominal symptoms resolved after two months of oral itraconazole. Multiple splenic abscesses are a rare presentation of blastomycosis and should be considered in the differential diagnosis of left upper quadrant abdominal pain in a patient with a history of travel or residence in a region endemic for B dermatitidis.

  2. Splenic Artery Syndrome After Orthotopic Liver Transplantation: Treatment With the Amplatzer Vascular Plug

    International Nuclear Information System (INIS)

    Purpose: To evaluate the safety and efficacy of the Amplatzer vascular plug (AVP) for embolization of the splenic artery in patients with hepatic hypoperfusion after orthotopic liver transplantation (OLT). Materials and Methods: Thirteen patients (9 men and 4 women) with a mean age of 56 years (range 22–70) who developed splenic artery syndrome after OLT with decreased liver perfusion and clinically relevant impairment of liver function (increased transaminase or serum bilirubin levels, thrombocytopenia, and/or therapy-refractory ascites) were treated by embolization of the proximal third of the splenic artery using the AVP. The plugs ranged in diameter from 6 to 16 mm, and they were introduced through femoral (n = 9), axillary (n = 3), or brachial (n = 1) access using a 5F or 8F guiding catheter. Results: The plugs were successfully placed, and complete occlusion of the splenic artery was achieved in all patients. Placement of two plugs was necessary for complete occlusion in 3 of the 13 patients. Occlusion took on average 10 min (range 4–35). There was no nontarget embolization or plug migration into more distal segments of the splenic artery. All patients showed improved arterial perfusion, including the liver periphery, on postinterventional angiogram. After embolization, liver function parameters (transaminase and bilirubin levels) improved with normalization of concomitant thrombocytopenia and a decrease in ascites volume. Conclusion: Our initial experience in a small patient population with SAS suggests that the AVP enables precise embolization of the proximal splenic artery, thus providing safe and effective treatment for poor liver perfusion after OLT due to SAS.

  3. Endovascular Treatment of Active Splenic Bleeding After Colonoscopy: A Systematic Review of the Literature

    International Nuclear Information System (INIS)

    Purpose: Colonoscopy is reported to be a safe procedure that is routinely performed for the diagnosis and treatment of colorectal diseases. Splenic rupture is considered to be a rare complication with high mortality and morbidity that requires immediate diagnosis and management. Nonoperative management (NOM), surgical treatment (ST), and, more recently, proximal splenic artery embolization (PSAE) have been proposed as treatment options. The goal of this study was to assess whether PSAE is safe even in high-grade ruptures. Methods: We report two rare cases of post colonoscopy splenic rupture. A systematic review of the literature from 2002 to 2010 (first reported case of PSAE) was performed and the three types of treatment compared. Results: All patients reviewed (77 of 77) presented with intraperitoneal hemorrhage due to isolated splenic trauma. Splenic rupture was high-grade in most patients when grading was possible. Six of 77 patients (7.8 %) were treated with PSAE, including the 2 cases reported herein. Fifty-seven patients (74 %) underwent ST. NOM was attempted first in 25 patients with a high failure rate (11 of 25 [44 %]) and requiring a salvage procedure, such as PSAE or ST. Previous surgery (31 of 59 patients), adhesions (10 of 13), diagnostic colonoscopies (49 of 71), previous biopsies or polypectomies (31 of 57) and female sex (56 of 77) were identified as risk factors. In contrast, splenomegaly (0 of 77 patients), medications that increase the risk of bleeding (13 of 30) and difficult colonoscopies (16 of 51) were not identified as risk factors. PSAE was safe and effective even in elderly patients with comorbidities and those taking medications that increase the risk of bleeding, and the length of the hospital stay was similar to that after ST. Conclusion: We propose a treatment algorithm based on clinical and radiological criteria. Because of the high failure rate after NOM, PSAE should be the treatment of choice to manage grade I through IV splenic

  4. Endovascular Treatment of Active Splenic Bleeding After Colonoscopy: A Systematic Review of the Literature

    Energy Technology Data Exchange (ETDEWEB)

    Corcillo, Antonella, E-mail: antonella.corcillo@chuv.ch [Centre Hospitalier Universitaire Vaudois (CHUV), Departement de Medecine Interne (Switzerland); Aellen, Steve, E-mail: steve.aellen@hopitalvs.ch; Zingg, Tobias [Centre Hospitalier Universitaire Vaudois (CHUV), Service de Chirurgie Viscerale (Switzerland); Bize, Pierre [Centre Hospitalier Universitaire Vaudois (CHUV), Departement de Radiologie Interventionnelle (Switzerland); Demartines, Nicolas [Centre Hospitalier Universitaire Vaudois (CHUV), Service de Chirurgie Viscerale (Switzerland); Denys, Alban [Centre Hospitalier Universitaire Vaudois (CHUV), Departement de Radiologie Interventionnelle (Switzerland)

    2013-10-15

    Purpose: Colonoscopy is reported to be a safe procedure that is routinely performed for the diagnosis and treatment of colorectal diseases. Splenic rupture is considered to be a rare complication with high mortality and morbidity that requires immediate diagnosis and management. Nonoperative management (NOM), surgical treatment (ST), and, more recently, proximal splenic artery embolization (PSAE) have been proposed as treatment options. The goal of this study was to assess whether PSAE is safe even in high-grade ruptures. Methods: We report two rare cases of post colonoscopy splenic rupture. A systematic review of the literature from 2002 to 2010 (first reported case of PSAE) was performed and the three types of treatment compared. Results: All patients reviewed (77 of 77) presented with intraperitoneal hemorrhage due to isolated splenic trauma. Splenic rupture was high-grade in most patients when grading was possible. Six of 77 patients (7.8 %) were treated with PSAE, including the 2 cases reported herein. Fifty-seven patients (74 %) underwent ST. NOM was attempted first in 25 patients with a high failure rate (11 of 25 [44 %]) and requiring a salvage procedure, such as PSAE or ST. Previous surgery (31 of 59 patients), adhesions (10 of 13), diagnostic colonoscopies (49 of 71), previous biopsies or polypectomies (31 of 57) and female sex (56 of 77) were identified as risk factors. In contrast, splenomegaly (0 of 77 patients), medications that increase the risk of bleeding (13 of 30) and difficult colonoscopies (16 of 51) were not identified as risk factors. PSAE was safe and effective even in elderly patients with comorbidities and those taking medications that increase the risk of bleeding, and the length of the hospital stay was similar to that after ST. Conclusion: We propose a treatment algorithm based on clinical and radiological criteria. Because of the high failure rate after NOM, PSAE should be the treatment of choice to manage grade I through IV splenic

  5. Dynamic contrast-enhanced MRI improves accuracy for detecting focal splenic involvement in children and adolescents with Hodgkin disease

    Energy Technology Data Exchange (ETDEWEB)

    Punwani, Shonit; Taylor, Stuart A.; Halligan, Steve [University College London, Centre for Medical Imaging, London (United Kingdom); University College London Hospital, Department of Radiology, London (United Kingdom); Cheung, King Kenneth; Skipper, Nicholas [University College London, Centre for Medical Imaging, London (United Kingdom); Bell, Nichola; Humphries, Paul D. [University College London Hospital, Department of Radiology, London (United Kingdom); Bainbridge, Alan [University College London, Department of Medical Physics and Bioengineering, London (United Kingdom); Groves, Ashley M.; Hain, Sharon F.; Ben-Haim, Simona [University College Hospital, Institute of Nuclear Medicine, London (United Kingdom); Shankar, Ananth; Daw, Stephen [University College London Hospital, Department of Paediatrics, London (United Kingdom)

    2013-08-15

    Accurate assessment of splenic disease is important for staging Hodgkin lymphoma. The purpose of this study was to assess T2-weighted imaging with and without dynamic contrast-enhanced (DCE) MRI for evaluation of splenic Hodgkin disease. Thirty-one children with Hodgkin lymphoma underwent whole-body T2-weighted MRI with supplementary DCE splenic imaging, and whole-body PET-CT before and following chemotherapy. Two experienced nuclear medicine physicians derived a PET-CT reference standard for splenic disease, augmented by follow-up imaging. Unaware of the PET-CT, two experienced radiologists independently evaluated MRI exercising a locked sequential read paradigm (T2-weighted then DCE review) and recorded the presence/absence of splenic disease at each stage. Performance of each radiologist was determined prior to and following review of DCE-MRI. Incorrect MRI findings were ascribed to reader (lesion present on MRI but missed by reader) or technical (lesion not present on MRI) error. Seven children had splenic disease. Sensitivity/specificity of both radiologists for the detection of splenic involvement using T2-weighted images alone was 57%/100% and increased to 100%/100% with DCE-MRI. There were three instances of technical error on T2-weighted imaging; all lesions were visible on DCE-MRI. T2-weighted imaging when complemented by DCE-MRI imaging may improve evaluation of Hodgkin disease splenic involvement. (orig.)

  6. Pseudoaneurysm of the pancreas and aneurysm spurions of the splenic artery - diagnosis by angio-CT and ultrasound

    Energy Technology Data Exchange (ETDEWEB)

    Gamroth, A.; Hirning, T.; Rosenthal, R.

    1986-02-01

    Pseudoaneurysm of the pancreas is a severe complication secondary to pancreatitis. The splenic artery is most often involved, followed by the pancreaticoduodenal vessels and the gastroduodenal artery. Selective arteriography is considered the method of choice in preoperative diagnosis. In a patient with chronic pancreatitis angio-CT and ultrasound enable a definitive diagnosis of pseudoaneurysm of the splenic artery. (orig.).

  7. Comparison of Simultaneous Splenic Sample PCR with Blood Sample PCR for Diagnosis and Treatment of Experimental Ehrlichia canis Infection

    OpenAIRE

    Harrus, Shimon; Kenny, Martin; Miara, Limor; Aizenberg, Itzhak; Waner, Trevor; Shaw, Susan

    2004-01-01

    This report presents evidence that dogs recover from acute canine monocytic ehrlichiosis (CME) after 16 days of doxycycline treatment (10 mg/kg of body weight every 24 h). Blood PCR was as valuable as splenic aspirate PCR for early diagnosis of acute CME. Splenic aspirate PCR was, however, superior to blood PCR for the evaluation of ehrlichial elimination.

  8. Dynamic contrast-enhanced MRI improves accuracy for detecting focal splenic involvement in children and adolescents with Hodgkin disease

    International Nuclear Information System (INIS)

    Accurate assessment of splenic disease is important for staging Hodgkin lymphoma. The purpose of this study was to assess T2-weighted imaging with and without dynamic contrast-enhanced (DCE) MRI for evaluation of splenic Hodgkin disease. Thirty-one children with Hodgkin lymphoma underwent whole-body T2-weighted MRI with supplementary DCE splenic imaging, and whole-body PET-CT before and following chemotherapy. Two experienced nuclear medicine physicians derived a PET-CT reference standard for splenic disease, augmented by follow-up imaging. Unaware of the PET-CT, two experienced radiologists independently evaluated MRI exercising a locked sequential read paradigm (T2-weighted then DCE review) and recorded the presence/absence of splenic disease at each stage. Performance of each radiologist was determined prior to and following review of DCE-MRI. Incorrect MRI findings were ascribed to reader (lesion present on MRI but missed by reader) or technical (lesion not present on MRI) error. Seven children had splenic disease. Sensitivity/specificity of both radiologists for the detection of splenic involvement using T2-weighted images alone was 57%/100% and increased to 100%/100% with DCE-MRI. There were three instances of technical error on T2-weighted imaging; all lesions were visible on DCE-MRI. T2-weighted imaging when complemented by DCE-MRI imaging may improve evaluation of Hodgkin disease splenic involvement. (orig.)

  9. Multiple splenic infarcts in acute Plasmodium vivax malaria:A rare case report

    Institute of Scientific and Technical Information of China (English)

    Hari Krishan Aggarwal; Deepak Jain; Vipin Kaverappa; Promil Jain; Ashwani Kumar; Sachin Yadav

    2013-01-01

    In tropical countries like India, malaria has been one of the most common parasitic illnesses leading to frequent hospitalization and causing major economic burden among the masses. Although Plasmodium vivax infection is considered to be benign, in contrast to Plasmodium falciparum infection which is notorious for its severe splenic complications can occur frequently. Splenomegaly tends not to receive special attention, as it is not usually accompanied by any symptoms and can be gradually resolved via standard antimalarial therapy. Splenic infarction, although rarely attributable to malaria in an endemic region with high parasitemia, can be a rare presentation of this disease entity.

  10. Abnormal splenic uptake of gallium-67 citrate in a case of infectious mononucleosis

    International Nuclear Information System (INIS)

    A case of fever of undetermined origin (FUO) demonstrated abnormal intense concentration of Ga-67 citrate in the spleen. Initial workup demonstrated two negative mono spot tests for infectious mononucleosis (IM) but, on hospital day 2, a repeat mono test was positive. The diagnosis was subsequently confirmed by rising heterophilic antibody titers. Six weeks after hospital discharge, repeat Ga-67 citrate imaging demonstrated absence of abnormal splenic activity. To our knowledge, this phenomenon has not been previously described in IM. In the appropriate clinical setting, intense splenic uptake of Ga-67 should alert the clinician to include the possibility of IM in the differential diagnosis

  11. Variations of Thickness of Splenic Capsule of Different Age and Sex in Bangladeshi Cadaver.

    Science.gov (United States)

    Shumi, M S; Khalil, M; Sultana, S Z; Mannan, S; Sultana, J; Farzana, T; Sultana, R

    2016-01-01

    The spleen is the most frequently injured organ in the abdomen. Splenic rupture is usually precipitated by a crushing injury or severe blow. If ruptured the spleen will bleed profusely because its capsule is thin and its parenchyma is soft and pulpy. Such "spontaneous ruptures" never occur in truly normal spleen but rather than from some minor physical insult to a spleen that has been rendered fragile by an underlying condition. The most common predisposing conditions are infectious mononucleosis, malaria, typhoid fever and lymphoid neoplasms. These diverse entities can all cause rapid splenic enlargement, producing a thin, tense splenic capsule that is susceptible to rupture. Understanding of splenic capsular structure may help explain mechanical properties of the normal and diseased spleen. Histological changes are evident in advancing age along with functional capability of the human spleen. This cross sectional descriptive study was done to measure the thickness of splenic capsule to establish the difference between sexes of different age groups in Bangladeshi cadaver. The study was carried out in the department of Anatomy, Mymensingh Medical College, Mymensingh from June 2013 to July 2014. A total 30 human spleen were collected by purposive sampling technique from October 2013 to April 2014, among them 14 were male and 16 were female. The specimens were collected from Bangladeshi cadavers of age ranging from 6 months to 60 years, from autopsy laboratory of the Department of Forensic Medicine of Mymensingh Medical College. For convenience of differentiating the thickness of splenic capsule in relation to age and sex, the collected specimens were divided into three groups like Group A (upto 20 years), Group B (21 to 40 years) & Group C (41 to 60 years). Each group was again divided into male & female groups. In this study 10 slides from each age group were chosen for measuring the thickness of splenic capsule and examined under low power objective. In present

  12. Necrosis of the tail of pancreas following proximal splenic artery embolization.

    Science.gov (United States)

    Talving, Peep; Rauk, Mariliis; Vipp, Liisa; Isand, Karl-Gunnar; Šamarin, Aleksandr; Põder, Kalle; Rätsep, Indrek; Saar, Sten

    2016-01-01

    The current case report presents a rare complication of a significant pancreatic tail necrosis following proximal splenic artery embolization in a 32-year-old male patient involved in a motorcycle accident. Proximal angiographic embolization of the splenic injury after trauma is a widely accepted method with excellent success rate; however, possible complications may occur and has been described in the literature. Nevertheless, only a few case reports pertinent to clinically significant pancreatic tail necrosis after the SAE has been reported. Thus, we add a case report to the scarce literature pertinent to this detrimental and rare complication. PMID:27177891

  13. Contributions of scintigraphy and sonography to the diagnosis of traumatic splenic lesions in children

    International Nuclear Information System (INIS)

    20 children who were sent to the Nuclear Medicine and Sonography services for evaluation of the spleen in the context of a history of abdominal trauma were studied. All but one of the children were treated conservately, the exception having had on emergency renal procedure performed for renal rupture. The working diagnosis, based on the clinical that of splenic trauma in all cases. The result show a sensitivity of 90% (2 false negatives) for scintigraphy, and of 30% (14 false negatives) for sonography for the non-invasive diagnosis of splenic trauma in children

  14. The comparative study between multi-slice spiral CT angiography and color flow ultrasonography in hepatic and splenic trauma

    International Nuclear Information System (INIS)

    Objective: To investigate the clinical value of multi-slice spiral CT angiography and color flow ultra- sonography in hepatic and splenic trauma. Methods Thirty-six cases of hepatic and splenic trauma were collected, the MSCT were analyzed and compared with that of color flow ultrasonography. Results: Seventeen cases were Hepatic trauma including nine cases of hepatic contusion, six cases of sub-envelope hematoma, two cases of both sub-envelope hematoma and hepatic contusion. Nineteen cases were splenic trauma including nine cases of splenic contusion, ten cases of sub-envelope hematoma. Conclusion: Multi-slice spiral CT angiography show hepatic and splenic trauma clearer than that of color flow ultrasonography, and can provide reliable basis for clinic diagnosis and therapy. (authors)

  15. Clinical indications and biological mechanisms of splenic irradiation in autoimmune diseases

    Energy Technology Data Exchange (ETDEWEB)

    Weinmann, M.; Becker, G. [Tuebingen Univ. (Germany). Abt. fuer Strahlenonkologie; Einsele, H.; Bamberg, M. [Tuebingen Univ. (Germany). Abt. fuer Innere Medizin 2

    2001-02-01

    Background: Splenic irradiation (SI) is a fairly unknown treatment modality in autoimmune disorders like autoimmune thrombocytopenia (AIT) or autoimmune hemolytic anemia (AIHA), which may provide an effective, low toxic and cost-effective treatment for selected patients. Patients, Materials and Methods: This article reviews the limited experiences on splenic irradiation in autoimmune thrombocytopenia by analyzing the current studies including 71 patients and some preliminary reports on splenic irradiation in autoimmune hemolytic anemia. Results: In autoimmune thrombocytopenia between 40 and 90% of all patients responded, but most of them relapsed within 4 to 6 months after splenic irradiation. Between 10 and 20% of all patients had a sustained response. The efficacy of splenic irradiation in HIV-associated cases of thrombocytopenia is probably lower than in other forms of autoimmune thrombocytopenia, but especially in this group immunosuppressive drug treatment of autoimmune thrombocytopenia exposes some problems. In autoimmune hemolytic anemia there are some case reports about efficacy of splenic irradiation. Toxicity of splenic irradiation in both diseases was very moderate. Conclusions: For HIV patients, for elderly patients or patients at high risk for complications following splenectomy splenic irradiation might be a treatment option. Splenic irradiation as preoperative treatment in patients not responding to or not suitable for immunosuppressive drugs prior to splenectomy may be a promising new application of splenic irradiation to reduce adverse effects of splenectomy in thrombocytopenic patients. A further analysis of the biological mechanisms underlying splenic irradiation may help to improve patient selection, to optimize dose concepts and treatment schedules and will improve understanding of radiotherapy as an immunomodulatory treatment modality. (orig.) [German] Hintergrund: Die Bestrahlung der Milz zur Behandlung von haematologischen

  16. APRIL stimulates NF-κB-mediated HoxC4 induction for AID expression in mouse B cells.

    Science.gov (United States)

    Park, Seok-Rae; Kim, Pyeung-Hyeun; Lee, Kyu-Seon; Lee, Sang-Hoon; Seo, Goo-Young; Yoo, Yung-Choon; Lee, Junglim; Casali, Paolo

    2013-02-01

    Activation-induced cytidine deaminase (AID) plays a key role in B cell immunoglobulin (Ig) class switch recombination (CSR) and somatic hypermutation (SHM). We have previously reported that the highly conserved homeodomain HoxC4 transcription factor binds to the Aicda (AID gene) promoter to induce AID expression. Here, we investigated the regulation of HoxC4 transcription by a proliferation-inducing ligand (APRIL) and B cell-activating factor belonging to the TNF family (BAFF) in mouse B cells. APRIL substantially increased both HoxC4 and AID expression, whereas BAFF induced the expression of AID but not HoxC4. To elucidate the underlying mechanisms, we constructed a HoxC4 gene promoter reporter vector and analyzed the promoter induction after APRIL stimulation. APRIL enhanced the HoxC4 promoter activity by 2.3-fold, and this increase disappeared when the second putative NF-κB-binding promoter element (NBE2) was mutated. Based on ChIP assays, we found that NF-κB bound to the HoxC4 promoter NBE2 region. Furthermore, the overexpression of NF-κB augmented the APRIL-induced HoxC4 promoter activity, while the expression of dominant negative-IκBα suppressed it. Taken together, our findings suggest that NF-κB mediates APRIL-induced HoxC4 transcription. PMID:23178148

  17. Intratracheal administration of fullerene nanoparticles activates splenic CD11b+ cells

    International Nuclear Information System (INIS)

    Highlights: → Fullerene administration triggered splenic responses. → Splenic responses occurred at different time-points than in the lung tissue. → CD11b+ cells were demonstrated to function as responder cells to fullerene. - Abstract: Fullerene nanoparticles ('Fullerenes'), which are now widely used materials in daily life, have been demonstrated to induce elevated pulmonary inflammation in several animal models; however, the effects of fullerenes on the immune system are not fully understood. In the present study, mice received fullerenes intratracheally and were sacrificed at days 1, 6 and 42. Mice that received fullerenes exhibited increased proliferation of splenocytes and increased splenic production of IL-2 and TNF-α. Changes in the spleen in response to fullerene treatment occurred at different time-points than in the lung tissue. Furthermore, fullerenes induced CDK2 expression and activated NF-κB and NFAT in splenocytes at 6 days post-administration. Finally, CD11b+ cells were demonstrated to function as responder cells to fullerene administration in the splenic inflammatory process. Taken together, in addition to the effects on pulmonary responses, fullerenes also modulate the immune system.

  18. Diagnosis and treatment of non-parasitic splenic cysts in children

    International Nuclear Information System (INIS)

    Splenic cysts of various types are rare surgical abnormalities. The diagnostic and therapeutic procedures are discussed with special reference to the author's clinical material consisting of six children with non-parasitic cysts. Sonography and, in special cases, CT are the most important methods of examination. The desirability of conserving the spleen, while removing the cyst, is stressed. (orig.)

  19. Intratracheal administration of fullerene nanoparticles activates splenic CD11b{sup +} cells

    Energy Technology Data Exchange (ETDEWEB)

    Ding, Ning [Department of Immunology and Parasitology, School of Medicine, University of Occupational and Environmental Health, Japan, 1-1 Iseigaoka, Yahata-nishi-ku, Kitakyushu 807-8555 (Japan); Kunugita, Naoki [Department of Environmental Health, National Institute of Public Health, 2-3-6, Minami, Wako 351-0197 (Japan); Ichinose, Takamichi [Department of Health Sciences, Oita University of Nursing and Health Sciences, Oita 870-1201 (Japan); Song, Yuan [Department of Immunology and Parasitology, School of Medicine, University of Occupational and Environmental Health, Japan, 1-1 Iseigaoka, Yahata-nishi-ku, Kitakyushu 807-8555 (Japan); Yokoyama, Mitsuru [Bio-information Research Center, University of Occupational and Environmental Health, Japan, 1-1 Iseigaoka, Yahata-nishi-ku, Kitakyushu 807-8555 (Japan); Arashidani, Keiichi [School of Health Sciences, University of Occupational and Environmental Health, Japan, 1-1 Iseigaoka, Yahata-nishi-ku, Kitakyushu 807-8555 (Japan); Yoshida, Yasuhiro, E-mail: freude@med.uoeh-u.ac.jp [Department of Immunology and Parasitology, School of Medicine, University of Occupational and Environmental Health, Japan, 1-1 Iseigaoka, Yahata-nishi-ku, Kitakyushu 807-8555 (Japan)

    2011-10-30

    Highlights: {yields} Fullerene administration triggered splenic responses. {yields} Splenic responses occurred at different time-points than in the lung tissue. {yields} CD11b{sup +} cells were demonstrated to function as responder cells to fullerene. - Abstract: Fullerene nanoparticles ('Fullerenes'), which are now widely used materials in daily life, have been demonstrated to induce elevated pulmonary inflammation in several animal models; however, the effects of fullerenes on the immune system are not fully understood. In the present study, mice received fullerenes intratracheally and were sacrificed at days 1, 6 and 42. Mice that received fullerenes exhibited increased proliferation of splenocytes and increased splenic production of IL-2 and TNF-{alpha}. Changes in the spleen in response to fullerene treatment occurred at different time-points than in the lung tissue. Furthermore, fullerenes induced CDK2 expression and activated NF-{kappa}B and NFAT in splenocytes at 6 days post-administration. Finally, CD11b{sup +} cells were demonstrated to function as responder cells to fullerene administration in the splenic inflammatory process. Taken together, in addition to the effects on pulmonary responses, fullerenes also modulate the immune system.

  20. Splenic autotransplantation in rabbits: no restoration of response to host defense

    Institute of Scientific and Technical Information of China (English)

    2000-01-01

    Objective:TO explore the effectiveness of splenic tissue autotransplantation in restoring host defense. Methods: Rabbits were divided into three groups,Sham Operation(SO), Splenic Autotransplantation(SA)and Total Splenectomy(TS), and dynamic changes in histology and immunology were observed for over 24 weeks. Results: Histologic study shows that the white pulps were poorly developed and central arterioles disappeared in the regenerated splenic tissue. The weight of regenerated spleens recovered six months later in SA was 11% of that in SO, and was significantly reduced comparing with the implanted weight( P <0.05). Tere were no significant difference in the number of T lymphocytes and the levels of serum lysozyme among the three groups. A poor antibody response by the rabbits of SA and TS as compared to those of SO was noted after the primary intravenous administration with sheep red blood cells. After the challenge with type 3 pneumococci intravenously, pneumococcal clearance from bloodstream in SA did not differ significantly from that in TS,but was marKedly delayed compared with that in SO(P<0.01). Conclusion: The results indicate that the low quantity and poor quality of the regenerated spleens may contribute to the inferior immunoprotective ability of 1/3 splenic autotransplantation. Therefore, it implies that the regenerated spleens can not fully compensate the original one in im-munology, especially, host resistance to infection.

  1. Low-dose splenic irradiation in symptomatic congestive splenomegaly: report of five cases with literature data

    International Nuclear Information System (INIS)

    To show effectiveness of low-dose splenic irradiation in symptomatic congestive splenomegaly. Five patients were referred to our department for symptomatic congestive splenomegaly within three years. Primary diseases were autoimmune hepatitis with liver cirrhosis (n = 2), cystic fibrosis (n = 1), granulomatous liver disease (n = 1) and Werlhof disease with liver cirrhosis (n = 1). Mean age was 54 years (range: 36–67). Patients received splenic irradiation with a total dose of 3 Gy (single dose: 0.5 Gy). One patient was re-irradiated after long-term failure with the same treatment schedule. In four patients long term relief of splenic pain could be observed during the follow-up time of median 20 (range: 2–36) months. Four patients showed haematological response after irradiation with an increase of erythrocytes, leucocytes and/or platelets. A slightly decrease in spleen size was found in two patients. Low-dose splenic irradiation in symptomatic congestive splenomegaly is feasible and perhaps as effective as in lympho-and myeloproliferative malignancies regarding pain relief and haematological response

  2. Bleeding Esophageal Varices and Portal Hypertension Caused by Arteriovenous Fistula of Splenic Artery

    OpenAIRE

    Moshe Shleapnik; Baruch Shpitz; Annette Siegal; Alex Dinbar

    1990-01-01

    Splenic arteriovenous fistula is a rare but curable cause of portal hypertension. This report describes a patient with such a disorder, presenting with bleeding esophageal varices and ascites. It emphasises the importance of performing selective catheterization of the celiac and superior mesenteric artery in all patients with signs of portal hypertension without evidence of chronic liver disease. Etiopathology and management are discussed.

  3. A Two-Step Control of Secondary Splenic Pedicles Using Ligasure during Laparoscopic Splenectomy

    Directory of Open Access Journals (Sweden)

    Bai Ji, Yahui Liu, Ping Zhang, Yingchao Wang, Guangyi Wang

    2012-01-01

    Full Text Available Objective: We modified the LigaSure vessel sealing into a two-step technique without using Endo-GIA stapler for the secondary splenic pedicle control in laparoscopic splenectomy (LS. This study evaluated the efficacy and safety outcomes of this technique.Methods: Patients (n = 105 scheduled for elective LS were consecutively and prospectively enrolled, including 24 males and 81 females, with a mean age of 43.6 (range 11-75 years. Following the mobilization of the spleen, the splenic inflow was interrupted by applying a Hem-o-lock clip. LigaSure was used to seal and transect the secondary splenic pedicles adjacent to the pancreatic tail and subsequently in proximity to the spleen.Results: Of 105 patients, 103 patients (98.1% underwent successful LS, whereas two patients (1.9% required the conversion to laparotomy. The mean operative time was 100 min, whilst the mean volume of blood loss was 500 mL. No clinically significant morbidities or mortality occurred following LS. An average of 8,000 RMB (range: 6900 to 9000; 1 USD = 6.5 RMB was saved by using this two-step technique.Conclusion: Secondary splenic pedicles can be successfully controlled in LS by using a two-step technique with the LigaSure vessel sealing system in an economically favorable way.

  4. Life-Threatening Autoimmune Hemolytic Anemia and Idhiopatic Thrombocytopenic Purpura. Successful Selective Splenic Artery Embolization

    Science.gov (United States)

    Molica, Matteo; Massaro, Fulvio; Annechini, Giorgia; Baldacci, Erminia; D’Elia, Gianna Maria; Rosati, Riccardo; Trisolini, Silvia Maria; Volpicelli, Paola; Foà, Robin; Capria, Saveria

    2016-01-01

    Selective splenic artery embolization (SSAE) is a nonsurgical intervention characterized by the transcatheter occlusion of the splenic artery and/or its branch vessels using metallic coils or other embolic devices. It has been applied for the management of splenic trauma, hypersplenism with portal hypertension, hereditary spherocytosis, thalassemia and splenic hemangioma. We hereby describe a case of a patient affected by idiopathic thrombocytopenic purpura (ITP) and warm auto-immune hemolytic anemia (AIHA) both resistant to immunosuppressive and biological therapies, not eligible for a surgical intervention because of her critical conditions. She underwent SSAE and achieved a hematologic complete response within a few days without complications. SSAE is a minimally invasive procedure to date not considered a standard option in the management of AIHA and ITP. However, following the progressive improvement of the techniques, its indications have been extended, with a reduction in morbidity and mortality compared to splenectomy in patients with critical clinical conditions. SSAE was a lifesaving therapeutic approach for our patient and it may represent a real alternative for the treatment of resistant AIHA and ITP patients not eligible for splenectomy. PMID:27158433

  5. Splenic arteriovenous malformation manifested by thrombocytopenia in hereditary hemorrhagic telangiectasia: a case report

    Energy Technology Data Exchange (ETDEWEB)

    Kwon, Hee Jin; Choi, Jong Cheol; Oh, Jong Yeong; Cho, Jin Han; Kang, Myong Jin; Lee, Jin Hwa; Yoon, Seong Kuk; Nam, Kyeong Jin [College of Medicine, Dong-A University, Busan (Korea, Republic of)

    2008-09-15

    Hereditary hemorrhagic telangiectasia (HHT) is an autosomal dominant inherited disease characterized by epistaxis, telangiectases and visceral arteriovenous malformations (AVMs). The involvement of the gastrointestinal tract, liver, lung and cerebrum for HHT has been described, whereas little is known about AVMs of the spleen. We report here the radiological findings of a case of a splenic AVM manifested by thrombocytopenia in HHT.

  6. Splenic infarcts as a rare manifestation of parvovirus B19 infection

    Science.gov (United States)

    Kranidiotis, Georgios; Efstratiadis, Efrosini; Kapsalakis, Georgios; Loizos, Georgios; Bilis, Apostolos; Melidonis, Andreas

    2016-01-01

    Introduction Human parvovirus B19 is a DNA virus most known for causing erythema infectiosum in children, and polyarthropathy or transient aplastic crisis in adults. However, various unusual clinical manifestations have also been reported in association with it. We describe a young patient who presented with splenic infarcts as a rare complication of B19 infection. Case report A 33-year old previously healthy man was admitted to our hospital because of a 5-day history of fever and headache. Imaging studies revaled two splenic infarcts. Endocarditis was ruled out, whereas serologic testing for B19 was indicative of acute infection. Discussion To our knowledge, three cases of thromboembolism in the setting of B19 infection have been reported up to now, including one occurence of splenic infarction. These events were attributed to the development of a transient antiphospholipid antibody syndrome. In contrast, our patient did not have elevated titers of antiphospholipid antibodies. Conclusions Splenic infarcts can be an atypical presentation of B19 infection. Parvovirus B19 may induce thromboembolic events, even in the absence of antiphospholipid antibodies. PMID:27213135

  7. NON - OPERATIVE MANAGEMENT OF BLUNT HEPATIC AND/OR SPLENIC TRAUMA : A PROSPECTIVE STUDY

    Directory of Open Access Journals (Sweden)

    Ravikar

    2015-03-01

    Full Text Available PURPOSE: The incidence of blunt splenic and hepatic injuries are on a rise not only because of an increase in the overall incidence of Road Traffic Accidents but also due to more liberal use of radiological tests in the work - up of these patients. Spleen and liver are respectively the first and the second most common intra - abdominal organs to be injured in blunt abdominal injury. However, most of these patients can be treated without a formal laparotomy and its associated complications, as long as they remain hemody namically stable. Although few studies have proven the efficacy of conservative management, most of them are retrospective. This prospective study aims to evaluate the efficacy of conservative management of blunt liver and/or splenic injuries. MATERIALS AN D METHODS: Over a 12 - month period, a total of 56 patients with blunt hepatic and/or splenic injury were evaluated prospectively. Fourteen [25%] patients underwent immediate exploration for hemodynamic instability and the rest 42 patients constituted the st udy group. Injury Severity Score [ISS] was used to assess the extent of overall injury. Unstable patients underwent emergent laparotomies, and stable patients had abdominal computed tomography (CT scans to grade the source and severity of their injury. He patic and splenic injuries were graded using AAST grading for solid organ injuries. Those with nonhepatic, nonsplenic operative indications underwent exploration, and the remaining patients were intentionally managed nonoperatively in the trauma intensive care unit. Frequent measurement of vitals and estimation of hemoglobin and hematocrit was done. The outcome was measured in terms of total blood transfused, total duration of hospital stay and complications due to conservative management. RESULTS: A total of 56 patients presented to our ED with blunt abdominal trauma. Fourteen patients had to undergo emergent surgery for hemodynamic stability. The rest 42 were

  8. Splenic volume measurements on computed tomography utilizing automatically contouring software and its relationship with age, gender, and anthropometric parameters

    Energy Technology Data Exchange (ETDEWEB)

    Harris, Ardene, E-mail: ardene_b@yahoo.co [Department of Radiology, Hokkaido University Hospital, North 15, West 7, Kita-ku, Sapporo 060-0815 (Japan); Kamishima, Tamotsu, E-mail: ktamotamo2@yahoo.co.j [Department of Radiology, Hokkaido University Hospital, North 15, West 7, Kita-ku, Sapporo 060-0815 (Japan); Hao, Hong Yi, E-mail: haohongyi88@yahoo.co.j [Department of Radiology, Hokkaido University Hospital, North 15, West 7, Kita-ku, Sapporo 060-0815 (Japan); Kato, Fumi [Department of Radiology, Hokkaido University Hospital, North 15, West 7, Kita-ku, Sapporo 060-0815 (Japan); Omatsu, Tokuhiko, E-mail: omatoku@me.co [Department of Radiology, Hokkaido University Hospital, North 15, West 7, Kita-ku, Sapporo 060-0815 (Japan); Onodera, Yuya, E-mail: yuyaonodera@med.hokudai.ac.j [Department of Radiology, Hokkaido University Hospital, North 15, West 7, Kita-ku, Sapporo 060-0815 (Japan); Terae, Satoshi, E-mail: saterae@med.hokudai.ac.j [Department of Radiology, Hokkaido University Hospital, North 15, West 7, Kita-ku, Sapporo 060-0815 (Japan); Shirato, Hiroki, E-mail: shirato@med.hokudai.ac.j [Department of Radiology, Hokkaido University Hospital, North 15, West 7, Kita-ku, Sapporo 060-0815 (Japan)

    2010-07-15

    Objective: The present research was conducted to establish the normal splenic volume in adults using a novel and fast technique. The relationship between splenic volume and age, gender, and anthropometric parameters was also examined. Materials and methods: The splenic volume was measured in 230 consecutive patients who underwent computed tomography (CT) scans for various indications. Patients with conditions that have known effect on the spleen size were not included in this study. A new technique using volumetric software to automatically contour the spleen in each CT slice and quickly calculate splenic volume was employed. Inter- and intra-observer variability were also examined. Results: The average splenic volume of all the subjects was 127.4 {+-} 62.9 cm{sup 3}, ranging from 22 to 417 cm{sup 3}. The splenic volume (S) correlated with age (A) (r = -0.33, p < 0.0001), body weight (W) (r = 0.35, p < 0.0001), body mass index (r = 0.24, p < 0.0001) and body surface area (BSA) (r = 0.31, p < 0.0001). The age-adjusted splenic volume index correlated with gender (p = 0.0089). The formulae S = W[6.47A{sup (-0.31)}] and S = BSA[278A{sup (-0.36)}] were derived and can be used to estimate the splenic volume. Inter- and intra-observer variability were 6.4 {+-} 9.8% and 2.8 {+-} 3.5% respectively. Conclusion: Of the anthropometric parameters, the splenic volume was most closely linked to body weight. The automatically contouring software as well as formulae can be used to obtain the volume of the spleen in regular practice.

  9. Spleen-Preserving Distal Pancreatectomy with Resection of the Splenic Vessels. Should One Rely on the Short Gastric Arteries?

    Directory of Open Access Journals (Sweden)

    Vyacheslav Ivanovich Egorov

    2011-09-01

    Full Text Available Context Knowing the collaterals is essential for a spleen-preserving distal pancreatectomy with resection of the splenic vessels. Objective To ascertain the sources of the blood supply to the spleen after a spleen-preserving distal pancreatectomy with resection of the splenic vessels. Methods Perfusion of the cadaveric left gastric and right gastroepiploic arteries with methylene blue after occlusion of all the arteries except the short gastric arteries (n=10. Intraoperative color Doppler ultrasound was used for the evaluation of the hilar arterial blood flow at distal pancreatectomy (n=23 after 1 clamping of the splenic artery alone, 2 clamping of the splenic and left gastroepiploic arteries and 3 clamping of the splenic and short gastric arteries. CT angiography of the gastric and splenic vessels before and after a spleen-preserving distal pancreatectomy (n=10. Results Perfusion of the cadaveric arteries revealed no effective direct or indirect (through the submucous gastric arterial network communication between the left gastric and the branches of the short gastric arteries. In no case did intraoperative color Doppler ultrasound detect any hilar arterial blood flow after the clamping of the splenic and left gastroepiploic arteries. The clamping of the short gastric arteries did not change the flow parameters. In none of the cases did a post-spleen-preserving distal pancreatectomy with resection of the splenic vessels CT angiography delineate the short gastric vessels supplying the spleen. In all cases, the gastroepiploic arcade was the main arterial pathway feeding the spleen. Conclusion Experimental, intra- and postoperative instrumental investigations did not show the short gastric arteries to be engaged in the blood supply to the spleen after a spleen-preserving distal pancreatectomy with resection of the splenic vessels. In all cases, the left gastroepiploic artery was the main collateral vessel.

  10. Engineered hepatitis B virus surface antigen L protein particles for in vivo active targeting of splenic dendritic cells

    Directory of Open Access Journals (Sweden)

    Matsuo H

    2012-07-01

    Full Text Available Hidenori Matsuo,1 Nobuo Yoshimoto,1 Masumi Iijima,1 Tomoaki Niimi,1 Joohee Jung,2,3 Seong-Yun Jeong,3 Eun Kyung Choi,3,4 Tomomitsu Sewaki,5 Takeshi Arakawa,6,7 Shun’ichi Kuroda11Graduate School of Bioagricultural Sciences, Nagoya University, Nagoya, Japan; 2College of Pharmacy, Duksung Women’s University, Seoul, South Korea; 3Institute for Innovative Cancer Research, ASAN Medical Center, Seoul, South Korea; 4Department of Radiation Oncology, University of Ulsan College of Medicine, Seoul, South Korea; 5GenoLac BL Corporation, Okinawa, Japan; 6COMB, Tropical Biosphere Research Center, 7Graduate School of Medicine, University of the Ryukyus, Okinawa, JapanAbstract: Dendritic cells (DCs are key regulators of adaptive T-cell responses. By capturing exogenous antigens and presenting antigen-derived peptides via major histocompatibility complex molecules to naïve T cells, DCs induce antigen-specific immune responses in vivo. In order to induce effective host immune responses, active delivery of exogenous antigens to DCs is considered important for future vaccine development. We recently generated bionanocapsules (BNCs consisting of hepatitis B virus surface antigens that mediate stringent in vivo cell targeting and efficient endosomal escape, and after the fusion with liposomes (LP containing therapeutic materials, the BNC-LP complexes deliver them to human liver-derived tissues in vivo. BNCs were further modified to present the immunoglobulin G (IgG Fc-interacting domain (Z domain derived from Staphylococcus aureus protein A in tandem. When mixed with IgGs, modified BNCs (ZZ-BNCs displayed the IgG Fv regions outwardly for efficient binding to antigens in an oriented-immobilization manner. Due to the affinity of the displayed IgGs, the IgG-ZZ-BNC complexes accumulated in specific cells and tissues in vitro and in vivo. After mixing ZZ-BNCs with antibodies against DCs, we used immunocytochemistry to examine which antibodies delivered ZZ-BNCs to

  11. Clonal X-chromosome inactivation suggests that splenic cord capillary hemangioma is a true neoplasm and not a subtype of splenic hamartoma.

    Science.gov (United States)

    Chiu, A; Czader, M; Cheng, L; Hasserjian, R P; Wang, M; Bhagavathi, S; Hyjek, E M; Al-Ahmadie, H; Knowles, D M; Orazi, A

    2011-01-01

    Splenic hamartoma is a rare tumor-like lesion composed of structurally disorganized red pulp elements. It has been hypothesized that two other splenic lesions, cord capillary hemangioma and myoid angioendothelioma, may fall within the spectrum of splenic hamartoma, simply representing morphological variants. In this study, we compared the vascular and stromal composition of cord capillary hemangioma and myoid angioendothelioma with those of classical hamartoma. In addition, we assessed the clonal vs polyclonal nature of the lesions in nine female cases by performing clonality analysis for X-chromosome inactivation at the human androgen receptor locus (HUMARA) on laser-assisted microdissected samples. In 15 of 17 cases, increased reticulin and/or collagen content was observed. The classical hamartoma cases showed a vasculature predominantly composed of CD8+ CD31+ CD34- splenic sinuses, whereas cases of cord capillary hemangioma and myoid angioendothelioma contained many CD8- CD31+ CD34+ cord capillaries, but very little CD8+ vasculature. All cases lacked expression of D2-40 and Epstein Barr virus-encoded RNA. All cases showed a proliferation index of ≤5% by Ki-67. Cases of classical hamartoma lacked significant perisinusoidal expression of collagen IV and low-affinity nerve growth factor receptor. Both markers were variably expressed in the other lesions. Increased CD163-positive histiocytes were found in four cases (three cord capillary hemangiomas and one myoid angioendothelioma). HUMARA analysis was informative in all nine tested cases, of which three cases showed a non-random X-chromosome inactivation pattern, indicating clonality. All three clonal cases were cord capillary hemangiomas. Our study has shown that in spite of considerable morphologic heterogeneity and overlapping features, classical hamartoma and cord capillary hemangioma and myoid angioendothelioma are different in terms of their vascular and stromal composition. Clonality analysis supports a

  12. Splenic torsion and ureteropelvic junction obstruction - a case report; Torcao esplenica e estenose da juncao ureteropielica - relato de um caso

    Energy Technology Data Exchange (ETDEWEB)

    Barroso, Vivian Alvim; Bauab Junior, Tufik [Instituto de Radiodiagnostico Rio Preto, Sao Jose do Rio Preto, SP (Brazil); Barroso Junior, Ubirajara [Universidade Federal de Sao Paulo (UNIFESP), SP (Brazil). Escola Paulista de Medicina. Div. de Urologia

    2000-04-01

    We report a case of a 13-year-old boy with a pedicle splenic torsion associated with ureteropelvic junction obstruction. The symptoms, clinical outcome and the imaging findings are presented. (author)

  13. Primary epithelial splenic cyst with micro-rupture and raised carbohydrate antigen CA 19-9: a proposal for management

    Science.gov (United States)

    Papadopoulos, Iordanis N; Davatzikos, Anastasios; Kasabalis, Georgios; Manti, Christina; Konstantoudakis, Georgios

    2010-01-01

    Background Epithelial splenic cysts are rare entities which surgeons may not have previously encountered. Their management is based on historical studies. Case presentation A 21-year-old woman presented with a cyst of the spleen that produced a high serum concentration of carbohydrate antigen CA 19-9. A partial splenectomy with removal of the entire cyst and preservation of the splenic parenchyma by laparotomy was performed and the patient made an uneventful recovery. A microscopic rupture of the wall of the cyst and blood degradation products in the fluid of the cyst were confirmed. A functional splenic parenchyma was documented 18 months after surgery. There was no infection during follow-up. Conclusion Partial surgical splenectomy with resection of the entire cyst prevents recurrence and preserves splenic function. PMID:22791783

  14. Primary epithelial splenic cyst with micro-rupture and raised carbohydrate antigen CA 19-9: a paradigm of management

    Science.gov (United States)

    Papadopoulos, Iordanis N; Davatzikos, Anastasios; Kasabalis, Georgios; Manti, Christina; Konstantoudakis, Georgios

    2010-01-01

    Epithelial splenic cysts are rare entities that surgeons might not have previously encountered and their management is based on historical studies. A 21-year-old female presented with a cyst of the spleen that produced a high serum concentration of carbohydrate antigen CA 19-9. A partial splenectomy with the removal of the entire cyst and preservation of splenic parenchyma by laparotomy was performed and the patient made an uneventful recovery. A microscopic rupture of the wall of the cyst and degradation of blood in the fluid of the cyst were confirmed. Eighteen months following surgery a functional splenic parenchyma was documented. There was no episode of infection during this follow-up time. Partial surgical splenectomy with resection of the entire cyst prevents recurrence and preserves splenic function. PMID:22767471

  15. Radiation-induced splenic atrophy in patients with Hodgkin's disease and non-Hodgkin's lymphomas

    Energy Technology Data Exchange (ETDEWEB)

    Dailey, M.O.; Coleman, C.N.; Kaplan, H.S.

    1980-01-24

    Effective treatment of Hodgkin's disease requires the determination of the extent of the disease. This usually involves staging laparotomy, which includes splenectomy and biopsies of the para-aortic lymph nodes, liver, and bone marrow. Absence of the spleen predisposes a person to fulminant septicemia from encapsulated bacteria, a risk even greater in patients undergoing treatment for Hodgkin's disease. For this reason, some investigators have suggested that spleens not be removed for diagnosis but, rather, that they be included within the fields of radiation, which would preserve normal splenic function. We present a case of fatal spontaneous pneumococcal sepsis in a patient with splenic atrophy; the sepsis occurred 12 years after successful treatment of Hodgkin's disease by total nodal and splenic irradiation. A retrospective study of patients treated for Hodgkin's and non-Hodgkin's lymphomas indicated that atrophy and functional asplenia may be an important sequela of splenic irradiation.

  16. Splenic red pulp macrophages are intrinsically superparamagnetic and contaminate magnetic cell isolates.

    Science.gov (United States)

    Franken, Lars; Klein, Marika; Spasova, Marina; Elsukova, Anna; Wiedwald, Ulf; Welz, Meike; Knolle, Percy; Farle, Michael; Limmer, Andreas; Kurts, Christian

    2015-01-01

    A main function of splenic red pulp macrophages is the degradation of damaged or aged erythrocytes. Here we show that these macrophages accumulate ferrimagnetic iron oxides that render them intrinsically superparamagnetic. Consequently, these cells routinely contaminate splenic cell isolates obtained with the use of MCS, a technique that has been widely used in immunological research for decades. These contaminations can profoundly alter experimental results. In mice deficient for the transcription factor SpiC, which lack red pulp macrophages, liver Kupffer cells take over the task of erythrocyte degradation and become superparamagnetic. We describe a simple additional magnetic separation step that avoids this problem and substantially improves purity of magnetic cell isolates from the spleen. PMID:26260698

  17. Diagnosis of a large splenic tumor in a dog: computed tomography versus magnetic resonance imaging.

    Science.gov (United States)

    Kim, Mijin; Choi, Sooyoung; Choi, Hojung; Lee, Youngwon; Lee, Kija

    2016-01-01

    This study demonstrated magnetic resonance imaging (MRI) and computed tomography for large-sized splenic hemangiosarcoma. Radiography and ultrasonography revealed the presence of a large-sized soft-tissue mass in the cranial abdomen. Computed tomography showed hypoattenuating mass. The mass was located in contact with liver, spleen and stomach, and the origin of the mass remained ambiguous. The mass was T2-hyperintense and T1-hypointense with mild contrast enhancement. MRI allowed a differentiation between large-sized tumor and neighboring normal structure, and the mass was consequently identified as arising from spleen. These results suggested that MRI might be a useful tool to visualize large-sized splenic tumors and improve the accuracy of diagnosis. PMID:26194745

  18. Ultrasonography of the healing process during a 3-month follow-up after a splenic injury

    Directory of Open Access Journals (Sweden)

    Vasileios Rafailidis

    2015-07-01

    Full Text Available We present a 14-year-old boy with a grade III splenic injury due to a bicycle accident, who was treated conservatively. The boy’s medical history included splenomegaly due to thalassemia. The splenic lesion was initially investigated with computed tomography (CT and then, was followed by ultrasonography for 3 months. CT revealed a large intraparenchymal hematoma which appeared hyperechoic on ultrasonography. During follow-up, the hematoma developed a more complex echogenicity and became gradually hypoechoic. The hematoma increased in size during the first week but then, started decreasing until it eventually resolved completely. The patient had an uneventful full recovery. In this report, we discuss the ultrasonographic changes of the hematoma throughout the healing process.

  19. Symptomatic heterotopic suprarenal splenic tissue; Symptomatisches heterotopes Milzgewebe in der Nebennierenloge

    Energy Technology Data Exchange (ETDEWEB)

    Heider, J.; Kreft, B. [Bonn Univ. (Germany). Radiologische Klinik; Winter, P. [Bonn Univ. (Germany). Klinik und Poliklinik fuer Urologie

    1998-05-01

    We report on a 33-year-old man with symptomatic heterotopic suprarenal splenic tissue. Heterotopic splenic tissue can often be found after posttraumatic splenectomy. It is a result of autotransplantation induced by trauma (splenosis). Additionally it can grow during embryogenic development. Such an accessory spleen is found in 10-44% of all autopsies. In this case report the patient was treated by resection due to increasing flank pain and suspected neoplasm. (orig.) [Deutsch] Wir berichten ueber einen 33jaehrigen Patienten mit symptomatischen heterotopem Milzgewebe in der linken Nebennierenlage. Heterotopes Milzgewebe wird haeufig nach posttraumatischer Splenektomie gefunden und auf eine traumabedingte Autotransplantation von Milzgewebe zurueckgefuehrt (Splenose). Es kann auch waehrend der embryologischen Entwicklung der Milz als akzessorisches Milzgewebe entstehen und wird autopisch in 10-44% der Faelle gefunden. Im vorliegenden Fall wurde der Patient aufgrund der zunehmenden Flankenschmerzen und bestehendem Tumorverdacht operiert. Es werden die Differentialdiagnosen sowie die unterschiedlichen diagnostischen Moeglichkeiten und deren Stellenwert besprochen. (orig.)

  20. Anaphylaxis due to spontaneous rupture of primary isolated splenic hydatid cyst.

    Science.gov (United States)

    Ozkan, Fuat; Yesilkaya, Yakup; Peker, Onur; Yuksel, Murvet

    2013-04-01

    Echinococcosis is a helminthic zoonosis mainly caused by Echinococcus granulosus and commonly encountered in endemic areas. The liver and lung are the most frequently involved organs. A primary isolated hydatid cyst of spleen is an extremely rare disease even in endemic areas. Anaphylactic reaction is a known complication of cystic hydatid disease, a parasitic infestation caused by the larval/cyst stage of E. granulosus that usually occurs after trauma or during interventions. To the best of our knowledge, anaphylaxis with spontaneous rupture of primary isolated splenic hydatidoses had not been reported previously. The main purpose of this report is to highlight life-threatening complications such as anaphylactic shock that should be considered due to primary isolated splenic cyst hydatid rupture in especially endemic regions. PMID:23961460

  1. Immunological and catalytic quantitation of splenic glucocerebrosidase from the three clinical forms of Gaucher disease.

    Science.gov (United States)

    Pentchev, P G; Neumeyer, B; Svennerholm, L; Groth, C G; Brady, R O

    1983-07-01

    The enzymatic activity of glucocerebrosidase in splenic extracts of the adult nonneurological form of Gaucher disease (type I) was 15% +/- 7% of normal, and the titer of enzyme cross-reacting material (ECRM) in these spleens was 54% +/- 9% of normal. The titer of ECRM in splenic extracts of tissues obtained from patients with the neurological forms of Gaucher disease (types II and III) was essentially the same as in type I Gaucher spleens (59% +/- 10% of normal), but the measurable catalytic activity of glucocerebrosidase in these spleens was substantially lower than that found in type I Gaucher spleens (2.3% +/- 0.6% of normal). Thus, the attentuated glucocerebrosidase activity in spleens from all three forms of Gaucher disease appears to stem from a structurally mutated enzyme that is altered in its catalytic efficiency and possibly in its antigenic expression. PMID:6881138

  2. Coil embolization of splenic artery for the treatment of pseudoaneurysm related with pancreatitis

    International Nuclear Information System (INIS)

    Objective: To evaluate the effect of embolotherapy in treating the splenic pseudoaneurysm related with pancreatitis. Methods: In 8 cases with 8 pseudoaneurysms, in which six cases had bleeding after operation for acute pancreatitis and others were related with chronic pancreatitis, embolization had been carried out to the parent artery both distal and proximal with coils. CT scanning was performed after the embolization. Results: All cases had been embolized successfully, and haemorrhage in 7 cases was stopped immediately, of which CT scan had been done in 5 cases after embolization, it showed that the pseudoaneurysms were not enhanced at all. Follow up was done for 3-21 months, 6 cases did not bleed again. Conclusion: Percutaneous embolization of splenic artery is a simple, safe, and effective treatment mean for secondary pseudoaneurysm of pancreatitis. (authors)

  3. Laparoscopic distal pancreatectomy with preservation of the spleen and splenic vessels for pancreatic adenocarcinoma

    Directory of Open Access Journals (Sweden)

    Yan-Guo Zheng

    2009-06-01

    Full Text Available Background: A laparoscopic surgery can be beneficial in a spleen-preserving distal pancreatectomy. Aims: This report shows a 60-year-old woman who presented to her persistent upper abdominal and bilateral lumbodorsal distending pain for one year. A computed tomography scan demonstrated a 4cm×5cm×5cm solid space-occupying mass in the distal pancreas. The patient was referred to minimally invasive surgery service for resection of the pancreatic lesion. Methods: A laparoscopic spleen-preserving distal pancreatectomy was performed. Results: The mass was completely excised, the pathological examination revealed pancreatic adenocarcinoma with grade II. The postoperative advantages of this approach were the early return of bowel function, minimal complications, and early resumption of normal activities. Conclusions: This case illustrates that minimally invasive surgery in the performance of a spleen-and-splenic-vessel preserving distal pancreatectomy is a feasible procedure without compromising the splenic function.

  4. Operative management of splenic injury in a patient with proteus syndrome

    Directory of Open Access Journals (Sweden)

    Umashankkar Kannan

    2014-01-01

    Full Text Available A 20-year-old female with Proteus syndrome sustained splenic injury after fall from a bike. She was initially managed non-operatively at a different hospital for three days and was then referred to our level I trauma center in view of increasing abdominal pain and distention. On admission in the Emergency Department (ED, her pulse rate was 120 per minute and blood pressure was 108/68 mm Hg. Clinical examination showed a distended abdomen with left hypochondrial pain. Ultrasonogram (USG and Computed Tomography (CT of the abdomen showed splenomegaly and grade III splenic injury with significant hemoperitoneum. Her hemoglobin was 2.9 g/dl with packed cell volume (PCV of 12%. In view of low hemoglobin and possibility of pathologic spleen, splenectomy was done. Microscopic examination of the spleen showed hemangiolymphangioma. The patient was discharged on the 5 th post-operative day and is doing well at 6 months of follow-up.

  5. Acute Splenic Sequestration Crisis in a 70-Year-Old Patient With Hemoglobin SC Disease.

    Science.gov (United States)

    Squiers, John J; Edwards, Anthony G; Parra, Alberto; Hofmann, Sandra L

    2016-01-01

    A 70-year-old African American female with a past medical history significant for chronic bilateral shoulder pain and reported sickle cell trait presented with acute-onset bilateral thoracolumbar pain radiating to her left arm. Two days after admission, Hematology was consulted for severely worsening microcytic anemia and thrombocytopenia. Examination of the patient's peripheral blood smear from admission revealed no cell sickling, spherocytes, or schistocytes. Some targeting was noted. A Coombs test was negative. The patient was eventually transferred to the medical intensive care unit in respiratory distress. Hemoglobin electrophoresis confirmed a diagnosis of hemoglobin SC disease. A diagnosis of acute splenic sequestration crisis complicated by acute chest syndrome was crystallized, and red blood cell exchange transfusion was performed. Further research is necessary to fully elucidate the pathophysiology behind acute splenic sequestration crisis, and the role of splenectomy to treat hemoglobin SC disease patients should be better defined. PMID:27047980

  6. Splenic Arterial Embolization in the Treatment of Severe Portal Hypertension Due to Pancreatic Diseases: The Primary Experience in 14 Patients

    Energy Technology Data Exchange (ETDEWEB)

    Wang, Qi, E-mail: wqtjmu@gmail.com; Xiong, Bin, E-mail: herrxiong@126.com; Zheng, ChuanSheng, E-mail: hqzcsxh@sina.com; Liang, Ming, E-mail: whliangming@163.com; Han, Ping, E-mail: cjr.hanping@vip.163.com [Huazhong University of Science and Technology, Department of Radiology, Union Hospital, Tongji Medical College (China)

    2016-03-15

    ObjectiveThis retrospective study reports our experience using splenic arterial particle embolization and coil embolization for the treatment of sinistral portal hypertension (SPH) in patients with and without gastric bleeding.MethodsFrom August 2009 to May 2012, 14 patients with SPH due to pancreatic disease were diagnosed and treated with splenic arterial embolization. Two different embolization strategies were applied; either combined distal splenic bed particle embolization and proximal splenic artery coil embolization in the same procedure for acute hemorrhage (1-step) or interval staged distal embolization and proximal embolization in the stable patient (2-step). The patients were clinically followed.ResultsIn 14 patients, splenic arterial embolization was successful. The one-step method was performed in three patients suffering from massive gastric bleeding, and the bleeding was relieved after embolization. The two-step method was used in 11 patients, who had chronic gastric variceal bleeding or gastric varices only. The gastric varices disappeared in the enhanced CT scan and the patients had no gastric bleeding during follow-up.ConclusionsSplenic arterial embolization, particularly the two-step method, proved feasible and effective for the treatment of SPH patients with gastric varices or gastric variceal bleeding.

  7. Action of crude Radix Aconiti Lateralis (Fuzi) and its processed products on splenic lymphocytes growth investigated by microcalorimetry

    Energy Technology Data Exchange (ETDEWEB)

    Liu, Tiantian [Pharmacy College, Chengdu University of Traditional Chinese Medicine, Chengdu 611137 (China); China Military Institute of Chinese Medicine, 302 Hospital of People' s Liberation Army, 100, the 4th Ring Road, Beijing 100039 (China); Zhao, Yanling, E-mail: zhaoyanl2855@126.com [China Military Institute of Chinese Medicine, 302 Hospital of People' s Liberation Army, 100, the 4th Ring Road, Beijing 100039 (China); Wang, Jiabo; Zhou, Xu [China Military Institute of Chinese Medicine, 302 Hospital of People' s Liberation Army, 100, the 4th Ring Road, Beijing 100039 (China); Sun, Zhiyong; Zheng, Quanfu [Pharmacy College, Chengdu University of Traditional Chinese Medicine, Chengdu 611137 (China); China Military Institute of Chinese Medicine, 302 Hospital of People' s Liberation Army, 100, the 4th Ring Road, Beijing 100039 (China); Li, Ruisheng; Zhang, Ping; Li, Jianyu; Song, Xueai; Xiao, Xiaohe [China Military Institute of Chinese Medicine, 302 Hospital of People' s Liberation Army, 100, the 4th Ring Road, Beijing 100039 (China)

    2013-11-10

    Highlights: • This article investigated the effects of crude Radix Aconiti Lateralis and its processed products on splenic lymphocytes. • The results showed that bioeffects of crude Radix Aconiti Lateralis could be obtained by thermodynamic parameters. • This study gave the hint that the microcalorimetry is a useful tool to estimate the efficiency and toxicity of medicine. - Abstract: Using the TAM air isothermal microcalorimeter, the HFP–time curves of splenic lymphocytes growth were measured, and the effects of crude Radix Aconiti Lateralis and its processed products including Yanfuzi, Danfupian, Baifupian on splenic lymphocytes growth were investigated. Some quantitative information, such as k, P{sub max} etc. was obtained from the HFP–time curves. The results revealed that crude Radix Aconiti Lateralis and Yanfuzi had inhibitory effect on mice splenic lymphocytes growth: crude Radix Aconiti Lateralis with IC{sub 50} of 18 mg mL{sup −1} showed stronger inhibitory effect than Yanfuzi with IC{sub 50} of 32 mg mL{sup −1}. Danfupian and Baifupian promoted splenic lymphocytes growth: Baifupian with EC{sub 50} of 25 mg mL{sup −1} showed a little stronger promotion effect than Danfupian with EC{sub 50} of 28 mg mL{sup −1}. The result may be related to their toxicity and we could evaluate different bioeffects of crude Radix Aconiti Lateralis and its processed products on splenic lymphocytes growth from microcalorimetric measurement.

  8. Splenic Arterial Embolization in the Treatment of Severe Portal Hypertension Due to Pancreatic Diseases: The Primary Experience in 14 Patients

    International Nuclear Information System (INIS)

    ObjectiveThis retrospective study reports our experience using splenic arterial particle embolization and coil embolization for the treatment of sinistral portal hypertension (SPH) in patients with and without gastric bleeding.MethodsFrom August 2009 to May 2012, 14 patients with SPH due to pancreatic disease were diagnosed and treated with splenic arterial embolization. Two different embolization strategies were applied; either combined distal splenic bed particle embolization and proximal splenic artery coil embolization in the same procedure for acute hemorrhage (1-step) or interval staged distal embolization and proximal embolization in the stable patient (2-step). The patients were clinically followed.ResultsIn 14 patients, splenic arterial embolization was successful. The one-step method was performed in three patients suffering from massive gastric bleeding, and the bleeding was relieved after embolization. The two-step method was used in 11 patients, who had chronic gastric variceal bleeding or gastric varices only. The gastric varices disappeared in the enhanced CT scan and the patients had no gastric bleeding during follow-up.ConclusionsSplenic arterial embolization, particularly the two-step method, proved feasible and effective for the treatment of SPH patients with gastric varices or gastric variceal bleeding

  9. Blunt hepatic and splenic trauma in children: correlation of a CT injury severity scale with clinical outcome

    International Nuclear Information System (INIS)

    The purpose of this report is to compare a computed tomography (CT) injury severity scale for hepatic and splenic injury with the following outcome measures: requirement for surgical hemostasis, requirement for blood transfusion and late complications. Sixty-nine children with isolated hepatic injury and 53 with isolated splenic injury were prospectively classified at CT according to extent of parenchymal involvement. Clinical records were reviewed to determine clinical outcome. Ninety-seven children (80%) were managed non-operatively without transfusion. One child with hepatic injury required surgical hemostasis, and 17 (25%) required transfusion of blood. Increasing severity of hepatic injury at CT was associated with progressively greater frequency of transfusion (P = 0.002 by χ2-test). One child with splenic injury underwent surgery and eight (15%) required transfusion of blood. Splenic injury grade at CT did not correlate with frequency (P = 0.41 by χ2-test) or amount (P = 0.35 by factorial analysis of variance) of transfusion. There was one late complication in the nonsurgical group. A majority of children with hepatic and splenic injury were managed non-operatively without requiring blood transfusion. The severity of injury by CT scan did not correlate with need for surgery. Increasing grade of hepatic injury at CT was associated with increasing frequency of blood transfusion. CT staging was not discriminatory in predicting transfusion requirement in splenic injury. (orig.)

  10. Identification of Functional Human Splenic Memory B Cells by Expression of CD148 and CD27

    OpenAIRE

    Tangye, Stuart G.; Liu, Yong-Jun; Aversa, Gregorio; Phillips, Joseph H.; Vries, Jan E. de

    1998-01-01

    Memory B cells isolated from human tonsils are characterized by an activated cell surface phenotype, localization to mucosal epithelium, expression of somatically mutated immunoglobulin (Ig) variable (V) region genes, and a preferential differentiation into plasma cells in vitro. In spleens of both humans and rodents, a subset of memory B cells is believed to reside in the marginal zone of the white pulp. Similar to tonsil-derived memory B cells, splenic marginal zone B cells can be distingui...

  11. Diagnosis of a large splenic tumor in a dog: computed tomography versus magnetic resonance imaging

    OpenAIRE

    Kim, Mijin; CHOI, Sooyoung; Choi, Hojung; Lee, Youngwon; LEE, Kija

    2015-01-01

    This study demonstrated magnetic resonance imaging (MRI) and computed tomography for large-sized splenic hemangiosarcoma. Radiography and ultrasonography revealed the presence of a large-sized soft-tissue mass in the cranial abdomen. Computed tomography showed hypoattenuating mass. The mass was located in contact with liver, spleen and stomach, and the origin of the mass remained ambiguous. The mass was T2-hyperintense and T1-hypointense with mild contrast enhancement. MRI allowed a different...

  12. Ultrasonographic assessment of splenic volume and its correlation with body parameters in a Jordanian population

    OpenAIRE

    Badran, Darwish H.; Kalbouneh, Heba M.; Al-Hadidi, Maher T.; Shatarat, Amjad T.; Emad S Tarawneh; Hadidy, Azmy M.; Mahafza, Waleed S.

    2015-01-01

    Objectives: To estimate normal linear dimensions and volume of spleen in Jordanians using ultrasonography, and to correlate splenic volume with age and body parameters: height, weight, body surface area (BSA), and body mass index (BMI). Methods: A prospective pilot study was conducted on 205 volunteers (115 males and 90 females) not known to have any conditions likely to be associated with splenomegaly. The study was performed at the Radiology Department, Jordanian University Hospital, Amman,...

  13. Systemic Mastocytosis Associated with Splenic Marginal Zone Lymphoma with Villous Lymphocytes

    OpenAIRE

    R. Fernández-Torres; Verea, M. M.; A. Álvarez; P. TORRES; Fonseca, E

    2011-01-01

    The development of a second haematological disease during the course of systemic mastocytosis is a well-known phenomenon. In most of the cases, they consist of myelodysplasia or myeloproliferative disorders. The association with lymphoproliferative disorders has also been described, but it is uncommon and the relationship is not well established. We report a patient diagnosed with systemic mastocytosis who three years later developed a splenic marginal zone lymphoma with villous lymphocytes.

  14. Endoscopic management of splenic pseudocysts associated with acute and chronic pancreatitis

    OpenAIRE

    Rana, Surinder Singh; Sharma, Ravi; Chhabra, Puneet; Sharma, Vishal; Gupta, Rajesh; Bhasin, Deepak Kumar

    2016-01-01

    Background Splenic pseudocysts (SP) are a rare consequence of both acute and chronic pancreatitis. Surgery has been conventional treatment for SP and literature on role of endoscopic treatment is scant. In this study, we retrospectively evaluated SP clinical and radiological characteristics as well as the outcome following endoscopic drainage. Methods Retrospective analysis of SP patients seen at our unit from January 2002 to June 2015. All patients were treated with attempted endoscopic tran...

  15. A rare ultrasound presentation of splenic lesion in a patient with disseminated Penicillium marneffei infection

    International Nuclear Information System (INIS)

    Focal hypoechoic lesions in the spleen often represent malignant disease in patients with acquired immune deficiency syndrome (AIDS). However, some infection can produce similar images. The abdominal ultrasound imaging about disseminated Penicillium marneffei (P. marneffei) infection has been rarely described in the medical literature. This case report presents a 47-year-old Chinese man with newly diagnosed AIDS who was infected by P. marneffei. An isolated splenic lesion was detected by ultrasound scan before, and assessed following, diagnostic treatment.

  16. Medial Pancreatectomy for a Neuroendocrine Tumor Invading the Splenic Artery and Vein

    Directory of Open Access Journals (Sweden)

    Abdelmounaim Ait-Ali

    2010-01-01

    Full Text Available Context Pancreatic tumors in the midportion have traditionally been treated by an extended right or left pancreatectomy. A medial or central pancreatectomy is an alternative technique for benign or low-grade malignant neoplasms located to the left of the gastroduodenal artery and close to the splenomesenteric confluence. Case report A 38-year-old woman with no previous surgical history presented with epigastric abdominal pain. A computed tomography scan showed a 4 cm heterogeneous lesion within the pancreatic body. This tumor invaded the splenic artery and vein. There was no postoperative diabetes mellitus or exocrine insufficiency. The patient continues to be well after a 10-month follow-up without pancreatic insufficiency or local recurrence, and CT has demonstrated splenic perfusion by the collateral vessels. Conclusion We believe that a medial or central pancreatectomy may be a safe procedure where there is involvement of the large splenic vessels by a low grade malignant pancreatic tumor and that a systematic splenectomy is not justified.

  17. Endogenous vagal activation dampens intestinal inflammation independently of splenic innervation in postoperative ileus.

    Science.gov (United States)

    Costes, L M M; van der Vliet, J; van Bree, S H W; Boeckxstaens, G E; Cailotto, C

    2014-10-01

    Postoperative ileus is encountered by patients undergoing open abdominal surgery and is characterized by intestinal inflammation associated with impaired gastrointestinal motility. We recently showed that inflammation of the gut muscularis triggered activation of the vagal efferent pathway mainly targeting the inflamed zone. In the present study we investigate further the modulatory role of endogenous activation of the vagal motor pathway on the innate immune response. Intestinal or splenic denervation was performed two weeks prior to intestinal manipulation (IM) or laparotomy (L). Twenty-four hour post-surgery, the gastrointestinal transit, immune cell influx, and pro-inflammatory cytokine levels were measured in the gut muscularis. Manipulation of the small intestine led to a delay in intestinal transit, an influx of leukocytes and increased pro-inflammatory cytokine expression. Surgical lesion of the vagal branch that selectively innervates the small intestine did not further delay the intestinal transit but significantly enhanced the expression levels of the pro-inflammatory cytokines IL-1β and IL-6 in the gut muscularis. Splenic denervation did not affect intestinal inflammation or gastrointestinal transit after intestinal manipulation. Our study demonstrates that selective vagotomy, leaving the splenic innervation intact, increases surgery-induced intestinal inflammation. These data suggest that endogenous activation of the vagal efferent pathway by intestinal inflammation directly dampens the local immune response triggered by intestinal manipulation independently of the spleen. PMID:25103359

  18. Neural innervation stimulates splenic TFF2 to arrest myeloid cell expansion and cancer.

    Science.gov (United States)

    Dubeykovskaya, Zina; Si, Yiling; Chen, Xiaowei; Worthley, Daniel L; Renz, Bernhard W; Urbanska, Aleksandra M; Hayakawa, Yoku; Xu, Ting; Westphalen, C Benedikt; Dubeykovskiy, Alexander; Chen, Duan; Friedman, Richard A; Asfaha, Samuel; Nagar, Karan; Tailor, Yagnesh; Muthupalani, Sureshkumar; Fox, James G; Kitajewski, Jan; Wang, Timothy C

    2016-01-01

    CD11b(+)Gr-1(+) myeloid-derived suppressor cells (MDSCs) expand in the spleen during cancer and promote progression through suppression of cytotoxic T cells. An anti-inflammatory reflex arc involving the vagus nerve and memory T cells is necessary for resolution of acute inflammation. Failure of this neural circuit could promote procarcinogenic inflammation and altered tumour immunity. Here we show that splenic TFF2, a secreted anti-inflammatory peptide, is released by vagally modulated memory T cells to suppress the expansion of MDSCs through CXCR4. Splenic denervation interrupts the anti-inflammatory neural arc, resulting in the expansion of MDSCs and colorectal cancer. Deletion of Tff2 recapitulates splenic denervation to promote carcinogenesis. Colorectal carcinogenesis could be suppressed through transgenic overexpression of TFF2, adenoviral transfer of TFF2 or transplantation of TFF2-expressing bone marrow. TFF2 is important to the anti-inflammatory reflex arc and plays an essential role in arresting MDSC proliferation. TFF2 offers a potential approach to prevent and to treat cancer. PMID:26841680

  19. A novel method for the angiographic estimation of the percentage of spleen volume embolized during partial splenic embolization

    International Nuclear Information System (INIS)

    Purpose: To evaluate the efficacy of estimating the volume of spleen embolized in partial splenic embolization (PSE) by measuring the diameters of the splenic artery and its branches. Materials and methods: A total of 43 liver cirrhosis patients (mean age, 62.19 ± 9.65 years) with thrombocytopenia were included. Among these, 24 patients underwent a follow-up CT scan which showed a correlation between angiographic estimation and measured embolized splenic volume. Estimated splenic embolization volume was calculated by a method based on diameters of the splenic artery and its branches. The diameters of each of the splenic arteries and branches were measured via 2D angiographic images. Embolization was performed with gelatin sponges. Patients underwent follow-up with serial measurement of blood counts and liver function tests. The actual volume of embolized spleen was determined by computed tomography (CT) measuring the volumes of embolized and non-embolized spleen two months after PSE. Results: PSE was performed without immediate major complications. The mean WBC count significantly increased from 3.81 ± 1.69 × 103/mm3 before PSE to 8.56 ± 3.14 × 103/mm3 at 1 week after PSE (P < 0.001). Mean platelet count significantly increased from 62.00 ± 22.62 × 103/mm3 before PSE to 95.40 ± 46.29 × 103/mm3 1 week after PSE (P < 0.001). The measured embolization ratio was positively correlated with estimated embolization ratio (Spearman's rho [ρ] = 0.687, P < 0.001). The mean difference between the actual embolization ratio and the estimated embolization ratio was 16.16 ± 8.96%. Conclusions: The method provides a simple method to quantitatively estimate embolized splenic volume with a correlation of measured embolization ratio to estimated embolization ratio of Spearman's ρ = 0.687

  20. Resolvin D1 activates the inflammation resolving response at splenic and ventricular site following myocardial infarction leading to improved ventricular function.

    Science.gov (United States)

    Kain, Vasundhara; Ingle, Kevin A; Colas, Romain A; Dalli, Jesmond; Prabhu, Sumanth D; Serhan, Charles N; Joshi, Medha; Halade, Ganesh V

    2015-07-01

    Unresolved inflammation is a major contributor to the development of heart failure following myocardial infarction (MI). Pro-resolving lipid mediators, such as resolvins (e.g. RvD1), are biosynthesized endogenously. The role of RvD1 in resolving post-MI inflammation has not been elucidated due to its unstable nature. Here, we have tested the role for two forms of RvD1, after incorporation into liposomes (Lipo-RvD1) and its free acid form (RvD1) in the left ventricle (LV) and splenic remodeling post-MI. 8 to 12-week old male, C57BL/6J-mice were subjected to coronary artery ligation and Lipo-RvD1 or RvD1 (3 μg/kg/day) was injected 3h post-MI for day (d)1 or until d5. No-MI mice and saline-injected MI mice served as controls. RvD1 injected groups showed improved fractional shortening post-MI; preserving transient changes in the splenic reservoir compared to MI-saline. RvD1-groups showed an early exit of neutrophils from LV and spleen at d5 post-MI with an increased expression of lipoxin A4 receptor (ALX; synonym formyl peptide receptor; FPR2) compared to the MI-saline group. The levels of pro-resolving mediators RvD1, RvD2, Maresin 1 (MaR1) and Lipoxin A4 (LXA4) were increased in spleens from RvD1 injected mice at d5 post-MI. RvD1 administration reduced macrophage density, ccr5 and cxcl5 levels at d5 post-MI compared to saline injected mice (both, p macrophage-mediated clearance of necrotic cells in RvD1-groups. RvD1 reduced the pro-fibrotic genes (colla1, coll2a1 and tnc (all; p < 0.05)) and decreased collagen deposition, thereby reducing post-MI fibrosis and thus stabilizing the extracellular matrix. In summary, RvD1 and Lipo-RvD1 promote the resolution of acute inflammation initiated by MI, thereby delaying the onset of heart failure. PMID:25870158

  1. Scintigraphic follow-up of the effects of therapy with hydroxyurea on splenic function in patients with sickle cell disease

    International Nuclear Information System (INIS)

    Patients with sickle cell disease (SCD) may develop functional asplenia as a chronic complication, secondary to repeated episodes of polymerisation of haemoglobin S. It is known that increased plasma concentrations of fetal haemoglobin (HbF) reduce the polymerisation of haemoglobin S. Hydroxyurea is a chemotherapeutic agent capable of increasing HbF levels in the red blood cells and its use has recently been proposed in the treatment of SCD. The objective of this study was to evaluate the effects of long-term therapy with hydroxyurea on recovery of splenic function. Twenty-one patients (aged 3-22 years; 14 with SS haemoglobinopathy, 7 with Sβ0 haemoglobinopathy) were studied with liver/spleen scintigraphy before and after 6 and 12 months of treatment. All studies were submitted to visual inspection and semi-quantitative analyses using spleen/liver ratios. Imaging prior to treatment demonstrated functional asplenia in nine SS patients and one Sβ0 patient and impaired splenic function in five SS patients and six Sβ0 patients. After treatment, splenic function improved in ten patients, remained unchanged in eight and worsened in three. Using liver/spleen imaging, it was possible to demonstrate that hydroxyurea is capable of improving splenic function in some SCD patients. Improvement is not always possible and frequently does not lead to a normal splenic function even after 1 year of treatment. (orig.)

  2. Scintigraphic follow-up of the effects of therapy with hydroxyurea on splenic function in patients with sickle cell disease

    Energy Technology Data Exchange (ETDEWEB)

    Santos, Allan [Division of Nuclear Medicine, Department of Radiology, Campinas State University (UNICAMP), Campinas (Brazil); Servico de Medicina Nuclear, Hospital das Clinicas da UNICAMP, Campina (Brazil); Pinheiro, Vitoria; Anjos, Ana Claudia; Brandalise, Silvia [Centro Infantil Domingos A. Boldrini, Campinas (Brazil); Fahel, Fernanda; Lima, Mariana; Etchebehere, Elba; Ramos, Celso; Camargo, Edwaldo E. [Division of Nuclear Medicine, Department of Radiology, Campinas State University (UNICAMP), Campinas (Brazil)

    2002-04-01

    Patients with sickle cell disease (SCD) may develop functional asplenia as a chronic complication, secondary to repeated episodes of polymerisation of haemoglobin S. It is known that increased plasma concentrations of fetal haemoglobin (HbF) reduce the polymerisation of haemoglobin S. Hydroxyurea is a chemotherapeutic agent capable of increasing HbF levels in the red blood cells and its use has recently been proposed in the treatment of SCD. The objective of this study was to evaluate the effects of long-term therapy with hydroxyurea on recovery of splenic function. Twenty-one patients (aged 3-22 years; 14 with SS haemoglobinopathy, 7 with S{beta}{sup 0} haemoglobinopathy) were studied with liver/spleen scintigraphy before and after 6 and 12 months of treatment. All studies were submitted to visual inspection and semi-quantitative analyses using spleen/liver ratios. Imaging prior to treatment demonstrated functional asplenia in nine SS patients and one S{beta}{sup 0} patient and impaired splenic function in five SS patients and six S{beta}{sup 0} patients. After treatment, splenic function improved in ten patients, remained unchanged in eight and worsened in three. Using liver/spleen imaging, it was possible to demonstrate that hydroxyurea is capable of improving splenic function in some SCD patients. Improvement is not always possible and frequently does not lead to a normal splenic function even after 1 year of treatment. (orig.)

  3. Splenic arteriovenous fistula and sudden onset of portal hypertension as complications of a ruptured splenic artery aneurysm: Successful treatment with transcatheter arterial embolization. A case study and review of the literature

    Institute of Scientific and Technical Information of China (English)

    Dimitrios Siablis; Zafiria G Papathanassiou; Dimitrios Karnabatidis; Nikolaos Christeas; Konstantinos Katsanos; Constantine Vagianos

    2006-01-01

    Splenic arteriovenous fistula (SAVF) accounts for an unusual but well-documented treatable cause of portal hypertension[1-4]. A case of a 50-year-old multiparous female who developed suddenly portal hypertension due to SAVF formation is presented. The patient suffered from repeated episodes of haematemesis and melaena during the past twelve days and thus was emergently admitted to hospital for management. Clinical and laboratory investigations established the diagnosis of portal hypertension in the absence of liver parenchymal disease. Endoscopy revealed multiple esophageal bleeding varices. Abdominal computed tomography (CT)and transfemoral celiac arteriography documented the presence of a tortuous and aneurysmatic splenic artery and premature filling of an enlarged splenic vein, findings highly suggestive of an SAVF. The aforementioned vascular abnormality was successfully treated with percutaneous transcatheter embolization. Neither recurrence nor other complications were observed.

  4. Blunt splenic trauma: Can contrast enhanced sonography be used for the screening of delayed pseudoaneurysms?

    Energy Technology Data Exchange (ETDEWEB)

    Poletti, Pierre-Alexandre, E-mail: Pierre-Alexandre.Poletti@hcuge.ch [Department of Radiology, University Hospital of Geneva, 4 Rue Gabrielle Perret-Gentil, 1211 Geneva 14 (Switzerland); Becker, Christoph D.; Arditi, Daniel; Terraz, Sylvain [Department of Radiology, University Hospital of Geneva, 4 Rue Gabrielle Perret-Gentil, 1211 Geneva 14 (Switzerland); Buchs, Nicolas [Department of Surgery, University Hospital of Geneva, 4 Rue Gabrielle Perret-Gentil, 1211 Geneva 14 (Switzerland); Shanmuganathan, Kathirkamanathan [Department of Diagnostic Radiology and Nuclear Medicine, 22 S. Greene Street, Baltimore, MD 21201 (United States); Platon, Alexandra [Department of Radiology, University Hospital of Geneva, 4 Rue Gabrielle Perret-Gentil, 1211 Geneva 14 (Switzerland)

    2013-11-01

    Purpose: To assess the value of contrast-enhanced sonography (CES) for the detection of delayed post-traumatic splenic pseudo-aneurysms, usually considered an indication for angiographic embolization. Methods: Sixty-three consecutive hemodynamically stable trauma patients in whom admission CT displayed a splenic injury of grade II or higher (AAST classification), without evidence of vascular involvement, were included in the study. CES of the spleen using a second generation contrast agent was systematically performed within 48–72 h after admission, for the detection of a pooling of contrast media suggestive of pseudoaneurysm. Within 6 h after contrast-enhanced sonography, all patients underwent an abdominal CT for control purposes. CES results were compared to CT findings, which were considered the reference standard. This study received approval from the institutional ethical board. Results: CES showed a blush of contrast consistent with a pseudoaneurysm in 6 of the 63 patients. All were confirmed at subsequent control CT. Pooling of contrast was found at CT in 2 patients in whom contrast-enhanced sonography was negative. There was no false positive CES examination for the suspicion of pseudoaneurysms. When compared to CT, the sensitivity, specificity, positive and negative predictive values of CES to suggest a pseudoaneurysms, were 75% (6/8), 100% (55/55), 100% (6/6), and 96% (55/57), respectively. Conclusion: Our data suggest that CES may be useful for the screening of delayed traumatic splenic pseudoaneurysms: if a negative CES does not absolutely rule out a pseudoaneurysm, a positive CES warrants an angiography, without need of control CT.

  5. Exercise induced pulmonary, hepatic and splenic blood volume changes in diabetic subjects

    International Nuclear Information System (INIS)

    Exercise induced blood volume changes in visceral organs were determined by scintillation gamma camera imaging in 11 normal healthy male volunteers and 15 NIDDM male diabetics without clinical signs of neuropathy. After in-vivo labelling of red cells with Technetium-99m, the data was acquired in the supine position at rest and immediately after graded upright ergometer bicycle exercise. From rest to peak exercise, pulmonary blood volume increased 19% and 75% in normal volunteers of less than and more than 40 years of age respectively. A decrease of 18% and 42% was noted in the hepatic and splenic blood volume respectively, regardless of the age, in the normal subjects. In contrast to normals, the diabetic patients showed in response to peak exercise as compared to age-matched controls. A significant difference in the drop in pulmonary blood volume 82.37% and 90% was observed between diabetics of more than and less than 7 years duration respectively. The liver and spleen of the diabetic subjects revealed a lesser decrease of 87.6% and 71.33% respectively in response to peak stress in comparison to the age matched controls. The reduction in the hepatic and splenic blood volume was equally evident in diabetics of more than or less than 50 years of age and it was statistically nonsignificant. This study demonstrates that the normal pattern of redistribution of blood volume in response to maximum exercise in diabetics is altered such that there is restricted pulmonary perfusion and diminished vasoconstriction of the hepato splenic vascular bed and the changes in the pulmonary circulation are related to the duration of the diabetics rather than the age of the patient. (author)

  6. A rare case: Spontaneous cutaneous fistula of infected splenic hydatid cyst

    Institute of Scientific and Technical Information of China (English)

    Kemal Kismet; Ali Haldun Ozcan; Mehmet Zafer Sabuncuoglu; Cem Gencay; Bulent Kilicoglu; Ceyda Turan; Mehmet Ali Akkus

    2006-01-01

    Hydatid disease is caused by the larval stage of the genus Echinococcus. Live hydatid cysts can rupture into physiologic channels, free body cavities or adjacent organs. Although hydatid disease can develop anywhere in the human body, the liver is the most frequently involved organ, followed by the lungs. Cysts of the spleen are unusual. There are only five case reports of spontaneous cutaneous fistulization of liver hydatid cysts in the literature. But there isn't any report about cutaneous fistula caused by splenic hydatid cyst. We report a first case of spontaneous cutaneous fistula of infected splenic hydatid cyst.A 43-year-old man was admitted to our Emergency Service with abdominal pain and fluid drainage from the abdominal wall. He has been suffering from a reddish swelling on the abdominal wall skin for four months.After a white membrane had been protruded out from his abdominal wall, he was admitted to our Emergency Service. On physical examination, a white membrane was seen to protrude out from the 2cm× 1cm skin defect on the left superolateral site of the umblicus. Large,complex, cystic and solid mass of 9.5 cm-diameter was located in the spleen on ultrasonographic examination.At operation, partial cystectomy and drainage was performed. After the operation, he was given a dosage of 10 mg/kg per day of albendazole, divided into three doses. He was discharged on the postoperative 10th d.It should be kept in mind that splenic hydatid cysts can cause such a rare complication.

  7. The involvement of the mitochondrial pathway in manganese-induced apoptosis of chicken splenic lymphocytes.

    Science.gov (United States)

    Zhu, Yihao; Li, Shu; Teng, Xiaohua

    2016-06-01

    The purpose of this study was to investigate the effect of excess manganese (Mn)-induced cytotoxicity on apoptosis in chicken splenic lymphocytes. Chicken splenic lymphocytes were cultured in medium in the absence and presence of manganese (II) chloride (MnCl2) (2 × 10(-4), 4 × 10(-4), 6 × 10(-4), 8 × 10(-4), 10 × 10(-4), and 12 × 10(-4) mM), in N-acetyl-l-cysteine (NAC) (1 mM), and the combination of MnCl2 and NAC for 12, 24, 36, and 48 h. Tests were performed on morphologic observation, reactive oxygen species (ROS) and malondialdehyde (MDA) content, manganese superoxide dismutase (Mn-SOD) and glutathione peroxidase (GSH-Px) activities, B-cell lymphoma-2 (Bcl-2), Bcl-2 associated X protein (Bax), p53, and calmodulin (CaM) messenger RNA (mRNA) expression, Caspase-3 mRNA and protein expression, intracellular free Ca(2+) ([Ca(2+)]i), and mitochondrial transmembrane potential (ΔΨm). Our research indicated that excess Mn induced ROS and MDA content, inhibited Mn-SOD and GSH-Px activities, induced Bax and p53 mRNA expression, inhibited Bcl-2 and CaM mRNA expression, induced Caspase-3 mRNA and protein expression, upregulated [Ca(2+)]i, inhibited ΔΨm, and induced apoptosis in a dose effect. NAC relieved excess Mn-caused the changes of all above factors. Mn-induced oxidative injuries were alleviated by treatment with NAC, an ROS scavenger. The above results demonstrated that excess Mn caused oxidative stress and apoptosis via mitochondrial pathway in chicken splenic lymphocytes. PMID:27035383

  8. Blunt splenic trauma: Can contrast enhanced sonography be used for the screening of delayed pseudoaneurysms?

    International Nuclear Information System (INIS)

    Purpose: To assess the value of contrast-enhanced sonography (CES) for the detection of delayed post-traumatic splenic pseudo-aneurysms, usually considered an indication for angiographic embolization. Methods: Sixty-three consecutive hemodynamically stable trauma patients in whom admission CT displayed a splenic injury of grade II or higher (AAST classification), without evidence of vascular involvement, were included in the study. CES of the spleen using a second generation contrast agent was systematically performed within 48–72 h after admission, for the detection of a pooling of contrast media suggestive of pseudoaneurysm. Within 6 h after contrast-enhanced sonography, all patients underwent an abdominal CT for control purposes. CES results were compared to CT findings, which were considered the reference standard. This study received approval from the institutional ethical board. Results: CES showed a blush of contrast consistent with a pseudoaneurysm in 6 of the 63 patients. All were confirmed at subsequent control CT. Pooling of contrast was found at CT in 2 patients in whom contrast-enhanced sonography was negative. There was no false positive CES examination for the suspicion of pseudoaneurysms. When compared to CT, the sensitivity, specificity, positive and negative predictive values of CES to suggest a pseudoaneurysms, were 75% (6/8), 100% (55/55), 100% (6/6), and 96% (55/57), respectively. Conclusion: Our data suggest that CES may be useful for the screening of delayed traumatic splenic pseudoaneurysms: if a negative CES does not absolutely rule out a pseudoaneurysm, a positive CES warrants an angiography, without need of control CT

  9. A Unique Cause of Intestinal and Splenic Infarction in a Sickle Cell Trait Patient

    OpenAIRE

    Asfaw, Sofya H.; Falk, Gavin A.; Gareth Morris-Stiff; Tuthill, Ralph J.; Moorman, Matthew L.; Samotowka, Michael A.

    2013-01-01

    Sickle-cell trait is a common genetic abnormality in the African American population. A sickle-cell crisis in a patient with sickle-cell trait is uncommon at best. Abdominal painful crises are typical of patients with sickle cell anemia. The treatment for an abdominal painful crisis is usually medical and rarely surgical. We present the case of a cocaine-induced sickle-cell crisis in a sickle-cell trait patient that resulted in splenic, intestinal, and cerebral infarctions and multisystem org...

  10. Basic anatomy of splenic preservation on laparoscopic corporocaudal pancreatectomy. A case report

    Directory of Open Access Journals (Sweden)

    Al Awad, Adel

    2013-03-01

    Full Text Available The removal of the spleen is a common practice in the distal pancreatic surgery which is associated with increased postoperative morbidity compared with the general population (infections, thromboembolic disease, etc.. Due to the high mortality have postsplenectomy infections, two techniques have been developed to preserve it based on their extensive vascular network mainly given by the splenic artery, a branch of the celiac axis, set in relation to the upper edge of the pancreas, by irrigating through pancreatic arteries until reach the hilum of the spleen where it ends. From there part the gastrosplenic ligament where they reach the short gastric vessels and left gastroepiploic artery to the greater curvature of stomach and gastric fundus. In normal blood flow is directed from the spleen into the stomach. The compensatory change in the direction of blood flow is the lifeblood anatomical Warshaw technique, which allows splenic preservation in distal pancreatectomy, despite its pedicle ligation. Women of 15 years old who presented since 6 months ago colicky hypogastric pain radiating to the whole abdomen, dyspepsia and gastroesophageal reflux. Screening studies are conducted and reported an imaging space-occupying lesion in pancreatic body and tail of 11.3 x 8.7 x 7.2 cm. deciding to perform laparoscopic surgery for pancreatectomy being based on the Warshaw technique, taking samples for biopsy reporting solid - cystic - pseudopapillary pancreatic. Preserving the left gastroepiploic vessels and short gastric vessels. Surgery time of 225 minutes and hospital stay of 4 days. It is clear that the resection of the spleen increases the risk of severe infections, so if possible you should try to preserve it on distal pancreatectomy, in order to reduce complications. However, the location of these tumors and in some cases, the need for a lymph node dissection, splenectomy should be considered. Among others, the Warshaw technique has proved been

  11. Intra-aortic mural thrombosis and splenic infarction in association with ulcerative colitis.

    LENUS (Irish Health Repository)

    Kok, H K

    2010-03-04

    BACKGROUND: Arterial thrombosis is a very rare, but recognised complication of inflammatory bowel disease that can result in significant morbidity and mortality. CASE PRESENTATION: We present the case of a 48-year-old female with previously well-controlled ulcerative colitis who presented with severe left upper quadrant abdominal pain. Imaging investigations subsequently revealed a large intra-aortic mural thrombus extending into the coeliac axis complicated by splenic infarction. This occurred in the absence of other prothrombotic states such as thrombophilias or vasculitis. CONCLUSION: This case highlights the frequently overlooked association between inflammatory bowel disease and arterial thrombosis.

  12. Phagocytosis of 131I labelled Salmonella typhymurium in splenic remnants. Experimental study in rats

    International Nuclear Information System (INIS)

    Forty-one male Wistar rats were divided into three groups, namely: Group I - Normal animals; Group II - Animals submitted to total splenectomy with subsequent intraperitoneal splenic autotransplantion; Group III - Animals submitted to partial 50% splenectomy with subsequent autotransplantation of the removed fragment. After 40 weeks of close observation all animals were administred 70 Micro Ci of an 131I - labelled ''Salmonella Typhymurium'' suspension. Twelve hours later all animals were sacrificed and a complete peritoneal cavity inventory was performed. Samples of both topic spleen and regenerated autotransplant were obtained, processed and autoradiographed. (M.A.C.)

  13. Operative management of splenic injury in a patient with proteus syndrome

    OpenAIRE

    Umashankkar Kannan; Biplab Mishra; Arulselvi Subramanian; Sushma Sagar; Subodh Kumar; Maneesh Singhal

    2014-01-01

    A 20-year-old female with Proteus syndrome sustained splenic injury after fall from a bike. She was initially managed non-operatively at a different hospital for three days and was then referred to our level I trauma center in view of increasing abdominal pain and distention. On admission in the Emergency Department (ED), her pulse rate was 120 per minute and blood pressure was 108/68 mm Hg. Clinical examination showed a distended abdomen with left hypochondrial pain. Ultrasonogram (USG) and ...

  14. Residual tissue post splenectomy detected by splenic scintillography with erythrocytes damaged by heat

    International Nuclear Information System (INIS)

    Feminine of 26 years old with diagnostic of purple thrombocytopenic idiopathic to those 4 years of age, tried with steroids and splenectomy at 11 years old. Pathway practically asymptomatic until 4 months ago she had presented asthenia, adynamia and general uneasiness, with platelet figures of 40,000 plat/microliter. It was carried out scintillographic study with damaged erythrocytes for post surgical remainder search. Its were took two-dimensional images and tomography by single photon emission (SPECT), being knitted splenic residual in area of anatomical projection of the spleen. (Author)

  15. Discordant sup(99m)Tc sulfur colloid and 67Ga-citrate scintigrams in Aspergillus splenic abscesses

    International Nuclear Information System (INIS)

    A 43-year old man with acute and undifferentiated leukemia developed high fever and stomatitis followed by severe abdominant pain after completion of a first course of chemotherapy. A sup(99m)Tc-sulfur colloid (SC) scan showed multiple, irregular defects in an enlarged spleen. A 67Ga-citrate scan showed uniform tracer distribution except for a large defect in the upper portion of the spleen. The size of the spleen in the 67Ga-scan was much larger than in the SC scan. At surgery an abscess cavity was found between the spleen and the greater gastric curvature with multiple smaller abscesses on the splenic capsule and throughout the splenic parenchyma. A hematoma was pesent in the upper pole of the spleen. The disparate splenic size and seemingly discordant distribution patterns of tracer in the sup(99m)Tc- and 67Ga-scans were fully explained by histopathological study of the surgically resected spleen. (orig.)

  16. Hemoptysis and hemoperitoneum due to metastatic gestational choriocarcinma: bronchial artery embolization and superselective splenic artery embolization: a case report

    Energy Technology Data Exchange (ETDEWEB)

    Shin, Tae Beom; Park, Byung Ho; Yoon, Seong Kuk; Kim, Chan Sung; Lee, Jin Hwa; Oh, Jong Young [Donga University School of Medicine, Pusan (Korea, Republic of); Seong, Chang Kyu; Kim, Yong Joo; Kim, Young Hwan [Kyungpook National University School of Medicine, Daegu (Korea, Republic of)

    2003-01-01

    Gestational choriocarcinoma is easily disseminated hematogenously and its hypervascular nature places the patient at risk of significant hemorrhage both at the sites of metastatic lesion and in the uterus. In addition, its tends to give rise to pseudoaneurysm formation. Treatment of the condition by percutaneous embolization has been reported in several published articles, and hemoperitoneum secondary to rupture of splenic metastasis of gestational choriocarcinoma has also been reported, as has angiographic embolization. Hemoptysis resulting from pulmonary metastasis and treatment by means of embolization of the bronchial artery have not been reported, however. In this article, we describe a case of hemoptysis and hemoperitoneum due to pulmonary and splenic metastasis of gestational choriocarcinoma. Treatment of the condition involved embolization of the bronchial artery and superselective embolization of the splenic artery.

  17. The unexpected finding of a splenic infarction in a patient with infectious mononucleosis due to Epstein-Barr virus.

    Science.gov (United States)

    Machado, Catarina; Melo Salgado, Joana; Monjardino, Leonor

    2015-01-01

    The authors present a case of a 24-year-old man with infectious mononucleosis (IM) due to Epstein-Barr virus (EBV). Among his symptoms, he reported abdominal pain in the upper left quadrant. An abdominal ultrasound and CT revealed an extensive splenic infarction. During the acute stage of this disease, the thrombophilic screening revealed reduced free protein S and elevated factor VIII, with normalisation on re-evaluation 6 weeks later. Splenic infarction is a very rare complication of IM due to EBV but should be considered in patients presenting abdominal pain. A hypercoagulability state should be investigated. To our knowledge, this is the first described case of a splenic infarction in a patient with IM due to EBV associated with a transient reduction of protein S and elevation of factor VIII. Thus, this work promotes the importance of including these factors in the thrombophilic screening conducted during the investigation of similar cases. PMID:26607191

  18. Outcome and prognostic factors for dogs with a histological diagnosis of splenic hematoma following splenectomy: 35 cases (2001-2013).

    Science.gov (United States)

    Patten, Steve G; Boston, Sarah E; Monteith, Gabrielle J

    2016-08-01

    Canine splenic hematoma can be indistinguishable from hemangiosarcoma on clinical presentation and grossly at the time of surgery. However, hemangiosarcoma represents an aggressive malignancy and a misdiagnosis of hematoma would forgo indications for chemotherapy. This study describes a long-term follow-up of cases with a histologic diagnosis of splenic hematoma following splenectomy to determine if the clinical course of the disease corroborated the diagnosis. Thirty-five dogs were evaluated to determine survival and prognostic associations with signalment and clinical data. Overall median survival time was 647 days (range: 0 to 3287 days). Statistically significant variables included a palpable abdominal mass during physical examination, sub-clinical coagulopathy, and metastasis. Four cases (11%) had reported evidence of metastasis at the time of euthanasia; 1 case was histologically confirmed. Overall prognosis for splenic hematoma appears excellent, as expected, but a small proportion of cases may have an undiagnosed malignant component. PMID:27493283

  19. Spontaneous rupture of a splenic hydatid cyst with anaphylaxis in a patient with multi-organ hydatid disease.

    Science.gov (United States)

    Constantin, V; Popa, F; Socea, B; Carâp, A; Bălălău, C; Motofei, I; Banu, P; Costea, D

    2014-01-01

    Hidatid cysts of the spleen are a rare occurrence, the spleen being the third most common organ for the development of Echinococcus Granulosus. Splenic hydatid cysts are commonly part of multi-organ hydatid disease. Diagnosis is often established when investigating a splenomegaly or by chance during an unrelated consult. It can also be diagnosed after rupture, be it following trauma (the most common occurrence)or spontaneous. Splenic hydatid cyst rupture requires immediate action and is a life-threatening condition. It results, most often, in splenectomy. We present the case of a patient with multi-organ hydatid disease that presented with a ruptured splenic cyst and developed anaphylaxis. The case was resolved by splenectomy and recovered well. PMID:24956347

  20. Splenic and hepatic ultrasound and cytology in canine lymphoma: effects of findings on stage migration and assessment of prognosis.

    Science.gov (United States)

    Nerschbach, V; Eberle, N; Joetzke, A E; Hoeinghaus, R; Hungerbuehler, S; Mischke, R; Nolte, I; Betz, D

    2014-12-01

    Stage migration is described in humans and dogs as a sequel of using more sensitive diagnostic methods. One hundred eighty-six dogs with multicentric lymphoma were enrolled with results of conventional staging as well as ultrasonographic and cytological examination of liver and spleen being available. The addition of splenic respective hepatic ultrasound and cytology findings resulted in slightly lower number of dogs classified as having liver and spleen involvement. In dogs with multicentric lymphoma, addition of cytology led to a significant shift of individuals from stage IV to stage III. Findings of hepatic and splenic ultrasound and cytology exerted no significant influence on complete remission and survival durations in dogs with combination chemotherapy. Staging methodology in canine lymphoma should be redefined, considering that the prognostic significance of splenic and hepatic ultrasound and cytology warrants further investigation. PMID:25470748

  1. ”Vascular Lock” Causing Splenic Perfusion Defects During Irreversible Electroporation of a Locally Advanced Pancreatic Tumor

    Directory of Open Access Journals (Sweden)

    Anna Maria Ierardi

    2014-11-01

    Full Text Available Context There is little reported experience of irreversible electroporation (IRE of locally advanced pancreatic tumors (LAP. In literature, few data reported complications. In particular vascular vasoconstriction miming splenic infarcts in humans has never been found. Case report This report describes the onset of asymptomatic multiple little splenic perfusion defects after the treatment of a LAP localized in the boby tail portion of the pancreas with the application of five percutaneous probes for IRE, in a 79 year-old man. Splenic artery was regularly patent but entirely trapped in the tumor. Conclusion To the best of our knowledge, until now, no experience concerning percutaneous IRE of pancreatic cancer described that phenomenon. The cause could not be established with certainty and “vascular lock" may be a valid hypothesis. Additional studies are necessary to evaluate its frequency and its exact pathophysiological cause in humans.

  2. Clinical significance of No. 10 and 11 lymph nodes posterior to the splenic vessel in D2 radical total gastrectomy

    Science.gov (United States)

    Wang, Wei; Xiong, Wenjun; Liu, Zhiwei; Luo, Lijie; Zheng, Yansheng; Tan, Ping; Diao, Dechang; Zou, Liaonan; Wan, Jin

    2016-01-01

    Abstract D2 lymphadenectomy is widely performed for advanced proximal gastric cancer, but complete dissection of No. 10 and 11 lymph nodes (LNs) is technically challenging, especially for those posterior to the splenic vessel. This study aimed to investigate the clinical significance of removing No. 10 and 11 LNs posterior to the splenic vessel in radical total gastrectomy. Between January 2013 and February 2015, 53 patients who underwent spleen-preserving D2 radical total gastrectomy were enrolled. While dissecting No. 10 and 11 LNs, we divided them into 2 parts, namely LNs anterosuperior and posterior to the splenic vessel, and the pathological data were reviewed. Sixteen patients underwent laparoscopy and 37 underwent laparotomy. No mortality was recorded. According to the pathological results, the TNM stages of the tumor were IIA in 11 patients (20.8%), IIB in 5 (9.4%), IIIA in 7 (13.2%), IIIB in 10 (18.9%), and IIIC in 20 (18.9%). The mean number of LNs retrieved was 30.3 ± 12.3. The sum of No. 10 and 11 LNs posterior to the splenic vessel was 59 and the mean number was 1.11 ± 1.47. One LN with metastasis was found in the special 59 regional LNs, and the metastasis rate was 1.9% (1/53). Concerning the low metastasis rate (1.9%) and difficult complete dissection of No. 10 and 11 LNs posterior to the splenic vessel, our initial analysis suggests that the rate of No. 10 and 11 LNs posterior to the splenic vessel metastasis was 1.9%, but further studies are needed to reveal its clinical significance in D2 radical total gastrectomy for advanced proximal gastric cancer. PMID:27512888

  3. Central muscarinic cholinergic activation alters interaction between splenic dendritic cell and CD4+CD25- T cells in experimental colitis.

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    Peris Munyaka

    Full Text Available BACKGROUND: The cholinergic anti-inflammatory pathway (CAP is based on vagus nerve (VN activity that regulates macrophage and dendritic cell responses in the spleen through alpha-7 nicotinic acetylcholine receptor (a7nAChR signaling. Inflammatory bowel disease (IBD patients present dysautonomia with decreased vagus nerve activity, dendritic cell and T cell over-activation. The aim of this study was to investigate whether central activation of the CAP alters the function of dendritic cells (DCs and sequential CD4+/CD25-T cell activation in the context of experimental colitis. METHODS: The dinitrobenzene sulfonic acid model of experimental colitis in C57BL/6 mice was used. Central, intracerebroventricular infusion of the M1 muscarinic acetylcholine receptor agonist McN-A-343 was used to activate CAP and vagus nerve and/or splenic nerve transection were performed. In addition, the role of α7nAChR signaling and the NF-kB pathway was studied. Serum amyloid protein (SAP-A, colonic tissue cytokines, IL-12p70 and IL-23 in isolated splenic DCs, and cytokines levels in DC-CD4+CD25-T cell co-culture were determined. RESULTS: McN-A-343 treatment reduced colonic inflammation associated with decreased pro-inflammatory Th1/Th17 colonic and splenic cytokine secretion. Splenic DCs cytokine release was modulated through α7nAChR and the NF-kB signaling pathways. Cholinergic activation resulted in decreased CD4+CD25-T cell priming. The anti-inflammatory efficacy of central cholinergic activation was abolished in mice with vagotomy or splenic neurectomy. CONCLUSIONS: Suppression of splenic immune cell activation and altered interaction between DCs and T cells are important aspects of the beneficial effect of brain activation of the CAP in experimental colitis. These findings may lead to improved therapeutic strategies in the treatment of IBD.

  4. A Correlative Study of Splenic Parasite Score and Peripheral Blood Parasite Load Estimation by Quantitative PCR in Visceral Leishmaniasis.

    Science.gov (United States)

    Sudarshan, Medhavi; Singh, Toolika; Chakravarty, Jaya; Sundar, Shyam

    2015-12-01

    Parasitological diagnosis of visceral leishmaniasis (VL) by splenic smear is highly sensitive, but it is associated with the risk of severe hemorrhage. In this study, the diagnosis of VL using quantitative PCR (qPCR) in peripheral blood was evaluated in 100 patients with VL. Blood parasitemia ranged from 5 to 93,688 leishmania parasite genomes/ml of blood and positively correlated with splenic score (P<0.0001; r2=0.58). Therefore, quantification of parasite genomes by qPCR can replace invasive procedures for diagnostic and prognostic evaluations. PMID:26400788

  5. Association between macroscopic appearance of liver lesions and liver histology in dogs with splenic hemangiosarcoma: 79 cases (2004-2009).

    Science.gov (United States)

    Clendaniel, Daphne C; Sivacolundhu, Ramesh K; Sorenmo, Karin U; Donovan, Taryn A; Turner, Avenelle; Arteaga, Theresa; Bergman, Philip J

    2014-01-01

    Medical records for 79 dogs with confirmed splenic hemangiosarcoma (HSA) following splenectomy were reviewed for information regarding either the presence or absence of macroscopic liver lesions and the histopathological characteristics of the liver. Only 29 of 58 dogs (50%) with grossly abnormal livers had HSA metastasis. No dogs with grossly normal livers had metastasis detected on liver pathology. Gross lesions in the liver such as multiple nodules, dark-colored nodules, and active bleeding nodules were highly associated with malignancy. For the dogs in this study, performing biopsy in a grossly normal liver was a low-yield procedure in dogs with splenic HSA. PMID:25001171

  6. Non-traumatic splenic rupture: Report of seven cases and review of the literature

    Institute of Scientific and Technical Information of China (English)

    Ercan Gedik; Sadullah Girgin; Mustafa Aldemir; Celalettin Keles; Mehmet Cudi Tuncer; Ayfer Aktas

    2008-01-01

    AIM:To evaluate seven patients with non-traumatic splenic rupture (NSR).NSR is an uncommon dramatic abdominal emergency that requires immediate diagnosis and prompt surgical treatment to ensure the patient's survival.METHODS:Within 11 years,seven cases were evaluated for patient characteristics,anamnesis and symptoms,method of diagnosis,findings of laparotomy,and etiology of NSR.RESULTS:There were six (86%) male and one female (14%) patient,whose mean age was 36±12.8 (17-56)years.We report here four cases of Plasmodium vivax malaria (cases Ⅰ-Ⅳ),one case of hemodialysis (case V),one case of spontaneous splenic rupture (case Ⅵ),and one case of hairy cell leukemia (case Ⅶ).Splenectomy was performed in all patients.All of them made an uneventful recovery and were discharged in stable condition.CONCLUSION:NSR is a rare entity that needs a high index of suspicion for diagnosis.Using ultrasonography or computer tomography,and peritoneal aspiration of fresh blood may assist in the diagnosis of NSR.Increased awareness of NSR can enhance early diagnosis and effective treatment.

  7. Clinical significance of color Doppler ultrasound in detection of hepatic cirrhosis and splenic venous hemodynamics

    Institute of Scientific and Technical Information of China (English)

    Jian-Xia Liu

    2016-01-01

    Objective:To investigate the clinical significance of color Doppler ultrasound in the diagnosis of liver cirrhosis patients with portal and splenic venous hemodynamics.Methods:Select from August 2014 to August 2015 60 cases of liver cirrhosis in our hospital were liver cirrhosis, according to the standard of grading of liver function in Child-Pauh points A, B, C grade and healthy people as healthy group comparative study, the use of color Doppler ultrasound in portal vein diameter (DPV), blood flow velocity (VPV), blood flow (QPV) and splenic vein (DSV), blood flow velocity (VSV), blood flow (QSV) were measured, and calculated DSV/DPV.Results:DPV, DSV, QPV, QSV in liver cirrhosis group were significantly higher than those in the healthy group, VSV and VPV were significantly lower than those in the healthy group (P0.05).Conclusions: Color Doppler ultrasound in portal vein hemodynamics detection has is a simple, noninvasive, repeated operation and other advantages, has an important significance in the evaluation of liver function in patients with liver cirrhosis.

  8. Stereotyped patterns of B-cell receptor in splenic marginal zone lymphoma

    KAUST Repository

    Zibellini, S.

    2010-05-29

    Antigen stimulation may be important for splenic marginal zone lymphoma pathogenesis. To address this hypothesis, the occurrence of stereotyped B-cell receptors was investigated in 133 SMZL (26 HCV+) compared with 4,414 HCDR3 sequences from public databases. Sixteen SMZL (12%) showed stereotyped BCR; 7 of 86 (8%) SMZL sequences retrieved from public databases also belonged to stereotyped HCDR3 subsets. Three categories of subsets were identified: i) SMZL-specific subsets (n=5), composed only of 12 SMZL (9 HCV- from our series); ii) Non-Hodgkin\\'s lymphoma-like subsets (n=5), comprising 5 SMZL (4 from our series) clustering with other indolent lymphomas; iii) "CLL-like subsets" (n=6), comprising 6 SMZL (3 from our series) that belonged to known CLL subsets (n=4) or clustered with public CLL sequences. Immunoglobulin 3D modeling of 3 subsets revealed similarities in antigen binding regions not limited to HCDR3. Overall, data suggest that the pathogenesis of splenic marginal zone lymphoma may involve also HCV unrelated epitopes or an antigenic trigger common to other indolent lymphomas. ©2010 Ferrata Storti Foundation.

  9. Transcriptional modulation in a leukocyte-depleted splenic cell population during prion disease.

    Science.gov (United States)

    Huzarewich, Rhiannon L C H; Medina, Sarah; Robertson, Catherine; Parchaliuk, Debra; Booth, Stephanie A

    2011-01-01

    Prion replication in the periphery precedes neuroinvasion in many experimental rodent scrapie models, and in natural sheep scrapie and chronic wasting disease (CWD) in cervids. Prions propagate in the germinal centers of secondary lymphoid organs and are strongly associated with follicular dendritic cells (FDC) and possibly circulating dendritic cells and macrophages. Given the importance of lymphoid organs in prion disease transmission and pathogenesis, gene expression studies may reveal host factors or biological pathways related to prion replication and accumulation. A procedure was developed to enrich for FDC, dendritic cells, and macrophages prior to the investigation of transcriptional alterations in murine splenic cells during prion pathogenesis. In total, 1753 transcripts exhibited fold changes greater than three (false discovery rates less than 2%) in this population isolated from spleens of prion-infected versus uninfected mice. The gene for the small leucine-rich proteoglycan decorin (DCN) was one of the genes most overexpressed in infected mice, and the splenic protein levels mirrored this in mice infected with scrapie as well as bovine spongiform encephalopathy (BSE) and variant Creutzfeldt-Jakob disease (vCJD). A number of groups of functionally related genes were also significantly decreased in infected spleens. These included genes related to iron metabolism and homeostasis, pathways that have also been implicated in prion pathogenesis in the brain. These gene expression alterations provide insights into the molecular mechanisms underlying prion disease pathogenesis and may serve as a pool of potential surrogate markers for the early detection and diagnosis of some prion diseases. PMID:22043911

  10. Clinical application of trisacryl gelatin microsphere in partial splenic embolization for secondary hypersplenism

    International Nuclear Information System (INIS)

    Objective: To evaluate partial splenic embolization (PSE) with trisacryl gelatin microsphere in treating secondary hypersplenism. Methods: Thirty patients with hypersplenism were treated with PSE. The patients were randomly divided into two groups. Trisacryl gelatin microsphere used as the embolic material was employed in study group (n = 14), while Gelfoam was employed in control group(n = 16). The occlusive area was controlled within 50% to 80%. All patients were followed up for six months. After the PSE procedure the peripheral white blood cell (WBC) count and the platelet (PLT) count were determined, and the adverse reaction was observed. Results: Six months after the treatment, both WBC and PLT counts fell to normal in 28 patients, and recurrence was seen in two patients of control group. No significant difference in clinical therapeutic results existed between two groups. However, the abdominal pain in the patients of study group was obviously mild and lasted shorter than that in the patients of control group. In performing the embolization procedure, the embolic agent trisacryl gelatin microsphere was easily to be managed. Conclusion: Used as an embolic agent in partial splenic embolization for secondary hypersplenism, trisacryl gelatin microsphere is effective and safe, moreover, it is easy to be operated with fewer postoperative side effects. (authors)

  11. Early Loss of Splenic Tfh Cells in SIV-Infected Rhesus Macaques.

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    Félicien Moukambi

    2015-12-01

    Full Text Available Follicular T helper cells (Tfh, a subset of CD4 T lymphocytes, provide crucial help to B cells in the production of antigen-specific antibodies. Although several studies have analyzed the dynamics of Tfh cells in peripheral blood and lymph nodes (LNs during Aids, none has yet addressed the impact of SIV infection on the dynamics of Tfh cells in the spleen, the primary organ of B cell activation. We show here a significant decrease in splenic Tfh cells in SIVmac251-infected rhesus macaques (RMs during the acute phase of infection, which persists thereafter. This profound loss is associated with lack of sustained expression of the Tfh-defining transcription factors, Bcl-6 and c-Maf but with higher expression of the repressors KLF2 and Foxo1. In this context of Tfh abortive differentiation and loss, we found decreased percentages of memory B cell subsets and lower titers of SIV-specific IgG. We further demonstrate a drastic remodeling of the lymphoid architecture of the spleen and LNs, which disrupts the crucial cell-cell interactions necessary to maintain memory B cells and Tfh cells. Finally, our data demonstrated the early infection of Tfh cells. Paradoxically, the frequencies of SIV DNA were higher in splenic Tfh cells of RMs progressing more slowly suggesting sanctuaries for SIV in the spleen. Our findings provide important information regarding the impact of HIV/SIV infection on Tfh cells, and provide new clues for future vaccine strategies.

  12. Current trends and controversies in the management of patients with splenic flexure tumours

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    Chan DS

    2013-03-01

    Full Text Available Aim: There exists a variation in practice in the management of tumours around the splenic flexure. We aim to determine the current opinion regarding the management of these tumours. Methods: An anonymised 10-part online questionnaire was sent to all members of the Association of Coloproctology of Great Britain and Ireland (ACPGBI. Results: The response rate was 24% (111/464 with approximately half of respondents performing laparoscopic surgery. Electively, an extended right hemicolectomy is the preferred option by 63% of respondents followed by left hemicolectomy (23% and segmental resection (14%. The upper sigmoid and rectosigmoid is the preferred site of anastomosis by 90% and 10% of respondents respectively. There were no significant differences in the type of operations performed by surgeons who practice laparoscopic or open surgery (p=0.10. A hand-sewn end-to-end anastomosis is most commonly performed (51% followed by a stapled side-to-side (36% and a stapled end-to-end (13% technique. Extended right hemicolectomy is also the preferred option in obstructing tumours. Of surgeons who perform segmental resections, 27% perform an on-table lavage and 9% perform a defunctioning stoma. Internal herniation following laparoscopic resection was only reported by a handful of surgeons. Conclusion: Opinion and practice in the management of patients with tumours around the splenic flexure are divided. Further trials are indicated to determine the best practice.

  13. Arterial steal syndrom in patients after liver transplantation: transarterial embolization of the splenic and gastroduodenal arteries

    International Nuclear Information System (INIS)

    Purpose: To evaluate transaterial embolization of splenohepatic and gastroduodenal steal syndrome in patients with impaired liver function tests after liver transplantation. Methods and Material: In a prospective study 22 patients (10 male, 12 female; mean age 49.5 years) with unexplained elevation of hepatic enzymes after liver transplantation underwent transcatheter arterial embolization of splenohepatic (n = 18) and gastroduodenal (n = 4) steal syndrome with use of Gianturco coils or microcoils. Liver and spleen parenchyma were surveyed and evaluated before and after embolization with plain helical CT, including volumetry of liver and spleen. Results: DSA examinations revealed a dilated splenic artery (n = 18) or gastroduodenal artery (n = 4) combined with a slightly decreased perfusion of the hepatic arteries, while immediately after successful embolization a normal perfusion of the hepatic arteries could be noted. Volumetric measurements before and after embolization showed no significant changes in liver parenchyma (x = + 7% ± 2), and variable changes in splenic volume of - 5% to + 28% (mean, + 11%), with initial measurements. Clinical follow-up examinations revealed a normalization of the previously elevated hepatic enzymes and a normalization of liver function tests after successful embolization. Complications were observed in 4 patients (infarction of the spleen). Conclusions: The preliminary results reveal that in liver transplant candidates with splenohepatic and gastroduodenal steal syndrome successful embolization results in an improvement of organ perfusion with normalization of function tests. (orig.)

  14. DNA methylation profiling identifies two splenic marginal zone lymphoma subgroups with different clinical and genetic features.

    Science.gov (United States)

    Arribas, Alberto J; Rinaldi, Andrea; Mensah, Afua A; Kwee, Ivo; Cascione, Luciano; Robles, Eloy F; Martinez-Climent, Jose A; Oscier, David; Arcaini, Luca; Baldini, Luca; Marasca, Roberto; Thieblemont, Catherine; Briere, Josette; Forconi, Francesco; Zamò, Alberto; Bonifacio, Massimiliano; Mollejo, Manuela; Facchetti, Fabio; Dirnhofer, Stephan; Ponzoni, Maurilio; Bhagat, Govind; Piris, Miguel A; Gaidano, Gianluca; Zucca, Emanuele; Rossi, Davide; Bertoni, Francesco

    2015-03-19

    Splenic marginal zone lymphoma is a rare lymphoma. Loss of 7q31 and somatic mutations affecting the NOTCH2 and KLF2 genes are the commonest genomic aberrations. Epigenetic changes can be pharmacologically reverted; therefore, identification of groups of patients with specific epigenomic alterations might have therapeutic relevance. Here we integrated genome-wide DNA-promoter methylation profiling with gene expression profiling, and clinical and biological variables. An unsupervised clustering analysis of a test series of 98 samples identified 2 clusters with different degrees of promoter methylation. The cluster comprising samples with higher-promoter methylation (High-M) had a poorer overall survival compared with the lower (Low-M) cluster. The prognostic relevance of the High-M phenotype was confirmed in an independent validation set of 36 patients. In the whole series, the High-M phenotype was associated with IGHV1-02 usage, mutations of NOTCH2 gene, 7q31-32 loss, and histologic transformation. In the High-M set, a number of tumor-suppressor genes were methylated and repressed. PRC2 subunit genes and several prosurvival lymphoma genes were unmethylated and overexpressed. A model based on the methylation of 3 genes (CACNB2, HTRA1, KLF4) identified a poorer-outcome patient subset. Exposure of splenic marginal zone lymphoma cell lines to a demethylating agent caused partial reversion of the High-M phenotype and inhibition of proliferation. PMID:25612624

  15. Interventional embolization with coils in the way of 'sandwich pattern' for the treatment of large splenic aneurysms: a therapeutic analysis of six cases

    International Nuclear Information System (INIS)

    Objective: To assess the feasibility and effectiveness of interventional embolization with coils in the way of 'sandwich pattern' for the treatment of large splenic aneurysms. Methods: From March 2000 to December 2008, the authors had treated six patients with large splenic aneurysms (4 females and 2 males; mean age 54 years) by means of interventional embolization with coils in the way of 'sandwich pattern'. There were 5 true splenic aneurysms, of which 2 were located at the origin of the splenic artery and 3 at the middle segment of the splenic artery. The remaining one lesion was a pseudo aneurysm that was located at the middle segment of the splenic artery. The diagnosis was confirmed by colour-Doppler ultrasonography and/or CT-angiography in all patients. Interventional embolization with coils in the way of 'sandwich pattern' was performed in all patients. Both the efferent and afferent arteries of the splenic aneurysms were embolized successively, the procedure was thus called 'sandwich pattern' way. The patients were followed up for 1 to 9 years. Based on CT angiographic manifestations, colour-Doppler ultrasound findings and clinical conditions the therapeutic results were evaluated. Results: All the six splenic aneurysms were successfully isolated by interventional embolization in 'sandwich pattern' way, with no occurrence of severe complications. One patient died from malignant bone tumor four months after the treatment. The followup CT imaging showed no signs of re-canalization of the lesions in other 5 cases, although small-sized, fan-shaped splenic infarction was seen in 2 cases. Conclusion: Interventional embolization with coils in the way of 'sandwich pattern' is a safe and effective technique for the treatment of splenic aneurysms, especially valuable when the aneurysm is a large one. (authors)

  16. Spontaneous resolution of splenic infarcts after distal splenorenal shunt in children with extra hepatic portal venous obstruction: Our experience

    Directory of Open Access Journals (Sweden)

    Arbinder Kumar

    2014-01-01

    Full Text Available Background: In cases of portal hypertension with splenic infarcts, splenectomy with proximal splenorenal shunt has been recommended. We are sharing our experience with distal splenorenal shunt in these cases contrary to the popular belief. Materials and Methods: Splenic infarcts were graded as mild, moderate and severe according to the pre-operative CT portogram. Mild, moderate and severe infarcts were defined as an infarct involving 50% area of the spleen, respectively. Mild and moderate infarcts were managed by spleen-preserving distal splenorenal shunt while those with extensive infarcts were subjected to splenectomy and proximal splenorenal shunt. Those with spleen-preserving shunts were closely followed in the post-operative period according to a uniform protocol. Clinical examination was regularly done to assess the size of the spleen and note the presence of pain, tenderness in the left intercostal space. An ultrasound Doppler was done after 7 days to assess shunt patency while CT portogram was repeated at 6 monthly intervals. Results: Fourteen cases with splenic infarcts formed the study group. Eight cases had mild infarcts, 3 had moderate infarcts and 3 had severe infarcts. Four underwent proximal splenorenal shunt, and 10 underwent warren′s shunt (8 with mild and 2 with moderate infarcts. In 9/10 (90%, spleen could eventually be retained. Spleen completely regressed in them and so did the infarct. Conclusions:Spleen-preserving distal splenorenal shunt can be considered as a viable option in the management of cases with mild and carefully selected moderate splenic infarcts.

  17. Metastatic Melanoma to the Pancreas with a Thrombus in the Splenic Vein and Superior Mesenteric Vein: A Case Report

    Energy Technology Data Exchange (ETDEWEB)

    Hong, Seong Sook; Kim, Jung Hoon; Kwon, Kui Hyang; Choi, Duek Lin; Park, Sung Tae; Kim, Yong Jae; Goo, Dong Erk; Hwang, Jung Hwa [Soonchunhyang University Hospital, Seoul (Korea, Republic of)

    2009-11-15

    Metastatic melanoma to the pancreas has been observed infrequently, and the presence of a thrombus in the splenic vein and superior mesenteric vein has rarely been seen for metastatic melanoma. We present the CT and MRI findings of a case of metastatic melanoma to the pancreas, which presented with diffuse multiple pancreatic metastatic nodules and a venous thrombus.

  18. Metastatic Melanoma to the Pancreas with a Thrombus in the Splenic Vein and Superior Mesenteric Vein: A Case Report

    International Nuclear Information System (INIS)

    Metastatic melanoma to the pancreas has been observed infrequently, and the presence of a thrombus in the splenic vein and superior mesenteric vein has rarely been seen for metastatic melanoma. We present the CT and MRI findings of a case of metastatic melanoma to the pancreas, which presented with diffuse multiple pancreatic metastatic nodules and a venous thrombus

  19. Radioprotective effect of vitamin A and selenium in mice splenic and blood lymphocytes by comet assay

    International Nuclear Information System (INIS)

    The aim of this study was to investigate the protective effects of vitamin A and/or selenium treatments prior to whole-body irradiation in mice. This was obtained the radioprotective effect of vitamin A and selenium by evaluation of DNA damage levels in mice spleen and blood after irradiation. Six-week-old ICR male mice were administrated with vitamin A(low dose : 3.0 mg/kg, high dose : 12mg/kg) and/or selenium( low dose : 0.5 mg/kg, high dose : 2.0 mg/kg) orally once a day for 6 days and then irradiated with 8.0 Gy of γ-ray. After that, the mice were sacrificed 3 days later. Spleen and blood were taken and then lymphocytes were isolated. Spleen and blood were collected aseptically and isolated the lymphocytes by Ficollhistopaque gradient centrifugation. Cells embedded in agarose are lysed, subjected briefly to an electric field, stained with a fluorescent DNA binding stain and viewed using a fluorescence microscope. The tail moment(TM) of DNA single-strand breaks in mice splenic and blood lymphocytes were evaluated by single cell gel electrophoresis assay (Comet assay). Comet assay has been applied for detection of DNA damage due to many chemicals like environmental toxic materials. The comet assay is a novel method to assess DNA single-strand breaks, alkali-labile sites in individual cells. TM values of selenium and vitamin A in splenic lymphocytes and blood lymphocytes reduced a little compared to the irradiated control group. TM values in high administration doses of vitamin A(12mg/kg) and plus selenium(2mg/kg) reduced the most compared to low administration dose group and those of all experimental groups in blood lymphocytes. From these results, it showed that vitamin A and selenium were a little radioprotective effect in mice like other antioxidants but combined effect of these chemical in splenic lymphocytes showed a little unlike blood lymphocytes

  20. Splenic Trapping of Heat-Treated Erythrocytes in Leukaemia and Allied Conditions

    International Nuclear Information System (INIS)

    In a trial to find whether or not the enlarged spleen plays a role in the production of the form of anaemia commonly encountered in leukaemias and allied conditions, 44 patients suffering from these disease states were studied using 51Cr-labelled erythrocytes heated at 50°C for 60 min. Cells altered in this manner have been shown by various workers to be selectively sequestered by the spleen. As a control, the test was performed on 24 normal subjects. In these normals, the disappearance half-time of radioactivity from the circulation (T½ amounted to 172 ± 69 min (mean ± 1 S.D.), the lowest limit being 74 min. Accordingly, patients with less than 74 min were considered to have an abnormally rapid disappearance of heat-treated erythrocytes from the circulation and consequently exaggerated splenic sequestration of these altered cells. Splenic trapping of heat-treated erythrocytes was most marked in acute leukaemia (four out of six patients). However, three had associated normoblastic hypoplasia of the sternal marrow. Corticosteroids induced a remission with reversion of both processes responsible for the anaemia in two out of the four patients. In chronic myeloid leukaemia, exaggerated splenic sequestration of altered cells was seen in four of the 15 cases examined. This condition was of extra-erythrocytic origin, since repetition of the test using normal donor heat-treated erythrocytes did not significantly alter the disappearance half-time. However, there was no correlation between the size of the spleen and its avidity for trapping the altered cells. Follow-up studies showed that therapy caused prolongation of the half-time of heat-treated erythrocytes, the effect being more apparent after corticosteroids than with X-rays or Endoxan, In Hodgkin’s disease, increased red cell trapping was observed in two out of the seven patients studied. In contrast, five cases of chronic lymphatic leukaemia, six lymphosarcoma and five reticulum cell sarcoma had normal

  1. Altered splenic uptake in the biodistribution of 99MTc-stannous fluoride colloid in rats

    International Nuclear Information System (INIS)

    Full text: Radiolabelled white cells have found extensive application in nuclear medicine practice, with use in detecting sites of infection and inflammation. In 99MTc-stannous flu- oride (SnF2) colloid labelled leucocyte scans high liver and spleen activity is visualised, limiting the potential of this technique. This is thought to be due to free or unphagocytosed 99MTc-SnF2 colloid in the preparation. Labelling white cells with 99MTc-SnF2 depends upon phagocytic engulfment of this colloid. Non-phagocy-tosed colloid may be a cause of increased splenic activity. Our aims were to assess if it were possible to reduce liver/spleen uptake of 99MTc-SnF2 colloid in a rat model, by administering unlabelled SnF2 colloid before injection of radiocolloid, in a modification of the standard British Pharmacopoeial test. The biodistribution of 99MTc-SnF2 colloid alone gave 85.4% uptake in the liver and 7.6% in the spleen. A pre-injection of 26.5μg cold SnF2 and then 99MTc-SnF2 colloid resulted in decreased spleen uptake by 43%. A higher (52μg) pre-injection dose gave a greater decrease in splenic uptake by 53%. When ex vivo opsonised 99MTc-SnF2 colloid was administered, both liver and spleen uptake was not reduced. From these results, a pre-injection of unlabelled SnF2 substantially depletes the circulating opsonin concentration, thereby decreasing the opsonisation rate of unopsonised 99MTc-SnF2 colloid. The limiting factor is likely to be the amount of opsonisation in the plasma rather than phagocytic capacity of the macrophages of liver and spleen. In conclusion these results suggest that a pre-injection of cold stannous fluoride may reduce splenic uptake in 99MTc-SnF2 colloid labelled white cell scans. Copyright (2003) The Australian and New Zealand Society of Nuclear Medicine Inc

  2. Multidetector CT findings of splenic artery aneurysm in children with chronic liver disease

    International Nuclear Information System (INIS)

    Splenic artery aneurysm (SAA) is a well-known complication of chronic liver disease and portal hypertension in adults. The incidence of SAA in children undergoing selective hepatic angiography prior to liver transplantation is reported as 4%, but there are few systematic studies. To investigate the SAAs detected by multidetector CT angiography (MDCTA) among children with chronic liver disease. A total of 124 children (71 girls, 53 boys; mean age 118 months; age range 5 days to 204 months) with chronic liver disease underwent MDCTA to display the vascular anatomy and any vascular complications during the pretransplantation period. Of these children, 23 also underwent coeliac angiography. The digital subtraction angiography (DSA) and MDCTA findings were compared. SAAs were detected in 13 children (10.4%); none was detectable by US. All patients had more than one aneurysm; ten patients had more than three. In all except one patient, the SAAs were located only in the intraparenchymal branches of the splenic artery; in one patient they were located in the intraparenchymal segment and in the distal third of the splenic artery. The mean size of the aneurysms was 6.5 mm (range 2.5-18 mm). All patients with aneurysms had splenomegaly and vascular collaterals. Nine of the children with SAAs had portal vein pathologies (two occlusions, two stenoses, five dilatations). A statistically significant difference existed with regard to the size of spleen (P < 0.05) and patient age (P < 0.05) between children with SAAs and children without SAAs. There was an increased risk of SAAs in patients with portal vein pathologies. In 19 patients without SAAs on MDCTA, no SAAs were seen on DSA. It is likely that the incidence of SAA in children with chronic liver disease will increase with improved survival of children with long-standing portal hypertension and chronic liver disease. MDCTA with multiplanar reconstruction is a noninvasive and effective means of imaging paediatric patients with

  3. A novel method for the angiographic estimation of the percentage of spleen volume embolized during partial splenic embolization

    Energy Technology Data Exchange (ETDEWEB)

    Ou, Ming-Ching; Chuang, Ming-Tsung [Department of Diagnostic Radiology, National Cheng-Kung University Hospital, No. 138 Sheng Li Road, Tainan 704, Taiwan, ROC (China); Lin, Xi-Zhang [Department of Internal Medicine, National Cheng-Kung University Hospital, No. 138 Sheng Li Road, Tainan 704, Taiwan, ROC (China); Tsai, Hong-Ming; Chen, Shu-Yuan [Department of Diagnostic Radiology, National Cheng-Kung University Hospital, No. 138 Sheng Li Road, Tainan 704, Taiwan, ROC (China); Liu, Yi-Sheng, E-mail: taicheng100704@yahoo.com.tw [Department of Diagnostic Radiology, National Cheng-Kung University Hospital, No. 138 Sheng Li Road, Tainan 704, Taiwan, ROC (China)

    2013-08-15

    Purpose: To evaluate the efficacy of estimating the volume of spleen embolized in partial splenic embolization (PSE) by measuring the diameters of the splenic artery and its branches. Materials and methods: A total of 43 liver cirrhosis patients (mean age, 62.19 ± 9.65 years) with thrombocytopenia were included. Among these, 24 patients underwent a follow-up CT scan which showed a correlation between angiographic estimation and measured embolized splenic volume. Estimated splenic embolization volume was calculated by a method based on diameters of the splenic artery and its branches. The diameters of each of the splenic arteries and branches were measured via 2D angiographic images. Embolization was performed with gelatin sponges. Patients underwent follow-up with serial measurement of blood counts and liver function tests. The actual volume of embolized spleen was determined by computed tomography (CT) measuring the volumes of embolized and non-embolized spleen two months after PSE. Results: PSE was performed without immediate major complications. The mean WBC count significantly increased from 3.81 ± 1.69 × 10{sup 3}/mm{sup 3} before PSE to 8.56 ± 3.14 × 10{sup 3}/mm{sup 3} at 1 week after PSE (P < 0.001). Mean platelet count significantly increased from 62.00 ± 22.62 × 10{sup 3}/mm{sup 3} before PSE to 95.40 ± 46.29 × 10{sup 3}/mm{sup 3} 1 week after PSE (P < 0.001). The measured embolization ratio was positively correlated with estimated embolization ratio (Spearman's rho [ρ] = 0.687, P < 0.001). The mean difference between the actual embolization ratio and the estimated embolization ratio was 16.16 ± 8.96%. Conclusions: The method provides a simple method to quantitatively estimate embolized splenic volume with a correlation of measured embolization ratio to estimated embolization ratio of Spearman's ρ = 0.687.

  4. Evaluation of the effect of partial splenic embolization on platelet values for liver cirrhosis patients with thrombocytopenia

    Institute of Scientific and Technical Information of China (English)

    Chi-Ming Lee; Ting-Kai Leung; Hung-Jung Wang; Wei-Hsing Lee; Li-Kuo Shen; Jean-Dean Liu; Chun-Chao Chang; Ya-Yen Chen

    2007-01-01

    AIM: To investigate the effect of partial splenic embolization (PSE) on platelet values in liver cirrhosis patients with thrombocytopenia and to determine the effective embolization area for platelet values improvement.METHODS: Blood parameters and liver function indicators were measured on 10 liver cirrhosis patients (6 in Child-Pugh grade A and 4 in grade B) with thrombocytopenia (platelet values < 80 × 103/μL) before embolization. Computed tomography scan was also needed in advance to acquire the splenic baseline. After 2 to 3 d, angiography and splenic embolization were performed. A second computed tomography scan was made to confirm the embolization area after 2 to 3 wk of embolization. The blood parameters of patients were also examined biweekly during the 1 year follow-up period.RESULTS: According to the computed tomography images after partial splenic embolization, we divided all patients into two groups: low (< 30%), and high (≥ 30%) embolization area groups. The platelet values were increased by 3 times compared to baseline levels after 2 wk of embolization in high embolization area group. In addition, there were significant differences in platelet values between low and high embolization area groups. GPT values decreased significantly in all patients after 2 wk of embolization. The improvement in platelet and GPT values still persisted until 1 year after PSE.In addition, 3 of 4 (75%) Child-Pugh grade B patients progressed to grade A after 2 mo of PSE. The complication rate in < 30% and ≥ 30% embolization area groups was 50% and 100%, respectively.CONCLUSION: Partial splenic embolization is an effective method to improve platelet values and GPT values in liver cirrhosis patients with thrombocytopenia and the ≥ 30% embolization area is meaningful for platelet values improvement. The relationship between the complication rate and embolization area needs further studies.

  5. Scintigraphic tracking of mesenchymal stem cells after portal, systemic intravenous and splenic administration in healthy beagle dogs.

    Science.gov (United States)

    Spriet, Mathieu; Hunt, Geraldine B; Walker, Naomi J; Borjesson, Dori L

    2015-01-01

    Mesenchymal stem cells have been proposed to treat liver disease in the dog. The objective of this study was to compare portal, systemic intravenous and splenic injections for administration of mesenchymal stem cells to target the liver in healthy beagle dogs. Four healthy beagle dogs were included in the study. Each dog received mesenchymal stem cells via all three delivery methods in randomized order, 1 week apart. Ten million fat-derived allogeneic mesenchymal stem cells labeled with Technetium-99m (99mTc)-hexamethyl-propylene amine oxime(HMPAO) were used for each injection. Right lateral, left lateral, ventral, and dorsal scintigraphic images were obtained with a gamma camera equipped with a low-energy all-purpose collimator immediately after injection and 1, 6, and 24 h later. Mesenchymal stem cells distribution was assessed subjectively using all four views. Pulmonary, hepatic, and splenic uptake was quantified from the right lateral view, at each time point. Portal injection resulted in diffuse homogeneous high uptake through the liver, whereas the systemic intravenous injection led to mesenchymal stem cell trapping in the lungs. After splenic injection, mild splenic retention and high homogeneous diffuse hepatic uptake were observed. Systemic injection of mesenchymal stem cells may not be a desirable technique for liver therapy due to pulmonary trapping. Splenic injection represents a good alternative to portal injection. Scintigraphic tracking with 99mTc-HMPAO is a valuable technique for assessing mesenchymal stem cells distribution and quantification shortly after administration. Data obtained at 24 h should be interpreted cautiously due to suboptimal labeling persistence. PMID:25582730

  6. A Case Presenting with Splenic Infarct Diagnosed as Primary Bone Marrow CD5 Positive DLBCL: A Clinicopathological Correlation.

    Science.gov (United States)

    Bansal, Anupriya; Mittal, Suchi; Dass, Jasmita; Gupta, Nitin; Agarwal, P K; Kotwal, Jyoti

    2016-06-01

    De novo CD5+ Diffuse large B cell lymphoma (DLBCL) is a rare and aggressive subtype of DLBCL. It is a distinct clinicopathologic entity with complex molecular profile and poor prognosis. A 59 year old female presented with pyrexia of unknown origin since 1 month. On examination, there was severe pallor, hepatosplenomegaly and no palpable lymphadenopathy. Complete blood count revealed bicytopenia with normal total leucocyte count. Liver and renal function tests were normal. Ultrasonography abdomen revealed splenic enlargement with two focal lesions attributed to either splenic abscess or infarcts. Patient was being managed as splenic infarct but continued to have bicytopenia. Further investigation showed elevated serum ferritin, triglycerides and LDH. With a clinical suspicion of infection and haemophagocytic lymphohistiocytosis bone marrow aspiration (BMA) and biopsy (BMBx) was done. BMA showed extensive haemophagocytosis and ~7.4 % large lymphoma-like cells. On this basis PET-CT was suggested which showed enlarged spleen with diffuse uptake. BMBx showed nodular and intrasinusoidal collection of abnormal lymphoid cells. On immunohistochemistry, these cells were positive for CD20, CD5, MUM1, BCL-2, BCL-6 and negative for CD3, CD10 and CD23. CD34 highlighted focal intrasinusoidal pattern. The complete clinicopathological profile suggested the diagnosis of de novo CD5+ DLBCL, with primary hepatosplenic pattern of involvement. CD5+ DLBCL presenting as splenic infarct is very rare. This case was unusual as the diagnosis of a primary aggressive lymphoma with haemophagocytosis was established in a patient who presented with fever and splenic infarct without lymphadenopathy. This indicates the importance of good morphological assessment of a bone marrow aspirate and biopsy to make a correct diagnosis. PMID:27408381

  7. In vitro biosynthesis of globular proteins by murine splenic lymphocytes: effect of serum components as supplement

    International Nuclear Information System (INIS)

    Studies on replacement of foetal calf serum (FCS) with precipitable protein, non precipitable protein, dialysable and non dialysable components of the FCS in media for the growth and proliferation of murine splenic rat lymphocytes have revealed that the whole serum could be completely replaced by either of the components without any appreciable deleterious effect on the mitogenic response but none of these components could offer optimum immune response. These findings establish a covalent association of whole FCS for synthesis and secretion of immunologically important pulsed proteins in terms of turnover rate and quantification by FPLC and suggest an important and yet undefined role of FCS in the process of immunoglobulin synthesis. (author). 10 refs., 2 figs., 1 tab

  8. A rare case of splenic littoral cell angioma in a child

    Directory of Open Access Journals (Sweden)

    Recep Bedir

    2014-01-01

    Full Text Available Littoral cell angioma (LCA is a rare, benign primary vascular neoplasm of the spleen. The tumor originates from the littoral cells lining the sinuses of the red pulp of the spleen. Preoperative distinction of this tumor from other benign or malign splenic lesions is difficult. Radiologically most cases present as multiple nodules. Definitive diagnosis can only be made histopathologically and immunohistochemically following splenectomy. This clinical situation can coexist with various malignancies and autoimmune disorders. Even though, it is mostly benign, since it has the potential to become malignant after splenectomy, long-term follow-up is required. We present an LCA case, which appeared as a solitary mass in the spleen of an 11-year-old girl with abdominal pain admitted to our hospital.

  9. Association of canine splenic hemangiosarcomas and hematomas with nodular lymphoid hyperplasia or siderotic nodules.

    Science.gov (United States)

    Cole, Patricia Ann

    2012-07-01

    Hemorrhagic splenic masses diagnosed as hemangioma or hemangiosarcoma were reviewed. Lymphoid hyperplasia was present in none of the hemangiosarcoma cases and in 27% of the hematoma cases. Siderotic nodules in the capsule or trabeculae were present in 25% of hemangiosarcoma cases and in 36% of hematoma cases. Hemoabdomen was noted in the clinical history of 54% of hemangiosarcoma cases and in 22% of hematoma cases. The average age (10.3 and 9.6 years, respectively), sex ratios (slightly more males), and most common breeds (Labrador Retriever, Golden Retriever, and German Shepherd Dog) were similar for the hemangiosarcoma and hematoma cases. Since lymphoid hyperplasia is much more common in cases of hematoma, the presence of this feature lends support to a diagnosis of hematoma rather than hemangiosarcoma. Signalment, history of hemoabdomen, and presence of siderotic nodules do not point to one diagnosis over the other. PMID:22621950

  10. Interference from lupus anticoagulant on von Willebrand factor measurement in splenic marginal zone lymphoma

    DEFF Research Database (Denmark)

    Vinholt, Pernille J; Nybo, Mads

    2015-01-01

    We present a case concerning a patient with splenic marginal zone lymphoma (SMZL) and isolated prolonged activated partial thromboplastin time (aPTT) caused by lupus anticoagulant. Von Willebrand factor (VWF) activity and antigen were immeasurable by latex particle immunoturbidimetric assays, and...... several coagulation factor levels were decreased. However, VWF activity and antigen were normal when analyzed by other methods. Also, coagulation factor levels were normal if an aPTT reagent with low lupus anticoagulant sensitivity or a chromogenic method was applied. Altogether, the initial findings were...... because of lupus anticoagulant interference and in fact, the patient had normal VWF activity and coagulation status. Interference of lupus anticoagulant in clot-based assays is well known but has not previously been described in VWF assays. This is furthermore the first report in which lupus anticoagulant...

  11. The role of splenic implants in spleen injuries and postoperative immunity

    Directory of Open Access Journals (Sweden)

    Jovanović Milan M.

    2004-01-01

    Full Text Available Introduction Spleen preservation by autotransplantation is indicated in cases of injuries which result with conquassation or total devascularization of this organ. Material and methods Thirty dogs, experimental group, had multiple, devascularized spleen injuries and underwent splenectomy and splenic autotransplantation. The same number of animals were treated by primary splenectomy (control group. Seventy five days later, animals from both groups were exposed to pneumococcal sepsis - by intravenous inoculation of sublethal pneumococcal doses, in order to estimate the immunity of lienal implants and compare the mortality rate between these two groups. Results Positive hemoculture, as well as logarithmic increase of diplococci in blood samples was established in all 60 animals. Higher mortality rate and significantly higher pneumococcal growth was established in control, compared to experimental group. Conclusion These results point to the important role of lienal implants in total immunity and advantage of autotransplantation compared to conventional splenectomy, in cases of most severe and nonreconstructibile spleen injuries.

  12. Isolated metachronous splenic metastasis from renal cell carcinoma after 5 years

    Science.gov (United States)

    Nunes, Thiago Franchi; Szejnfeld, Denis; Miiji, Luciana Nakao Odashiro; Goldman, Suzan Menasce

    2012-01-01

    Primary and metastatic tumours of the spleen are uncommon. The incidence of isolated metastasis from other organs is less than 1%. We report the case of a 55-year-old woman with clear cell carcinoma of the kidney, who underwent radical nephrectomy. After a 5-year follow-up period, a hypervascular nodule was detected in the spleen on MRI. Six months later, control MRI showed that its appearance had changed to a hypervascular mass with areas of central necrosis. A splenectomy was performed and histopathological examination of the spleen confirmed the presence of clear cell carcinoma with infiltration of the capsule. This is only the seventh case described in the literature of isolated splenic metastasis from clear cell carcinoma and the first such case containing MRI. PMID:23242082

  13. Massive upper gastrointestinal haemorrhage due to direct visceral erosion of splenic artery aneurysm.

    Directory of Open Access Journals (Sweden)

    Shahani R

    1994-10-01

    Full Text Available Six male patients (age group: 30-60 years with aneurysm of the splenic artery presented with massive upper gastrointestinal tract hemorrhage. Five patients presented with hematemesis and one with melena. Chronic pancreatitis was noted in all the patients, four of whom were chronic alcoholics. Endoscopy was not useful in diagnosis. Bleeding through the Ampulla of Vater was seen in the patient with melena. Angiography was diagnostic in all. Pancreatic resection including the aneurysm(2, and bipolar ligation with underrunning of the aneurysm (3 were the operative procedures. Distal pancreatectomy with pancreatogastrostomy was carried out in the patient with hemosuccus pancreaticus. If endoscopy is inconclusive, angiography and early intervention is recommended to reduce the high mortality associated with conservative management.

  14. Ferrokinetic study of splenic erythropoiesis: Relationships among clinical diagnosis, myelofibrosis, splenomegaly, and extramedullary erythropoiesis

    Energy Technology Data Exchange (ETDEWEB)

    Beguin, Y.; Fillet, G.; Bury, J.; Fairon, Y. (Univ. of Liege (Belgium))

    1989-10-01

    Splenic erythropoiesis was demonstrated by surface counting of {sup 59}Fe in 129 of 1,350 ferrokinetic studies performed over a 15 year period. These 129 studies were carried out in 108 patients, including 40 with chronic myelogenous leukemia (CML), 24 with agnogenic myeloid metaplasia (AMM), 18 with polycythemia vera (PV), six with a myelodysplastic syndrome, five with acute leukemia, three with prostate or breast carcinoma, two each with aplastic anemia or Hodgkin's disease, and one each with idiopathic thrombocythemia, multiple myeloma, chronic renal failure, or treated hypopituitarism. Splenomegaly was present in 83% of the studies and hepatomegaly in 72%. Grade II-III myelofibrosis was demonstrated in 62% of the cases. Hepatic erythropoiesis was present in 77% of the studies (only 38% in PV), and marrow erythropoiesis was undetectable in 33%. Total erythropoiesis was about twice normal (range 0.2 to 8 times normal) but was ineffective to varying degrees in 86% of the studies. Relationships between organomegaly, myelofibrosis, and extramedullary erythropoiesis, as well as differences among clinical disorders, are discussed. Differences observed between CML in chronic or blastic phase suggested that the erythroid cell line was involved in the proliferative process. It is concluded that splenic erythropoiesis (1) is encountered in a variety of clinical conditions; (2) is not necessarily associated with splenomegaly or myelofibrosis, even in the myeloproliferative disorders; (3) is part of a predominantly extramedullary (in the liver as well as in the spleen), expanded, and largely inefficient total erythropoiesis; and (4) can be evaluated in a semiquantitative manner by surface counting.

  15. Partial splenic embolization using polyvinyl alcohol particles for hypersplenism in cirrhosis: A prospective randomized study

    Energy Technology Data Exchange (ETDEWEB)

    Zhu Kangshun [Department of Radiology, Third Affiliated Hospital, Sun Yat-sen University, 600 Tianhe Road, Guangzhou, Guangdong Province 510630 (China)], E-mail: zhksh010@163.com; Meng Xiaochun [Department of Radiology, Third Affiliated Hospital, Sun Yat-sen University, 600 Tianhe Road, Guangzhou, Guangdong Province 510630 (China)], E-mail: mengxiaochun1972@163.com; Li Zhengran [Department of Radiology, Third Affiliated Hospital, Sun Yat-sen University, 600 Tianhe Road, Guangzhou, Guangdong Province 510630 (China)], E-mail: andyreede@21cn.com; Huang Mingsheng [Department of Radiology, Third Affiliated Hospital, Sun Yat-sen University, 600 Tianhe Road, Guangzhou, Guangdong Province 510630 (China)], E-mail: laom502@tom.com; Guan Shouhai [Department of Radiology, Third Affiliated Hospital, Sun Yat-sen University, 600 Tianhe Road, Guangzhou, Guangdong Province 510630 (China)], E-mail: guanshouhai@163.com; Jiang Zaibo [Department of Radiology, Third Affiliated Hospital, Sun Yat-sen University, 600 Tianhe Road, Guangzhou, Guangdong Province 510630 (China)], E-mail: jiangzaibo@yahoo.com.cn; Shan Hong [Department of Radiology, Third Affiliated Hospital, Sun Yat-sen University, 600 Tianhe Road, Guangzhou, Guangdong Province 510630 (China)], E-mail: gzshsums@public.guangzhou.gd.cn

    2008-04-15

    Purpose: To prospectively evaluate the efficacy and safety of partial splenic embolization (PSE) using polyvinyl alcohol (PVA) particles for hypersplenism in cirrhosis, as compared to PSE using gelfoam particles. Materials and methods: PSE was performed in 60 consecutive patients with hypersplenism caused by cirrhosis. The patients were randomly assigned into 2 groups: gelfoam group, 32 patients received PSE using gelfoam particles as the embolic material; PVA group, 28 patients received PSE using PVA particles. The follow-up contents included peripheral blood cell counts (leukocyte, platelet and red blood cell) and complications associated with PSE. Results: Prior to PSE, there was no significant difference between the two groups in sex, age, Child-Pugh grade, the extent of embolization and peripheral blood cell counts. After PSE, no matter in which group, leukocyte and platelet counts kept significantly higher than pre-PSE during the 3-year follow-up period (P < .0001), but the post-PSE improvement of leukocyte and platelet counts was significantly better in PVA group than in gelfoam group (P < .05). Red blood cell counts showed no remarkable changes after PSE (P > .05). Severe complications occurred in 8 patients (25.0%) in gelfoam group and 6 patients (21.4%) in PVA group (P > .05), but the degree of abdominal pain was higher in the latter than in the former (P < .05). Among 17 patients who received more than 70% embolization of spleen, 10 (58.8%) developed severe complications, while among 43 patients who received 70% or less embolization of spleen, only four (9.3%) had severe complications. This difference was statistically significant (P < .05). Conclusion: PVA particles could be used as the embolic material in PSE; in comparison with PSE using gelfoam particles, PSE using PVA particles can achieve even better efficacy in alleviating hypersplenism, but the extent of embolization should be strictly limited to not more than 70% of splenic volume.

  16. Spontaneous splenic rupture and Anisakis appendicitis presenting as abdominal pain: a case report

    Directory of Open Access Journals (Sweden)

    Valle Joaquín

    2012-04-01

    Full Text Available Abstract Introduction Anisakidosis, human infection with nematodes of the family Anisakidae, is caused most commonly by Anisakis simplex. Acquired by the consumption of raw or undercooked marine fish or squid, anisakidosis occurs where such dietary customs are practiced, including Japan, the coastal regions of Europe and the United States. Rupture of the spleen is a relatively common complication of trauma and many systemic disorders affecting the reticuloendothelial system, including infections and neoplasias. A rare subtype of rupture occurring spontaneously and arising from a normal spleen has been recognized as a distinct clinicopathologic entity. Herein we discuss the case of a woman who presented to our institution with appendicitis secondary to Anisakis and spontaneous spleen rupture. Case presentation We report the case of a 53-year-old Caucasian woman who presented with hemorrhagic shock and abdominal pain and was subsequently found to have spontaneous spleen rupture and appendicitis secondary to Anisakis simplex. She underwent open surgical resection of the splenic rupture and the appendicitis without any significant postoperative complications. Histopathologic examination revealed appendicitis secondary to Anisakis simplex and splenic rupture of undetermined etiology. Conclusions To the best of our knowledge, this report is the first of a woman with the diagnosis of spontaneous spleen rupture and appendicitis secondary to Anisakis simplex. Digestive anisakiasis may present as an acute abdomen. Emergency physicians should know and consider this diagnosis in patients with ileitis or colitis, especially if an antecedent of raw or undercooked fish ingestion is present. Spontaneous rupture of the spleen is an extremely rare event. Increased awareness of this condition will enhance early diagnosis and effective treatment. Further research is required to identify the possible risk factors associated with spontaneous rupture of the spleen.

  17. In Vivo MRI Assessment of Hepatic and Splenic Disease in a Murine Model of Schistosomiasis [corrected].

    Directory of Open Access Journals (Sweden)

    Brice Masi

    2015-09-01

    Full Text Available Schistosomiasis (or bilharzia, a major parasitic disease, affects more than 260 million people worldwide. In chronic cases of intestinal schistosomiasis caused by trematodes of the Schistosoma genus, hepatic fibrosis develops as a host immune response to the helminth eggs, followed by potentially lethal portal hypertension. In this study, we characterized hepatic and splenic features of a murine model of intestinal schistosomiasis using in vivo magnetic resonance imaging (MRI and evaluated the transverse relaxation time T2 as a non-invasive imaging biomarker for monitoring hepatic fibrogenesis.CBA/J mice were imaged at 11.75 T two, six and ten weeks after percutaneous infection with Schistosoma mansoni. In vivo imaging studies were completed with histology at the last two time points. Anatomical MRI allowed detection of typical manifestations of the intestinal disease such as significant hepato- and splenomegaly, and dilation of the portal vein as early as six weeks, with further aggravation at 10 weeks after infection. Liver multifocal lesions observed by MRI in infected animals at 10 weeks post infection corresponded to granulomatous inflammation and intergranulomatous fibrosis with METAVIR scores up to A2F2. While most healthy hepatic tissue showed T2 values below 14 ms, these lesions were characterized by a T2 greater than 16 ms. The area fraction of increased T2 correlated (rS = 0.83 with the area fraction of Sirius Red stained collagen in histological sections. A continuous liver T2* decrease was also measured while brown pigments in macrophages were detected at histology. These findings suggest accumulation of hematin in infected livers.Our multiparametric MRI approach confirms that this murine model replicates hepatic and splenic manifestations of human intestinal schistosomiasis. Quantitative T2 mapping proved sensitive to assess liver fibrogenesis non-invasively and may therefore constitute an objective imaging biomarker for treatment

  18. Splenectomy with chemotherapy vs surgery alone as initial treatment for splenic marginal zone lymphoma

    Institute of Scientific and Technical Information of China (English)

    Rajko Milosevic; Milena Todorovic; Bela Balint; Miodrag Jevtic; Miodrag Krstic; Elizabeta Ristanovic; Nebojsa Antonijevic; Mirjana Pavlovic; Maja Perunicic; Milan Petrovic; Biljana Mihaljevic

    2009-01-01

    AIM:To evaluate the clinical characteristics of splenic marginal-zone lymphoma (SMZL) following antigen expression and the influence of therapeutic approaches on clinical outcome and overall survival (OS).METHODS:A total of 30 patients with typical histological and immunohistochemical SMZL patterns were examined.Splenectomy plus chemotherapy was applied in 20 patients,while splenectomy as a single treatment-option was performed in 10 patients.Prognostic factor and overall survival rate were analyzed.RESULTS:Complete remission (CR) was achieved in 20 (66.7%),partial remission (PR) in seven (23.3%),and lethal outcome due to disease progression occurred in three (10.0%) patients.Median survival of patients with a splenectomy was 93.0 mo and for patients with splenectomy plus chemotherapy it was 107.5 mo (Log rank=0.056,P>0.05).Time from onset of first symptoms to the beginning of the treatment (mean 9.4 mo) was influenced by spleen dimensions,as measured by computerized tomography and ultra-sound (t=2.558,P=0.018).Strong positivity (+++) of CD20 antigen expression in splenic tissue had a positive influence on OS (Log rank = 5.244,P 0.05) effects on the OS.The expression of other antigens (immunohistochemistry) also had no effect on survival-rate,as measured by a χ2 test (P > 0.05).CONCLUSION:Initial splenectomy combined with chemotherapy has been shown to be beneficial due to its advanced remission rate/duration;however,a larger controlled clinical study is required to confirm our findings.

  19. Endovascular treatment of splenic artery aneurysms; Trattamento endovascolare degli aneurismi dell'arteria splenica

    Energy Technology Data Exchange (ETDEWEB)

    Lagana, Domenico; Carrafiello, Gianpaolo; Mangini, Monica; Fontana, Federico; Dizonno, Massimiliano; Fugazzola, Carlo [Insubria Univ., Varese (Italy). Cattedra di radiologia; Castelli, Patrizio [Insubria Univ., Varese (Italy). Chirurgia vascolare

    2005-07-15

    Purpose. To assess the feasibility and effectiveness of endovascular treatment of splenic artery aneurysm (SAAs). Materials and methods. Between May 2000 and June 2003 we treated 11 true SAAs in 9 patients (7 females and 2 males; mean age 58 years), 8 saccular and 3 fusiform, 4 located at the middle tract of the splenic artery, 5 at the distal tract and 2 intra-parenchymal. The diagnosis was performed with colour-Doppler ultrasound and/or CT-angiography; 7 patients were symptomless, 1 had left hypochondriac pain, and 1 had acute abdomen caused by a ruptured SAA. Four SAAs were treated by micro coil embolisation of the aneurysmal sac with preservation of splenic artery patency; in 2 cases this was associated with transcatheter injection of N-butyl-2-cyanoacrylate. Four cases were treated by endovascular ligature, with sectoral spleen ischaemia. One ruptured SAA received emergency treatment with splenic artery cyanoacrylate embolisation. Two intra-parenchymal SAAs were excluded, one by cyanoacrylate embolisation of the afferent artery and the other by transcatheter thrombin injection in the aneurysmal sac. Results. Technical success was observed in all cases (in 10/11 at the end of the procedure; in 1/11 at CT performed 3 days after the procedure). The follow-up (mean 18 months; range 6-36) was performed by colour-Doppler ultrasound and/or CT-angiography 3, 6 and 12 months after the procedure and subsequently once a year; the complete exclusion of the aneurysms was confirmed in 11/11 cases. The complications were: 4 cases of mild pleuritis; fever and left hypochondriac pain 1 day after the procedure (in the same 4 patients and in one other case); 5 cases of sectorial spleen ischaemia and 1 case of diffuse spleen infarction with partial revascularization by collateral vessels. No alteration of the levels of pancreatic enzymes was found; a transitory increase in platelet count occurred only in the patient with diffuse spleen infarction. Conclusions. Using different

  20. Mediation Analysis

    OpenAIRE

    David P. MacKinnon; Fairchild, Amanda J.; Fritz, Matthew S.

    2007-01-01

    Mediating variables are prominent in psychological theory and research. A mediating variable transmits the effect of an independent variable on a dependent variable. Differences between mediating variables and confounders, moderators, and covariates are outlined. Statistical methods to assess mediation and modern comprehensive approaches are described. Future directions for mediation analysis are discussed.

  1. Hemorrhagic Shock as a Sequela of Splenic Rupture in a Patient with Infectious Mononucleosis: Focus on the Potential Role of Salicylates

    OpenAIRE

    Konstantinos Bouliaris; Dimos Karangelis; Marios Daskalopoulos; Konstantinos Spanos; Michael Fanariotis; Anargyros Giaglaras

    2012-01-01

    Despite the fact that the vast majority of splenic ruptures are traumatic, infectious mononucleosis has been incriminated as a major predisposing factor that affects the integrity of the spleen, thus causing atraumatic ruptures and life-threatening hemorrhages. Herein we present a case of a 23-year-old Caucasian male who underwent an emergency laparotomy for acute abdomen and hemorrhagic shock, caused by spontaneous splenic rupture secondary to infectious mononucleosis. The potential role of ...

  2. AB96. The first clinical research in the world of combined kidney transplantation and splenic fossa auxiliary heterotopic liver transplantation in highly sensitized recipients

    OpenAIRE

    Yuan, Jianlin; Zhang, Geng; Qin, Weijun; Yu, Lie

    2014-01-01

    Objective To study the clinical effect of combined kidney transplantation and splenic fossa auxiliary heterotopic liver transplantation to treat highly sensitized recipients. Methods Combined kidney transplantation and splenic fossa auxiliary heterotopic liver transplantation from the same donor was used to treat a highly sensitized recipient with panel reactive antibodies (PRA) >50% and pre-existing donor specific antibodies (DSA). The hyperacute rejection and the function of renal after the...

  3. Cytomegalovirus-associated splenic infarcts in a female patient with Factor V Leiden mutation: a case report

    Directory of Open Access Journals (Sweden)

    Atzmony Lihi

    2008-12-01

    Full Text Available Abstract Introduction Cytomegalovirus-associated thrombosis has rarely been reported in the medical literature, and if so, mainly in immunocompromized patients. Case presentation We report the case of a 36-year-old Caucasian woman with acute cytomegalovirus infection presenting with spontaneous splenic infarcts. Trans-esophageal echocardiography did not show any vegetations or mural thrombi. The patient was also found to be heterozygous for the Factor V Leiden mutation. Anticoagulation treatment was considered but ruled out since cytomegalovirus was the obvious trigger for thrombosis in this patient. To the best of our knowledge, this is only the third report to date of cytomegalovirus-associated splenic infarcts. Conclusion This case report serves as additional evidence for the role of cytomegalovirus in thrombosis.

  4. Splenic sequestration of Tc-99m labeled heat treated red blood cells. [Feasibility of use for spleen imaging

    Energy Technology Data Exchange (ETDEWEB)

    Atkins, H L; Goldman, A G; Fairchild, R G; Oster, Z H; Som, P; Richards, P; Meinken, G E; Srivastava, S C

    1979-01-01

    The rate of blood clearance and spleen uptake as well as the total spleen uptake of heat damaged red blood cells labeled with Tc-99m was determined in eight patients, six of whom had chronic lymphatic leukemia, one had polycythemia vera and one had eosinophilia of unknown origin. Spleen uptake at 2 hrs was 72.0 +- 18.5%. Approximately 82.6% of the initial radioactivity was cleared from the blood by 2 hrs with a rapid T 1/2 component of 6.3 +- 4.7 min. The T 1/2 of splenic uptake was 8.3 +- 4.6 min with a plateauing of splenic radioactivity by 30 min. The preliminary results indicate that the method of preparation is reliable but the usefulness of the method for evaluating spleen function remains to be determined.

  5. A case of conventional treatment failure in visceral leishmaniasis: leukocyte distribution and cytokine expression in splenic compartments

    OpenAIRE

    dos-Santos, Washington LC; Carla PAGLIARI; Santos, Lina G; Almeida, Valter A; e Silva, Thiago LV; Coutinho Jr, João de J; Souza, Tulio; Duarte, Maria IS; de Freitas, Luiz AR; Costa, Carlos HN

    2014-01-01

    Background In this paper we study the distribution of leukocyte populations and of cytokine-producing cells in the spleen of a patient with visceral leishmaniasis resistant to clinical treatment. It is the first attempt to compare the distribution of leukocyte populations and cytokine-producing cells in the splenic compartments of a patient with visceral leishmaniasis with those observed in patients without the disease. Case presentation A 25-year-old male, farmer, was hospitalized on several...

  6. Clinical characteristics and prognostic factors of splenic abscess: A review of 67 cases in a single medical center of Taiwan

    Institute of Scientific and Technical Information of China (English)

    Kuo-Chin Chang; Chuan-Mo Lee; Tsung-Hui Hu; Seng-Kee Chuah; Chi-Sin Changchien; Tung-Lung Tsai; Sheng-Nan Lu; Yi-Chun Chiu; Yaw-Sen Chen; Chih-Chi Wang; Jui-Wei Lin

    2006-01-01

    AIM: To analyze 67 cases of splenic abscess in a medical center of Taiwan during a period of 19 years.METHODS: From January 1986 to December 2004, a total of 67 patients with splenic abscess were enrolled for the retrospective study. The clinical characteristics,underlying diseases, organism spectra, therapeutic methods, APACHE Ⅱ scores, and mortality rates were analyzed.RESULTS: There were 41 males and 26 females with the mean age of 54.1± 14.1 years. Multiple splenic abscesses (MSA) account for 28.4% and solitary splenic abscess in 71.6% of the patients. Twenty-six of sixtyseven patients (35.8%) had extrasplenic abscesses, with leading site of liver (34.6%). Microbiological cultures were positive in 58 patients (86.6%), with 71.8% in blood culture and 93.5% in abscess culture. Gram negative bacillus (GNB) infection predominated (55.2%),with leading pathogen ofKlebsiella pneumoniae (22.4%),followed by gram positive coccus (GPC) infection (31%).Splenectomy was performed in 26 patients (38.8%),percutaneous drainage or aspiration in 21 (31.3%),and antibiotic therapy alone in 20 patients (29.9%).Eventually, 12 of 67 patients expired (17.9 %). By statistics, spleen infected with GNB was likely to develop multiple abscesses compared with infection with GPC(P=0.036). Patients with GNB infection (P= 0.009) andmultiple abscesses (P= 0.011) experienced a higher mortality rate than patients with GPC infection and solitary abscess. The mean APACHE Ⅱ score of 12 expired patients (16.3 ±3.2) was significantly higher than that of the 55 survivals (7.2 ± 3.8) (P< 0.001).CONCLUSION: MSA, GNB infection, and high APACHEⅡ scores are poor prognostic factors. Early surgical intervention should be encouraged when these risk factors are present.

  7. Repeated pancreatitis-induced splenic vein thrombosis leads to intractable gastric variceal bleeding: A case report and review

    OpenAIRE

    Tang, Shan-Hong; Zeng, Wei-Zheng; He, Qian-Wen; Qin, Jian-Ping; WU, XIAO-LING; Tao WANG; Wang, Zhao; He, Xuan; Zhou, Xiao-Lei; Fan, Quan-Shui; Jiang, Ming-De

    2015-01-01

    Gastric varices (GV) are one of the most common complications for patients with portal hypertension. Currently, histoacryl injection is recommended as the initial treatment for bleeding of GV, and this injection has been confirmed to be highly effective for most patients in many studies. However, this treatment might be ineffective for some types of GV, such as splenic vein thrombosis-related localized portal hypertension (also called left-sided, sinistral, or regional portal hypertension). H...

  8. Changes in count and function of splenic lymphocytes from patients with portal hypertension

    Institute of Scientific and Technical Information of China (English)

    Zong-Fang Li; Shu Zhang; Gao-Bo Lv; Ying Huang; Wei Zhang; Song Ren; Jun Yang; Shuang-Suo Dang

    2008-01-01

    AIM: To investigate changes in numbers and proliferative function of splenic lymphocytes in patients with hypersplenism due to portal hypertension (PH), to provide evidence for further study of immune status of the spleen during PH.METHODS: Twelve spleens from patients with hypersplenism due to PH served as the PH group, and four spleens from cases of traumatic spleen rupture were regarded as the control group. After weighing the spleen, lymphocytes were separated and counted using a cell counting plate to calculate the lymphocyte count per gram of spleen tissue (relative quantity) and total lymphocyte count in whole spleen (absolute quantity). The immunohistochemical SP method was used to observe the density and distribution of lymphocytes in the spleen. The MTT method was used to observe changes in lymphocyte proliferative function.RESULTS: As compared to the control group, the splenic lymphocytes in the PH group showed that: (1) There was no difference in distribution but a significant decrease in density; (2) the number of lymphocytes per gram of spleen (relative quantity) decreased significantly [(0.822±0.157) × 108 vs (1.174±0.254) × 108, P < 0.01];(3) with the significant increase in the weight of the PH spleen (832.6±278.2 g vs 211.7±85.6 g, P < 0.01),the total quantity of lymphocytes (absolute quantity)increased significantly [(0.685±0.072) × 1011 vs (0.366±0.057) × 1011, P < 0.01]; and (4) the proliferative function of lymphocytes was enhanced: T lymphocytes,(0.022±0.005 vs 0.015±0.003, P < 0.05), and B lymphocytes (0.034±0.006 vs 0.023±0.001, P < 0.01).CONCLUSION: Although lymphocyte density in the spleen decreased in patients with PH, the total quantity of lymphoytes increased because spleen weight increased greatly, along with the proliferating function. With respect to changes in lymphocytes, PH spleens may still have immune function, although it may be disordered. However,complete evaluation of the immune function of the spleenin PH

  9. IL-1β in eosinophil-mediated small intestinal homeostasis and IgA production.

    Science.gov (United States)

    Jung, Y; Wen, T; Mingler, M K; Caldwell, J M; Wang, Y H; Chaplin, D D; Lee, E H; Jang, M H; Woo, S Y; Seoh, J Y; Miyasaka, M; Rothenberg, M E

    2015-07-01

    Eosinophils are multifunctional leukocytes that reside in the gastrointestinal (GI) lamina propria, where their basal function remains largely unexplored. In this study, by examining mice with a selective deficiency of systemic eosinophils (by lineage ablation) or GI eosinophils (eotaxin-1/2 double deficient or CC chemokine receptor 3 deficient), we show that eosinophils support immunoglobulin A (IgA) class switching, maintain intestinal mucus secretions, affect intestinal microbial composition, and promote the development of Peyer's patches. Eosinophil-deficient mice showed reduced expression of mediators of secretory IgA production, including intestinal interleukin 1β (IL-1β), inducible nitric oxide synthase, lymphotoxin (LT) α, and LT-β, and reduced levels of retinoic acid-related orphan receptor gamma t-positive (ROR-γt(+)) innate lymphoid cells (ILCs), while maintaining normal levels of APRIL (a proliferation-inducing ligand), BAFF (B cell-activating factor of the tumor necrosis factor family), and TGF-β (transforming growth factor β). GI eosinophils expressed a relatively high level of IL-1β, and IL-1β-deficient mice manifested the altered gene expression profiles observed in eosinophil-deficient mice and decreased levels of IgA(+) cells and ROR-γt(+) ILCs. On the basis of these collective data, we propose that eosinophils are required for homeostatic intestinal immune responses including IgA production and that their affect is mediated via IL-1β in the small intestine. PMID:25563499

  10. Splenic microenvironment and self recognition as factors in allograft rejection in rats. A study using indium-111-labeled cells

    International Nuclear Information System (INIS)

    Splenectomy facilitates organ allograft survival in some rat strains, and in weak donor-recipient histoincompatible pairs. We have found using a heart spleen twin graft model, using ACI rats as recipients and Lewis rats as donors, that the transplanted heart will survive in most recipients after delayed host splenectomy. The presence of a viable mass of splenic tissue will allow rejection to proceed only when the transplanted spleen is of host origin, and not when it comes from the donor (i.e., when it is allogeneic). The use of 111In-labeled cells has allowed us to show that lymphocyte traffic and trapping is markedly altered in the transplanted allogeneic spleens, when compared with control transplanted syngeneic spleens. Thus, despite the presence of the splenic ''microenvironment,'' cardiac allograft rejection does not occur in the absence of syngeneic splenic tissue. We conclude that the role of the spleen in the immune response is to facilitate the recognition of self and the acquisition of alloreactivity in weak responder rat strains and donor-recipient pairs

  11. Dangerous Course and Atypical Termination of the Splenic Vein in Relation to Pancreas – A Case Report

    Directory of Open Access Journals (Sweden)

    Satheesha Nayak Badagabettu

    2014-11-01

    Full Text Available Context Knowledge of variations of the vessels closely related to the pancreas adds greatly to the success of pancreatic surgery. Splenic vein is one of the vessels that are closely related to the pancreas. Its variations might not only change the haemodynamics in the vein but also cause unexpected bleeding during pancreatic surgery. Case report During our dissection classes, we noted the variations in the course and termination of the splenic vein. After emerging from the spleen, it coursed upward and to the right, embedded in a groove on the anterior surface of body of pancreas. After reaching the upper border, it turned downwards and entered the body of the pancreas. After having a downward course in the body of pancreas, it emerged out and united with the superior mesenteric vein at an angle of about 160 degrees to form the portal vein. Conclusion This peculiar course of the vein might predispose it for thrombosis in case of pancreatitis. It can also lead to iatrogenic injuries during pancreatic or splenic surgeries.

  12. Literature Review of the Role of Ultrasound, Computed Tomography, and Transcatheter Arterial Embolization for the Treatment of Traumatic Splenic Injuries

    International Nuclear Information System (INIS)

    IntroductionThe spleen is the second most frequently injured organ following blunt abdominal trauma. Trends in management have changed over the years. Traditionally, laparotomy and splenectomy was the standard management. Presently, nonoperative management (NOM) of splenic injury is the most common management strategy in hemodynamically stable patients. Splenic injuries can be managed via simple observation (OBS) or with angiography and embolization (AE). Angio-embolization has shown to be a valuable alternative to observational management and has increased the success rate of nonoperative management in many series.DiagnosticsImproved imaging techniques and advances in interventional radiology have led to a better selection of patients who are amenable to nonoperative management. Despite this, there is still a lot of debate about which patients are prone to NOM.Angiography and EmbolizationThe optimal patient selection is still a matter of debate and the role of CT and angio-embolization has not yet fully evolved. We discuss the role of sonography and CT features, such as contrast extravasation, pseudoaneurysms, arteriovenous fistulas, or hemoperitoneum, to determine the optimal patient selection for angiography and embolization. We also review the efficiency, technical considerations (proximal or selective embolization), logistics, and complication rates of AE for blunt traumatic splenic injuries.

  13. Bulk protein biosynthesis of the spleen and some splenic cell populations after induction of splenomegaly by application of Bordetella pertussis

    International Nuclear Information System (INIS)

    Autoradiographic studies and liquid scintillation counting were carried out in female NMRI mice just reaching maturity. All animals had received a single injection, either of bovine serum albumin (BSA) or of pertussis organism (PO) or BSA + PO. The animals were sacrificed 4 d and 10 d after this pretreatment. 2 h before decapitation, a single dose of 3H-l phenyl alamine was applied intraperitoneally. The following results were obtained: The splenic index (splenic weight in mg/mouse weight in g) increased as a result of splenomegaly caused by PO. Morphometric data suggested an enlarged cell and nuclear area with enhanced cellular amino acid turnover and migration of RNP-containing matter into the nucleus, especially in the megakaryocytes and in lymphocytoid blastic cells. Incorporation of 3H-l-phenylalanine per unit of dry weight of the spleen is slowed down during the experiment while amiro acid incorporation by the total spleen increases with PO-induced splenomegaly. Incorporation of amino acid per unit of dry weight is constant in all experimental and control animals. The increased amino acid incorporation in lymphocytoid blastic cells is probably caused by the immunological situations during the experiment. An explanation of total cell increase and cell increase of megakaryocytic splenic cells is attempted. (orig./MG)

  14. Repeated pancreatitis-induced splenic vein thrombosis leads to intractable gastric variceal bleeding: A case report and review.

    Science.gov (United States)

    Tang, Shan-Hong; Zeng, Wei-Zheng; He, Qian-Wen; Qin, Jian-Ping; Wu, Xiao-Ling; Wang, Tao; Wang, Zhao; He, Xuan; Zhou, Xiao-Lei; Fan, Quan-Shui; Jiang, Ming-De

    2015-10-16

    Gastric varices (GV) are one of the most common complications for patients with portal hypertension. Currently, histoacryl injection is recommended as the initial treatment for bleeding of GV, and this injection has been confirmed to be highly effective for most patients in many studies. However, this treatment might be ineffective for some types of GV, such as splenic vein thrombosis-related localized portal hypertension (also called left-sided, sinistral, or regional portal hypertension). Herein, we report a case of repeated pancreatitis-induced complete splenic vein thrombosis that led to intractable gastric variceal bleeding, which was treated by splenectomy. We present detailed radiological and pathological data and blood rheology analysis (the splenic artery - after a short gastric vein or stomach vein - gastric coronary vein - portal vein). The pathophysiology can be explained by the abnormal direction of blood flow in this patient. To our knowledge, this is the first reported case for which detailed pathology and blood rheology data are available. PMID:26488031

  15. Splenic Rupture Diagnosed with Bedside Ultrasound in a Patient with Shock in the Emergency Department Following Colonoscopy

    Directory of Open Access Journals (Sweden)

    William Mulkerin

    2015-10-01

    Full Text Available A 64-year-old male presented to the emergency department (ED with near syncope and worsening left flank and shoulder pain. He had undergone a difficult colonoscopy two days prior due to a tortuous colon. Initial vital signs were normal. He looked uncomfortable and had significant left upper quadrant abdominal tenderness with guarding. Thirty minutes after ED arrival, his blood pressure dropped to 73/59 mmHg, requiring aggressive fluid resuscitation. Bedside focused assessment with sonography in trauma (FAST exam demonstrated free fluid in the abdomen with mixed echogenicity of the spleen, suggestive of splenic injury. Computed tomography (CT demonstrated a large subcapsular splenic hematoma with active extravasation and surrounding intraperitoneal free fluid (Figure, Video. He was admitted to the surgical intensive care unit. Hemorrhage continued after interventional radiology performed embolization of the splenic artery. He then required laparoscopic splenectomy on hospital day 2 to control bleeding. He subsequently did well and was discharged on hospital day 10.

  16. Magnetic Resonance Imaging Revealed Splenic Targeting of Canine Parvovirus Capsid Protein VP2

    Science.gov (United States)

    Ma, Yufei; Wang, Haiming; Yan, Dan; Wei, Yanquan; Cao, Yuhua; Yi, Peiwei; Zhang, Hailu; Deng, Zongwu; Dai, Jianwu; Liu, Xiangtao; Luo, Jianxun; Zhang, Zhijun; Sun, Shiqi; Guo, Huichen

    2016-03-01

    Canine parvovirus (CPV) is a highly contagious infectious virus, whose infectious mechanism remains unclear because of acute gastroenteritis and the lack of an efficient tool to visualize the virus in real time during virology research. In this study, we developed an iron oxide nanoparticle supported by graphene quantum dots (GQD), namely, FeGQD. In this composite material, GQD acts as a stabilizer; thus, vacancies are retained on the surface for further physical adsorption of the CPV VP2 protein. The FeGQD@VP2 nanocomposite product showed largely enhanced colloidal stability in comparison with bare FeGQD, as well as negligible toxicity both in vitro and in vivo. The composite displayed high uptake into transferrin receptor (TfR) positive cells, which are distinguishable from FeGQD or TfR negative cells. In addition, the composite developed a significant accumulation in spleen rather than in liver, where bare FeGQD or most iron oxide nanoparticles gather. As these evident targeting abilities of FeGQD@VP2 strongly suggested, the biological activity of CPV VP2 was retained in our study, and its biological functions might correspond to CPV when the rare splenic targeting ability is considered. This approach can be applied to numerous other biomedical studies that require a simple yet efficient approach to track proteins in vivo while retaining biological function and may facilitate virus-related research.

  17. Loss of Ia-bearing splenic adherent cells after whole body ultraviolet irradiation

    International Nuclear Information System (INIS)

    Daily uv irradiation of mice results in a marked decrease in the antigen-presenting capability of SAC from these mice after 1 wk of uv exposure. To directly examine this cell population, we developed a technique for purifying SAC that involves passing mouse splenocytes through two cycles of glass adherence with an intervening incubation on rabbit anti-mouse Ig-coated dishes. SAC from externally uv irradiated mice prepared by this method, when pulsed with antigen, activate primed T cells to proliferate much less efficiently than SAC from normal mice. Both the proportion and absolute number of Ia-bearing cells in this purified SAC population from uv irradiated mice are considerably smaller than that seen in similarly prepared populations from normal mice. Previous adjuvant immunization was shown to override functional defects elicited by external uv irradiation. This demonstration of a uv irradiation induced selective loss of Ia bearing splenic adherent cells and the functional consequences of this loss provide further evidence for the importance of Ia-bearing accessory cells in antigen presentation of T dependent antigens, and provides insight into the origin of the immunologic defects induced by whole body uv irradiation

  18. Nano-sized titanium dioxide-induced splenic toxicity: a biological pathway explored using microarray technology.

    Science.gov (United States)

    Sheng, Lei; Wang, Ling; Sang, Xuezi; Zhao, Xiaoyang; Hong, Jie; Cheng, Shen; Yu, Xiaohong; Liu, Dong; Xu, Bingqing; Hu, Renping; Sun, Qingqing; Cheng, Jie; Cheng, Zhe; Gui, Suxin; Hong, Fashui

    2014-08-15

    Titanium dioxide nanoparticles (TiO2 NPs) have been widely used in various areas, and its potential toxicity has gained wide attention. However, the molecular mechanisms of multiple genes working together in the TiO2 NP-induced splenic injury are not well understood. In the present study, 2.5, 5, or 10mg/kg body weight TiO2 NPs were administered to the mice by intragastric administration for 90 consecutive days, their immune capacity in the spleen as well as the gene-expressed characteristics in the mouse damaged spleen were investigated using microarray assay. The findings showed that with increased dose, TiO2 NP exposure resulted in the increases of spleen indices, immune dysfunction, and severe macrophage infiltration as well as apoptosis in the spleen. Importantly, microarray data showed significant alterations in the expressions of 1041 genes involved in immune/inflammatory responses, apoptosis, oxidative stress, stress responses, metabolic processes, ion transport, signal transduction, cell proliferation/division, cytoskeleton and translation in the 10 mg/kg TiO2 NP-exposed spleen. Specifically, Cyp2e1, Sod3, Mt1, Mt2, Atf4, Chac1, H2-k1, Cxcl13, Ccl24, Cd14, Lbp, Cd80, Cd86, Cd28, Il7r, Il12a, Cfd, and Fcnb may be potential biomarkers of spleen toxicity following exposure to TiO2 NPs. PMID:24968254

  19. Employment of Oligodeoxynucleotide plus Interleukin-2 Improves Cytogenetic Analysis in Splenic Marginal Zone Lymphoma

    Directory of Open Access Journals (Sweden)

    Antonella Bardi

    2011-01-01

    Full Text Available To compare the efficiency of novel mitogenic agents and traditional mitosis inductors, 18 patients with splenic marginal zone lymphoma (SMZL were studied. Three cultures using oligodeoxynucleotide (ODN plus interleukin-2 (IL-2, or TPA, or LPS were setup in each patient. Seventeen/18 cases with ODN+IL2 had moderate/good proliferation (94,4% as compared with 10/18 cases with TPA and LPS (55% (P=.015; 14/18 (77,7% cases with ODN+IL2 had sufficient good quality of banding as compared with 8/18 cases (44,4% with TPA and LPS. The karyotype could be defined from ODN+IL2-stimulated cultures in all 18 patients, 14 of whom (77,7% had a cytogenetic aberration, whereas clonal aberrations could be documented in 9 and in 3 cases by stimulation with LPS and TPA, respectively. Recurrent chromosome aberrations in our series were represented by aberrations of chromosome 14q in 5 patients, by trisomy 12 and 7q deletion in 4 cases each, and by abnormalities involving 11q and 13q in two cases each. These findings show that stimulation with ODN+IL2 offers more mitotic figures of better quality and results in an increased rate of clonal aberrations in SMZL, making this method ideal for prospective studies aiming at the definition of the prognostic impact of cytogenetic aberrations in this disorder.

  20. Regional and splenic lymphocyte proliferative responses of mice exposed to normal or irradiated Schistosoma mansoni cercariae

    Energy Technology Data Exchange (ETDEWEB)

    Lewis, F.A.; Wilson, E.M.

    1982-05-01

    Developing larvae of Schistosoma mansoni migrate through various tissues en route to the liver and mesenteric veins of their definitive host. Regional (lymph node) and systemic (spleen) blastogenic responses to cercarial, adult and egg antigens were measured in CBA/J mice at various times after exposure to normal or irradiated S. mansoni cercariae. Among the separate lymph node groups studied were those draining the tail, thoracic region, intestines, head and neck, and the pelvis. Blastogenic responses were assayed by a micromethod requiring 10(5) cells in 20 microliter volumes per culture. Up to 5 weeks post-cercarial exposure the pattern of responses in lymphoid tissues of infected mice coincided with the migratory route of the parasites. Following oviposition, cellular reactivity was pronounced in all lymph node groups. The reactivity of mice exposed to irradiated cercariae followed a pattern suggestive of a sustained antigenic stimulus only in the nodes draining the tail and lungs. Splenic (systemic) reactivity was roughly comparable between the two exposure groups. These data show the independence and vast differences in the host regional responses following normal or irradiated cercarial exposure.

  1. Regional and splenic lymphocyte proliferative responses of mice exposed to normal or irradiated Schistosoma mansoni cercariae

    International Nuclear Information System (INIS)

    Developing larvae of Schistosoma mansoni migrate through various tissues en route to the liver and mesenteric veins of their definitive host. Regional (lymph node) and systemic (spleen) blastogenic responses to cercarial, adult and egg antigens were measured in CBA/J mice at various times after exposure to normal or irradiated S. mansoni cercariae. Among the separate lymph node groups studied were those draining the tail, thoracic region, intestines, head and neck, and the pelvis. Blastogenic responses were assayed by a micromethod requiring 10(5) cells in 20 microliter volumes per culture. Up to 5 weeks post-cercarial exposure the pattern of responses in lymphoid tissues of infected mice coincided with the migratory route of the parasites. Following oviposition, cellular reactivity was pronounced in all lymph node groups. The reactivity of mice exposed to irradiated cercariae followed a pattern suggestive of a sustained antigenic stimulus only in the nodes draining the tail and lungs. Splenic (systemic) reactivity was roughly comparable between the two exposure groups. These data show the independence and vast differences in the host regional responses following normal or irradiated cercarial exposure

  2. The Impact of Nanochloroquine on Restoration of Hepatic and Splenic Mitochondrial Damage against Rodent Malaria

    Directory of Open Access Journals (Sweden)

    Satyajit Tripathy

    2013-01-01

    Full Text Available The applications of nanotechnology to pharmacology are the potential appliance of biodegradable polymers and convection-enhanced drug delivery in the diagnostics and treatment of diseases. Chitosan is a natural polysaccharide that has attracted significant scientific interest during the last two decades. The present study was to evaluate the possible effects of chitosan tripolyphosphate conjugated nanochloroquine against Plasmodium berghei infection on select makers of oxidative damage and antioxidant status in mitochondria of liver and spleen. P. berghei infection was developed in Swiss mice by intraperitoneal injection of 200 µL of infected blood. Parasite-infected mice were treated with chloroquine and nanoconjugated chloroquine. Superoxide radical generation, nitrate level, and oxidized glutathione were increased significantly (P<0.05 in the mitochondria of infected group as compared to control group, and reduced glutathione level, activity of SOD, GPx, GR, and GST, and mitochondrial transmembrane potential were decreased significantly (P<0.05, which were increased or decreased significantly (P<0.05 near to normal in nanoconjugated chloroquine treated group than chloroquine treated group. So, the findings may suggest the advantageous role of nanoconjugated chloroquine against the P. berghei induced oxidative damage in hepatic and splenic mitochondria.

  3. Right hemithoracic pseudocyst with splenic artery aneurysm: two rare complications of uncommon disease

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    John Freels

    2006-06-01

    Full Text Available Pleural involvement is an uncommon but well recognized complication of chronic pancreatitis, mainly in the form of pleural effusion affecting the left hemithorax. Pancreatic pseudocyst extending to the posterior mediastinum with or without communication with the pleural space is another rare form of this involvement.The treatment of chronic pancreatic pleural effusions and pancreatic pseudocysts generally starts with a conservative approach including bowel rest, drainage of the pleural effusion by repeated thoracentesis or a chest tube, and total parenteral nutrition (TPN for a period of time determined by the clinical course. Other treatment modalities including percutaneous drainage, endoscopic retrograde cholangiopancreatogram (ERCP with stenting of the pancreatic duct and surgical drainage are used if conservative approaches fail.We report a patient with a complicated pancreatic pseudocyst who showed an involvement of the posterior mediastinum and right pleural space, with conspectus sparing of the left hemithorax. The patient had a prolonged and complicated course that included recurrence of the pseudocyst with oral feedings and the development of a splenic artery aneurysm. Some of the above findings have been reported separately as uncommon complications of chronic pancreatitis and pancreatic pseudcyst, but to our knowledge a single case with all these complications was not published in the English literature.

  4. Real-time contrast enhanced ultrasound imaging of focal splenic lesions

    International Nuclear Information System (INIS)

    Objective: To investigate the imaging features of focal splenic lesions (FSLs) on contrast-enhanced ultrasound (CEUS). Methods: Thirty two patients with FSLs proved by pathology were retrospectively analyzed. CEUS was performed using intravenous bolus injection of 2.4 ml sulfur hexafluoride-filled microbubble contrast agent and real time scanning. There were hemangioma (n = 7), lymphoma (n = 8), true cyst (n = 3), infarction (n = 4), hematolymphangioma (n = 2), metastasis tumor (n = 2), and one for each of the following entities extramedullary hemopoiesis, hamartoma, tuberculosis, Langerhans’ cell histiocytosis, inflammatory pseudotumor and myxofibrosarcoma. Results: Among 21 benign lesions, 4 infarctions and 3 cysts presented non-enhancement throughout CEUS scanning, and the other 14 lesions displayed various enhancement levels with 6 (42.9%) hyper-enhancement, 2 (14.3%) iso-enhancement and 6 (42.9%) hypo-enhancement in arterial phase and 11 (78.6%) hypo-enhancement, 1 (7.1%) iso-enhancement and 2 (14.3%) hyper-enhancement in late phase, respectively. The enhancement pattern included 9 (64.3%) homogeneous, 4 (28.6%) heterogeneous and 1 (7.1%) rim-like enhancement. As for the malignant FSLs, all the lesions became completely or extensively hypo-enhancement during the late phase no matter their vascularity during arterial phase. Conclusions: The CEUS features reported in this series may enrich the knowledge for CEUS characterization of FSLs

  5. Real-time contrast enhanced ultrasound imaging of focal splenic lesions

    Energy Technology Data Exchange (ETDEWEB)

    Li, Wei [Department of Medical Ultrasonics, The First Affiliated Hospital of Sun Yat-Sen University, Institute of Diagnostic and Interventional Ultrasound, Sun Yat-Sen University, Guangzhou (China); Liu, GuangJian, E-mail: liugj@mail.sysu.edu.cn [Department of Medical Ultrasonics, The First Affiliated Hospital of Sun Yat-Sen University, Institute of Diagnostic and Interventional Ultrasound, Sun Yat-Sen University, Guangzhou (China); Wang, Wei; Wang, Zhu; Huang, Yang; Xu, ZuoFeng; Xie, XiaoYan [Department of Medical Ultrasonics, The First Affiliated Hospital of Sun Yat-Sen University, Institute of Diagnostic and Interventional Ultrasound, Sun Yat-Sen University, Guangzhou (China); Lu, MingDe [Department of Medical Ultrasonics, The First Affiliated Hospital of Sun Yat-Sen University, Institute of Diagnostic and Interventional Ultrasound, Sun Yat-Sen University, Guangzhou (China); Department of Hepatobiliary Surgery, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou (China)

    2014-04-15

    Objective: To investigate the imaging features of focal splenic lesions (FSLs) on contrast-enhanced ultrasound (CEUS). Methods: Thirty two patients with FSLs proved by pathology were retrospectively analyzed. CEUS was performed using intravenous bolus injection of 2.4 ml sulfur hexafluoride-filled microbubble contrast agent and real time scanning. There were hemangioma (n = 7), lymphoma (n = 8), true cyst (n = 3), infarction (n = 4), hematolymphangioma (n = 2), metastasis tumor (n = 2), and one for each of the following entities extramedullary hemopoiesis, hamartoma, tuberculosis, Langerhans’ cell histiocytosis, inflammatory pseudotumor and myxofibrosarcoma. Results: Among 21 benign lesions, 4 infarctions and 3 cysts presented non-enhancement throughout CEUS scanning, and the other 14 lesions displayed various enhancement levels with 6 (42.9%) hyper-enhancement, 2 (14.3%) iso-enhancement and 6 (42.9%) hypo-enhancement in arterial phase and 11 (78.6%) hypo-enhancement, 1 (7.1%) iso-enhancement and 2 (14.3%) hyper-enhancement in late phase, respectively. The enhancement pattern included 9 (64.3%) homogeneous, 4 (28.6%) heterogeneous and 1 (7.1%) rim-like enhancement. As for the malignant FSLs, all the lesions became completely or extensively hypo-enhancement during the late phase no matter their vascularity during arterial phase. Conclusions: The CEUS features reported in this series may enrich the knowledge for CEUS characterization of FSLs.

  6. Combined treatment of hepatocellular carcinoma with partial splenic embolization and transcatheter hepatic arterial chemoembolization

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    AIM: To prospectively evaluate the efficacy and safety of partial splenic embolization (PSE) combined with transcatheter hepatic arterial chemoembolization (TACE)in treatment of hepatocellular carcinoma (HCC).METHODS: Fifty patients suffering from primary HCC associated with hypersplenism caused by cirrhosis were randomly assigned to 2 groups: group A receiving PSE combined with TACE (n = 26) and group B receiving TACE alone (n = 24). Follow-up examinations included calculation of peripheral blood cells (leukcytes,platelets and red blood cells) and treatment-associated complications.RESULTS: Prior to treatment, there was no significant difference in sex, age, Child-Pugh grade, tumor diameter,mass pathology type and peripheral blood cell counts between the 2 groups. After treatment, leukocyte and platelet counts were significantly higher in group A during the 3-mo follow-up period (P < 0.05), but lower in group B (P < 0.05). Severe complications occurred in 3 patients (11.5%) of group A and in 19 patients (79.2%) of group B (P < 0.05), and there was no significant difference in symptoms of post-embolization syndrome,including abdominal pain, fever, mild nausea and vomiting between the 2 groups (P > 0.05).CONCLUSION: PSE combined with TACE is more effective and safe than TACE alone for patients with HCC associated with hypersplenism caused by cirrhosis.

  7. Splenic marginal zone lymphoma: a review of the clinical presentation, pathology, molecular biology, and management

    Directory of Open Access Journals (Sweden)

    Teixeira Mendes LS

    2014-07-01

    Full Text Available Larissa Sena Teixeira Mendes,1 Ming-Qing Du,2 Estella Matutes,3 Andrew Wotherspoon11Histopathology Department, Royal Marsden Hospital, London, UK; 2Molecular Malignancy Laboratory and Department of Histopathology, University Hospital NHS Foundation Trust/Division of Molecular Histopathology, Department of Pathology, University of Cambridge, Cambridge, UK; 3Hematopathology Unit, Hospital Clinic, Barcelona University, Barcelona, Spain Abstract: Splenic marginal zone lymphoma is a distinct low grade B-cell lymphoma primarily occurring in the spleen and separate from nodal marginal zone lymphoma and extranodal marginal zone lymphoma of mucosa-associated lymphoid tissue. It is characterized by a relative indolent course, splenomegaly, moderate lymphocytosis, and an intrasinusoidal pattern of involvement, especially in the bone marrow. It is postulated that the neoplastic clone originates from persistent antigenic stimulation of marginal zone B-cells. Molecular and cytogenetic studies have failed to show specific alterations. There is no standard criterion to initiate treatment, which may include a watch and wait policy, splenectomy, or chemo/immunotherapy. This review highlights the main features of this entity, reassessing the guidelines for diagnosis, prognostic factors, staging, and management published by the SMZL Working Group (2008. Keywords: splenectomy, villous lymphocytes, guidelines

  8. Splenic Epidermoid Cyst during Pregnancy; Case Report and Review of the Literature

    Directory of Open Access Journals (Sweden)

    Majid Forouzesh

    2013-10-01

    Full Text Available Cystic disease of the spleen is not frequently encountered in surgical practice. It is broadly classified as parasitic and non-parasitic, the latter being a rare entity. In this case report, an epidermoid cyst of spleen led to acute abdomen in young age pregnant woman is presented.A 26-year-old woman with 15 weeks gestational age second pregnancy referred to emergency ward with left upper quadrant pain and tenderness that ultra sonography revealed large cyst (100х110mm with internal echo in spleen in favor of hydatic cyst or abscess. The patient was managed medically for one week but developed her abdominal pain, epigastric fullness, anorexia and fever. New sonography was done for her and large cyst was detected in spleen (120х110mm. She had severe pain accompanied with anorexia and vomiting. Fetus was normal in sonography. Exploratory laprotomy with splenectomy was performed. Splenomegaly (200х130х90mm with a cyst without any adhesion and inflammation was detected. Histopathology examination showed epidermoid cyst of spleen. (140х10х90mm. Though splenic epidermoid cyst is an uncommon entity, it should be considered in the differential diagnosis of an abdominal mass in a young individual. An attempt should be made to preserve the spleen provided there is adequate parenchyma otherwise splenectomy is the rule.

  9. Morphologic and Functional Effects of Gamma Secretase Inhibition on Splenic Marginal Zone B Cells

    Directory of Open Access Journals (Sweden)

    Maria Cristina de Vera Mudry

    2012-01-01

    Full Text Available The γ-secretase complex is a promising target in Alzheimer’s disease because of its role in the amyloidogenic processing of β-amyloid precursor protein. This enzyme also catalyzes the cleavage of Notch receptor, resulting in the nuclear translocation of intracellular Notch where it modulates gene transcription. Notch signaling is essential in cell fate decisions during embryogenesis, neuronal differentiation, hematopoiesis, and development of T and B cells, including splenic marginal zone (MZ B cells. This B cell compartment participates in the early phases of the immune response to blood-borne bacteria and viruses. Chronic treatment with the oral γ-secretase inhibitor RO4929097 resulted in dose-dependent decreased cellularity (atrophy of the MZ of rats and mice. Significant decreases in relative MZ B-cell numbers of RO4929097-treated animals were confirmed by flow cytometry. Numbers of MZ B cells reverted to normal after a sufficient RO4929097-free recovery period. Functional characterization of the immune response in relation to RO4929097-related MZ B cell decrease was assessed in mice vaccinated with inactivated vesicular stomatitis virus (VSV. Compared with the immunosuppressant cyclosporin A, RO4929097 caused only mild and reversible delayed early neutralizing IgM and IgG responses to VSV. Thus, the functional consequence of MZ B cell decrease on host defense is comparatively mild.

  10. Co-existence of a giant splenic hemangioma and multiple hepatic hemangiomas and the potential association with the use of oral contraceptives: a case report

    Directory of Open Access Journals (Sweden)

    Chatzoulis George

    2008-05-01

    Full Text Available Abstract Introduction Hepatic and splenic hemangiomas are common benign tumors that mainly affect female patients. Giant splenic hemangiomas are extremely rare, especially when correlated with multiple hepatic hemangiomas. Pathogenetic mechanisms between hemangiomas and oral contraceptives, as well as therapeutic approaches, are analyzed in this case report, in particular for the management of synchronous splenic and hepatic hemangiomas. Case presentation We report here a 42-year-old woman with a giant splenic hemangioma, multiple hepatic hemangiomas and a history of oral estrogen intake for many years. At first it was difficult to determine the organ from which the giant hemangioma originated. Angiography proved extremely helpful in tracing its origin in the spleen. Hematomas in the giant hemangioma posed a significant threat of rupture and catastrophic hemorrhage. We left the small hepatic hemangiomas in place, and removed the spleen along with the giant splenic hemangioma. Conclusion Diagnostic pitfalls in the determination of the origin of this giant hemangioma, attribution of its origin to the spleen angiographically, the unusual co-existence of the giant splenic hemangioma with multiple hepatic ones, and the potential threat of rupture of the giant hemangioma are some of the highlights of this case report. Estrogen administration represents a pathogenic factor that has been associated with hemangiomas in solid organs of the abdominal cavity. The therapeutic dilemma between resection and embolization of giant hemangiomas is another point of discussion in this case report. Splenectomy for the giant splenic hemangioma eliminates the risk of rupture and malignant degeneration, whereas observation for the small hepatic ones (

  11. Nano-sized titanium dioxide-induced splenic toxicity: A biological pathway explored using microarray technology

    International Nuclear Information System (INIS)

    Highlights: • Exposure to TiO2 NPs could be accumulated in the spleen. • Exposure to TiO2 NPs caused spleen lesions in mice. • Exposure to TiO2 NPs resulted in immune dysfunction in mice. • Exposure to TiO2 NPs caused alteration of 1041 genes expression of known function in the spleen. - Abstract: Titanium dioxide nanoparticles (TiO2 NPs) have been widely used in various areas, and its potential toxicity has gained wide attention. However, the molecular mechanisms of multiple genes working together in the TiO2 NP-induced splenic injury are not well understood. In the present study, 2.5, 5, or 10 mg/kg body weight TiO2 NPs were administered to the mice by intragastric administration for 90 consecutive days, their immune capacity in the spleen as well as the gene-expressed characteristics in the mouse damaged spleen were investigated using microarray assay. The findings showed that with increased dose, TiO2 NP exposure resulted in the increases of spleen indices, immune dysfunction, and severe macrophage infiltration as well as apoptosis in the spleen. Importantly, microarray data showed significant alterations in the expressions of 1041 genes involved in immune/inflammatory responses, apoptosis, oxidative stress, stress responses, metabolic processes, ion transport, signal transduction, cell proliferation/division, cytoskeleton and translation in the 10 mg/kg TiO2 NP-exposed spleen. Specifically, Cyp2e1, Sod3, Mt1, Mt2, Atf4, Chac1, H2-k1, Cxcl13, Ccl24, Cd14, Lbp, Cd80, Cd86, Cd28, Il7r, Il12a, Cfd, and Fcnb may be potential biomarkers of spleen toxicity following exposure to TiO2 NPs

  12. Nano-sized titanium dioxide-induced splenic toxicity: A biological pathway explored using microarray technology

    Energy Technology Data Exchange (ETDEWEB)

    Sheng, Lei [Medical College of Soochow University, Suzhou 215123 (China); Wang, Ling [Library of Soochow University, Suzhou 215123 (China); Sang, Xuezi; Zhao, Xiaoyang; Hong, Jie; Cheng, Shen; Yu, Xiaohong; Liu, Dong; Xu, Bingqing; Hu, Renping; Sun, Qingqing; Cheng, Jie; Cheng, Zhe; Gui, Suxin [Medical College of Soochow University, Suzhou 215123 (China); Hong, Fashui, E-mail: Hongfsh_cn@sina.com [Medical College of Soochow University, Suzhou 215123 (China)

    2014-08-15

    Highlights: • Exposure to TiO{sub 2} NPs could be accumulated in the spleen. • Exposure to TiO{sub 2} NPs caused spleen lesions in mice. • Exposure to TiO{sub 2} NPs resulted in immune dysfunction in mice. • Exposure to TiO{sub 2} NPs caused alteration of 1041 genes expression of known function in the spleen. - Abstract: Titanium dioxide nanoparticles (TiO{sub 2} NPs) have been widely used in various areas, and its potential toxicity has gained wide attention. However, the molecular mechanisms of multiple genes working together in the TiO{sub 2} NP-induced splenic injury are not well understood. In the present study, 2.5, 5, or 10 mg/kg body weight TiO{sub 2} NPs were administered to the mice by intragastric administration for 90 consecutive days, their immune capacity in the spleen as well as the gene-expressed characteristics in the mouse damaged spleen were investigated using microarray assay. The findings showed that with increased dose, TiO{sub 2} NP exposure resulted in the increases of spleen indices, immune dysfunction, and severe macrophage infiltration as well as apoptosis in the spleen. Importantly, microarray data showed significant alterations in the expressions of 1041 genes involved in immune/inflammatory responses, apoptosis, oxidative stress, stress responses, metabolic processes, ion transport, signal transduction, cell proliferation/division, cytoskeleton and translation in the 10 mg/kg TiO{sub 2} NP-exposed spleen. Specifically, Cyp2e1, Sod3, Mt1, Mt2, Atf4, Chac1, H2-k1, Cxcl13, Ccl24, Cd14, Lbp, Cd80, Cd86, Cd28, Il7r, Il12a, Cfd, and Fcnb may be potential biomarkers of spleen toxicity following exposure to TiO{sub 2} NPs.

  13. Anticoagulation therapy prevents portal-splenic vein thrombosis after splenectomy with gastroesophageal devascularization

    Institute of Scientific and Technical Information of China (English)

    Wei Lai; Shi-Chun Lu; Guan-Yin Li; Chuan-Yun Li; Ju-Shan Wu; Qing-Liang Guo; Meng-Long Wang; Ning Li

    2012-01-01

    AIM:To compare the incidence of early portal or splenic vein thrombosis (PSVT) in patients treated with irregular and regular anticoagulantion alter splenectomy with gastroesophageal devascularization.METHODS:We retrospectively analyzed 301 patients who underwent splenectomy with gastroesophageal devascularization for portal hypertension due to cirrhosis between April 2004 and July 2010.Patients were categorized into group A with irregular anticoagulation and group B with regular anticoagulation,respectively.Group A (153 patients) received anticoagulant monotherapy for an undesignated time period or with aspirin or warfarin without low-molecular-weight heparin (LMWH) irregularly.Group B (148 patients) received subcutaneous injection of LMWH routinely within the first 5 d after surgery,followed by oral warfarin and aspirin for one month regularly.The target prothrombin time/international normalized ratio (PT/INR) was 1.25-1.50.Platelet and PT/INR were monitored.Color Doppler imaging was performed to monitor PSVT as well as the effectiveness of thrombolytic therapy.RESULTS:The patients' data were collected and analyzed retrospectively.Among the patients,94 developed early postoperative mural PSVT,including 63patients in group A (63/153,41.17%) and 31 patients in group B (31/148,20.94%).There were 50 (32.67%)patients in group A and 27 (18.24%) in group B with mural PSVT in the main trunk of portal vein.After the administration of thrombolytic,anticoagulant and antiaggregation therapy,complete or partial thrombus dissolution achieved in 50 (79.37%) in group A and 26 (83.87%) in group B.CONCLUSION:Regular anticoagulation therapy can reduce the incidence of PSVT in patients who undergo splenectomy with gastroesophageal devascularization,and regular anticoagulant therapy is safer and more effective than irregular anticoagulant therapy.Early and timely thrombolytic therapy is imperative and feasible for the prevention of PSVT.

  14. Case report of lymph nodal, hepatic and splenic tuberculosis in an HIV-positive patient

    Directory of Open Access Journals (Sweden)

    Bianca Barone

    2006-04-01

    Full Text Available We describe a case of a male patient, 38 years old, HIV-positive (most recent CD4 count about 259/mm³, with abdominal pain, nausea, vomiting, anorexia, weight loss, and vespertine high fever with chills. His hemogram showed normocytic and normochromic anemia, with a high erythrocyte sedimentation rate (ESR and gross granulations in the neutrophils. Transaminases were normal. Bone marrow biopsy evidenced a chronic disease anemia pattern and a lack of infectious agents. Abdominal ultrasound examination showed a normal-size spleen, which exhibited heterogeneous parenchyma and multiple small hypoechoic images, together with small ascites, peripancreatic and para-aortic lymphadenopathy. These findings were confirmed by abdominal CT. The liver was normal in size, but had a hyperechoic image, which was not visualized on CT. Histopathological analysis of one of the multiple abdominal lymph nodes obtained by laparoscopic biopsy exhibited a chronic granulomatous inflammatory process, with caseous necrosis. Tissue sections were positive for BAAR (acid-alcohol-resistant bacillus, and the cultures were positive for Mycobacterium tuberculosis. Anti-tuberculosis treatment was begun, and the patient evolved with improvement of his general state, fever remission and weight gain. Splenic tuberculosis is a rare disease, occurring predominantly in patients in late stages of AIDS and/or disseminated tuberculosis. It is a difficult diagnosis, since there are no specific findings. Hence, complementary examinations, such as abdominal ultrasound/ CT, or fine needle aspiration, are usually necessary for investigation and differential diagnosis. Often, lesion regression after anti-tuberculosis regimens can be seen, and splenectomy is restricted to complicated or refractory disease.

  15. Inter-radiologist agreement for CT scoring of pediatric splenic injuries and effect on an established clinical practice guideline

    International Nuclear Information System (INIS)

    The American Pediatric Surgical Association (APSA) advocates for the use of a clinical practice guideline to direct management of hemodynamically stable pediatric spleen injuries. The clinical practice guideline is based on the CT score of the spleen injury according to the American Association for the Surgery of Trauma (AAST) CT scoring system. To determine the potential effect of radiologist agreement for CT scoring of pediatric spleen injuries on an established APSA clinical practice guideline. We retrospectively analyzed blunt splenic injuries occurring in children from January 2007 to January 2012 at a single level 1 trauma center (n = 90). Abdominal CT exams performed at clinical presentation were reviewed by four radiologists who documented the following: (1) splenic injury grade (AAST system), (2) arterial extravasation and (3) pseudoaneurysm. Inter-rater agreement for AAST injury grade was assessed using the multi-rater Fleiss kappa and Kendall coefficient of concordance. Inter-rater agreement was assessed using weighted (AAST injury grade) or prevalence-adjusted bias-adjusted (binary measures) kappa statistics; 95% confidence intervals were calculated. We evaluated the hypothetical effect of radiologist disagreement on an established APSA clinical practice guideline. Inter-rater agreement was good for absolute AAST injury grade (kappa: 0.64 [0.59-0.69]) and excellent for relative AAST injury grade (Kendall w: 0.90). All radiologists agreed on the AAST grade in 52% of cases. Based on an established clinical practice guideline, radiologist disagreement could have changed the decision for intensive care management in 11% (10/90) of children, changed the length of hospital stay in 44% (40/90), and changed the time to return to normal activity in 44% (40/90). Radiologist agreement when assigning splenic AAST injury grades is less than perfect, and disagreements have the potential to change management in a substantial number of pediatric patients. (orig.)

  16. Proton irradiation impacts age-driven modulations of cancer progression influenced by immune system transcriptome modifications from splenic tissue

    International Nuclear Information System (INIS)

    Age plays a crucial role in the interplay between tumor and host, with additional impact due to irradiation. Proton irradiation of tumors induces biological modulations including inhibition of angiogenic and immune factors critical to 'hallmark' processes impacting tumor development. Proton irradiation has also provided promising results for proton therapy in cancer due to targeting advantages. Additionally, protons may contribute to the carcinogenesis risk from space travel (due to the high proportion of high-energy protons in space radiation). Through a systems biology approach, we investigated how host tissue (i.e. splenic tissue) of tumor-bearing mice was altered with age, with or without whole-body proton exposure. Transcriptome analysis was performed on splenic tissue from adolescent (68-day) versus old (736-day) C57BL/6 male mice injected with Lewis lung carcinoma cells with or without three fractionations of 0.5 Gy (1-GeV) proton irradiation. Global transcriptome analysis indicated that proton irradiation of adolescent hosts caused significant signaling changes within splenic tissues that support carcinogenesis within the mice, as compared with older subjects. Increases in cell cycling and immunosuppression in irradiated adolescent hosts with CDK2, MCM7, CD74 and RUVBL2 indicated these were the key genes involved in the regulatory changes in the host environment response (i.e. the spleen). Collectively, these results suggest that a significant biological component of proton irradiation is modulated by host age through promotion of carcinogenesis in adolescence and resistance to immunosuppression, carcinogenesis and genetic perturbation associated with advancing age. (author)

  17. Inter-radiologist agreement for CT scoring of pediatric splenic injuries and effect on an established clinical practice guideline

    Energy Technology Data Exchange (ETDEWEB)

    Leschied, Jessica R.; Smith, Ethan A.; Ladino-Torres, Maria F.; Dillman, Jonathan R. [University of Michigan Health System, Department of Radiology, Section of Pediatric Radiology, C.S. Mott Children' s Hospital, Ann Arbor, MI (United States); Mazza, Michael B.; Chong, Suzanne T.; Hoff, Carrie N. [University of Michigan Health System, Department of Radiology, Division of Emergency Radiology, C.S. Mott Children' s Hospital, Ann Arbor, MI (United States); Davenport, Matthew S. [University of Michigan Health System, Department of Radiology, Division of Abdominal Imaging, C.S. Mott Children' s Hospital, Ann Arbor, MI (United States); Khalatbari, Shokoufeh [University of Michigan, Michigan Institute for Clinical and Health Research, Ann Arbor, MI (United States); Ehrlich, Peter F. [University of Michigan Health System, Department of Surgery, Section of Pediatric Surgery, C.S. Mott Children' s Hospital, Ann Arbor, MI (United States)

    2016-02-15

    The American Pediatric Surgical Association (APSA) advocates for the use of a clinical practice guideline to direct management of hemodynamically stable pediatric spleen injuries. The clinical practice guideline is based on the CT score of the spleen injury according to the American Association for the Surgery of Trauma (AAST) CT scoring system. To determine the potential effect of radiologist agreement for CT scoring of pediatric spleen injuries on an established APSA clinical practice guideline. We retrospectively analyzed blunt splenic injuries occurring in children from January 2007 to January 2012 at a single level 1 trauma center (n = 90). Abdominal CT exams performed at clinical presentation were reviewed by four radiologists who documented the following: (1) splenic injury grade (AAST system), (2) arterial extravasation and (3) pseudoaneurysm. Inter-rater agreement for AAST injury grade was assessed using the multi-rater Fleiss kappa and Kendall coefficient of concordance. Inter-rater agreement was assessed using weighted (AAST injury grade) or prevalence-adjusted bias-adjusted (binary measures) kappa statistics; 95% confidence intervals were calculated. We evaluated the hypothetical effect of radiologist disagreement on an established APSA clinical practice guideline. Inter-rater agreement was good for absolute AAST injury grade (kappa: 0.64 [0.59-0.69]) and excellent for relative AAST injury grade (Kendall w: 0.90). All radiologists agreed on the AAST grade in 52% of cases. Based on an established clinical practice guideline, radiologist disagreement could have changed the decision for intensive care management in 11% (10/90) of children, changed the length of hospital stay in 44% (40/90), and changed the time to return to normal activity in 44% (40/90). Radiologist agreement when assigning splenic AAST injury grades is less than perfect, and disagreements have the potential to change management in a substantial number of pediatric patients. (orig.)

  18. Splenic Long-Lived Plasma Cells Promote the Development of Follicular Helper T Cells during Autoimmune Responses.

    Science.gov (United States)

    Jang, Eunkyeong; Cho, Wang Sik; Oh, Yeon-Kyung; Cho, Mi-La; Kim, Jung Mogg; Paik, Doo-Jin; Youn, Jeehee

    2016-02-01

    Long-lived plasma cells (LLPCs) develop under the help of follicular helper T (Tfh) cells and reside mainly in the bone marrow. However, these cells are unusually abundant in the spleen of several autoimmune models including K/BxNsf mice, yet their pathogenic impact remains unknown. To investigate a previously unappreciated role of splenic LLPCs, we sorted splenic plasma cells (PCs) from K/BxNsf and K/BxN mice, corresponding to LLPCs and conventional short-lived PCs, respectively, and compared their phenotypes and ability to prime and induce the differentiation of naive CD4(+) T cells into effector cells in vitro and in vivo. We found that K/BxNsf PCs had lower levels of the Ag presentation machinery and costimulators than K/BxN PCs, and also a lower CD4(+) T cell priming capacity. Autoantigen-pulsed K/BxNsf PCs selectively polarized cognate CD4(+) T cells toward the expression of molecules necessary for Tfh development and function. As a result, the K/BxNsf PC-primed CD4(+) T cells were more effective in stimulating B cells to produce autoantigen-specific IgGs than K/BxN PCs or even dendritic cells. Adoptive transfer of K/BxNsf PCs, but not K/BxN PCs, to K/BxN mice increased numbers of Tfh cells in draining lymph nodes. These results propose that abnormal accumulation of LLPCs in the spleen of autoimmune models drives the differentiation of autoantigen-primed CD4(+) T cells to Tfh cells. This positive feedback loop between splenic LLPCs and Tfh cells may contribute to the persistence of humoral autoimmunity. PMID:26729802

  19. Dynamic left ventricular outflow tract obstruction secondary to hypovolemia in a German Shepard dog with splenic hemangiosarcoma

    OpenAIRE

    AOKI, Takuma; Sunahara, Hiroshi; Sugimoto, Keisuke; ITO, Tetsuro; KANAI, Eiichi; NEO, Sakurako; FUJII, Yoko; WAKAO, Yoshito

    2015-01-01

    Dynamic left ventricular outflow tract obstruction (DLVOTO) is a common condition in cats and humans. In this case report, a dog is described with DLVOTO secondary to severe intra-abdominal hemorrhage caused by a hemangiosarcoma. The dog was a 9-year-old, 35.7-kg, spayed female German Shepard dog that presented with a history of tachypnea and collapse. A Levine II/VI systolic murmur was present at the heart base. Abdominal ultrasonography revealed a splenic mass and a large amount of ascites....

  20. Severe clinical presentation of visceral leishmaniasis in naturally infected dogs with disruption of the splenic white pulp.

    Directory of Open Access Journals (Sweden)

    Isadora S Lima

    Full Text Available In this work, we investigated the association between the disruption of splenic lymphoid tissue and the severity of visceral leishmaniasis in dogs. Clinical and laboratory data from 206 dogs were reviewed. Spleen sections collected during the euthanasia of these animals were analyzed, and the splenic lymphoid tissue samples were classified as well organized (spleen type 1, slightly disorganized (spleen type 2, or moderately to extensively disorganized (spleen type 3. Of 199 dogs with evidence of Leishmania infection, 54 (27% had spleen type 1, 99 (50% had spleen type 2, and 46 (23% had spleen type 3. The number of clinical signs associated with visceral leishmaniasis was significantly higher in the animals with evidence of Leishmania infection and spleen type 2 or 3 than in the animals with spleen type 1. Alopecia, anemia, dehydration, dermatitis, lymphadenopathy, and onychogryphosis were all more frequent among animals with evidence of Leishmania infection and spleen type 3 than among the dogs with evidence of Leishmania infection and spleen type 1. The association between the severity of canine visceral leishmaniasis and the disorganization of the splenic lymphoid tissue was even more evident in the group of animals with positive spleen culture. Conjunctivitis and ulceration were also more common in the animals with spleen type 3 than in the animals with spleen type 1. The serum levels (median, interquartile range of albumin (1.8, 1.4-2.3 g/dL and creatinine (0.7, 0.4-0.8 mg/dL were significantly lower and the serum levels of aspartate aminotransferase were significantly higher (57, 39-95 U in animals with spleen type 3 than in animals with spleen type 1 (2.8, 2.4-3.4 g/dL; 0.9, 0.7-1.2 mg/dL and 23, 20-32 U, respectively. Our data confirm the hypothesis that disruption of the splenic lymphoid tissue is associated with a more severe clinical presentation of canine visceral leishmaniasis.

  1. Intrasplenic masses of ''preserved'' functioning splenic tissue in sickle cell disease: correlation of imaging findings (CT, ultrasound, MRI, and nuclear scintigraphy)

    International Nuclear Information System (INIS)

    Purpose. We studied six patients with sickle cell disease (SSD), five homozygous for sickle cell anemia and one with sickle beta-thalassemia, in whom rounded intrasplenic masses proved to be preserved functioning splenic tissue. Materials and methods. Available images including computed tomography, ultrasonography, bone scans (Tc-99m MDP), liver spleen scans (Tc-99m sulfur colloid), and MRI were evaluated. Results. The masses were low density on CT (in an otherwise calcified spleen), hypoechoic relative to the echogenic spleen on US, and had the imaging characteristics of normal spleen on MRI. They failed to accumulate Tc-99m MDP but did demonstrate uptake of Tc-99m sulfur colloid. Conclusion. In a patient with SSD and intrasplenic masses, proper correlation of multiple imaging modalities will establish the diagnosis of functioning splenic tissue and avoid mistaken diagnosis of splenic abscess or infarction. (orig.). With 2 figs., 1 tab

  2. Intrasplenic masses of ``preserved`` functioning splenic tissue in sickle cell disease: correlation of imaging findings (CT, ultrasound, MRI, and nuclear scintigraphy)

    Energy Technology Data Exchange (ETDEWEB)

    Levin, T.L. [Department of Radiology, Columbia-Presbyterian Medical Center, Babies and Children`s Hospital of New York, 3959 Broadway, BHN 3-318, New York, NY 10032 (United States); Berdon, W.E. [Department of Radiology, Columbia-Presbyterian Medical Center, Babies and Children`s Hospital of New York, 3959 Broadway, BHN 3-318, New York, NY 10032 (United States); Haller, J.O. [Department of Radiology, SUNY Downstate Medical Center, Brooklyn, New York (United States); Ruzal-Shapiro, C. [Department of Radiology, Columbia-Presbyterian Medical Center, Babies and Children`s Hospital of New York, 3959 Broadway, BHN 3-318, New York, NY 10032 (United States); Hurlet-Jenson, A. [Department of Pediatrics, Columbia-Presbyterian Medical Center, Babies and Children`s Hospital of New York, New York (United States)

    1996-09-01

    Purpose. We studied six patients with sickle cell disease (SSD), five homozygous for sickle cell anemia and one with sickle beta-thalassemia, in whom rounded intrasplenic masses proved to be preserved functioning splenic tissue. Materials and methods. Available images including computed tomography, ultrasonography, bone scans (Tc-99m MDP), liver spleen scans (Tc-99m sulfur colloid), and MRI were evaluated. Results. The masses were low density on CT (in an otherwise calcified spleen), hypoechoic relative to the echogenic spleen on US, and had the imaging characteristics of normal spleen on MRI. They failed to accumulate Tc-99m MDP but did demonstrate uptake of Tc-99m sulfur colloid. Conclusion. In a patient with SSD and intrasplenic masses, proper correlation of multiple imaging modalities will establish the diagnosis of functioning splenic tissue and avoid mistaken diagnosis of splenic abscess or infarction. (orig.). With 2 figs., 1 tab.

  3. Incidence of malignancy and outcomes for dogs undergoing splenectomy for incidentally detected nonruptured splenic nodules or masses: 105 cases (2009-2013).

    Science.gov (United States)

    Cleveland, Matthew J; Casale, Sue

    2016-06-01

    OBJECTIVE To determine the frequency of malignancy and survival rates of dogs that underwent splenectomy for incidentally detected nonruptured splenic masses or nodules. DESIGN Retrospective case series. ANIMALS 105 client-owned dogs. PROCEDURES Medical records of dogs that underwent splenectomy at a veterinary teaching hospital between 2009 and 2013 were examined to identify patients with incidentally detected nonruptured splenic masses or nodules without associated hemoperitoneum. Only dogs with histologically confirmed diagnoses were included. Information regarding signalment, preoperative diagnostic tests, perioperative blood product transfusions, splenic mass diameter, histologic findings, adjunctive treatments, and survival time was collected and analyzed. RESULTS 74 of 105 (70.5%) patients had benign splenic lesions and 31 (29.5%) had malignant neoplasia, most commonly hemangiosarcoma (18/31 [58%]). The hazard of death decreased as preoperative PCV increased; histopathologic diagnosis of malignant neoplasia was significantly associated with an increased hazard of death. Median life expectancy of dogs with benign and malignant lesions was 436 and 110 days, respectively; 41 of 74 patients with benign lesions and 3 of 31 patients with malignant neoplasia were still alive at study conclusion. Median life expectancy of dogs with hemangiosarcoma was 132 days; only 7 of these 18 dogs received any adjunctive chemotherapeutic treatments. CONCLUSIONS AND CLINICAL RELEVANCE Incidentally found, nonruptured splenic masses or nodules without associated hemoperitoneum were most commonly benign. Results suggested that life expectancy for these dogs with incidentally detected benign or malignant splenic lesions that received prompt intervention was better than has previously been reported for other studied populations. PMID:27172343

  4. Assessment of microseeds biodegradability of Sm and Sm:Ba splenic implants in rabbits

    International Nuclear Information System (INIS)

    . Seeds of radioactive Sm-153 can be produced in an appropriate spatial distribution of the implant capable to combat splenic tumors. (author)

  5. Late development of splenic sarcoidosis-like lesions in a patient with metastatic melanoma and long-lasting clinical response to ipilimumab

    DEFF Research Database (Denmark)

    Andersen, Rikke; Nørgaard, Peter Henrik; Al-Jailawi, Mohamad Kadhem Mohamad;

    2014-01-01

    A male patient with Stage IV melanoma was treated with ipilimumab resulting in a long-lasting partial response according to RECIST criteria. However, twenty months after ipilimumab treatment, routine follow-up CT scan revealed new splenic lesions initially interpreted as indicative of progressive...... months the splenic lesions slowly disappeared and to date the patient remains in remission. Ipilimumab is now widely used in the treatment of melanoma patients. Our case-report illustrates that physicians should consider the possibility of ipilimumab induced visceral sarcoidosis-like reactions, mimicking...

  6. Immunologic effects of whole body ultraviolet (uv) irradiation. II. Defect in splenic adherent cell antigen presentation for stimulation of T cell proliferation

    International Nuclear Information System (INIS)

    Ultraviolet (uv) irradiation has been shown to alter many parameters of the immunologic reactivity of mice. The altered responsiveness of uv-irradiated mice, as measured by delayed-type hypersensitivity (DTH) and primary in vitro plaque-forming cell (PFC) responses to T-dependent antigens, has recently been correlated with a functional defect in the splenic adherent cell population of these animals. The present studies describe a model of this altered responsiveness, which allows further clarification of the effects of external uv irradiation on the splenic antigen-presenting cell (APC) in its interactions with T cells

  7. Non-operative management of a rare diagnosis of splenic torsion in a child with a history of giant omphalocele: a case report and literature review

    OpenAIRE

    Sheikh, Fariha; Kim, Michael E; Zamora, Irving J.; Olutoye, Oluyinka O.

    2014-01-01

    Background Splenic torsion is rare and as a result the appropriate management is unclear. While there has been a shift towards splenectomy and laparoscopic splenopexy, we present a successful case of non-operative management of splenic torsion in a patient with a history of a giant omphalocele. Case presentation A 3 year-old female presented with a three-day history of abdominal pain, fever and non-bloody emesis three and a half years after repair of her giant omphalocele. Abdominal radiograp...

  8. Splenic Preservation after Laparoscopic Left Pancreatectomy is associated with Less Postoperative Major Complications. An Analysis of 115 Consecutive Patients

    Directory of Open Access Journals (Sweden)

    Santiago Sánchez-Cabús

    2016-02-01

    Full Text Available Introduction Laparoscopic left pancreatectomy is progressively becoming the new gold standard procedure for the surgical treatment of left pancreatic disorders. However, as open pancreatic surgery, laparoscopic left pancreatectomy patients may present postoperative complications that could impair outcomes. Our aim was to identify preoperative or intraoperative risk factors for major postoperative complications. Patients and methods This is a retrospective analysis of a prospectively collected database of 115 consecutive patients undergoing laparoscopic left pancreatectomy. Surgical procedures performed were laparoscopic left splenopancreatectomy, left pancreatectomy with splenic vessels preservation and left pancreatectomy without splenic vessels preservation (Warshaw’s technique, LLP-WT. 60-day major postoperative complications were classified according to the Dindo-Clavien classification, reviewed and analyzed.Results Out of the 115 patients, 51 (44.3% underwent LLSP, 25 (21.8% LLP-SVP and 39 (33.9% LLP-WT. Major postoperative complications occurred in 15 (13% patients. Univariate analysis idenfied LLSP as the most important risk factor for major complications (22% vs 6%, p=0.024. Multivariate analysis identified LLSP as an independent risk of postoperative major complications (p=0.019, HR (95% CI: 4.617 (1.292-16.497. Conclusions Although splenectomy during laparoscopic left pancreatectomy is necessary in some cases, spleen must be preserved whenever possible, since splenectomy might be associated with a higher risk of major postoperative complications.

  9. Effect of 89Sr-induced monocytopenia on splenic and pulmonary alveolar macrophage populations in a normal steady state

    International Nuclear Information System (INIS)

    A bone-seeking radioisotope, 89Sr eliminates blood monocytes and their precursors in the bone marrow after a selective deposition in the skeletal bone. In the present study, we investigated whether or not such a prominent monocyte depletion can induce any alterations in tissue macrophage populations in 89Sr-injected mice. The number of monocytes or leukocytes possessing a macrophage differentiation antigen, Mac-1, phagocytic or Fc receptor (FcR) activity was significantly reduced in the blood and the bone marrow for about 6 weeks after 89Sr administration. Splenic macrophages characterized by these phenotypic or functional markers were not, however, altered in number during the post-injection period, despite the fact that the total number of spleen cells recovered significantly increased together with macrophage colony forming stem cells (M-CFC) and cells under DNA synthesis. The population of lavaged pulmonary alveolar macrophages (PAM) was invariable not only in the number recovered but also in DNA synthesis. Colony formation by PAM was consistently noted, and the total number of M-CFC in the lung was not reduced during the 8 weeks post-injection period. These results indicate that 89Sr-induced depletion of bone marrow-derived monocytes/macrophages or their precursors has little effect at least on the number of splenic and pulmonary alveolar macrophage populations in a normal steady state. (author)

  10. A case of splenic metastasis of ovarian cancer treated with complete laparoscopic splenectomy and transvaginal specimen extraction.

    Science.gov (United States)

    Takase, Yoshiaki; Tomizawa, Naoki; Enokida, Yasuaki; Shiraishi, Takuya; Katoh, Ryuji; Suto, Yujin; Sato, Hiroaki; Muroya, Ken; Kurosaki, Ryo; Kobayashi, Katsumi; Arakawa, Kazuhisa; Ando, Tatsumasa; Takesyohi, Izumi

    2016-12-01

    A 61-year-old woman was diagnosed with right inguinal lymph node and splenic metastasis of ovarian serous cystadenocarcinoma. We performed right inguinal lymph node dissection and total laparoscopic splenectomy in the supine position followed by transvaginal specimen extraction (TVSE). First, using three ports, we extracted the right inguinal lymph node. We repaired the posterior wall of the inguinal canal using a mesh plug. We added two ports and displaced the spleen from the retroperitoneum and lifted it using a snake retractor, disconnecting the hilum using an automatic suturing device. Next, the posterior wall of the vagina was intraperitoneally incised. And an Alexis® laparoscopic system was inserted into the vagina. The cap maintained aeroperitoneum, a collection bag was inserted in the abdominal cavity via the vagina, and the spleen was collected. When the spleen was removed from the body, partial fragmentation of the organ was required in the bag. Organ fragmentation was performed only within the bag, and we made sure not to tear the bag. The vaginal wound was laparoscopically sutured. The patient had no operative complications and was able to actively ambulate at the first day after surgery due to a slight postoperative pain. Total laparoscopic splenectomy with TVSE in the supine position may be a safe and feasible method for selected female patients. This technique enables minimally invasive surgery for female patients with splenic disease. PMID:26976616

  11. The role of microfibrillar-associated protein 4 (MFAP4) in the formation and function of splenic compartments during embryonic and adult life

    DEFF Research Database (Denmark)

    Milićević, Novica M; Schmidt, Friederike; Kunz, Natalia;

    2016-01-01

    infections; however, the significance of MFAP4 for the function of the spleen is unknown. Immunohistochemistry, morphometry and real-time RT-PCR were used to analyze wild-type and MFAP4-deficient spleens. In addition, they were compared with splenic tissue, which was newly formed 8 weeks after avascular...

  12. Bovine NK cells acquire cytotoxic activity and produce IFN-gamma after stimulation by Mycobacterium bovis BCG- or Babesia bovis-exposed splenic dendritic cells

    Science.gov (United States)

    Early interactions of innate immune cell populations such as DC, monocytes/macrophages and NK cells, can affect the ability of the acquired immune response to control infection of intracellular microorganisms. In this study, we investigated the activation of bovine NK cells by CD13+ splenic DC or CD...

  13. Alkylglycerols modulate the proliferation and differentiation of non-specific agonist and specific antigen-stimulated splenic lymphocytes.

    Directory of Open Access Journals (Sweden)

    Linxi Qian

    Full Text Available Alkylglycerols (AKGs are ether-linked glycerols derived from shark liver oil and found in small amounts in human milk. Previous studies showed that oral AKGs administration significantly increased the immune response in mice. The aim of the present study was to investigate the in vitro immunomodulatory effect of AKGs on stimulating splenic lymphocyte responses. C57BL/6 mice were immunized with hepatitis B surface antigen (HBsAg. Splenic B cells were purified and stimulated with anti-BCR and anti-CD38. Meanwhile, splenic CD4+ T cells were purified and stimulated with anti-CD3 and anti-CD28. For antigen specific stimulation, the purified CD4+ T cells were cocultured with HBsAg -pulsed dendritic cells. The stimulated lymphocytes were treated with different concentrations of AKGs. The cell proliferation was assessed by [3H]-thymidine incorporation assay. The maturation of B cells was assessed by examining the germline (GL transcription of IgG (γ1 mRNA expression, and the surface expressions of CD80/CD86 markers were examined by flow cytometry analysis. Th1/Th2 polarity was assessed by T-BET (Th1/GATA-3 (Th2 flow cytometry assay and by characteristic cytokines ELISA assay (TNF-α and IFN-γ for Th1; IL-4 and IL-10 for Th2. It was found that AKGs significantly increased the BCR/CD38 -stimulated B cell proliferation. The T cell proliferation in response to CD3/CD28 or specific antigen stimulation was also increased by AKGs. The transcriptional level of IgG (γ1 and the expressions of CD80/CD86 molecules were markedly increased by AKGs in BCR/CD38 -stimulated B cells. Meanwhile, the results showed that AKGs increased the expression of T-BET transcriptional factor and the production of Th1 cytokines (TNF-α and IFN-γ upon CD3/CD28 stimulation; whereas, levels of Th2 cytokines (IL-4 and IL-10 were decreased by AKGs. Our study demonstrated that AKGs can modulate immune responses by boosting the proliferation and maturation of murine lymphocytes in vitro.

  14. Alkylglycerols modulate the proliferation and differentiation of non-specific agonist and specific antigen-stimulated splenic lymphocytes.

    Science.gov (United States)

    Qian, Linxi; Zhang, Mingshun; Wu, Shengmei; Zhong, Yan; Van Tol, Eric; Cai, Wei

    2014-01-01

    Alkylglycerols (AKGs) are ether-linked glycerols derived from shark liver oil and found in small amounts in human milk. Previous studies showed that oral AKGs administration significantly increased the immune response in mice. The aim of the present study was to investigate the in vitro immunomodulatory effect of AKGs on stimulating splenic lymphocyte responses. C57BL/6 mice were immunized with hepatitis B surface antigen (HBsAg). Splenic B cells were purified and stimulated with anti-BCR and anti-CD38. Meanwhile, splenic CD4+ T cells were purified and stimulated with anti-CD3 and anti-CD28. For antigen specific stimulation, the purified CD4+ T cells were cocultured with HBsAg -pulsed dendritic cells. The stimulated lymphocytes were treated with different concentrations of AKGs. The cell proliferation was assessed by [3H]-thymidine incorporation assay. The maturation of B cells was assessed by examining the germline (GL) transcription of IgG (γ1) mRNA expression, and the surface expressions of CD80/CD86 markers were examined by flow cytometry analysis. Th1/Th2 polarity was assessed by T-BET (Th1)/GATA-3 (Th2) flow cytometry assay and by characteristic cytokines ELISA assay (TNF-α and IFN-γ for Th1; IL-4 and IL-10 for Th2). It was found that AKGs significantly increased the BCR/CD38 -stimulated B cell proliferation. The T cell proliferation in response to CD3/CD28 or specific antigen stimulation was also increased by AKGs. The transcriptional level of IgG (γ1) and the expressions of CD80/CD86 molecules were markedly increased by AKGs in BCR/CD38 -stimulated B cells. Meanwhile, the results showed that AKGs increased the expression of T-BET transcriptional factor and the production of Th1 cytokines (TNF-α and IFN-γ) upon CD3/CD28 stimulation; whereas, levels of Th2 cytokines (IL-4 and IL-10) were decreased by AKGs. Our study demonstrated that AKGs can modulate immune responses by boosting the proliferation and maturation of murine lymphocytes in vitro. PMID

  15. Tortuosity and calcification of the splenic artery. More than an additional finding; Schlaengelung und Verkalkung der Milzarterie im Roentgenbild. Mehr als ein Nebenbefund

    Energy Technology Data Exchange (ETDEWEB)

    Golder, W.A. [SELARL Association d' Imagerie Medicale, Troyes (France)

    2008-11-15

    Tortuosity of the splenic artery and calcification of the vessel wall are typical additional findings on plain abdominal x-ray. The combination of both anomalies is common in elderly persons presenting without symptoms of splenic ischemia. Its pathogenesis is thought to be multifactorial. In infancy and childhood, the splenic artery is stretched in its entire course. A growing difference between the length of the vessel and the distance between its origin and the splenic hilum gives rise to tortuosity. The artery's proximal segment is involved more frequently and more severely than the distal one. The tortuous route of the vessel is accentuated by the direction of its major branches, which is roughly perpendicular to the main trajectory. Neither tortuosity nor calcification should be taken to be risk factors for the comparatively common splenic artery aneurysm. Calcific deposits are not confined to the media but are also detected in the intima of the vascular wall. Critical narrowings of the lumen arising on the calcium deposits are not observed. Calcifying atherosclerosis of the splenic artery is comparable to medial sclerosis of the peripheral arteries frequently noticed in diabetics and dialysis patients. Only the less important calcification of the intima may be attributed to mechanisms of the hydrohemodynamic theory of atherosclerosis. The spleen's blood storage capacity may contribute to the characteristic age-dependent alterations of the shape and course of the splenic artery. (orig.) [German] Die Schlaengelung der Milzarterie und Verkalkungen in der Wand des Gefaesses sind ein typischer Nebenbefund bei der Roentgenuntersuchung des Abdomens. Die Kombination wird v. a. bei Senioren beobachtet, ohne dass Symptome einer Mangelperfusion der Milz fassbar sind. Bei der Pathogenese wirken eine Reihe verschiedener Faktoren zusammen. Im Kindesalter verlaeuft die A. lienalis stets gestreckt. Die zunehmende Schlaengelung wird durch die wachsende Differenz

  16. Complex Mediation

    DEFF Research Database (Denmark)

    Bødker, Susanne; Andersen, Peter Bøgh

    2005-01-01

    This article has its starting point in a large number of empirical findings regarding computer-mediated work. These empirical findings have challenged our understanding of the role of mediation in such work; on the one hand as an aspect of communication and cooperation at work and on the other ha...

  17. Specialized Mediation.

    Science.gov (United States)

    Hammond, Carol; And Others

    1992-01-01

    Six articles discuss librarians as mediators in special circumstances. Highlights include the reference librarian and the information paraprofessional; effective reference mediation for nontraditional public library users, including mentally impaired patrons and illiterate adults; the academic librarian's role in the education process; and…

  18. Splenic uptake of both technetium-99m diphosphonate and technetium-99m sulfur colloid in sickle cell beta degrees thalassemia

    International Nuclear Information System (INIS)

    A 19-year-old black woman with sickle cell beta degrees thalassemia had experienced more than 100 hospital admissions for sickle cell crisis and aseptic necrosis of both femoral heads. Her spleen was enlarged threefold and accumulated both radiocolloid and bone-seeking agent on two occasions, demonstrating an exception to the rule in sickle cell anemia that spleens that take up bone-seeking agents demonstrate functional asplenia. In the context of fever, left upper quadrant pain, and splenomegaly, the pattern of calcification in the patient's spleen as revealed in ultrasound and CT studies suggested possible abscess and led to unnecessary splenectomy. The nuclear medicine studies did not support this diagnosis. Nuclear medicine physicians should not be misled by splenic findings of sickle cell thalassemia (and possibly of other heterozygous sickle cell disorders) that differ from those of the more familiar homozygous sickle cell anemia

  19. Dynamic left ventricular outflow tract obstruction secondary to hypovolemia in a German Shepard dog with splenic hemangiosarcoma.

    Science.gov (United States)

    Aoki, Takuma; Sunahara, Hiroshi; Sugimoto, Keisuke; Ito, Tetsuro; Kanai, Eiichi; Neo, Sakurako; Fujii, Yoko; Wakao, Yoshito

    2015-09-01

    Dynamic left ventricular outflow tract obstruction (DLVOTO) is a common condition in cats and humans. In this case report, a dog is described with DLVOTO secondary to severe intra-abdominal hemorrhage caused by a hemangiosarcoma. The dog was a 9-year-old, 35.7-kg, spayed female German Shepard dog that presented with a history of tachypnea and collapse. A Levine II/VI systolic murmur was present at the heart base. Abdominal ultrasonography revealed a splenic mass and a large amount of ascites. Echocardiography showed a reduced left ventricular diameter and an increased aortic velocity caused by systolic anterior motion (SAM) of the mitral valve apparatus. The heart murmur and the SAM were resolved after treatment including a splenectomy and a blood transfusion. PMID:25924797

  20. Hemosuccus pancreaticus caused by rupture of a splenic artery pseudoaneurysm complicating chronic alcoholic pancreatitis: an uncommon cause of gastrointestinal bleeding.

    Science.gov (United States)

    Hiltrop, Nick; Vanhauwaert, Anke; Palmers, Pieter-Jan Liesbeth Herman; Cool, Mike; Deboever, Guido; Lambrecht, Guy

    2015-12-01

    We present a case of a 52-year old female patient with intermittent gastrointestinal bleeding and iron deficiency anaemia. Repeated endoscopic investigation revealed no diagnosis, but contrast-enhanced computed tomography showed a splenic artery pseudo-aneurysm secondary to chronic alcoholic pancreatitis. A distal pancreatectomy and splenectomy was performed. Hemosuccus pancreaticus is an uncommon cause of gastrointestinal bleeding, most frequently associated with chronic pancreatitis. Erosion of a peripancreatic artery by a pseudocyst can cause a pseudoaneurysm and rupture occurs in up to 10% of the cases. Bleeding from a pseudocyst wall or rupture of an atherosclerotic or traumatic aneurysm is rare. Angiography, contrast-enhanced computed tomography and endoscopic findings can be diagnostic in the majority of cases. Angiographic embolization or surgery are both therapeutic options depending on underlying nonvascular pancreas related indications requiring surgery. We discuss diagnostic pitfalls and current therapeutic strategies in the management of this disease. PMID:26712055

  1. Damage of Splenic T Lymphocyte Proliferation and Differentiation and Its Normalization by Electroacupuncture in Morphine-Dependent Mice Mode

    Directory of Open Access Journals (Sweden)

    Hong-Yu Li

    2011-01-01

    Full Text Available In a previous paper we reported that electroacupuncture (EA could suppress opioid withdrawal syndrome and increase the appetite, sleep, and body weight in heroin addicts or morphine dependent animals. Considering that opioids were known to inhibit immune function, the present study was designed to observe whether EA could modulate the immune status of morphine dependent and withdrawal mice. We found that chronic morphine-induced decrease of splenic T lymphocyte proliferation and IL-2 production can be significantly raised by 2 Hz EA, and the fluctuation of CD4+/CD8+ ratio was also run to the baseline level by the EA. These findings indicated that chronic morphine exposure-induced immune dysfunction in mice could be normalized by 2 Hz EA.

  2. Efficacy and surgical procedures of preoperative splenic artery embolization for laparoscopic splenectomy of a massive splenomegaly: A case report

    Directory of Open Access Journals (Sweden)

    Toshikatsu Nitta

    2015-01-01

    Full Text Available Here, we describe the case of a 58-year-old woman diagnosed with massive splenomegaly with a malignant lymphoma that had a maximum diameter of 24 cm. Splenectomy was indicated because of thrombocytopenia and abdominal distention. Therefore, a balloon catheter was inserted preoperatively through the splenic artery for embolization and continuous infusion to reduce the spleen volume. It enabled easy handling of the spleen and minimized bleeding. The volume of the spleen was estimated at 1896 g through the skin incision, as measured by volumetric computed tomography; thus, laparoscopy seemed difficult. However, the surgery was successfully performed only with laparoscopic surgery, and the volume of the resected spleen was 1020 g. This preoperative preparation is an effective alternative to laparoscopic removal of a huge splenomegaly.

  3. Nasopharyngeal carcinoma with splenic and cystic liver metastases in a pediatric patient: 18F-FDG PET-CT findings

    Energy Technology Data Exchange (ETDEWEB)

    Radhakrishnan, Venkatraman; Bakhshi, Sameer [All India Institute of Medical Sciences, Department of Medical Oncology, Dr. B. R. A. Institute Rotary Cancer Hospital, New Delhi (India); Thulkar, Sanjay [All India Institute of Medical Sciences, Department of Radiology, Dr. B. R. A. Institute Rotary Cancer Hospital, New Delhi (India); Karunanithi, Sellam [All India Institute of Medical Sciences, Department of Nuclear Medicine, Dr. B. R. A. Institute Rotary Cancer Hospital, New Delhi (India); Tanveer, Nadeem [All India Institute of Medical Sciences, Department of Pathology, Dr. B. R. A. Institute Rotary Cancer Hospital, New Delhi (India)

    2010-12-15

    Pediatric nasopharyngeal carcinoma (NPC) is rare and usually poorly differentiated. We report a 14-year-old boy with NPC with metastases to liver, spleen, lymph nodes and bone marrow. The liver metastases closely resembled benign cystic liver disease on imaging; however, they showed intense uptake similar to other metastatic sites on positron emission tomography (PET) scan. A liver biopsy could not be performed on the boy. The boy responded clinically to platinum-based chemotherapy, and all the baseline PET-positive lesions became negative. This case highlights the rarity of splenic and cystic liver metastases in pediatric NPC and demonstrates the potential use of PET/CT in diagnosis, staging and response assessment in metastatic pediatric NPC. (orig.)

  4. Two anomalous cases of the hepato-mesenteric and the gastro-splenic trunks independently arising from the abdominal aorta.

    Science.gov (United States)

    Hirai, Y; Yamaki, K; Saga, T; Hirata, T; Yoshida, M; Soejima, H; Kanazawa, T; Tanaka, K; Yoshizuka, M

    2000-01-01

    This report describes two arterial anomaly cases in the celiaco-mesenteric region, which were encountered in two Japanese male cadavers in the dissecting room at Kurume University School of Medicine in 1999. In these cases, the usual celiac trunks were not identified, and the hepato-mesenteric and the gastro-splenic trunks were independently arising from the abdominal aorta. Moreover, in the first case, the common hepatic artery passed ventral side of the portal vein and divided into the hepatic proper and the gastroduodenal arteries. This type of arterial anomaly belongs to the Type V of Adachi's classification and the Type IV' of Morita's classification. In the second case, the common hepatic artery passed dorsal side of the portal vein and divided into the hepatic proper and the gastroduodenal arteries. This type of arterial anomaly belongs to the Type VI of Adachi's classification and the Type IV' of Morita's classification. PMID:11059229

  5. Comparative Study of Images with Pathology:Superparamagnetic Iron Oxide-enhanced Magnetic Resonance Image(MRI)of Splenic VX2 Tumor in Rats

    Institute of Scientific and Technical Information of China (English)

    YANG Hong-yan; XU Yi-kai; WU Yuan-kui; LIU Wen-yuan; L(U) Guo-shi; CAO Guo-hong

    2008-01-01

    Objective:To establish a rodent model of VX2 tumor of the spleen,to analyze relationship between the change of the signal intensity on superparamagnetic iron oxide enhanced magnetic resonance image(MRI)and pathologic change to evaluate the ability of superparamagnetic iron oxide enhanced MRI for detection of splenic metastases.Methods:8 rodent models of VX2 tumor of spleen were established successfully.The images were obtained before and after administration of superparamagnetic iron oxide.T1-weighted spin-echo(SE)pulse sequence with a repetition time(TR)of 450 msec,and echo time(TE)of 12 msec(TR/TE=450/12)was used.The imaging parameters Of T2-weighted SE pulse sequence were as follows:TR/TE=4000/128. Results:On plain MR scanning T1-weighted splenic VX2 tumor showed hypointensity or isointensity which approximated to the SI of splenic parenchyma.Therefore all lesions were not displayed clearly.On superparamagnetic iron oxide enhancement T2WI sequence the SI of splenic parenchyma decreased obviously with percentage of signal intensity loss(PSIL)of 55.04%,But the SI of tumor was not evidently changed with PSIL of 0.87%. Nevertheless the SNR of normal splenic parenchyma around the lesions had obvious difference(P<0.001)comparatively.Therefore the contrast between tumor and spleen increased.and tumor displayed more clearly.Moreover the contrast-to-noise(CNR)between VX2 tumor and splenic parenchyma had an evident difference before and after admininstration of superparamagnetic iron oxide(P<0.001).Conclusion:On superparamagnetic iron oxide enhancement T1WI sequence the contrast of tumor-to-spleen is poor.Therefore it is not sensitive to characterize the lesions in spleen.On superparamagnetie iron oxide enhanced T2WI the contrast degree of lesions increases obviously.Consequently, superparamagnetic iron oxide-enhanced T2WI MRI scanning can improve the rate of detection and characterization for lesions of spleen.

  6. Occupational exposure to 50 Hz magnetic fields does not alter responses of inflammatory genes and activation of splenic lymphocytes in mice

    Directory of Open Access Journals (Sweden)

    Xue Luo

    2016-04-01

    Full Text Available Objectives: The objective of the present study was to observe the effects of 50 Hz magnetic fields (MFs on the immune function of splenic lymphocytes in mice. Material and Methods: Twenty male Kunming mice (6 weeks old, weighing 18– 25 g, were randomly divided into sham exposure (N = 10 and 500 μT MFs (N = 10 groups. The mice in the MFs group were exposed to 500 μT MFs for 8 h daily (5 days/week for up to 60 days. In vitro study was carried out to examine the effects of 50 Hz MFs on the expression of inflammatory factor genes and a cluster of differentiation 69 (CD69 in mouse prime splenic lymphocytes activated by para-Methoxyamphetamine (PMA and ionomycin. In the in vitro experiments, lymphocytes were isolated from the spleen of 10 healthy Kunming mice, the cells were cultured in the Roswell Park Memorial Institute 1640 medium (RPMI-1640 and exposed to 0 μT, 250 μT, 500 μT, or 1 mT MFs in an incubator under 5% carbon dioxide (CO2 at 37°C for 6 h. The levels of interleukin-2 (IL-2, IL-4, interferon-gamma (IFN-γ, GATA binding protein 3 (GATA-3 and T cell-specific T-box transcription factor (T-bet were assessed by the real-time quantitative reverse transcription polymerase chain reaction (RT-qPCR, respectively. The expression of CD69 was checked using the flow cytometry. Results: Under our experimental conditions, body weight of the mice exposed to occupational, extremely low frequency- electromagnetic fields (ELF-EMFs significantly decreased on day 20 and day 30. There were no significant changes observed in vivo in spleen weight, splenic coefficient, splenic histology profile and cytokine production in spleen tissues. Our in vitro experiments showed that 50 Hz MFs had no effect on the expression of these genes and CD69 to primary splenic cells. Conclusions: In conclusion, under the applied experimental conditions, occupational exposure to 50 Hz magnetic field did not alter responses of inflammatory genes and activation of splenic

  7. Mediatized Humanitarianism

    DEFF Research Database (Denmark)

    Vestergaard, Anne

    2014-01-01

    The article investigates the implications of mediatization for the legitimation strategies of humanitarian organizations. Based on a (full population) corpus of ~400 pages of brochure material from 1970 to 2007, the micro-textual processes involved in humanitarian organizations' efforts to...... legitimate themselves and their moral claim were examined. A time trend analysis of the prioritization of actors in the material indicates that marked shifts in legitimation loci have taken place during the past 40 years. A discourse analysis unfolds the three dominant discourses behind these shifts, namely...... legitimation by accountancy, legitimation by institutionalization, and legitimation by compensation. The analysis relates these changes to a problem of trust associated with mediatization through processes of mediation....

  8. Expression of nerve growth factor mRNA in splenic lymphocytes of bronchial asthma rats and its influencing actors

    Institute of Scientific and Technical Information of China (English)

    Jihong Dai; Yonghong Wang; Haixia He

    2008-01-01

    BACKGROUND: Previous research has proved that nerve growth factor (NGF) participates in the onset of asthma by the induction of neurogenic inflammation.OBJECTIVE: To investigate the effect of interleukin-13 (IL-13) and interferon-γ(IFN-γ) on the expression of NGF mRNA in the splenic lymphocytes of bronchial asthma rats.DESIGN, TIME AND SETTING: The experiment, a completely randomized study based on cellular immunology, was performed in the Laboratory of Neurology in Chongqing Medical University and the Department of Clinical Pharmacy in College of Clinical Medicine, Chongqing Medical University (Chongqing, China) from January 2006 to April 2007.MATERIALS: Four adult male Wistar rats were used in this study. Rat IL-13, IFN-γprobe and the total RNA extraction kit were produced by Shanghai Sangon Biological Technology & Services Co., Ltd (China). The NGF ELISA kit was a product of Wuhan Boster Bioengineering Co., Ltd (China). A Du-70 automatic UV spectrophotometer was produced by Beckman Company (USA).METHODS: Rats were subjected to 1-mL intraperitoneal injections each containing 100 mg of ovalbumin, and were sensitized by using antigen solution, which was sensitized with 5×109 Bacillus pertussis and 100 mg aluminum hydroxide powder. Four rats were challenged with 1% ovalbumin using an ultrasonic nebulizer for 60 minutes to establish an asthmatic model. After rats were anesthetized, splenic lymphocytes were isolated and cultured in medium, which was supplemented with IL-13 or IFN-γ, for 0, 12, 24 or 48 hours. A parallel study was conducted with cultured splenic lymphocytes, which were divided into a control group, an IL-13 group and an IFN-γ group. Culture medium was added with different concentrations of IL-13 (10, 50, 100 μg/L) and IFN-γ (1, 10, 50 μg/L); 24 hours later, all samples were harvested.MAIN OUTCOME MEASURES: The expression levels of NGF mRNA were detected by reverse transcription-polymerase chain reaction.RESULTS: In the control group, the

  9. Investigation of the action of some phospholipids and gangliosides on sensitivity of tumor cells to the cytostatic and membrane-toxic action of splenic effectors

    International Nuclear Information System (INIS)

    This investigation attempts to determine which parts of the lipid molecule are most responsible for the increase in sensitivity of tumor cells to the membrane-toxic and cytostatic action of natural splenic effectors. The characteristics of the lipids used are presented. Splenocytes from BALB/c mice were treated beforehand with actinomycin D to prevent incorporation of tritium-uridine. Either tritium-uridine or tritium-thymidine was added to each well. The experiments showed that ovolecithin, alone, introduced into the membrane of the tumor did not affect its sensitivity to the cytostatic and membrane-toxic action of splenic effectors, whereas a mixture of brain gangliosides actually reduced the sensitivity of target cells

  10. Mediatized play

    DEFF Research Database (Denmark)

    Johansen, Stine Liv

    Children’s play must nowadays be understood as a mediatized field in society and culture. Media – understood in a very broad sense - holds severe explanatory power in describing and understanding the practice of play, since play happens both with, through and inspired by media of different sorts........ In this presentation the case of ‘playing soccer’ will be outlined through its different mediated manifestations, including soccer games and programs on TV, computer games, magazines, books, YouTube videos and soccer trading cards....

  11. Mediating Business

    DEFF Research Database (Denmark)

    "Mediating Business" is a study of the expansion of business journalism. Building on evidence from Denmark, Finland, Norway and Sweden, "Mediating Business" is a comparative and multidisciplinary study of one of the major transformations of the mass media and the realm of business - nationally and...... globally. The book explores the history of key innovations and innovators in the business press. It analyzes changes in the discourse of business journalism associated with the growth in business news and the development of new ways of framing business issues and events. Finally, it examines the...... organizational implications of the increased media visibility of business and, in particular, the development of corporate governance and media relations....

  12. Rare case of isolated splenic metastases from gastric cancer detected with fluorine-18 fluorodeoxyglucose-positron emission tomography/computed tomography

    International Nuclear Information System (INIS)

    We report a rare case of isolated splenic metastasis from gastric cancer detected with fluorine-18 fluorodeoxyglucose-positron emission tomography/computed tomography (PET/CT). A 55-year-old man with gastric cancer 1 year post surgery, evaluated with PET/CT showed focal, intense uptake in the spleen, with no other abnormal findings. On splenectomy, the lesion was confirmed as metastasis from gastric cancer pathologically. (author)

  13. Ectopic splenic tissues mimicking gastro-intestinal stromal tumour in a patient after splenectomy for a giant epithelial cyst of spleen: A case report

    OpenAIRE

    Chung Kam Man; Lau Hiu Yan Stephanie; Lau Wan Yee

    2015-01-01

    Introduction: Ectopic splenic tissues left after a previous splenectomy can masquerade as a gastro-intestinal stromal tumour (GIST). Presentation of case: Splenectomy was carried out for a 17-year-old girl with a giant epithelial cyst of spleen. Four years later, an upper endoscopy carried out for dyspepsia revealed two sub-mucosal lesions at the posterior wall of the gastric fundus. Computed tomography diagnosed a GIST. At operation, a dump-bell shaped extragastric mass was excised. Histo...

  14. Splenic irradiation before hematopoietic stem cell transplantation for chronic myeloid leukemia: long-term follow-up of a prospective randomized study.

    Science.gov (United States)

    Gratwohl, Alois; Iacobelli, Simona; Bootsman, Natalia; van Biezen, Anja; Baldomero, Helen; Arcese, William; Arnold, Renate; Bron, Dominique; Cordonnier, Catherine; Ernst, Peter; Ferrant, Augustin; Frassoni, Francesco; Gahrton, Gösta; Richard, Carlos; Kolb, Hans Jochem; Link, Hartmut; Niederwieser, Dietger; Ruutu, Tapani; Schattenberg, Anton; Schmitz, Norbert; Torres-Gomez, Antonio; Zwaan, Ferry; Apperley, Jane; Olavarria, Eduardo; Kröger, Nicolaus

    2016-05-01

    In the context of discussions on the reproducibility of clinical studies, we reanalyzed a prospective randomized study on the role of splenic irradiation as adjunct to the conditioning for hematopoietic stem cell transplantation (HSCT) for chronic myeloid leukemia (CML). Between 1986 and 1989, a total of 229 patients with CML were randomized; of these, 225 (98 %; 112 with, 113 without splenic irradiation) could be identified in the database and their survival updated. Results confirmed the early findings with no significant differences in all measured endpoints (overall survival at 25 years: 42.7 %, 32.0-52.4 % vs 52.9 %, 43.2-62.6 %; p = 0.355, log rank test). Additional splenic irradiation failed to reduce relapse incidence. It did not increase non-relapse mortality nor the risk of late secondary malignancies. Comforting are the long-term results from this predefined consecutive cohort of patients: more than 60 % were alive at plus 25 years when they were transplanted with a low European Society for Blood and Marrow Transplantation (EBMT) risk sore. This needs to be considered today when treatment options are discussed for patients who failed initial tyrosine kinase inhibitor therapy and have an available low risk HLA-identical donor. PMID:26994010

  15. Erythropoietin withdrawal alters interactions between young red blood cells, splenic endothelial cells, and macrophages: an in vitro model of neocytolysis

    Science.gov (United States)

    Trial, J.; Rice, L.; Alfrey, C. P.

    2001-01-01

    BACKGROUND: We have described the rapid destruction of young red blood cells (neocytolysis) in astronauts adapting to microgravity, in polycythemic high altitude dwellers who descend to sea level, and in patients with kidney disorders. This destruction results from a decrease in erythropoietin (EPO) production. We hypothesized that such EPO withdrawal could trigger physiological changes in cells other than red cell precursors and possibly lead to the uptake and destruction of young red cells by altering endothelial cell-macrophage interactions, most likely occurring in the spleen. METHODS: We identified EPO receptors on human splenic endothelial cells (HSEC) and investigated the responses of these cells to EPO withdrawal. RESULTS: A monolayer of HSEC, unlike human endothelial cells from aorta, glomerulus, or umbilical vein, demonstrated an increase in permeability upon EPO withdrawal that was accompanied by unique morphological changes. When HSEC were cultured with monocyte-derived macrophages (but not when either cell type was cultured alone), EPO withdrawal induced an increased ingestion of young red cells by macrophages when compared with the constant presence or absence of EPO. CONCLUSIONS: HSEC may represent a unique cell type that is able to respond to EPO withdrawal by increasing permeability and interacting with phagocytic macrophages, which leads to neocytolysis.

  16. Scintigraphic assessment of indium-111-labeled granulocyte splenic pooling: A new approach to inflammatory bowel disease activity

    International Nuclear Information System (INIS)

    We have conducted a prospective study into the sensitivity and the specificity of the fall in splenic activity (FSA) as an index of activity in inflammatory bowel disease (IBD). FSA was measured on scintiscans obtained at 3 and 24 hr postinjection of indium-111-labeled granulocytes. One hundred and twenty-two scans were acquired in 96 patients who were divided into six groups: Gr. I = normal volunteers (n = 10); Gr. II = inflammatory rheumatism (n = 10); Gr. III = abscesses (n = 17); Gr. IV = ulcerative colitis (UC: n = 23); Gr. V = colonic Crohn's disease (CCD: n = 22); and Gr. VI = ileal Crohn's disease (ICD: n = 14). FSA for Groups I and II was constantly below 10%, but it was increased in the other four groups (abscesses: 39% +/- 12%; UC: 35% +/- 13.5%; CCD: 23.7% +/- 14.7%; ICD: 21.5% +/- 11.7%). There was a significant correlation between fecal excretion of 111In (FEI) and FSA in patients with IBD (UC: r = 0.71, p less than 0.001; CCD: r = 0.74, p less than 0.001; ICD: r = 0.43, p less than 0.001). FSA was followed in 16 patients with IBD after medical treatment and there was a significant correlation between variations in FSA and in FEI (r = 0.879, p less than 0.001). FSA is a very sensitive although nonspecific index of disease activity in IBD and may replace FEI in the assessment of IBD activity

  17. Hepatic and Splenic Acoustic Radiation Force Impulse Shear Wave Velocity Elastography in Children with Liver Disease Associated with Cystic Fibrosis

    Directory of Open Access Journals (Sweden)

    Teresa Cañas

    2015-01-01

    Full Text Available Background. Liver disease associated with cystic fibrosis (CFLD is the second cause of mortality in these patients. The diagnosis is difficult because none of the available tests are specific enough. Noninvasive elastographic techniques have been proven to be useful to diagnose hepatic fibrosis. Acoustic radiation force impulse (ARFI imaging is an elastography imaging system. The purpose of the work was to study the utility of liver and spleen ARFI Imaging in the detection of CFLD. Method. 72 patients with cystic fibrosis (CF were studied and received ARFI imaging in the liver and in the spleen. SWV values were compared with the values of 60 healthy controls. Results. Comparing the SWV values of CFLD with the control healthy group, values in the right lobe were higher in patients with CFLD. We found a SWV RHL cut-off value to detect CFLD of 1.27 m/s with a sensitivity of 56.5% and a specificity of 90.5%. CF patients were found to have higher SWC spleen values than the control group. Conclusions. ARFI shear wave elastography in the right hepatic lobe is a noninvasive technique useful to detect CFLD in our sample of patients. Splenic SWV values are higher in CF patients, without any clinical consequence.

  18. The prognostic impact of clinical and molecular features in hairy cell leukaemia variant and splenic marginal zone lymphoma.

    Science.gov (United States)

    Hockley, Sarah L; Else, Monica; Morilla, Alison; Wotherspoon, Andrew; Dearden, Claire; Catovsky, Daniel; Gonzalez, David; Matutes, Estella

    2012-08-01

    Hairy cell leukaemia variant (HCL-variant) and splenic marginal zone lymphoma (SMZL) are disorders with overlapping features. We investigated the prognostic impact in these disorders of clinical and molecular features including IGH VDJ rearrangements, IGHV gene usage and TP 53 mutations. Clinical and laboratory data were collected before therapy from 35 HCL-variant and 68 SMZL cases. End-points were the need for treatment and overall survival. 97% of HCL-variant and 77% of SMZL cases required treatment (P = 0·009). Survival at 5 years was significantly worse in HCL-variant [57% (95% confidence interval 38-73%)] compared with SMZL [84% (71-91%); Hazard Ratio 2·25 (1·20-4·25), P = 0·01]. In HCL-variant, adverse prognostic factors for survival were older age (P = 0·04), anaemia (P = 0·01) and TP 53 mutations (P = 0·02). In SMZL, splenomegaly, anaemia and IGHV genes with >98% homology to the germline predicted the need for treatment; older age, anaemia and IGHV unmutated genes (100% homology) predicted shorter survival. IGHV gene usage had no impact on clinical outcome in either disease. The combination of unfavourable factors allowed patients to be stratified into risk groups with significant differences in survival. Although HCL-variant and SMZL share some features, they have different outcomes, influenced by clinical and biological factors. PMID:22594855

  19. Protection against radio-oxidative damage of splenic lymphocytes by ethanolic extract of Nigella Sativa

    International Nuclear Information System (INIS)

    Cellular membranes are being recognized as a sensitive radiation target and evidence is accumulating in support of membrane oxidative damage playing a central role in the mechanism of radiation induced cell death. Present study was aimed to evaluate radio-oxidative damage in membrane of spleen lymphocytes and its modification by ethanolic extract of herb, Nigella sativa (black cumin), an herbaceous annual plant. Lymphocytes were obtained from swiss mice after cervical dislocation were suspended in culture medium (106 cells/ml) and were exposed to various doses of γ radiation (0.5-5 Gy). Oxidative damage related parameters, such as lipid peroxidation, reactive oxygen species (ROS) and reactive nitrogen species (RNS) were determined by thiobarbituric acid reactive substances (TBARS), H2DCFDA and Greiss reagent methods respectively. It was found that peroxides, ROS and RNS increased with the dose of radiation. When cells were pretreated with N. Sativa extract but present during irradiation, they were found significantly protected against radiation exposure as measured by cellular viability by trypan blue and the protective effect was concentration dependent (1-200 μg/ml). Extract treated cells were found to show reduced ROS, RNS and lipid peroxide formation suggesting that the protective effect was mediated by free radical mechanism. With the increasing dose of radiation, there was decreasing activity of endogenous antioxidant enzymes, superoxide dismutase (SOD), catalase (CAT), and glutathioneperoxidase (GPx). Pretreatment of lymphocytes with ethanolic extract was found to prevent radiation induced depletion of the intracellular antioxidant enzymes. It is concluded that radiation exposure of lymphocytes produced free radical induced membrane oxidative damage, which was significantly prevented by the ethanolic extract of N. Sativa. (author)

  20. CD8+ CD205+ splenic dendritic cells are specialized to induce Foxp3+ regulatory T cells.

    Science.gov (United States)

    Yamazaki, Sayuri; Dudziak, Diana; Heidkamp, Gordon F; Fiorese, Christopher; Bonito, Anthony J; Inaba, Kayo; Nussenzweig, Michel C; Steinman, Ralph M

    2008-11-15

    Foxp3(+)CD25(+)CD4(+) regulatory T cells (Treg) mediate immunological self-tolerance and suppress immune responses. A subset of dendritic cells (DCs) in the intestine is specialized to induce Treg in a TGF-beta- and retinoic acid-dependent manner to allow for oral tolerance. In this study we compare two major DC subsets from mouse spleen. We find that CD8(+) DEC-205/CD205(+) DCs, but not the major fraction of CD8(-) DC inhibitory receptor-2 (DCIR2)(+) DCs, induce functional Foxp3(+) Treg from Foxp3(-) precursors in the presence of low doses of Ag but without added TGF-beta. CD8(+)CD205(+) DCs preferentially express TGF-beta, and the induction of Treg by these DCs in vitro is blocked by neutralizing Ab to TGF-beta. In contrast, CD8(-)DCIR2(+) DCs better induce Foxp3(+) Treg when exogenous TGF-beta is supplied. In vivo, CD8(+)CD205(+) DCs likewise preferentially induce Treg from adoptively transferred, Ag-specific DO11.10 RAG(-/-) Foxp3(-)CD4(+) T cells, whereas the CD8(-)DCIR2(+) DCs better stimulate natural Foxp3(+) Treg. These results indicate that a subset of DCs in spleen, a systemic lymphoid organ, is specialized to differentiate peripheral Foxp3(+) Treg, in part through the endogenous formation of TGF-beta. Targeting of Ag to these DCs might be useful for inducing Ag-specific Foxp3(+) Treg for treatment of autoimmune diseases, transplant rejection, and allergy. PMID:18981112

  1. Evaluation of the potential immunotoxicity of 3-monochloro-1,2-propanediol in Balb/c mice I. Effect on antibody forming cell, mitogen-stimulated lymphocyte proliferation, splenic subset, and natural killer cell activity

    International Nuclear Information System (INIS)

    3-Monochloro-1,2-propanediol (MCPD) is a well-known by-product of acid-hydrolyzed soy sauce during its manufacturing process. MCPD has been reported genotoxic in vitro, and reproductive toxicity and carcinogenicity in rats. However, no previous studies have investigated MCPD-induced alterations in the immune system. In the present study, MCPD was administered by gavage for 14 days at 0, 25, 50, and 100 mg/kg per day to female Balb/c mice. The antibody-mediated immune response to sheep red blood cells (SRBC) was assessed using the antibody-forming cell (AFC) assay, and splenic cell phenotypes were quantified by flow cytometry. Hematological and histopathological changes were assessed. Mitogen-stimulated spleen lymphocyte proliferation and natural killer (NK) cell activity were evaluated. The T-lymphocyte blastogenesis by concanavalin A (Con A) or anti-CD3 and B-lymphocyte blastogenesis by lipopolysaccharide (LPS) were not significantly changed. There were no significant changes in the hematological and histopathological findings of MCPD-treated mice. However, the significant decrease in thymus weight was observed in 100 mg dose group, even though that did not change body weight gain. The cellularities of spleen and thymus were significantly reduced in high-dose group. Exposure to high dose of MCPD decreased the AFC response to SRBC in mice. There was a significant decrease in NK cell activity of mice treated with high dose of MCPD. These results indicate that MCPD could modulate the immune function in Balb/c mice

  2. Case report: diffuse splenic metastasis of occult breast cancer with incompatible blood group antigenic determinants.

    Science.gov (United States)

    Baranyay, Ferenc

    2009-01-01

    , where the complement-mediated tumor cell lysis immune rejection was not effective. PMID:19201455

  3. Scintigraphic assessment of indium-111-labeled granulocyte splenic pooling: A new approach to inflammatory bowel disease activity

    Energy Technology Data Exchange (ETDEWEB)

    Loreal, O.; Moisan, A.; Bretagne, J.F.; LeCloirec, J.; Raoul, J.L.; Gastard, J.; Herry, J.Y. (CHU, Pontchaillou, Rennes (France))

    1990-09-01

    We have conducted a prospective study into the sensitivity and the specificity of the fall in splenic activity (FSA) as an index of activity in inflammatory bowel disease (IBD). FSA was measured on scintiscans obtained at 3 and 24 hr postinjection of indium-111-labeled granulocytes. One hundred and twenty-two scans were acquired in 96 patients who were divided into six groups: Gr. I = normal volunteers (n = 10); Gr. II = inflammatory rheumatism (n = 10); Gr. III = abscesses (n = 17); Gr. IV = ulcerative colitis (UC: n = 23); Gr. V = colonic Crohn's disease (CCD: n = 22); and Gr. VI = ileal Crohn's disease (ICD: n = 14). FSA for Groups I and II was constantly below 10%, but it was increased in the other four groups (abscesses: 39% +/- 12%; UC: 35% +/- 13.5%; CCD: 23.7% +/- 14.7%; ICD: 21.5% +/- 11.7%). There was a significant correlation between fecal excretion of 111In (FEI) and FSA in patients with IBD (UC: r = 0.71, p less than 0.001; CCD: r = 0.74, p less than 0.001; ICD: r = 0.43, p less than 0.001). FSA was followed in 16 patients with IBD after medical treatment and there was a significant correlation between variations in FSA and in FEI (r = 0.879, p less than 0.001). FSA is a very sensitive although nonspecific index of disease activity in IBD and may replace FEI in the assessment of IBD activity.

  4. Splenic fibrosis and sarcomas in F344 rats fed diets containing aniline hydrochloride, p-chloroaniline, azobenzene, o-toluidine hydrochloride, 4,4'-sulfonyldianiline, or D & C red No. 9.

    Science.gov (United States)

    Goodman, D G; Ward, J M; Reichardt, W D

    1984-07-01

    In six carcinogenicity bioassays, male and female F344 rats were fed diets containing aniline hydrochloride (CAS: 142-04-1; hydrochloride benzenamide), p-chloroaniline (CAS: 106-47-8), azobenzene (CAS: 103-33-3), o-toluidine hydrochloride (CAS: 636-21-5), dapsone (CAS: 80-08-0; 4,4'-sulfonyldianiline), or D & C red No. 9 [CAS: D85500000; 5-chloro-2-[2-hydroxy-1-naphthalenyl)azo)-4-methylbenzenesulfon ic acid, barium salt]. The rats, from 6 weeks to 2 years old, were given the compounds at two dose levels, the estimated maximum tolerated dose and one-half that dose. In all six bioassays, dose-dependent incidences of splenic sarcomas and fibrosis were seen, with the highest incidences in male rats. Fibrosis occurred in the splenic parenchyma and/or the capsule. Fatty infiltration also was seen in the spleen. Sarcomas appeared to arise in the splenic red pulp or splenic capsule, usually in association with areas of parenchymal and capsular fibrosis and pigmentation. Larger tumors metastasized to the peritoneal cavity and abdominal organs. In some rats there was marked osseous metaplasia when the primary tumor metastasized to peritoneal surfaces. Other, less common, splenic neoplasms included hemangiosarcoma and hemangiopericytoma. Some rats had such extensive peritoneal involvement that the site of origin of their sarcoma was difficult to determine. PMID:6588231

  5. Critical role of CCL22/CCR4 axis in the maintenance of immune homeostasis during apoptotic cell clearance by splenic CD8α(+) CD103(+) dendritic cells.

    Science.gov (United States)

    Hao, Shengyu; Han, Xiaolei; Wang, Dan; Yang, Yang; Li, Qiuting; Li, Xiangzhi; Qiu, Chun-Hong

    2016-06-01

    Macrophages and dendritic cells (DCs) in murine spleen are essential for the maintenance of immune homeostasis by elimination of blood-borne foreign particles and organisms. It has been reported that splenic DCs, especially CD8α(+) CD103(+) DCs, are responsible for tolerance to apoptosis-associated antigens. However, the molecular mechanism by which these DCs maintain immune homeostasis by blood-borne apoptotic cell clearance remains elusive. Here, we found that the CCL22/CCR4 axis played a critical role in the maintenance of immune homeostasis during apoptotic cell clearance by splenic CD8α(+) CD103(+) DCs. The present results revealed that systemic administration of apoptotic cells rapidly induced a large number of CCL22 and CCR4(+) regulatory T (Treg) cells in the spleen of C57BL/6J mice. Further study demonstrated that CD8α(+) CD103(+) DCs dominantly produce much higher CCL22 than CD8α(+) CD103(-) DCs. Moreover, the transient deletion of CD8α(+) CD103(+) DCs caused a decrease in CCL22 levels together with CCR4(+) Treg cell percentage. Subsequently, the levels of some pro-inflammatory cytokines, such as interleukin-17 and interferon-γ in the spleen with the absence of CD8α(+) CD103(+) DCs increased in response to the administration of apoptotic cells. Hence, intravenous injection of apoptotic cells induced a subsequent increase in CCL22 expression and CCR4(+) Treg cells, which contribute to the maintenance of immune homeostasis at least partially by splenic CD8α(+) CD103(+) DCs. PMID:26868141

  6. 外伤致迟发性脾破裂的临床法医鉴定分析%Clinical forensic identification analysis of traumatic delayed splenic rupture

    Institute of Scientific and Technical Information of China (English)

    姚明阳

    2014-01-01

    目的:提高对外伤所致迟发性脾破裂疾病的临床法医鉴定工作质量。方法:2012年9月-2014年2月收治外伤所致迟发性脾破裂患者17例,作为研究对象。对所有患者一般资料展开回顾性分析。观察临床法医鉴定外伤致迟发性脾破裂的分级结果与患者手术治疗情况。结果:Ⅰ级裂伤7例,Ⅱ级裂伤5例,Ⅲ级裂伤4例,Ⅳ级裂伤1例。均给予患者手术治疗,治愈15例,住院10~45 d后出院,恢复良好,2例患者因合并多发伤致多器官功能衰竭死亡,死亡率11.76%。结论:外伤所致迟发性脾破裂疾病容易漏诊或误诊,需要结合临床表现、影像学检查、腹腔穿刺、病理检查等表现,综合诊断。%Objective:To improve the work quality of clinical forensic identification for traumatic delayed splenic rupture.Methods:17 cases with traumatic delayed splenic rupture were selected from September 2012 to February 2014.They were as the study objects.The general data of all patients were retrospectively analyzed.The classification results and surgical treatment condition of traumatic delayed splenic rupture with clinical forensic identification were observed.Results:7 cases were grade Ⅰ laceration;5 cases were grade Ⅱ laceration;4 cases were grade Ⅲ laceration;1 case was grade Ⅳ laceration.The patients were treated with operation,15 cases were cured.The patients left hospital and were good recovery after 10~45 days in hospital.2 cases combined with multiple injuries died of multiple organ failure,and the mortality rate was 11.76%.Conclusion:The traumatic delayed splenic rupture is easily missed or misdiagnosed.It requires a combination of clinical presentation,imaging examination, abdominal paracentesis and pathological examination to make comprehensive diagnosis.

  7. An anomalous case of the left gastric artery, the splenic artery and hepato-mesenteric trunk independently arising from the abdominal aorta.

    Science.gov (United States)

    Saga, Tsuyoshi; Hirao, Takeshi; Kitashima, Sadaharu; Watanabe, Koh-Ichi; Nohno, Mariko; Araki, Yoshio; Kobayashi, Seiji; Yamaki, Koh-Ichi

    2005-01-01

    This report describes a rare case of an arterial anomaly in the celiaco-mesenteric region, encountered in a Japanese female cadaver for dissection at the gross anatomy laboratory of Kurume University School of Medicine in 2003. The usual celiac trunk was not identified, and the left gastric artery, the splenic artery and the hepato-mesenteric trunk independently arose from the abdominal aorta. Moreover, the hepatic artery arising from the hepato-mesenteric trunk ran behind the portal vein. The classification for this type of arterial anomaly is a Type II' of Morita's classification and Type II of Higashi and Hirai's classification, not belong to the Adachi's. PMID:16119612

  8. Residual tissue post splenectomy detected by splenic scintillography with erythrocytes damaged by heat; Tejido residual postesplenectomia detectado por centellografia esplenica con eritrocitos danados por calor

    Energy Technology Data Exchange (ETDEWEB)

    Rivera B, B.; Garcia C, E.S.; Garcia O, J.R. [Centro Medico ABC, Departamento de Medicina Nuclear, Mexico, D.F. (Mexico)

    2005-07-01

    Feminine of 26 years old with diagnostic of purple thrombocytopenic idiopathic to those 4 years of age, tried with steroids and splenectomy at 11 years old. Pathway practically asymptomatic until 4 months ago she had presented asthenia, adynamia and general uneasiness, with platelet figures of 40,000 plat/microliter. It was carried out scintillographic study with damaged erythrocytes for post surgical remainder search. Its were took two-dimensional images and tomography by single photon emission (SPECT), being knitted splenic residual in area of anatomical projection of the spleen. (Author)

  9. PRACTICAL ASPECTS OF MEDIATION

    OpenAIRE

    IULIA FLOCA

    2011-01-01

    Today the Romanian state gives some advantages to those who use mediation. If the Romanian state would take further steps, mediation would work as in the countries with old tradition. The article refers to success and failure got in the two years of practice. The mediation can be seen in two aspects: The first aspect regarding the mediation itself can lead to a mediation agreement. The mediation agreement gives both winnings to the conflict parts and professional satisfactions to the mediator...

  10. Infant mouse brain passaged Dengue serotype 2 virus induces non-neurological disease with inflammatory spleen collapse in AG129 mice after splenic adaptation.

    Science.gov (United States)

    Rajmane, Yogesh; Shaikh, Sameer; Basha, Khalander; Reddy, G E C Vidyadhar; Nair, Soumya; Kamath, Sangita; Sreejesh, Greeshma; Rao, Harinarayana; Ramana, Venkata; Kumar, A S Manoj

    2013-05-01

    AG129 mice are known to be permissive to infection by multiple serotypes of Dengue virus (DENV). There exists a concern that mouse passaged strains of the virus may induce neurological complications rather than increased vascular permeability in these mice, hence the use of human clinical isolates of the virus to develop the AG129 mouse model of Dengue disease with increased vascular permeability. The present study evaluated four mouse brain passaged DENV strains, each belonging to a different serotype and three of them having an original isolation history in India, for their suitability to serve as candidates to induce rapid lethal disease in AG129 mice. While all the viruses were able to establish a productive infection in the spleen, none of them induced paralysis despite their mouse brain passage history. Only the type-2 virus acquired the ability to induce a lethal disease after a single round of spleen to spleen passage, and became highly virulent after five more rounds. This apparently non-neurological lethal disease was characterized by high viral burden, elevated vascular permeability, serum TNF-α surge immediately before moribund stage, transient leukocytosis followed by severe leukopenia, lymphopenia throughout the course of the infection, and transient thrombocytopenia. The disease was also characterized by inflammatory splenic collapse during moribund stage, reminiscent of spontaneous splenic rupture reported in rare cases of severe Dengue in humans. PMID:23337909

  11. Micro dynamics in mediation

    OpenAIRE

    Boserup, Hans

    2014-01-01

    The author has identified a number of styles in mediation, which lead to different processes and different outcomes. Through discourse and conversation analysis he examines the micro dynamics in three of these, the postmodern styles: systemic, transformative and narrative mediation. The differences between the three mediation ideologies and practice is illustrated through role play scripts enacted in each style. Mediator and providers of mediation and trainers in mediation are encouraged to a...

  12. A palindromic CpG-containing phosphodiester oligodeoxynucleotide as a mucosal adjuvant stimulates plasmacytoid dendritic cell-mediated T(H1 immunity.

    Directory of Open Access Journals (Sweden)

    Jun-ichi Maeyama

    Full Text Available BACKGROUND: CpG oligodeoxynucleotides (ODNs, resembling bacterial DNA, are currently tested in clinical trials as vaccine adjuvants. They have the nuclease-resistant phosphorothioate bond; the immune responses elicited differ according to the CpG ODN sequence and vaccination method. To develop a CpG ODN that can induce plasmacytoid dendritic cell (pDC-mediated T(H1 immunity through the mucosa, we constructed phosphodiester G9.1 comprising one palindromic CpG motif with unique polyguanosine-runs that allows degradation similar to naturally occurring bacterial DNA. METHODS: T(H1 and T(H2 immunity activation was evaluated by cytokine production pattern and T-bet/GATA-3 ratio in human peripheral blood mononuclear cells and mouse bone marrow cells. Adjuvanticity was evaluated in mice administered G9.1 with diphtheria toxoid (DT through nasal vaccination. RESULTS: G9.1 exhibited stronger IFN-α-inducing activity than A-class CpG ODN2216 and increased T-bet/GATA-3 ratio by enhancing T-bet expression. Nasally administered G9.1 plus DT induced DT-specific mucosal IgA and serum IgG, but not IgE, responses with antitoxin activity in C57BL/6 and BALB/c mice, possibly due to IFN/BAFF production. Induction of T(H1, but not T(H2-type Abs depended completely on pDCs, the first in vivo demonstration by CpG ODNs. CONCLUSIONS: G9.1 is a promising mucosal adjuvant for induction of pDC-mediated T(H1 immunity.

  13. TLR2 Mediates Immunity to Experimental Cysticercosis

    Directory of Open Access Journals (Sweden)

    José L. Reyes, Marisol I. González, Yadira Ledesma-Soto, Abhay R. Satoskar, Luis I. Terrazas

    2011-01-01

    Full Text Available Information concerning TLR-mediated antigen recognition and regulation of immune responses during helminth infections is scarce. TLR2 is a key molecule required for innate immunity and is involved in the recognition of a wide range of viruses, bacteria, fungi and parasites. Here, we evaluated the role of TLR2 in a Taenia crassiceps cysticercosis model. We compared the course of T. crassiceps infection in C57BL/6 TLR2 knockout mice (TLR2-/- with that in wild type C57BL/6 (TLR2+/+ mice. In addition, we assessed serum antibody and cytokine profiles, splenic cellular responses and cytokine profiles and the recruitment of alternatively activated macrophages (AAMφs to the site of the infection. Unlike wild type mice, TLR2-/- mice failed to produce significant levels of inflammatory cytokines in either the serum or the spleen during the first two weeks of Taenia infection. TLR2-/- mice developed a Th2-dominant immune response, whereas TLR2+/+ mice developed a Th1-dominant immune response after Taenia infection. The insufficient production of inflammatory cytokines at early time points and the lack of Th1-dominant adaptive immunity in TLR2-/- mice were associated with significantly elevated parasite burdens; in contrast, TLR2+/+ mice were resistant to infection. Furthermore, increased recruitment of AAMφs expressing PD-L1, PD-L2, OX40L and mannose receptor was observed in TLR2-/- mice. Collectively, these findings indicate that TLR2-dependent signaling pathways are involved in the recognition of T. crassiceps and in the subsequent activation of the innate immune system and production of inflammatory cytokines, which appear to be essential to limit infection during experimental cysticercosis.

  14. General Gaugino Mediation

    OpenAIRE

    Sudano, Matthew

    2010-01-01

    The spectrum of a class of gaugino mediation models with arbitrary hidden sector is considered. These models are defined by a diagonal breaking of the mediating gauge group, which places them outside the realm of General Gauge Mediation. While gauginos get masses as in ordinary gauge mediation, the scalar masses are screened.

  15. Vascular complications (splenic and hepatic artery aneurysms) in the occipital horn syndrome: report of a patient and review of the literature

    Energy Technology Data Exchange (ETDEWEB)

    Mentzel, H.-J. [Institute of Diagnostic and Interventional Radiology, University of Jena (Germany)]|[Institute of Diagnostic and Interventional Radiology, Bachstrasse 18, D-07 740 Jena (Germany); Seidel, J.; Vogt, L. [Department of Paediatrics, University of Jena, Friedrich-Schiller-Universitaet Jena, Jena/Thueringen (Germany); Vogt, S.; Kaiser, W.A. [Institute of Diagnostic and Interventional Radiology, University of Jena (Germany)

    1999-01-01

    We report an 18-year-old boy with occipital horn syndrome who developed aneurysms of the splenic and hepatic arteries. Occipital horn syndrome, also called X-linked cutis laxa or Ehlers-Danlos syndrome (EDS) type IX, is characterised by a skeletal dysplasia which includes occipital horns, broad clavicles, deformed radii, ulnae and humeri, narrow rib cage, undercalcified long bones and coxa valga. Distinctive features common to all patients are unusual facial appearance, hypermobility of finger joints, limitation of extension of elbows, chronic diarrhoea and genitourinary abnormalities. In this case report we describe the difficulties encountered in the diagnostic management of patients with EDS-related vascular lesions. (orig.) With 5 figs., 2 tabs., 12 refs.

  16. Fruit Extract from Pyropolyporus fomentarius (L. ex Fr.) Teng Induces Mitochondria-Dependent Apoptosis in Leukemia Cells but Enhances Immunomodulatory Activities of Splenic Lymphocytes.

    Science.gov (United States)

    Li, Yixiang; Zhou, Yuetao; Wang, Xiaobing; Wang, Pan; Xiao, Yaping; Cheng, Xiaoxia; Zhang, Yanhua; Liu, Yilin; Liu, Quanhong

    2016-01-01

    Pyropolyporus fomentarius (L. ex Fr.) Teng is a unique woody mushroom due to its medicinal value with numerous pharmacological activities. This study presented the potential antitumor and immunomodulatory properties of ethanol extract of P. fomentarius. The results showed that P. fomentarius extract inhibited the viability of murine leukemia L1210 cells in a dose-dependent manner with IC50 value of 69.35 μg/ml. Flow cytometry analysis demonstrated that the extract induced apoptosis in L1210 cells. Additionally, the decline of mitochondrial membrane potential was observed as well as the changes of caspase-3, caspase-9, Bcl-2, and Bax, suggesting that proapoptosis effect of the extract involved mitochondria-related pathway. Simultaneously, the P. fomentarius extract significantly enhanced the proliferation and activation of splenic lymphocytes in a dose-dependent manner. This P. fomentarius extract has potential applications as a natural antitumor agent with immunomodulatory activity. PMID:27115601

  17. Peripheral blood complete remission after splenic irradiation in Mantle-Cell Lymphoma with 11q22-23 deletion and ATM inactivation

    Directory of Open Access Journals (Sweden)

    Galliano Marco

    2006-09-01

    Full Text Available Abstract Mantle Cell Lymphoma (MCL is a well-known histological and clinical subtype of B-cell non-Hodgkin's Lymphomas. It is usually characterized by an aggressive disease course, presenting with advanced stage disease at diagnosis and with low response rates to therapy. However few cases of indolent course MCL have been described. We herein report a case of MCL with splenomegaly and peripheral blood involvement as main clinical features. The patient underwent moderate dose splenic radiation therapy and achieved spleen downsizing and peripheral blood complete remission. Splenic irradiation has been extensively used in the past as palliative treatment in several lymphoproliferative disorders and a systemic effect and sometimes peripheral blood complete remissions have been observed. Mainly advocated mechanisms responsible for this phenomenon are considered direct radiation-induced apoptotic cell death, immune modulation via proportional changes of lymphocyte subsets due to known differences in intrinsic radiosensitivity and a radiation-induced cytokine release. The peculiar intrinsic radiosensitivity pattern of lymphoid cells could probably be explained by well-defined individual genetic and molecular features. In this context, among NHLs, MCL subtype has the highest rate of ATM (Ataxia Teleangiectasia Mutated inactivation. While the ATM gene is thought to play a key-role in detecting radiation-induced DNA damage (expecially Double Strand Breaks, recent in vitro data support the hypothesis that ATM loss may actually contribute to the radiosensitivity of MCL cells. ATM status was retrospectively investigated in our patient, with the tool of Fluorescence In Situ Hybridization, showing a complete inactivation of a single ATM allele secondary to the deletion of chromosomal region 11q22-23. The presence of this kind of cytogenetic aberration may be regarded in the future as a potential predictive marker of radiation response.

  18. Peripheral blood complete remission after splenic irradiation in Mantle-Cell Lymphoma with 11q22-23 deletion and ATM inactivation

    International Nuclear Information System (INIS)

    Mantle Cell Lymphoma (MCL) is a well-known histological and clinical subtype of B-cell non-Hodgkin's Lymphomas. It is usually characterized by an aggressive disease course, presenting with advanced stage disease at diagnosis and with low response rates to therapy. However few cases of indolent course MCL have been described. We herein report a case of MCL with splenomegaly and peripheral blood involvement as main clinical features. The patient underwent moderate dose splenic radiation therapy and achieved spleen downsizing and peripheral blood complete remission. Splenic irradiation has been extensively used in the past as palliative treatment in several lymphoproliferative disorders and a systemic effect and sometimes peripheral blood complete remissions have been observed. Mainly advocated mechanisms responsible for this phenomenon are considered direct radiation-induced apoptotic cell death, immune modulation via proportional changes of lymphocyte subsets due to known differences in intrinsic radiosensitivity and a radiation-induced cytokine release. The peculiar intrinsic radiosensitivity pattern of lymphoid cells could probably be explained by well-defined individual genetic and molecular features. In this context, among NHLs, MCL subtype has the highest rate of ATM (Ataxia Teleangiectasia Mutated) inactivation. While the ATM gene is thought to play a key-role in detecting radiation-induced DNA damage (expecially Double Strand Breaks), recent in vitro data support the hypothesis that ATM loss may actually contribute to the radiosensitivity of MCL cells. ATM status was retrospectively investigated in our patient, with the tool of Fluorescence In Situ Hybridization, showing a complete inactivation of a single ATM allele secondary to the deletion of chromosomal region 11q22-23. The presence of this kind of cytogenetic aberration may be regarded in the future as a potential predictive marker of radiation response

  19. Fusion of the TBL1XR1 and HMGA1 genes in splenic hemangioma with t(3;6)(q26;p21)

    Science.gov (United States)

    PANAGOPOULOS, IOANNIS; GORUNOVA, LUDMILA; BJERKEHAGEN, BODIL; LOBMAIER, INGVILD; HEIM, SVERRE

    2016-01-01

    RNA-sequencing of a splenic hemangioma with the karyotype 45~47,XX,t(3;6)(q26;p21) showed that this translocation generated a chimeric TBL1XR1-HMGA1 gene. This is the first time that this tumor has been subjected to genetic analysis, but the finding of an acquired clonal chromosome abnormality in cells cultured from the lesion and the presence of the TBL1XR1-HMGA1 fusion in them strongly favor the conclusion that splenic hemangiomas are of a neoplastic nature. Genomic PCR confirmed the presence of the TBL1XR1-HMGA1 fusion gene, and RT-PCR together with Sanger sequencing verified the presence of the fusion transcripts. The molecular consequences of the t(3;6) would be substantial. The cells carrying the translocation would retain only one functional copy of the wild-type TBL1XR1 gene while the other, rearranged allele could produce a putative truncated form of TBL1XR1 protein containing the LiSH and F-box-like domains. In the TBL1XR1-HMGA1 fusion transcript, furthermore, untranslated exons of HMGA1 are replaced by the first 5 exons of the TBL1XR1 gene. The result is that the entire coding region of HMGA1 comes under the control of the TBL1XR1 promoter, bringing about dysregulation of HMGA1. This is reminiscent of similar pathogenetic mechanisms involving high mobility genes in benign connective tissue tumors such as lipomas and leiomyomas. PMID:26708416

  20. Biphasic onset of splenic apoptosis following hemorrhagic shock : critical implications for Bax, Bcl-2, and Mcl-1 proteins

    OpenAIRE

    Hostmann, Arwed; Jasse, Kerstin; Schulze-Tanzil, Gundula; Robinson, Yohan; Oberholzer, Andreas; Ertel, Wolfgang; Tschoeke, Sven K

    2008-01-01

    INTRODUCTION: The innate immune response to trauma hemorrhage involves inflammatory mediators, thus promoting cellular dysfunction as well as cell death in diverse tissues. These effects ultimately bear the risk of post-traumatic complications such as organ dysfunction, multiple organ failure, or adult respiratory distress syndrome. In this study, a murine model of resuscitated hemorrhagic shock (HS) was used to determine the apoptosis in spleen as a marker of cellular injury and reduced immu...

  1. Causal mediation analysis with a latent mediator.

    Science.gov (United States)

    Albert, Jeffrey M; Geng, Cuiyu; Nelson, Suchitra

    2016-05-01

    Health researchers are often interested in assessing the direct effect of a treatment or exposure on an outcome variable, as well as its indirect (or mediation) effect through an intermediate variable (or mediator). For an outcome following a nonlinear model, the mediation formula may be used to estimate causally interpretable mediation effects. This method, like others, assumes that the mediator is observed. However, as is common in structural equations modeling, we may wish to consider a latent (unobserved) mediator. We follow a potential outcomes framework and assume a generalized structural equations model (GSEM). We provide maximum-likelihood estimation of GSEM parameters using an approximate Monte Carlo EM algorithm, coupled with a mediation formula approach to estimate natural direct and indirect effects. The method relies on an untestable sequential ignorability assumption; we assess robustness to this assumption by adapting a recently proposed method for sensitivity analysis. Simulation studies show good properties of the proposed estimators in plausible scenarios. Our method is applied to a study of the effect of mother education on occurrence of adolescent dental caries, in which we examine possible mediation through latent oral health behavior. PMID:26363769

  2. CD8+ CD205+ splenic dendritic cells are specialized to induce Foxp3+ regulatory T cells1

    OpenAIRE

    Yamazaki, Sayuri; Dudziak, Diana; Heidkamp, Gordon F; Fiorese, Christopher; Bonito, Anthony J.; Inaba, Kayo; Nussenzweig, Michel C.; Steinman, Ralph M.

    2008-01-01

    Foxp3+CD25+CD4+ regulatory T cells (T reg) mediate immunological self-tolerance and suppress immune responses. A subset of dendritic cells (DCs) in the intestine is specialized to induce T reg in a transforming growth factor (TGF)-β and retinoic acid (RA) dependent manner to allow for oral tolerance. Here we compare two major DC subsets from mouse spleen. We find that CD8+ DEC-205/CD205+ DCs, but not the major fraction of CD8− dendritic cell inhibitory receptor-2 (DCIR2)+ DCs, induce function...

  3. Shared mediated workspaces

    OpenAIRE

    Greef, Tjerk de; Gullström, Charlie; Handberg, Leif; Nefs, H.T.; Parnes, Peter

    2012-01-01

    Shared mediated spaces provide viable alternatives for meetings and interactions. The development of collaborative mediated workspaces and shared negotiation spaces will have a fundamental impact on all human practices. Previous design-led research, has identified spatial design concepts, such as mediated gaze, and spatial montage, which, if unaddressed, may be said to impose friction, and thus impact negatively on the experience of mediated presence. The current paper discusses a set of conc...

  4. Mediation and Conflict Management

    OpenAIRE

    Gerald Eisenkopf

    2009-01-01

    Mediation is a popular process to manage conflicts, but there is little systematic insight into its mechanisms. This paper discusses the results from an experiment in which a mediator can induce two conflict parties to behave cooperatively. If the mediator recommends cooperative behavior and threatens to punish deviations, she achieves the efficient solution. Similar results even obtain if the mediator is biased towards one party or has no incentive to prevent the conflict. Communication betw...

  5. Confidentiality of mediation communications

    OpenAIRE

    Koo, AKC

    2011-01-01

    Discusses the common law protection afforded to mediation negotiations by the without prejudice rule, legal professional privilege and the mediation agreement signed by all parties prior to the commencement of the mediation process. Examines the inclusion of admissions within the without prejudice rule, and the exceptions to the rule. Notes two pieces of legislation offering protection, namely the US Uniform Mediation Act 2001 and Directive 2008/52. Argues that the limited protection in the U...

  6. Bayesian Mediation Analysis

    OpenAIRE

    Yuan, Ying; MacKinnon, David P.

    2009-01-01

    This article proposes Bayesian analysis of mediation effects. Compared to conventional frequentist mediation analysis, the Bayesian approach has several advantages. First, it allows researchers to incorporate prior information into the mediation analysis, thus potentially improving the efficiency of estimates. Second, under the Bayesian mediation analysis, inference is straightforward and exact, which makes it appealing for studies with small samples. Third, the Bayesian approach is conceptua...

  7. Mediation as Signal

    OpenAIRE

    Holler, M.J.; Lindner, I.

    2004-01-01

    This paper analyzes mediation as a signal. Starting from a stylized case, a game theoretical model of one-sided incomplete information, taken from Cho and Kreps (1987), is applied to discuss strategic effects of mediation. It turns out that to reject mediation can be interpreted as a ”negative signal” while the interpretation of accepting or proposing mediation is ambiguous and does not necessarily change the prior beliefs of the uninformed party. This asymmetry suggests that, in equilibrium,...

  8. Mediators as Walrasian Auctioneers

    OpenAIRE

    Dickenson, David L.

    2004-01-01

    This article opens up mediation to systematic economic analysis by considering mediators as analogous.to the Walrasian auctioneers of exchange theory. By altering trade-off rates among bargaining issues, mediators facilitate a process leading towards Pareto efficient voluntary settlements.

  9. Hybrid Gauge Mediation

    OpenAIRE

    McGarrie, Moritz

    2011-01-01

    Inspired by four dimensional (de)constructions, we use the framework of "General gauge mediation in five dimensions" to interpolate between gaugino and ordinary gauge mediation. In particular we emphasise that an intermediate hybrid regime of mediation may be obtained in these higher dimensional models as has been obtained in the quiver gauge models.

  10. Bayesian Mediation Analysis

    Science.gov (United States)

    Yuan, Ying; MacKinnon, David P.

    2009-01-01

    In this article, we propose Bayesian analysis of mediation effects. Compared with conventional frequentist mediation analysis, the Bayesian approach has several advantages. First, it allows researchers to incorporate prior information into the mediation analysis, thus potentially improving the efficiency of estimates. Second, under the Bayesian…

  11. mediation: R Package for Causal Mediation Analysis

    Directory of Open Access Journals (Sweden)

    Dustin Tingley

    2014-09-01

    Full Text Available In this paper, we describe the R package mediation for conducting causal mediation analysis in applied empirical research. In many scientific disciplines, the goal of researchers is not only estimating causal effects of a treatment but also understanding the process in which the treatment causally affects the outcome. Causal mediation analysis is frequently used to assess potential causal mechanisms. The mediation package implements a comprehensive suite of statistical tools for conducting such an analysis. The package is organized into two distinct approaches. Using the model-based approach, researchers can estimate causal mediation effects and conduct sensitivity analysis under the standard research design. Furthermore, the design-based approach provides several analysis tools that are applicable under different experimental designs. This approach requires weaker assumptions than the model-based approach. We also implement a statistical method for dealing with multiple (causally dependent mediators, which are often encountered in practice. Finally, the package also offers a methodology for assessing causal mediation in the presence of treatment noncompliance, a common problem in randomized trials.

  12. Anti-inflammatory effect of honokiol is mediated by PI3K/Akt pathway suppression1

    Institute of Scientific and Technical Information of China (English)

    Byung Hun KIM; Jae Youl CHO

    2008-01-01

    Aim: In this study, we investigated the regulatory effects of honokiol on various inflammatory events mediated by monocytes/macrophages (U937/RAW264.7 cells)and lymphocytes (splenic lymphocytes and CTLL-2 cells) and their putative ac-tion mechanism. Methods: In order to investigate the regulatory effects, various cell lines and primary cells (U937, RAW264.7, CTLL-2 cells, and splenic lymphocytes) were employed and various inflammatory events, such as the pro-duction of inflammatory mediators, cell adhesion, cell proliferation, and the early signaling cascade, were chosen. Results: Honokiol strongly inhibited various inflammatory responses, such as: (ⅰ) the upregulation of nitric oxide (NO), pros-taglandin.E2 and TNF-α production and costimulatory molecule CD80 induced by lipopolysaccharide (LPS); (ⅱ) the functional activation of β1-integrin (CD29) as-sessed by U937 cell-cell and cell-fibronectin adhesions; (ⅲ) the enhancement of lymphocytes and CD8+CTLL-2 cell proliferation stimulated by LPS, phytohemaglutinin A (PHA), and concanavalin A or interleukin (IL)-2; and (ⅳ) the transcriptional upregulation of inducible NO synthase, TNF-α, cyclooxygenase-2, IL-12, and monocyte chemoattractant protein (MCP)-1. These anti-inflammatory effects of honokiol seem to be mediated by interrupting the early activated intra-cellular signaling molecule phosphoinositide 3-kinase (PI3K)/Akt, but not Src, the extracellular signal-regulated kinase, and p38, according to pharmacological, biochemical, and functional analyses. Conclusion: These results suggest that honokiol may act as a potent anti-inflammatory agent with multipotential activities due to an inhibitory effect on the PI3K/Akt pathway.

  13. Phenomenological Implications of Deflected Mirage Mediation: Comparison with Mirage Mediation

    OpenAIRE

    Altunkaynak, Baris; Everett, Lisa L.; Kim, Ian-Woo; Nelson, Brent D.; Rao, Yongyan

    2010-01-01

    We compare the collider phenomenology of mirage mediation and deflected mirage mediation, which are two recently proposed "mixed" supersymmetry breaking scenarios motivated from string compactifications. The scenarios differ in that deflected mirage mediation includes contributions from gauge mediation in addition to the contributions from gravity mediation and anomaly mediation also present in mirage mediation. The threshold effects from gauge mediation can drastically alter the low energy s...

  14. Selective splenic targeting of In-114m by heat-treated red blood cells for the treatment of lymphoid cell malignancy

    International Nuclear Information System (INIS)

    Spleen targeted In-114m, using labelled autologous lymphocytes, has produced a significant antitumour effect in patients with chronic lymphocytic leukaemia and Non-Hodgkins lymphoma (Sharma et al, Anti-Cancer Research 17, 1815-1822,1997). Heat treated red blood cells could be used as alternative vectors for splenic targeting of In-114m, making the technique easier, more universally applicable and furthermore, may reduce the myelosuppression seen with labelled lymphocytes. Red blood cells from HO3T rats were labelled with In-114m-oxine, incubated at 49.5 deg. C for 15 minutes and their distribution investigated in the spleen, liver and blood or recipient animals. The splenic uptake in the spleen at 24h was 64.08%, remained unchanged at 7 days, cleared slowly after that, clearly demonstrating the specificity of HTRBC to target In-114m to the spleen. The depletion of peripheral blood lymphocytes was measured in two groups of HO3T rats following the administration of 1.6 and 3.2 MBq of In-114m-HTRBC respectively. Compared to the controls, ∼ 70% of lymphocytes were depleted in the treated animals within one week and remained unchanged for 6 weeks. Using a rat T-cell lymphocytic leukaemia model, with resemblance to the clinical disease, an anti-leukaemic effect of his method of treatment, was monitored. An average life span of the treated group (1.85 MBq of In-114m-HTRBC) was 17.1 days, compared to the 13.5 days for the untreated group. These results are similar to the ones reported by targeting In-114m with labelled lymphocytes. In summary, the project has shown that In-114m-HTRBC can be used to deposit the radioactivity, selectively in the spleen, which in turn, depletes the peripheral blood lymphocytes and produces an anti-leukaemic effect in terms of enhanced life span. The bone marrow toxicity from In-114m therapy is under investigation and a pharmacokinetic study in selected cancer patients is planned following which, a clinical trial will be considered. (author)

  15. The Main Productive Technical Points and Prospect of Comb Honey and Splenic Honey%巢蜜与脾蜜的生产技术要点及前景展望

    Institute of Scientific and Technical Information of China (English)

    郭际; 许喜兰; 江舰艇; 潘娟; 袁丽娟

    2012-01-01

    巢蜜和脾蜜作为一种天然蜂产品,不仅含有蜂蜜、蜂蜡,还含有一定量的蜂胶,具有原生态的美味和口感,是蜂产品中的高端产品.本文阐述了巢蜜与脾蜜的生产技术及管理要点,分析了目前我国养蜂产业面临的问题及巢蜜与脾蜜的市场发展前景.%As the natural bee products, comb honey and splenic honey not only have honey and beewax, but also have a certain amount of bee glue. They have original taste and flavor, and are high-end products in bee products. This article described the technology and management key points of comb honey and splenic honey, analyzed the problems facing beekeeping industry in our country and market development prospect of comb honey and splenic honey.

  16. Technology-Use Mediation

    DEFF Research Database (Denmark)

    Bansler, Jørgen P.; Havn, Erling C.

    This study analyzes how a group of ‘mediators’ in a large, multinational company adapted a computer-mediated communication technology (a ‘virtual workspace’) to the organizational context (and vice versa) by modifying features of the technology, providing ongoing support for users, and promoting...... appropriate conventions of use. Our findings corroborate earlier research on technology-use mediation, which suggests that such mediators can exert considerable influence on how a particular technology will be established and used in an organization. However, this study also indicates that the process of...... technology-use mediation is more complex and indeterminate than earlier literature suggests. In particular, we want to draw attention to the fact that advanced computer-mediated communication technologies are equivocal and that technology-use mediation consequently requires ongoing sensemaking (Weick 1995)....

  17. The Schizosaccharomyces pombe Mediator

    DEFF Research Database (Denmark)

    Venturi, Michela

    In the past several years great attention has been dedicated to the characterization of the Mediator complex in a different range of model organisms. Mediator is a conserved co-activator complex involved in transcriptional regulation and it conveys signals from regulatory transcription factors to...... the basal transcription machinery. Mediator was initially isolated from Saccharomyces cerevisiae based on its ability to render a RNA polymerase II in vitro transcription system responsive to activators. Additionally, structural studies have revealed striking structural similarities between S....... cerevisiae, Schizosaccharomyces pombe and mammalian Mediator. In our study, we have taken the S. pombe Mediator into consideration and characterized genetically and biochemically two subunits already know in S. cerevisiae, Med9 and Med11, but still not identified in the S. pombe Mediator. Genetic analysis...

  18. Technology-Use Mediation

    DEFF Research Database (Denmark)

    Bansler, Jørgen P.; Havn, Erling C.

    2003-01-01

    This study analyzes how a group of ‘mediators’ in a large, multinational company adapted a computer-mediated communication technology (a ‘virtual workspace’) to the organizational context (and vice versa) by modifying features of the technology, providing ongoing support for users, and promoting...... technology-use mediation is more complex and indeterminate than earlier literature suggests. In particular, we want to draw attention to the fact that advanced computer-mediated communication technologies are equivocal and that technology-use mediation consequently requires ongoing sensemaking (Weick 1995)....... appropriate conventions of use. Our findings corroborate earlier research on technology-use mediation, which suggests that such mediators can exert considerable influence on how a particular technology will be established and used in an organization. However, this study also indicates that the process of...

  19. Can the Splenic Artery Resistive Index Be an Ancillary Sign on Ultrasound for the Differentiation of Alcoholic Cirrhosis from Hepatitis B-virus Related Cirrhosis?

    Energy Technology Data Exchange (ETDEWEB)

    Byun, Joo Nam; Kim, Dong Hun [Chosun University Hospital, Gwangju (Korea, Republic of)

    2007-06-15

    We wanted to assess the usefulness of the splenic artery resistive index (RIS) for differentiating between alcoholic cirrhosis (AC) and hepatitis B-virus related cirrhosis (VC). A total of 109 subjects (28 normal healthy controls, 38 patients with VC and 43 patients with AC) were included in this study. The spleen sizes, Child-Pugh scores and RISs were compared between the two cirrhotic groups. The receiver operating characteristic (ROC) curve was used to determine an RIS cutoff value for the differentiation of the two cirrhotic groups. The mean spleen size and mean RIS in the controls were less than those of the two cirrhotic groups (p < 0.05), and the mean spleen sizes and Child-Pugh scores were not different between the two groups (AC vs. VC), (13.1 {+-} 3.2 cm vs. 12.9 {+-} 2.6 cm, p > 0.05: 6.6 {+-} 1.9 vs. 5.9 {+-} 1.6, p > 0.05, respectively). In contrast, the mean RIS of the AC patients was significantly higher than that of the VC patients (0.72 {+-} 0.07 vs. 0.62 {+-} 0.06, respectively, p < 0.01). The sensitivity, specificity and accuracy at an RIS cut-off value of 0.7 for differentiating the two cirrhotic groups were 76.7%, 68.4% and 72.8, respectively. The RIS is useful factor for differentiating the patients with AC from the patients with VC

  20. Can the Splenic Artery Resistive Index Be an Ancillary Sign on Ultrasound for the Differentiation of Alcoholic Cirrhosis from Hepatitis B-virus Related Cirrhosis?

    International Nuclear Information System (INIS)

    We wanted to assess the usefulness of the splenic artery resistive index (RIS) for differentiating between alcoholic cirrhosis (AC) and hepatitis B-virus related cirrhosis (VC). A total of 109 subjects (28 normal healthy controls, 38 patients with VC and 43 patients with AC) were included in this study. The spleen sizes, Child-Pugh scores and RISs were compared between the two cirrhotic groups. The receiver operating characteristic (ROC) curve was used to determine an RIS cutoff value for the differentiation of the two cirrhotic groups. The mean spleen size and mean RIS in the controls were less than those of the two cirrhotic groups (p 0.05: 6.6 ± 1.9 vs. 5.9 ± 1.6, p > 0.05, respectively). In contrast, the mean RIS of the AC patients was significantly higher than that of the VC patients (0.72 ± 0.07 vs. 0.62 ± 0.06, respectively, p < 0.01). The sensitivity, specificity and accuracy at an RIS cut-off value of 0.7 for differentiating the two cirrhotic groups were 76.7%, 68.4% and 72.8, respectively. The RIS is useful factor for differentiating the patients with AC from the patients with VC

  1. Role of splenic stroma in the action of bacterial lipopolysaccharides on radiation mortality: a study in mice carrying the Slsup(j) allele

    International Nuclear Information System (INIS)

    Slsup(j)/+ mice display a slight macrocytic anaemia due to a defect in their haemopoietic organ stroma. They have a deficient endogenous spleen colony (CFU-end) formation following sublethal doses of gamma-radiation compared with their normal +/+ littermates, which is likely to be due to the low pre-irradiation CFU-S content of the Slsup(j)/+ spleen. CFU-S in these congenic mice do not differ in their sensitivity to gamma-irradiation or stem cell-activating factor. While injection of +/+ mice with 10 μg of lipopolysaccharide-W (LPS) one day prior to irradiation led to a substantial increase in their survival, the survival of Slsup(j)/+ mice was only slightly increased. Irradiation induced a similar dose-related reduction in the numbers of CFU-S in the spleen and femora of LPS-injected Slsup(j)/+ mice compared to similarly treated +/+ mice when measured directly after irradiation. At Day 9 after irradiation injection of LPS led to a significantly higher CFU-end formation and higher numbers of CFU-S and nucleated cells in the Slsup(j)/+ spleens compared to LPS-injected +/+ mice. No such differences in the radioprotective effect of LPS were observed in the +/+ and Slsup(j)/+ mice with respect to the splenic and femoral 59Fe-incorporation and the femoral CFU-S numbers at Day 9. (author)

  2. The effect of mixed injection of splenic stromal cell suspension and bone marrow cells on the recovery of large dose radiation injury in mice

    International Nuclear Information System (INIS)

    The authors reported that C57 BL/6 mice after exposure to 8 Gy γ-rays irradiation were divided into three groups: (1) the control group (8 Gy only), (2) the group with bone marrow cell (BMC) injection only, (3) the group with mixed injection of BMC and splenic stromal cell (SSC) which cultured in order to observe the effect of bone marrow transplantation and injection of SSC on the survival rate of recipients and on the number of hemopoietic stem cells (CFU-S) after large dose irradiation and study of its mechanism. The results of experiments suggested that the survival rate of recipients of the group with BM cells injection was only 27% higher than that of the control group, but than of the group with SSC mixed injection was 49% higher than that of the control group and 22% higher than that of the group with BMC injection only. The CFU-S shows that mixed SSC injection improves the number of CFU-S, CFU-F and ANAE[+][-] lymphocyte in spleen significantly. The co-cultivation of splenocytes and SSC in vitro showed the spleen stromal cells support and regulate their parenchyma cells

  3. Partial splenic embolization combined with vincristine infusion for the treatment of refractory idiopathic thrombocytopenic purpura and Evans syndrome: observation of its long-term efficacy

    International Nuclear Information System (INIS)

    Objective: To observe the long-term efficacy of partial spleen embolization combined with vincristine infusion in treating refractory idiopathic thrombocytopenic purpura (ITP) and Evans syndrome. Methods: During the period of 2000-2007, partial spleen embolization together with vincristine infusion was carried out in 30 patients with refractory idiopathic thrombocytopenic purpura (n=24) or Evans syndrome (n=6). Vincristine infusion (2 mg) via splenic artery was performed before partial spleen embolization procedure. The long-term effectiveness was observed and analyzed. Results: One week after the treatment, the platelet count was increased from preoperative (10.23±8.28) × 109/L to (140.28±85.45) × 109/L in patients with ITP, while the platelet count was increased from preoperative (12±8) × 109/L to (210±60) × 109/L in patients with Evans syndrome. Meanwhile, the hemoglobin level showed an increase in different degrees, from preoperative (63.00±13.62) g/L to postoperative (123.00±13.14) g/L. The therapeutic effectiveness was 100%. During the follow-up time lasting for 3-5 years, recurrence was seen in 11 patients (36.7%) and the overall efficacy rate was 63.3%. Conclusion: For the treatment of refractory idiopathic thrombocytopenic purpura and Evans syndrome, partial spleen embolization combined with vincristine infusion carries reliable long-term efficacy. (author)

  4. Chronic Stress Induces Structural Alterations in Splenic Lymphoid Tissue That Are Associated with Changes in Corticosterone Levels in Wistar-Kyoto Rats

    Directory of Open Access Journals (Sweden)

    María Eugenia Hernandez

    2013-01-01

    Full Text Available Major depressive disorder patients present chronic stress and decreased immunity. The Wistar-Kyoto rat (WKY is a strain in which the hypothalamic-pituitary-adrenal axis is overactivated. To determine whether chronic stress induces changes in corticosterone levels and splenic lymphoid tissue, 9-week-old male rats were subject to restraint stress (3 h daily, chemical stress (hydrocortisone treatment, 50 mg/Kg weight, mixed stress (restraint plus hydrocortisone, or control treatment (without stress for 1, 4, and 7 weeks. The serum corticosterone levels by RIA and spleens morphology were analyzed. Corticosterone levels as did the structure, size of the follicles and morphology of the parenchyma (increase in red pulp in the spleen, varied depending on time and type of stressor. These changes indicate that chronic stress alters the immune response in the spleen in WKY rats by inducing morphological changes, explaining in part the impaired immunity that develops in organisms that are exposed to chronic stress.

  5. Prospects for Mirage Mediation

    OpenAIRE

    Pierce, Aaron; Thaler, Jesse

    2006-01-01

    Mirage mediation reduces the fine-tuning in the minimal supersymmetric standard model by dynamically arranging a cancellation between anomaly-mediated and modulus-mediated supersymmetry breaking. We explore the conditions under which a mirage "messenger scale" is generated near the weak scale and the little hierarchy problem is solved. We do this by explicitly including the dynamics of the SUSY-breaking sector needed to cancel the cosmological constant. The most plausible scenario for generat...

  6. Immunologically mediated oral diseases

    OpenAIRE

    Sudha Jimson; Balachader, N.; N Anita; Babu, R

    2015-01-01

    Immune mediated diseases of oral cavity are uncommon. The lesions may be self-limiting and undergo remission spontaneously. Among the immune mediated oral lesions the most important are lichen planus, pemphigus, erythema multiformi, epidermolysis bullosa, systemic lupus erythematosis. Cellular and humoral mediated immunity play a major role directed against epithelial and connective tissue in chronic and recurrent patterns. Confirmatory diagnosis can be made by biopsy, direct and indirect imm...

  7. Estudo histológico da regeneração esplênica de ratos submetidos a esplenectomia subtotal Histological study of splenic regeneration in rats underwent to subtotal splenectomy

    Directory of Open Access Journals (Sweden)

    Orlando Jorge Martins Torres

    2000-06-01

    Full Text Available Um aumento da susceptibilidade à infecção severa é uma complicação reconhecida da esplenectomia. Um grande número de alternativas tem sido propostas que poderiam impedir esta complicação do estado asplênico. O presente estudo analisa a regeneração histológica do tecido esplênico em ratos submetidos a esplenectomia subtotal. Foram utilizados trinta ratos machos da linhagem Wistar, adultos, pesando entre 160 e 210g. Os animais foram submetidos a esplenectomia subtotal e divididos em três grupos contendo dez ratos cada onde foram estudados após 15, 30 e 45 dias. Após este período de observação o tecido esplênico foi recuperado e submetido a exame histológico. A estrutura tecidual esplênica no 15º dia se apresentava irregular, porém sem necrose. Após 30 dias , a cápsula se apresentava histologicamente espessada e com maior desenvolvimento. Em 45 dias foi observado semelhança considerável entre o tecido esplênico remanescente e o baço normal. O presente estudo mostra que o baço submetido a esplenectomia subtotal se regenera completamente em um período de 45 dias.An increase susceptibility to overwhelming infection is now a well-recognized complication of splenectomy. A number of alternatives to splenectomy have been proposed that could possibly prevent this complication of the asplenic state. The present study analize the histological regeneration of the splenic tissue in rats underwent to subtotal splenectomy. Thirty adult male Wistar rats were used, weighing 160 to 210g. The rats were underwent to subtotal splenectomy, divided into three groups of ten rats each, and analized after 15, 30, and 45 days. After this period of time the splenic tissue were withdrawn and submitted to histological examination. The splenic tissue structure on the 15th day was irregular without necrosis. The histological examination on the 30th day, the splenic tissue in the capsule was now with a greater development. After 45th day, an

  8. 针灸对脾虚犬消化功能指标的影响%Effects of Acupuncture on Digestive Function Indicator in Dogs with Splenic Asthenia Syndrome

    Institute of Scientific and Technical Information of China (English)

    石达友; 李盛强; 宋晓琳; 代雪立; 肖敏华; 郭世宁

    2011-01-01

    本试验通过注射利血平复制犬脾虚证动物模型,观察犬临床体征、体重及部分消化功能指标的变化,并研究针灸对各项指标的调整作用.试验结果显示,在实验犬出现脾虚证后,其体重显著低于空白对照组( P<0.05);在经针灸治疗7d后,实验犬的胃蛋白酶、胰蛋白酶活性与胃动素水平均显著高于未经治疗的实验犬(P<0.05),而胃泌素与生长抑素均显著低于未经治疗的实验犬(P<0.05).结果表明,通过针刺脾虚犬足三里、脾俞两穴位,对改善脾虚犬临床症状、增加体重及恢复正常消化功能等方面具有明显的功效.%In this thesis, it made a splenic asthenia modeling by injection of reserpine. The clinical symptom, body weight and the part of digestive function indicator were observed. And it made a study about effect of acupuncture treatment on the observed indexes. The results showed that the body weight significantly decreased (P<0. 05) after the dog appeared splenic asthenia syndrome. After acupuncture treatment the dog with splenic asthenia syndrome for 7 days, the activity of pepsin and trypsin and the contents of motillin significantly increased (P<0. 05), but the contents of gastrin and somatostatin significantly decreased (P<0.05), compared without treated splenic asthenia dogs. The finding showed that it had an effect of acupuncture treatment splenic asthenia dogs in Zusanli and spleen points on improvement of clinical symptoms, weight gain and restoration of normal digestive function.

  9. Mediation in Romanian Legislation

    Directory of Open Access Journals (Sweden)

    Gianina Anemona Radu

    2012-05-01

    Full Text Available The complexity of the current social relations generates the necessity of developing and applyingnew methods of settling conflicts. Mediation can serve as an effective tool in resolving various conflictsincluding the criminal matters. This article gives a panoramic view on the application of the concept ofmediation and highlights the main features of mediation in criminal cases as they are reported to the nationallegislation and the legislation of Romania. Therefore the advantages of mediation and the opportunity toapply the latter in order to slave the conflicts caused by the commission of criminal offences are still beingdiscussed. The Romanian legislation and the Community rules establish the scope of expressly exemptedareas, the sides of freedom being the main principle, the mandatory dispositions being the exception. Fromthe contents of the Law 192/2006 result that mediation is exercisable in all areas with the condition that therights which make the subject of mediation could be used by the sides of the mediation. The mediation theoryanalyses the extrajudicial mediation and judicial mediation settlement.

  10. Evaluation of innate, humoral and cell-mediated immunity in mice following in vivo implantation of electrospun polycaprolactone

    International Nuclear Information System (INIS)

    Electrospun polycaprolactone (EPCL) is currently being investigated for use in tissue engineering applications such as vascular grafts. However, the effects of electrospun polymers on systemic immune responses following in vivo exposure have not previously been examined. The work presented evaluates whether EPCL in either a microfibrous or nanofibrous form affects innate, humoral and/or cell-mediated immunity using a standard immunotoxicological testing battery. Holistic in vivo endpoints examined include the antibody-forming cell assay (AFC or plaque assay) and the delayed-type hypersensitivity response to Candida albicans. In addition, natural killer cell cytotoxic activity was assessed using an ex vivo assay and splenic cell population phenotypes were analyzed by flow cytometry for material exposure-related changes. Results indicated that 28 day subcutaneous implantation of EPCL, either in microfibrous or nanofibrous form, did not affect the systemic functions of the immune system in 12–16 week old female B6C3F1 mice. (paper)

  11. Inhibition of murine splenic B lymphocyte activation following oral exposure to 7,12-dimethylbenz(a)anthracene (DMBA)

    International Nuclear Information System (INIS)

    Previous results from this laboratory have demonstrated that oral exposure of B6C3F1 mice to DMBA inhibited mitogen-stimulated lymphocyte activation in cells recovered from several lymphoid organs. These studies showed that both LPS and PHA-stimulated lymphocyte proliferation and PHA-induced Ca+2 mobilization were significantly inhibited by DMBA exposure, supporting the hypothesis that DMBA inhibits early events associated with lymphocyte activation. The purpose of the current studies was to test this hypothesis directly for B cell activation. B6C3F1 mice were treated with 0, 1.0, or 10 mg/kg/day doses of DMBA for 14 days (total cumulative doses of 0, 14, or 140 mg/kg). B lymphocyte populations were then selected on the flow cytometer by direct positive staining of spleen cells with phycoerythrin-labeled anti-Ly5 (B lymphocyte marker) antibodies. Ca+2 mobilization studies were performed using affinity-purified goat anti-mouse IgD antibodies as the stimulant and Indo-1 as the intracellular Ca+2 indicator. Cell proliferation studies were also performed using 3H-thymidine and insoluble anti-IgD antibodies. Anti-IgD stimulated Ca+2 mobilization was significantly reduced at the 140 mg/kg dose of DMBA. A statistically significant decrease in anti-IgD stimulated B lymphocyte proliferation at the 14 mg/kg and 140 mg/kg doses of DMBA was found. These results suggest that B lymphocytes may be important targets for DMBA-mediated immunosuppression

  12. Teaching Mediated Public Relations.

    Science.gov (United States)

    Kent, Michael L.

    2001-01-01

    Discusses approaches to teaching a mediated public relations course, emphasizing the World Wide Web. Outlines five course objectives, assignments and activities, evaluation, texts, and lecture topics. Argues that students mastering these course objectives will understand ethical issues relating to media use, using mediated technology in public…

  13. Mediation and Domestic Violence

    Directory of Open Access Journals (Sweden)

    Jacques Faget

    2005-07-01

    Full Text Available This paper analyzes the potential and limits of recourse to mediation for regulating domestic violence. On the basis of an empirical study of its implementation in France and of the existing academic literature, it shows the existence of two types of practices reflecting two conceptions of mediation and more generally, two conceptions of the articulation between social and penal regulation

  14. Mediation and Domestic Violence

    OpenAIRE

    Jacques Faget

    2005-01-01

    This paper analyzes the potential and limits of recourse to mediation for regulating domestic violence. On the basis of an empirical study of its implementation in France and of the existing academic literature, it shows the existence of two types of practices reflecting two conceptions of mediation and more generally, two conceptions of the articulation between social and penal regulation

  15. Music, Radio, and Mediatization

    DEFF Research Database (Denmark)

    Krogh, Mads; Michelsen, Morten

    2016-01-01

    Mediatization has become a key concept for understanding the relations between media and other cultural and social fields. Contributing to the discussions related to the concept of mediatization, this article discusses how practices of radio and music(al life) influence each other. We follow Deacon......’s and Stanyer’s advice to supplement the concept of mediatization with ‘a series of additional concepts at lower levels of abstraction’ and suggest, in this respect, the notion of heterogeneous milieus of music– radio. Hereby, we turn away from the all-encompassing perspectives related to the concept of...... mediatization where media as such seem to be ascribed agency. Instead, we consider historical accounts of music–radio in order to address the complex non- linearity of concrete processes of mediatization as they take place in the multiple meetings between a decentred notion of radio and musical life....

  16. Anti-PEG IgM and complement system are required for the association of second doses of PEGylated liposomes with splenic marginal zone B cells.

    Science.gov (United States)

    Shimizu, Taro; Mima, Yu; Hashimoto, Yosuke; Ukawa, Masami; Ando, Hidenori; Kiwada, Hiroshi; Ishida, Tatsuhiro

    2015-10-01

    The accelerated blood clearance (ABC) phenomenon makes it crucial to use PEGylated liposomes and micelles to deliver drugs. The ABC phenomenon is an immune response against an initial dose of PEGylated liposome, which causes subsequent doses to be rapidly cleared by macrophages in the liver. We recently found that in the early phase of the ABC phenomenon, subsequent doses of PEGylated liposomes were associated with splenic marginal zone (MZ)-B cells and were transported from the MZ to the follicle (FO). In this study, we investigated the underlying mechanisms behind the association of subsequent doses of PEGylated liposomes with MZ-B cells in the spleen. Serum factors, anti-PEG IgM and complement system, were crucial to the association of PEGylated liposomes with MZ-B cells, while the sensitization of MZ-B cells by the first dose of PEGylated liposomes was not significant. It was the complement receptors (CRs) on the MZ-B cells, rather than either the PEG-specific B-cell receptors or the IgM Fc receptors, that were the main contributors to the association between PEGylated liposomes and MZ-B cells. It appeared that anti-PEG IgM would bind to PEGylated liposomes and causes subsequent complement activation, resulting in the formation of immune complexes of PEGylated liposome-anti-PEG IgM-complement. The MZ-B cells then recognized these immune complexes via their CRs. Such an association via CRs might have triggered the transport of the immune complex by MZ-B cells to the FO in the spleen. The information obtained in this study might be useful in the development of an efficient antigen delivery system to usher PEGylated nanoparticles into FO dendritic cells. PMID:26095176

  17. n-3 PUFAs reduce T-helper 17 cell differentiation by decreasing responsiveness to interleukin-6 in isolated mouse splenic CD4⁺ T cells.

    Science.gov (United States)

    Allen, M Jeannie; Fan, Yang-Yi; Monk, Jennifer M; Hou, Tim Y; Barhoumi, Rola; McMurray, David N; Chapkin, Robert S

    2014-08-01

    Cluster of differentiation 4(+) (CD4(+)) effector T-cell subsets [e.g., T-helper (Th) 1 and Th17] are implicated in autoimmune and inflammatory disorders such as multiple sclerosis, psoriasis, and rheumatoid arthritis. Interleukin (IL)-6 is a pleiotropic cytokine that induces Th17 polarization via signaling through the membrane-bound transducer glycoprotein 130 (GP130). Previously, we demonstrated that n-3 (ω-3) polyunsaturated fatty acids (PUFAs) reduce CD4(+) T-cell activation and differentiation into pathogenic Th17 cells by 25-30%. Here we report that n-3 PUFAs alter the response of CD4(+) T cells to IL-6 in a lipid raft membrane-dependent manner. Naive splenic CD4(+) T cells from fat-1 transgenic mice exhibited 30% lower surface expression of the IL-6 receptor. This membrane-bound receptor is known to be shed during cellular activation, but the release of soluble IL-6 receptor after treatment with anti-CD3 and anti-CD28 was not changed in the CD4(+) T cells from fat-1 mice, suggesting that the decrease in surface expression was not due to ectodomain release. We observed a significant 20% decrease in the association of GP130 with lipid rafts in activated fat-1 CD4(+) T cells and a 35% reduction in GP130 homodimerization, an obligate requirement for downstream signaling. The phosphorylation of signal transducer and activator of transcription 3 (STAT3), a downstream target of IL-6-dependent signaling, was also decreased by 30% in response to exogenous IL-6 in fat-1 CD4(+) T cells. Our results suggest that n-3 PUFAs suppress Th17 cell differentiation in part by reducing membrane raft-dependent responsiveness to IL-6, an essential polarizing cytokine. PMID:24944284

  18. Axionic Mirage Mediation

    International Nuclear Information System (INIS)

    In this talk, we propose a model of mirage mediation, in which Peccei-Quinn symmetry is incorporated. In this axionic mirage mediation, it is shown that the Peccei-Quinn symmetry breaking scale is dynamically determined around 1010 GeV to 1012 GeV due to the supersymmetry breaking effects. The problems in the original mirage mediation such as the μ-problem and the moduli problem can be solved simultaneouly. Furthermore, in our model the axino, which is the superpartner of the axion, is the lightest sparticle.

  19. Axionic Mirage Mediation

    CERN Document Server

    Nakamura, Shuntaro; Yamaguchi, Masahiro

    2008-01-01

    In this talk, we propose a model of mirage mediation, in which Peccei-Quinn symmetry is incorporated. In this \\textit{axionic mirage mediation}, it is shown that the Peccei-Quinn symmetry breaking scale is dynamically determined around $10^{10}$ GeV to $10^{12}$ GeV due to the supersymmetry breaking effects. The problems in the original mirage mediation such as the $\\mu$-problem and the moduli problem can be solved simultaneouly. Furthermore, in our model the axino, which is the superpartner of the axion, is the lightest sparticle.

  20. Prospects for mirage mediation

    International Nuclear Information System (INIS)

    Mirage mediation reduces the fine-tuning in the minimal supersymmetric standard model by dynamically arranging a cancellation between anomaly-mediated and modulus-mediated supersymmetry breaking. We explore the conditions under which a mirage 'messenger scale' is generated near the weak scale and the little hierarchy problem is solved. We do this by explicitly including the dynamics of the SUSY-breaking sector needed to cancel the cosmological constant. The most plausible scenario for generating a low mirage scale does not readily admit an extra-dimensional interpretation. We also review the possibilities for solving the μ/Bμ problem in such theories, a potential hidden source of fine-tuning

  1. Axionic Mirage Mediation

    OpenAIRE

    Nakamura, Shuntaro; Okumura, Ken-ichi; Yamaguchi, Masahiro

    2008-01-01

    In this talk, we propose a model of mirage mediation, in which Peccei-Quinn symmetry is incorporated. In this \\textit{axionic mirage mediation}, it is shown that the Peccei-Quinn symmetry breaking scale is dynamically determined around $10^{10}$ GeV to $10^{12}$ GeV due to the supersymmetry breaking effects. The problems in the original mirage mediation such as the $\\mu$-problem and the moduli problem can be solved simultaneouly. Furthermore, in our model the axino, which is the superpartner ...

  2. General resonance mediation

    Energy Technology Data Exchange (ETDEWEB)

    McGarrie, Moritz

    2012-07-15

    We extend the framework of general gauge mediation to cases where the mediating fields have a nontrivial spectral function, as might arise from strong dynamics. We demonstrate through examples that this setup describes a broad class of possible models of gauge mediated supersymmetry breaking. A main emphasis is to give general formulas for cross sections for {sigma}(visible {yields} hidden) in these resonance models. We will also give formulas for soft masses, A-terms and demonstrate the framework with a holographic setup.

  3. Gravity in gauge mediation

    International Nuclear Information System (INIS)

    We investigate O'Raifeartaigh-type models for F-term supersymmetry breaking in gauge mediation scenarios in the presence of gravity. It is pointed out that the vacuum structure of those models is such that in metastable vacua gravity mediation contribution to scalar masses is always suppressed to the level below 1 percent, almost sufficient for avoiding FCNC problem. Close to that limit, gravitino mass can be in the range 10-100 GeV, opening several interesting possibilities for gauge mediation models, including Giudice-Masiero mechanism for μ and Bμ generation. Gravity sector can include stabilized moduli.

  4. Altered IFN-γ-mediated immunity and transcriptional expression patterns in N-Ethyl-N-nitrosourea-induced STAT4 mutants confer susceptibility to acute typhoid-like disease.

    Science.gov (United States)

    Eva, Megan M; Yuki, Kyoko E; Dauphinee, Shauna M; Schwartzentruber, Jeremy A; Pyzik, Michal; Paquet, Marilène; Lathrop, Mark; Majewski, Jacek; Vidal, Silvia M; Malo, Danielle

    2014-01-01

    Salmonella enterica is a ubiquitous Gram-negative intracellular bacterium that continues to pose a global challenge to human health. The etiology of Salmonella pathogenesis is complex and controlled by pathogen, environmental, and host genetic factors. In fact, patients immunodeficient in genes in the IL-12, IL-23/IFN-γ pathway are predisposed to invasive nontyphoidal Salmonella infection. Using a forward genomics approach by N-ethyl-N-nitrosourea (ENU) germline mutagenesis in mice, we identified the Ity14 (Immunity to Typhimurium locus 14) pedigree exhibiting increased susceptibility following in vivo Salmonella challenge. A DNA-binding domain mutation (p.G418_E445) in Stat4 (Signal Transducer and Activator of Transcription Factor 4) was the causative mutation. STAT4 signals downstream of IL-12 to mediate transcriptional regulation of inflammatory immune responses. In mutant Ity14 mice, the increased splenic and hepatic bacterial load resulted from an intrinsic defect in innate cell function, IFN-γ-mediated immunity, and disorganized granuloma formation. We further show that NK and NKT cells play an important role in mediating control of Salmonella in Stat4(Ity14/Ity14) mice. Stat4(Ity14/Ity14) mice had increased expression of genes involved in cell-cell interactions and communication, as well as increased CD11b expression on a subset of splenic myeloid dendritic cells, resulting in compromised recruitment of inflammatory cells to the spleen during Salmonella infection. Stat4(Ity14/Ity14) presented upregulated compensatory mechanisms, although inefficient and ultimately Stat4(Ity14/Ity14) mice develop fatal bacteremia. The following study further elucidates the pathophysiological impact of STAT4 during Salmonella infection. PMID:24285835

  5. Phenomenological Implications of Deflected Mirage Mediation: Comparison with Mirage Mediation

    CERN Document Server

    Altunkaynak, Baris; Kim, Ian-Woo; Nelson, Brent D; Rao, Yongyan

    2010-01-01

    We compare the collider phenomenology of mirage mediation and deflected mirage mediation, which are two recently proposed "mixed" supersymmetry breaking scenarios motivated from string compactifications. The scenarios differ in that deflected mirage mediation includes contributions from gauge mediation in addition to the contributions from gravity mediation and anomaly mediation also present in mirage mediation. The threshold effects from gauge mediation can drastically alter the low energy spectrum from that of pure mirage mediation models, resulting in some cases in a squeezed gaugino spectrum and a gluino that is much lighter than other colored superpartners. We provide several benchmark deflected mirage mediation models and construct model lines as a function of the gauge mediation contributions, and discuss their discovery potential at the LHC.

  6. Mediator scolar - School Mediator (Romanian version)

    OpenAIRE

    Madalina CONSTANTIN

    2011-01-01

    The present article proposes to highlight the most important concepts with regard to school mediator. In this case we intend to add into discution the folowing: 1. Planning activities 2 Teamwork 3. Professional Development 4. PC Use 5. Communication 6. Solving conflicts 7. Developing school-community partnership 8. Counseling families / social groups disadvantaged on the role and importance of schooling 9. Implementation of inclusive practices 10. Overcoming emotional and behavioral difficult...

  7. 抑郁症肝郁气滞证及肝郁脾虚证证候标准的研究%Studies on standards for syndromes of Hepatic Qi Stagnation and Hepatic Stagnation causing Splenic Deficiency for depression

    Institute of Scientific and Technical Information of China (English)

    陈珍贵; 陈泽奇; 胡随瑜; 张海男; 张宏耕

    2003-01-01

    目的探讨抑郁症肝郁气滞证、肝郁脾虚证的证候辨证标准.方法选择抑郁症临床流行病学调查肝郁气滞证588例,肝郁脾虚证487例,共1 075例,对75项证候指标进行频数分析、χ2检验等统计学处理,并建立判别方程.根据统计分析,采取主证辨证法确定两证的证候标准.结果肝郁气滞证的证候标准为:情绪抑郁、悲观厌世、善叹息、烦躁、脉弦,5项中具备3项(情绪抑郁必备),记分在4分以上者,即可诊断.肝郁脾虚证的证候标准为:情绪抑郁、悲观厌世、善叹息、倦怠乏力、纳差、形体消瘦、脉细,7项中具备4项,即肝郁两项(情绪抑郁必备),脾虚两项者,总记分在6分以上者,即可诊断.结论情绪抑郁、善叹息等5项为肝郁气滞证的证候标准,情绪抑郁、倦怠乏力、纳差等7项为肝郁脾虚证的证候标准.%Objective:To explore the standard of syndrome differentiation of the Hepatic Qi Stagnation and Hepatic Stagnation causing Splenic Deficiency for depression. Methods:588 cases with syndromes of the Hepatic Qi Stagnation and 487 cases with syndromes of the Hepatic Stagnation causing Splenic Deficiency, 1075 cases in sum,were from clinical epidemiological survery. 75 indexes were analyzed by frequency analysis and Chi-squared test. Then discriminant equations were established.According to the results of statistic analysis, by the differentiation of primary symptoms, the standard of syndrome with the Hepatic Qi Stagnation and syndrome with Hepatic Stagnation causing Splenic Deficiency for depression were developed. Results:The standard of syndrome with the Hepatic Qi Stagnation was the five symptoms including emotion depression, pessimism, sigh, dysphoria and stringy pulse.When more than three symptoms occur(emotion depression is necessary ) and the total scores are more than 4 ,the differentiation can be established. The standard of differentiation of syndrome with Hepatic Stagnation causing

  8. APRIL stimulates NF-κB-mediated HoxC4 induction for AID expression in mouse B cells

    OpenAIRE

    Park, Seok-Rae; Kim, Pyeung-Hyeun; Lee, Kyu-Seon; Lee, Sang-Hoon; Seo, Goo-Young; Yoo, Yung-Choon; Lee, Junglim; Casali, Paolo

    2012-01-01

    Activation-induced cytidine deaminase (AID) plays a key role in B cell immunoglobulin (Ig) class switch recombination (CSR) and somatic hypermutation (SHM). We have previously reported that the highly conserved homeodomain HoxC4 transcription factor binds to the Aicda (AID gene) promoter to induce AID expression. Here, we investigated the regulation of HoxC4 transcription by a proliferation-inducing ligand (APRIL) and B cell-activating factor belonging to the TNF family (BAFF) in mouse B cell...

  9. Technology-Use Mediation

    DEFF Research Database (Denmark)

    Bansler, Jørgen P.; Havn, Erling C.

    2004-01-01

    deepens our understanding of how organizations appropriate new electronic communication media. The paper analyzes how a group of mediators in a large, multinational company adapted a new web-based CMC technology (a virtual workspace) to the local organizational context (and vice versa) by modifying...... features of the technology, providing ongoing support for users, and promoting appropriate conventions of use. We found that these mediators exerted considerable influence on how the technology was established and used in the organization. The mediators were not neutral facilitators of a well......Implementation of new computer-mediated communication (CMC) systems in organizations is a complex socio-technical endeavour, involving the mutual adaptation of technology and organization over time. Drawing on the analytic concept of sensemaking, this paper provides a theoretical perspective that...

  10. Technology-Use Mediation

    DEFF Research Database (Denmark)

    Bansler, Jørgen P.; Havn, Erling C.

    2004-01-01

    Implementation of new computer-mediated communication (CMC) systems in organizations is a complex socio-technical endeavour, involving the mutual adaptation of technology and organization over time. Drawing on the analytic concept of sensemaking, this paper provides a theoretical perspective that...... deepens our understanding of how organizations appropriate new electronic communication media. The paper analyzes how a group of mediators in a large, multinational company adapted a new web-based CMC technology (a virtual workspace) to the local organizational context (and vice versa) by modifying...... features of the technology, providing ongoing support for users, and promoting appropriate conventions of use. We found that these mediators exerted considerable influence on how the technology was established and used in the organization. The mediators were not neutral facilitators of a well...

  11. Clinical application observation of shenling baizhu powder in damp abundance due to splenic asthenia%参苓白术散在脾虚湿盛证中的临床应用观察

    Institute of Scientific and Technical Information of China (English)

    鄢宏亮

    2015-01-01

    ABSTRACT:Objective To observe and analyze clinical application observation of shenling baizhu powder in damp abundance due to splenic asthenia. Method From July 2014 to March 2015 28 cases of patients in our hospital with spleen deficiency and dampness syndrome were selected as research object, use shenling baizhu therapy for them, and observe and analyze clinical effect. Result through treatment of shenling baizhu powder, 28 cases with damp abundance due to splenic asthenia were significantly improved, and cured basically. Conclusion shenling baizhu powder has ideal curative effect for damp abundance due to splenic asthenia, which has high clinical application value.%目的:观察分析参苓白术散在脾虚湿盛证中的临床应用。方法选取2014年7月至2015年3月于我院进行诊治的28例脾虚湿盛证患者作为研究对象,对这些患者予以服用参苓白术散治疗,观察分析临床效果。结果通过参苓白术散治疗,28例脾虚湿盛证患者病情均得到显著改善基本治愈。结论参苓白术散能对脾虚湿盛证具有理想的治疗效果,具有极高的临床应用价值。

  12. Inflammatory mediators in osteoarthritis

    OpenAIRE

    M Beekhuizen

    2014-01-01

    Osteoarthritis (OA) is a degenerative joint disorder involving cartilage destruction and joint inflammation. Despite extensive research, still much is unknown on the pathogenesis and aetiology of OA. Inflammation and inflammatory mediators (both local and systemic) are key in the pathogenesis of OA. For rheumatoid arthritis, multiple therapies are based on targeting the mediators that are associated with inflammation and joint destruction. Motivated by these findings we set off to identify wh...

  13. Interactive Mediated Reality

    OpenAIRE

    Grasset, Raphaël; Boissieux, Laurence; Gascuel, Jean-Dominique; Schmalstieg, Dieter

    2005-01-01

    International audience Mediated reality describes the concept of filtering our vision of reality, typically using a head-mounted video mixing display. We can redefine this idea in a more constructive context, applying dynamic changes to the appearance and geometry of objects in a real scene using computer graphics. In this paper, we propose new tools for interactively mediated reality. After describing a new generic framework for achieving this goal, we present a prototype system for paint...

  14. Chronic alloantibody mediated rejection

    OpenAIRE

    Smith, R. Neal; Colvin, Robert B.

    2011-01-01

    Alloantibodies clearly cause acute antibody mediated rejection, and all available evidence supports their pathogenic etiology in the development of chronic alloantibody mediated rejection (CAMR). But the slow evolution of this disease, the on-going immunosuppression, the variations in titer of alloantibodies, and variation in antigenic targets all complicate identifying which dynamic factors are most important clinically and pathologically. This review highlights the pathological factors rela...

  15. Hemorrhagic intra splenic pseudocyst as a complication of chronic pancreatitis in acute phase - a case report; Pseudocisto intra-esplenico hemorragico como complicacao de pancreatite cronica agudizada - relato de um caso

    Energy Technology Data Exchange (ETDEWEB)

    Almeida, Fabiola Assuncao de; Marchiori, Edson; Mello, Walter de Assis; Nogueira, Aline Silva; Sales, Anderson Ribeiro; Martins, Renata Romano; Santos, Tereza Cristina C.R.S. dos [Universidade Federal Fluminense, Niteroi, RJ (Brazil). Dept. de Radiologia

    1999-03-01

    The authors report a case of hemorrhagic intra splenic pseudocyst as a complication of chronic pancreatitis in acute phase. A 43-year-old woman, chronic alcoholic, who had pancreatitis 5 years ago, with symptoms of strong abdominal pain in the epigastrium, nausea and fever. Abdominal sonography showed a lesion contiguous to the spleen and computed tomography demonstrated an heterogeneous lesion of not well defined limits, in the lateral and posterior parts of the spleen. The patient was submitted to Roux-Y cystojejunostomy, he does not present any symptoms at the moment, and is undergoing clinical control. (author)

  16. 肝移植术中脾动脉结扎治疗脾功能亢进的疗效观察%Effect of splenic artery ligation for hypersplenism during liver transplantation

    Institute of Scientific and Technical Information of China (English)

    宋继勇; 杜国盛; 索龙龙; 周林; 郑德华; 封立魁; 石炳毅

    2015-01-01

    目的 观察肝移植术中行脾动脉结扎治疗终末期肝病患者严重脾功能亢进的安全性和疗效.方法 筛选术前存在脾功能亢进的肝移植受者32例,对其中17例于肝移植术中结扎脾动脉根部(作为结扎组),其余15例不予结扎脾动脉(作为未结扎组).比较两组受者术后白细胞、血小板、脾脏大小等变化情况,同时观察两组受者术后脾梗死、感染、再发消化道出血、脾动脉盗血综合征等并发症的发生情况.结果 所有受者随访时间均超过6个月.结扎组1例死于肝功能恢复延迟所致多器官功能衰竭,存活率为94.1%(16/17);未结扎组1例死于肺部感染所致呼吸功能衰竭,存活率为93.3%(14/15);两组存活率的差异无统计学意义(P>0.05).结扎组中无一例受者出现脾脏坏死,脾脏最大长、宽径乘积下降值为(33.17±8.26)cm2,而未结扎组下降值为(22.47±7.25)cm2,结扎组脾脏体积明显小于未结扎组(P<0.01).术后6个月内,结扎组受者各时点血小板计数均明显高于未结扎组(P<0.01);术后1周时,结扎组白细胞计数明显高于未结扎组(P<0.01),但之后两组白细胞计数的差异均无统计学意义(P>0.05).术后6个月内,结扎组感染发生率显著低于未结扎组(P<0.05),而再发消化道出血、脾动脉盗血综合征等发生率均无明显差异(P>0.05).结论 肝移植术中行脾动脉结扎术是安全的,术后早期可以迅速提升白细胞和血小板数,有利于受者术后恢复,且并不增加相关并发症发生率.%Objective To evaluate the efficacy and security of splenic artery ligation for severe hypersplenism during liver transplantation.Method Thirty-two liver transplant patients with preoperative hypersplenism were selected,including 17 cases (ligation group) treated by splenic artery ligation during liver transplantation,and rest 15 patients as non-ligation group.The fluctuation of white blood cells,platelets and volume

  17. Tracing the evolutionary lineage of pattern recognition receptor homologues in vertebrates: An insight into reptilian immunity via de novo sequencing of the wall lizard splenic transcriptome.

    Science.gov (United States)

    Priyam, Manisha; Tripathy, Mamta; Rai, Umesh; Ghorai, Soma Mondal

    2016-04-01

    Reptiles remain a deprived class in the area of genomic and molecular resources for the vertebrate classes. The transition of squamates from aquatic to terrestrial mode of life caused profound changes in their immune system to combat the altered variety of pathogens on land. The current study aims at delineating the evolution of defence mechanisms in wall lizard, Hemidactylus flaviviridis, by exploring its immunome. De novo sequencing of splenic transcriptome from wall lizard on the Illumina Hi-Seq platform generated 258,128 unique transcripts with an average GC content of 45%. Annotation of 555,557 and 6812 transcripts was carried out against NCBI (non-redundant database) and UniProt databases, respectively. The KEGG pathway annotation of transcripts classified them into 39 processes of six pathway function categories. A total of 3824 transcripts, involved in 23 immune-related pathways, were identified in the immune-relevant cluster built by harvesting the genes under KEGG pathways of immune system and immune diseases. Forty-two percent of the immune-relevant cluster was represented by pattern-recognition receptors (PRRs), of which the maximum number of transcripts was attributed to the Toll-like receptor (TLR) signalling pathway. Nine PRRs with potential full-length coding sequences were sorted for phylogenetic analysis and comparative domain analysis across the vertebrate lineage. They included DEC205/lymphocyte antigen 75 (ly75), nucleotide-binding oligomerisation domain-containing protein 1 (NOD1), NOD-like receptor family CARD domain-containing 3 (NLRC3), nucleotide-binding oligomerisation domain, leucine-rich repeat-containing X1 (NLRX1), DDX58/retinoic acid-inducible gene 1 (RIG-1), Toll-like receptor 3 (TLR3), TLR4, TLR5 and TLR7. From selection studies of these genes, we inferred positive selection for ly75, NOD1, RIG-1, TLR3 and TLR4. Apart from contributing to the scarce genomic resources available for reptiles and giving a broad scope for the immune

  18. [Immune-mediated neuropathies].

    Science.gov (United States)

    Stoll, G; Reiners, K

    2016-08-01

    The Guillain-Barré syndrome (GBS) and chronic inflammatory demyelinating polyneuropathy (CIDP) are the most common immune-mediated polyneuropathies, which can show variable clinical and electrophysiological manifestations. Rarer immune-mediated neuropathies encompass paraproteinemic neuropathies (PPN), multifocal motor neuropathy (MMN) and vasculitic neuropathies. The diagnosis usually relies on the history of symptom evolution, distribution of nerve dysfunction and particularly on characteristic features in nerve conduction studies, aided by cerebrospinal fluid (CSF) examination and nerve biopsy findings. The therapeutic toolbox encompasses corticosteroids, immunoglobulins and plasmapheresis often accompanied by long-term immunosuppression. It is important to note that immune-mediated neuropathies selectively respond to treatment and contraindications need to be considered. Despite treatment a considerable number of patients suffer from permanent neurological deficits. PMID:27474733

  19. The Strategic Mediator

    DEFF Research Database (Denmark)

    Rossignoli, Cecilia; Carugati, Andrea; Mola, Lapo

    2009-01-01

    The last 10 years have witnessed the emergence of electronic marketplaces as players that leverage new technologies to facilitate B2B internet-mediated collaborative business. Nowadays these players are augmenting their services from simple intermediation to include new inter-organizational relat......The last 10 years have witnessed the emergence of electronic marketplaces as players that leverage new technologies to facilitate B2B internet-mediated collaborative business. Nowadays these players are augmenting their services from simple intermediation to include new inter...... e-marketplace assumes the paradoxical role of strategic mediator: an agent who upholds and heightens the fences of the transactions instead of leveling them. The results have implication in shaping how we see the role of technology as strategic or commoditized....

  20. Immunologically mediated oral diseases

    Directory of Open Access Journals (Sweden)

    Sudha Jimson

    2015-01-01

    Full Text Available Immune mediated diseases of oral cavity are uncommon. The lesions may be self-limiting and undergo remission spontaneously. Among the immune mediated oral lesions the most important are lichen planus, pemphigus, erythema multiformi, epidermolysis bullosa, systemic lupus erythematosis. Cellular and humoral mediated immunity play a major role directed against epithelial and connective tissue in chronic and recurrent patterns. Confirmatory diagnosis can be made by biopsy, direct and indirect immunoflouresence, immune precipitation and immunoblotting. Therapeutic agents should be selected after thorough evaluation of immune status through a variety of tests and after determining any aggravating or provoking factors. Early and appropriate diagnosis is important for proper treatment planning contributing to better prognosis and better quality of life of patient.