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Sample records for splenic red pulp

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

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

    2015-08-11

    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.

  2. Symptomatic splenic hamartoma with renal, cutaneous, and hematological abnormalities

    International Nuclear Information System (INIS)

    Kassarjian, A.; Patenaude, Y.G.; Bernard, C.; Bell, L.

    2001-01-01

    Background. There is a rare association between splenic hamartomas and hematological abnormalities with, to our knowledge, only 24 reported cases in the English literature. Patients and methods. We report a case of a splenic hamartoma in a 14-year-old boy associated with membranoproliferative glomerulonephritis, multiple lobular capillary hemangiomas of the skin, hypertension, and anemia. Following imaging with ultrasonography, MRI, and nuclear scans, a hamartoma was suspected, but malignancy could not be excluded. The lesion was removed by partial splenectomy, and pathological examination confirmed the presence of a red pulp splenic hamartoma. Results. The renal, hematological, and dermatological abnormalities resolved following removal of the splenic hamartoma. This is the first reported case of a splenic hamartoma associated with renal, cutaneous, and hematological abnormalities and only the second reported case of a symptomatic splenic hamartoma treated by partial splenectomy. (orig.)

  3. Symptomatic splenic hamartoma with renal, cutaneous, and hematological abnormalities

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    Kassarjian, A.; Patenaude, Y.G. [Dept. of Medical Imaging, Montreal Children' s Hospital, PQ (Canada); Bernard, C. [Dept. of Pathology, Montreal Children' s Hospital, PQ (Canada); Bell, L. [Dept. of Nephrology, Montreal Children' s Hospital, PQ (Canada)

    2001-02-01

    Background. There is a rare association between splenic hamartomas and hematological abnormalities with, to our knowledge, only 24 reported cases in the English literature. Patients and methods. We report a case of a splenic hamartoma in a 14-year-old boy associated with membranoproliferative glomerulonephritis, multiple lobular capillary hemangiomas of the skin, hypertension, and anemia. Following imaging with ultrasonography, MRI, and nuclear scans, a hamartoma was suspected, but malignancy could not be excluded. The lesion was removed by partial splenectomy, and pathological examination confirmed the presence of a red pulp splenic hamartoma. Results. The renal, hematological, and dermatological abnormalities resolved following removal of the splenic hamartoma. This is the first reported case of a splenic hamartoma associated with renal, cutaneous, and hematological abnormalities and only the second reported case of a symptomatic splenic hamartoma treated by partial splenectomy. (orig.)

  4. Nitrotyrosine formation in splenic toxicity of aniline

    International Nuclear Information System (INIS)

    Khan, M. Firoze; Wu Xiaohong; Kaphalia, Bhupendra S.; Boor, Paul J.; Ansari, G.A.S.

    2003-01-01

    Splenic toxicity of aniline is characterized by vascular congestion, hyperplasia, fibrosis and development of a variety of sarcomas in rats. However, the mechanisms of this selective splenic toxicity are not well understood. Previously we showed that aniline exposure causes oxidative damage to spleen. To further explore the oxidative mechanisms of aniline toxicity, we evaluated the contributions of nitric oxide. Nitric oxide reacts with superoxide anion to form peroxynitrite, a powerful oxidant that converts the tyrosine residues of proteins to nitrotyrosine (NT). Therefore, aim of this study was to establish the role of nitric oxide through the formation and localization of NT in the spleen of rats exposed to aniline. Male Sprague-Dawley (SD) rats were given 1 mmol/kg per day aniline hydrochloride in water by gavage for 7 days, while the controls received water only. Immunohistochemical analysis for NT showed an intense staining in the red pulp areas of spleen from aniline-treated rats, localized in macrophages and sinusoidal cells. Occasionally mild NT immunostaining was also evident in the white pulp. Western blot analyses of the post-nuclear fraction of the spleens showed major nitrated proteins with molecular weights of 49, 30 and 18 kDa. Immunohistochemical analysis of inducible nitric oxide synthase (iNOS) also showed increased expression in the red pulp of the spleens from aniline-treated rats; the cellular localization was similar to nitrated proteins. These studies suggest that oxidative stress in aniline toxicity also includes aberration in nitric oxide production leading to nitration of proteins. Functional consequences of such nitration will further elucidate the contribution of nitric oxide to the splenic toxicity of aniline

  5. Radiological features of a symptomatic splenic hamartoma

    International Nuclear Information System (INIS)

    Thompson, S.E.; Walsh, E.A.; Cramer, B.C.; Pushpanathan, C.C.; Hollett, P.; Ingram, L.; Price, D.

    1996-01-01

    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. Radiological features of a symptomatic splenic hamartoma

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    Thompson, S.E. [Department of Radiology, Janeway Child Health Centre and Memorial University of Newfoundland, Janeway Place, St. John`s, NF A1A 1R8 (Canada); Walsh, E.A. [Department of Radiology, Janeway Child Health Centre and Memorial University of Newfoundland, Janeway Place, St. John`s, NF A1A 1R8 (Canada); Cramer, B.C. [Department of Radiology, Janeway Child Health Centre and Memorial University of Newfoundland, Janeway Place, St. John`s, NF A1A 1R8 (Canada); Pushpanathan, C.C. [Department of Pathology, Janeway Child Health Centre and Memorial University of Newfoundland, St. John`s, NF (Canada); Hollett, P. [Department of Nuclear Medicine, Health Sciences Centre and Memorial University of Newfoundland, St. John`s, NF (Canada); Ingram, L. [Department of Pediatrics, Janeway Child Health Centre and Memorial University of Newfoundland, St. John`s, NF (Canada); Price, D. [Department of Surgery, Janeway Child Health Centre and Memorial University of Newfoundland, St. John`s, NF (Canada)

    1996-09-01

    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.

  7. Splenic littoral cell angioma. Radio pathological correlation in two cases

    International Nuclear Information System (INIS)

    Asensio, J.; Montero, N.; Perez-Cidoncha, P.

    2000-01-01

    We present two cases of Littoral Cell Angiomas (LCA), a recently described variant of splenic angioma which originates in the cells that line the sinusoids from the red pulp (littoral cell). The histopathological and immunohistochemical characteristics of this neoplasm verifies its origin in the littoral cell with an intermediate origin between the endothelial and histiocyte cell and makes it possible to consider it as a pathological entity which is differentiated from the hemangiomas. The imaging findings are indistinguishable from the other splenic vascular neoplasms and the role of the Magnetic Resonance (MRI) stands out. (Author) 21 refs

  8. Scintigraphic follow up of autologous splenic grafts: An experimental and clinical study

    International Nuclear Information System (INIS)

    Reilmann, H.; Creutzig, H.; Pabst, R.; Kamran, D.

    1984-01-01

    The risk of overwhelming sepsis in splenectomized patients is well known and autotransplantation of splenic tissue might be considered as a prophylactic approach. Little is known, however, of the success of grafting in man. In six patients with autologous grafts after emergency splenectomy the ''trapping function'' (TF) was measured by sequential scintigraphy with heat damaged red cells every third month. To correlate TF with blood flow and histology, different experiments were done in pigs: ligation of the splenic artery or partial splenectomy or total splenectomy with grafting of fragments either subfascially or in the greater momentum. TF, blood flow with Rb-86 and immune response was measured at different times after surgery. Remnants left at the main vessels did not grow, while splenic tissue left at smaller vessels increased in size. There were great differences in blood flow per gram splenic tissue, but a significant correlation between TF and blood flow. All experimental grafts showed a normal function both of the white and the red pulp. In patients there was a growth of grafts in four, while in two no TF could be measured. TF is an indicator of relative blood flow to splenic grafts and therefore useful in the follow up of grafted patients

  9. Bacterial phagocytosis by macrophage of autogenous splenic implant

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    Marques R. G.

    2003-01-01

    Full Text Available Autogenous splenic implant seems to be the only alternative for preservation of splenic tissue after total splenectomy. This work was carried out to analyze the morphologic regeneration of autotransplanted splenic tissue in Wistar rats and to determine the bacterial phagocytic function of their macrophages. We utilized an experimental model with thirty-two rats, of both sexes, submitted to total splenectomy combined with autotransplantation in greater omentum of slices of the whole spleen mass. The animals were divided into two groups: I - young rats weighing 100 to 150 g; and II - adult rats weighing 250 to 300 g. Sixteen weeks later animals were intravenously inoculated with a suspension of Escherichia coli AB1157. Twenty minutes after inoculation, the animals were sacrificed and the splenic autotransplants were removed for morphological study. There was regeneration of autotransplanted splenic tissue in all animals. A similar morphological aspect among all animals was observed, with splenic tissue showing red and white pulps, lymphoid follicles, and marginal zone, with a moderate architectural disarrangement. Macrophages containing gram-negative bacterial aggregates as well as macrophages with hemosiderin pigments within the cytoplasm were observed. Blood vessels showed preserved walls, with no signs of vasculitis or thrombosis. The present results suggest that autogenous splenic implants in the greater omentum of the rat acquire the macro- and microscopic architecture of a normal spleen, with reduced dimensions, and preserve bacterial phagocyte function.

  10. The location of splenic NKT cells favours their rapid activation by blood-borne antigen

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    Barral, Patricia; Sánchez-Niño, María Dolores; van Rooijen, Nico; Cerundolo, Vincenzo; Batista, Facundo D

    2012-01-01

    Natural killer T (NKT) cells play an important role in mounting protective responses to blood-borne infections. However, though the spleen is the largest blood filter in the body, the distribution and dynamics of NKT cells within this organ are not well characterized. Here we show that the majority of NKT cells patrol around the marginal zone (MZ) and red pulp (RP) of the spleen. In response to lipid antigen, these NKT cells become arrested and rapidly produce cytokines, while the small proportion of NKT cells located in the white pulp (WP) exhibit limited activation. Importantly, disruption of the splenic MZ by chemical or genetic approaches results in a severe reduction in NKT cell activation indicating the need of cooperation between both MZ macrophages and dendritic cells for efficient NKT cell responses. Thus, the location of splenic NKT cells in the MZ and RP facilitates their access to blood-borne antigen and enables the rapid initiation of protective immune responses. PMID:22505026

  11. The location of splenic NKT cells favours their rapid activation by blood-borne antigen.

    Science.gov (United States)

    Barral, Patricia; Sánchez-Niño, María Dolores; van Rooijen, Nico; Cerundolo, Vincenzo; Batista, Facundo D

    2012-05-16

    Natural killer T (NKT) cells play an important role in mounting protective responses to blood-borne infections. However, though the spleen is the largest blood filter in the body, the distribution and dynamics of NKT cells within this organ are not well characterized. Here we show that the majority of NKT cells patrol around the marginal zone (MZ) and red pulp (RP) of the spleen. In response to lipid antigen, these NKT cells become arrested and rapidly produce cytokines, while the small proportion of NKT cells located in the white pulp (WP) exhibit limited activation. Importantly, disruption of the splenic MZ by chemical or genetic approaches results in a severe reduction in NKT cell activation indicating the need of cooperation between both MZ macrophages and dendritic cells for efficient NKT cell responses. Thus, the location of splenic NKT cells in the MZ and RP facilitates their access to blood-borne antigen and enables the rapid initiation of protective immune responses.

  12. Splenic scintigraphy using Tc-99m-labeled heat-denatured red blood cells in pediatric patients: concise communication

    International Nuclear Information System (INIS)

    Ehrlich, C.P.; Papanicolaou, N.; Treves, S.; Hurwitz, R.A.; Richards, P.

    1982-01-01

    Ten children underwent splenic imaging with heat-denatured red blood cells labeled with technetium-99m (Tc-99m DRBC). The presenting problems included the heterotaxia syndrome, recurrent idiopathic thrombocytopenic purpura following splenectomy, mass in the left posterior hemithorax, and blunt abdominal trauma. In nine patients, the presence or absence of splenic tissue was established. A splenic hematoma was identified in the tenth patient. All patients were initially scanned with Tc-99m sulfur colloid (Tc-99m SC), and were selected for Tc-99m DRBC scintigraphy only after the results of the SC scans failed to establish the clinical problem beyond doubt. The availability of kits containing stannous ions, essential for efficient and stable labeling of red blood cells with Tc-99m and requiring only a small volume of blood, make splenic scintigraphy in children a relatively simple and definitive diagnostic procedure, when identification of splenic tissue is of clinical importance

  13. Splenic scintigraphy using Tc-99m-labeled heat-denatured red blood cells in pediatric patients: concise communication

    Energy Technology Data Exchange (ETDEWEB)

    Ehrlich, C.P.; Papanicolaou, N.; Treves, S.; Hurwitz, R.A.; Richards, P.

    1982-03-01

    Ten children underwent splenic imaging with heat-denatured red blood cells labeled with technetium-99m (Tc-99m DRBC). The presenting problems included the heterotaxia syndrome, recurrent idiopathic thrombocytopenic purpura following splenectomy, mass in the left posterior hemithorax, and blunt abdominal trauma. In nine patients, the presence or absence of splenic tissue was established. A splenic hematoma was identified in the tenth patient. All patients were initially scanned with Tc-99m sulfur colloid (Tc-99m SC), and were selected for Tc-99m DRBC scintigraphy only after the results of the SC scans failed to establish the clinical problem beyond doubt. The availability of kits containing stannous ions, essential for efficient and stable labeling of red blood cells with Tc-99m and requiring only a small volume of blood, make splenic scintigraphy in children a relatively simple and definitive diagnostic procedure, when identification of splenic tissue is of clinical importance.

  14. Infection with Salmonella enterica Serovar Typhimurium Leads to Increased Proportions of F4/80+ Red Pulp Macrophages and Decreased Proportions of B and T Lymphocytes in the Spleen.

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    Kristin L Rosche

    Full Text Available Infection of mice with Salmonella enterica serovar Typhimurium (Salmonella causes systemic inflammatory disease and enlargement of the spleen (splenomegaly. Splenomegaly has been attributed to a general increase in the numbers of phagocytes, lymphocytes, as well as to the expansion of immature CD71+Ter119+ reticulocytes. The spleen is important for recycling senescent red blood cells (RBCs and for the capture and eradication of blood-borne pathogens. Conservation of splenic tissue architecture, comprised of the white pulp (WP, marginal zone (MZ, and red pulp (RP is essential for initiation of adaptive immune responses to captured pathogens. Using flow cytometry and four color immunofluorescence microscopy (IFM, we show that Salmonella-induced splenomegaly is characterized by drastic alterations of the splenic tissue architecture and cell population proportions, as well as in situ cell distributions. A major cause of splenomegaly appears to be the significant increase in immature RBC precursors and F4/80+ macrophages that are important for recycling of heme-associated iron. In contrast, the proportions of B220+, CD4+ and CD8+ lymphocytes, as well as MZ MOMA+ macrophages decrease significantly as infection progresses. Spleen tissue sections show visible tears and significantly altered tissue architecture with F4/80+ macrophages and RBCs expanding beyond the RP and taking over most of the spleen tissue. Additionally, F4/80+ macrophages actively phagocytose not only RBCs, but also lymphocytes, indicating that they may contribute to declining lymphocyte proportions during Salmonella infection. Understanding how these alterations of spleen microarchitecture impact the generation of adaptive immune responses to Salmonella has implications for understanding Salmonella pathogenesis and for the design of more effective Salmonella-based vaccines.

  15. Infection with Salmonella enterica Serovar Typhimurium Leads to Increased Proportions of F4/80+ Red Pulp Macrophages and Decreased Proportions of B and T Lymphocytes in the Spleen.

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    Rosche, Kristin L; Aljasham, Alanoud T; Kipfer, James N; Piatkowski, Bryan T; Konjufca, Vjollca

    2015-01-01

    Infection of mice with Salmonella enterica serovar Typhimurium (Salmonella) causes systemic inflammatory disease and enlargement of the spleen (splenomegaly). Splenomegaly has been attributed to a general increase in the numbers of phagocytes, lymphocytes, as well as to the expansion of immature CD71+Ter119+ reticulocytes. The spleen is important for recycling senescent red blood cells (RBCs) and for the capture and eradication of blood-borne pathogens. Conservation of splenic tissue architecture, comprised of the white pulp (WP), marginal zone (MZ), and red pulp (RP) is essential for initiation of adaptive immune responses to captured pathogens. Using flow cytometry and four color immunofluorescence microscopy (IFM), we show that Salmonella-induced splenomegaly is characterized by drastic alterations of the splenic tissue architecture and cell population proportions, as well as in situ cell distributions. A major cause of splenomegaly appears to be the significant increase in immature RBC precursors and F4/80+ macrophages that are important for recycling of heme-associated iron. In contrast, the proportions of B220+, CD4+ and CD8+ lymphocytes, as well as MZ MOMA+ macrophages decrease significantly as infection progresses. Spleen tissue sections show visible tears and significantly altered tissue architecture with F4/80+ macrophages and RBCs expanding beyond the RP and taking over most of the spleen tissue. Additionally, F4/80+ macrophages actively phagocytose not only RBCs, but also lymphocytes, indicating that they may contribute to declining lymphocyte proportions during Salmonella infection. Understanding how these alterations of spleen microarchitecture impact the generation of adaptive immune responses to Salmonella has implications for understanding Salmonella pathogenesis and for the design of more effective Salmonella-based vaccines.

  16. Simultaneous production of bio-ethanol and bleached pulp from red algae.

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    Yoon, Min Ho; Lee, Yoon Woo; Lee, Chun Han; Seo, Yung Bum

    2012-12-01

    The red algae, Gelidium corneum, was used to produce bleached pulp for papermaking and ethanol. Aqueous extracts obtained at 100-140 °C were subjected to saccharification, purification, fermentation, and distillation to produce ethanol. The solid remnants were bleached with chlorine dioxide and peroxide to make pulp. In the extraction process, sulfuric acid and sodium thiosulfate were added to increase the extract yield and to improve de-polymerization of the extracts, as well as to generate high-quality pulp. An extraction process incorporating 5% sodium thiosulfate by dry weight of the algae provided optimal production conditions for the production of both strong pulp and a high ethanol yield. These results suggest that it might be possible to utilize algae instead of trees and starch for pulp and ethanol production, respectively. Copyright © 2012 Elsevier Ltd. All rights reserved.

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

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    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.

  18. Born-again spleen. Return of splenic function after splenectomy for trauma

    International Nuclear Information System (INIS)

    Pearson, H.A.; Johnston, D.; Smith, K.A.; Touloukian, R.J.

    1978-01-01

    We assessed splenic activity after splenectomy by interference phase microscopical examination of circulating red cells. Normal eusplenic children had a low number (<1%) of red cells with surface indentations or pits. About 20% of red cells of children who had electively been subjected to splenectomy for hematologic indications were pitted. Thirteen of 22 children who had had emergency splenectomy because of traumatic injury had a low percentage of pitted red cells, suggesting a return of splenic function. In five of these children a /sup 99m/Tc sulfur colloid scan demonstrated multiple nodules of recurrent splenic tissue. In contrast to the prevailing opinion that splenosis is rare, we have found it to be a frequent occurrence. Return of splenic function may, in part, account for the low frequency with which overwhelming bacterial sepsis and meningitis have been documented after splenectomy for traumatic indications

  19. Splenic injury caused by therapeutic irradiation

    International Nuclear Information System (INIS)

    Dailey, M.O.; Coleman, C.N.; Fajardo, L.F.

    1981-01-01

    Splenic irradiation in the course of therapy for lymphoma can result in functional deficit, sometimes as severe as that caused by splenectomy, placing the patient at risk for fatal infection. We examined 33 spleens obtained at necropsy from patients irradiated for lymphomas (mainly Hodgkin's disease) and compared them with 18 nonirradiated spleens from similar patients. One to 8 years after a mean radiation dose of 3899 rads, fractionated over 5-6 weeks, most irradiated spleens were small (average weight 75 g) and had thick, wrinkled capsules, often with focal hemorrhage. There was collapse of the parenchyma, with close apposition of trabeculae and mild to severe diffuse fibrosis of the red pulp. Lymphocyte depletion was obvious in more than 50% of the specimens. The most consistent alteration was myointimal proliferation of arteries. Significant intimal thickening was seen only in the irradiated specimens. Similar myointimal changes were found in the veins of three cases. While none of these changes is specific, their combination appears to be characteristic of delayed radiation injury to the spleen

  20. Acute and Subacute Oral Toxicity of Periodate in Rats

    Science.gov (United States)

    2014-11-17

    associated with kidney disease are characterized by activation of the innate immune system coupled with immune deficiency. Sodium periodate exposed rats...lymphocytes in splenic nodules and was coded as white pulp atrophy. White pulp atrophy was noted in one of 10 females in the 40 mg/kg-day group and...and white cell precursors) and contracted sinuses or red pulp atrophy was noted in four of 10 females in the 318 mg/kg-day group. Red pulp atrophy was

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

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    Joselli Silva-O'Hare

    Full Text Available 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.

  2. Difficult preoperative diagnosis of a patient with sclerosing splenic hemangioma

    International Nuclear Information System (INIS)

    Edoute, Y.; Ben-Haim, S.A.; Ben-Arie, Y.; Fishman, A.; Barzilai, D.

    1989-01-01

    We present a young asymptomatic woman with splenomegaly and a large isolated splenic mass demonstrated by ultrasonography, 99m Tc sulfur colloid, and gallium scintigraphy studies. Computerized tomography (CT) and three-phase 99mTc-labeled red blood cell imaging suggested a malignant lesion. Repeated sonographically guided fine needle aspiration (FNA) obtained only blood, suggesting the possible vascular nature of the tumor. Splenectomy established the diagnosis of splenic hemangioma (SH) with marked sclerotic changes. We conclude from this case that (1) the sclerotic and cystic changes in the SH and the abdominal lymphadenopathy could explain why the three-phase red blood cell and CT scanning, respectively, suggested that the lesion was malignant rather than benign; (2) guided FNA of a splenic mass suspected to be hemangioma may be an additional safe and useful diagnostic procedure. Multiple aspirations yielding blood alone suggest hemangioma and may prevent an unnecessary operation. To the best of our knowledge, this is the first reported case in the literature of FNA of splenic hemangioma

  3. The effects of hematopoietic stem cell transplant on splenic extramedullary hematopoiesis in patients with myeloproliferative neoplasm-associated myelofibrosis.

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    Pizzi, Marco; Gergis, Usama; Chaviano, Felicia; Orazi, Attilio

    2016-09-01

    Hematopoietic stem cell transplant (HSCT) is the only curative treatment for myeloproliferative neoplasm-associated myelofibrosis (MPN-MF). The main clinical manifestation of MPN-MF is splenomegaly secondary to extramedullary hematopoiesis (EMH). The effects of HSCT on splenic EMH and associated vascular and stromal changes are unknown. This study compares the findings seen in spleens following HSCT with those of nontransplanted patients, normal controls, and matched bone marrow (BM) samples. This study included three transplanted MPN-MF spleens, three nontransplanted MPN-MF spleens, and three normal controls. Spleens were assessed for: (a) presence/extent of EMH; (b) presence of Gamna-Gandy bodies; (c) splenic fibrosis; (d) CD34-positive microvessel density; (e) CD8-positive sinusoids; (f) frequency of smooth muscle actin-positive myoid cells; and (g) nerve growth factor receptor-positive adventitial reticulum cells. In two cases, matched BM samples were assessed for cellularity, presence of atypical megakaryocytes, and fibrosis. Compared with normal controls, all MPN-MF spleens were larger in size, had EMH, red pulp fibrosis, higher CD34-positive microvessel density, and decreased CD8-positive sinusoids. Compared with nontransplanted cases, post-HSCT spleens showed disappearance or reduction of EMH. Gamna-Gandy bodies were increased; no differences in the remaining parameters were found. A reduction of splenic EMH was associated with normalization of BM cellularity and megakaryopoiesis. HSCT reduces/abrogates splenic EMH and is associated with an increased number of Gamna-Gandy bodies, which may suggest vascular damage. The lack of stromal changes in spleens removed shortly after transplant is in line with similar observations in the BM, where a longer interval is often necessary for resolution of fibrosis. Copyright © 2016 King Faisal Specialist Hospital & Research Centre. Published by Elsevier Ltd. All rights reserved.

  4. Red algae and their use in papermaking.

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    Seo, Yung-Bum; Lee, Youn-Woo; Lee, Chun-Han; You, Hack-Chul

    2010-04-01

    Gelidialian red algae, that contain rhizoidal filaments, except the family Gelidiellaceae were processed to make bleached pulps, which can be used as raw materials for papermaking. Red algae consist of rhizoidal filaments, cortical cells usually reddish in color, and medullary cells filled with mucilaginous carbohydrates. Red algae pulp consists of mostly rhizoidal filaments. Red algae pulp of high brightness can be produced by extracting mucilaginous carbohydrates after heating the algae in an aqueous medium and subsequently treating the extracted with bleaching chemicals. In this study, we prepared paper samples from bleached pulps obtained from two red algae species (Gelidium amansii and Gelidium corneum) and compared their properties to those of bleached wood chemical pulps. Copyright 2009 Elsevier Ltd. All rights reserved.

  5. Splenic abscess after splenic blunt injury angioembolization.

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    Tartaglia, Dario; Galatioto, Christian; Lippolis, Piero Vincenzo; Modesti, Matteo; Gianardi, Desirée; Bertolucci, Andrea; Cucinotta, Monica; Zocco, Giuseppe; Seccia, Massimo

    2014-11-03

    Splenic Angioembolization (SAE), during Nonoperative Management (NOM) of Blunt Splenic Injury (BSI), is an effective therapy for hemodynamically stable patients with grade III, IV, and V OIS splenic injuries. We report a case of a patient with a blunt abdominal trauma due to an accidental fall, who presented splenic abscess a week after SAE and a review of the literature. A 38-year-old male arrived at Emergency after an accidental fall with contusion of the left upper quadrant of the abdomen. Abdominal CT scan revealed the fracture of the lower splenic pole with intraparenchymal pseudoaneurysms (OIS spleen injury scale IV). Considering the hemodynamic stability, NOM was undertaken and SAE was performed. After a week, the patient developed a splenic abscess confirmed by Abdominal CT; therefore, splenectomy was performed. There was no evidence of bacterial growing in the perisplenic hematoma cultures but the histological examination showed multiple abscess and hemorrhagic areas in the spleen. Splenic abscess after SAE during NOM of BSI is a rare major complication. The most frequently cultured organisms include Clostridium perfringens, Alpha-Hemoliticus Streptococcus, gram-positive Staphylococcus, gram-negative Salmonella, Candida, and Aspergillus. This case represents our first reported splenic abscess after SAE. SAE is a very useful tool for BSI managing; splenic abscess can occur in a short time, even if it is a rare major complication, so it may be useful to monitor patients undergoing SAE, focusing not only on the hemodynamic parameters but also on the inflammatory and infectious aspects.

  6. 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).

  7. The Use of Headspace Solid-Phase Microextraction (HS-SPME to Assess the Quality and Stability of Fruit Products: An Example Using Red Mombin Pulp (Spondias purpurea L.

    Directory of Open Access Journals (Sweden)

    Katieli Martins Todisco

    2014-10-01

    Full Text Available The present study aimed to evaluate the volatiles profile of red mombin (Spondias purpurea pulp and its powder produced by spray-drying (SD as an example to show utility of headspace solid-phase microextraction (HS-SPME in the analysis of parameters such as the quality and stability of fruit products. Volatiles profiles of the pulp were identified by gas chromatography-mass spectrometry (GC-MS, quantified by gas chromatography-flame ionization detector (GC-FID and compared to the profile of the powder stored at 0, 60 and 120 days in plastic (PP or laminated packages (LP. The results showed that the technique was able to identify 36 compounds in the red mombin pulp, 17 out of which have been described for the first time in this fruit, showing that red mombin fresh pulp appears to be unique in terms of volatiles composition. However, only 24 compounds were detected in the powder. This decrease is highly correlated (r2 = 0.99, at least for the majority of compounds, to the degree of volatility of compounds. Furthermore, the powder stored in PP or LP showed no statistical differences in the amounts of its components for a period of 120 days of storage. Finally, this work shows how HS-SPME analysis can be a valuable tool to assess the quality and stability of fruit products.

  8. Cytological and histological changes in the spleen of continuously irradiated rats

    International Nuclear Information System (INIS)

    Praslicka, M.; Chlebovsky, O.

    1976-01-01

    The study evaluates quantitative cytological and histological changes in splenic white and red pulp of rats continuously irradiated for up to 140 days with daily doses ranging from 0.5 R to 82.5 R. A significant reduction of lymphocyte incidence begins at 5 R/day and it continues to drop with every further increase in the dose rate until a steady state of about 5 per cent is reached at 82.5 R/day. Small lymphocytes are relatively more affected. Irradiated animals show a wave-like increase in ectopic erythropoiesis in spleen red pulp from day 30 on even with the lowest dose rates of 0.5 and 1 R/day. The ratio or relative incidences of haemocytoblasts and erythroblasts increases approximately twofold, indicating that a substantial reduction of stem cells is compensated to a large extent already at an early stage of erythropoiesis. The incidence of myeloid elements rises, from the 40th day of exposure, the increase being more apparent at medium dose rates for eosinophils than for neutrophils. Both the red and white splenic pulps of exposed animals display an increased incidence of plasma cells. (author)

  9. Experimental Stroke Differentially Affects Discrete Subpopulations of Splenic Macrophages

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    Laura McCulloch

    2018-05-01

    Full Text Available Changes to the immune system after stroke are complex and can result in both pro-inflammatory and immunosuppressive consequences. Following ischemic stroke, brain resident microglia are activated and circulating monocytes are recruited to the injury site. In contrast, there is a systemic deactivation of monocytes/macrophages that may contribute to immunosuppression and the high incidence of bacterial infection experienced by stroke patients. The manipulation of macrophage subsets may be a useful therapeutic strategy to reduce infection and improve outcome in patients after stroke. Recent research has enhanced our understanding of the heterogeneity of macrophages even within the same tissue. The spleen is the largest natural reservoir of immune cells, many of which are mobilized to the site of injury after ischemic stroke and is notable for the diversity of its functionally distinct macrophage subpopulations associated with specific micro-anatomical locations. Here, we describe the effects of experimental stroke in mice on these distinct splenic macrophage subpopulations. Red pulp (RP and marginal zone macrophages (MZM specifically showed increases in density and alterations in micro-anatomical location. These changes were not due to increased recruitment from the bone marrow but may be associated with increases in local proliferation. Genes associated with phagocytosis and proteolytic processing were upregulated in the spleen after stroke with increased expression of the lysosome-associated protein lysosomal-associated membrane proteins specifically increased in RP and MZM subsets. In contrast, MHC class II expression was reduced specifically in these populations. Furthermore, genes associated with macrophage ability to communicate with other immune cells, such as co-stimulatory molecules and inflammatory cytokine production, were also downregulated in the spleen after stroke. These findings suggest that selective splenic macrophage functions

  10. Haematological and biochemical characteristics of the splenic effluent blood in schistosomal patients undergoing splenectomy

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    Andy Petroianu

    Full Text Available OBJECTIVE: To assess hematological and biochemical features of splenic effluent blood and their influence on the rise of hematological values after splenectomy. METHODS: we studied 20 patients undergoing surgical treatment for schistosomatic portal hypertension. We collected blood samples for CBC, coagulation, bilirubin and albumin in the splenic vein (perioperative and peripheral blood (immediately pre and postoperative periods. RESULTS: the splenic blood showed higher values of red blood cells, hemoglobin, hematocrit, platelet count, total leukocytes, neutrophils, lymphocytes, monocytes, eosinophils and basophils, as well as reduction of laboratory coagulation parameters in relation to peripheral blood collected preoperatively. In the postoperative peripheral blood there was an increase in the overall leukocytes and in their neutrophil component, and decreased levels of basophils, eosinophils and lymphocytes. The other postoperative variables of complete blood count and coagulation tests were not different compared with the splenic blood. The albumin values were lower postoperatively when compared to preoperative and splenic blood. There were higher values of direct bilirubin in the postoperative period when compared with the preoperative and splenic blood. Postoperative indirect bilirubin was lower compared to its value in the splenic blood. CONCLUSION: hematological and biochemical values of splenic effluent blood are higher than those found in peripheral blood in the presence of schistosomal splenomegaly. However, the splenic blood effluent is not sufficient to raise the blood levels found after splenectomy.

  11. Pediatric littoral cell angioma of the spleen: multimodality imaging including diffusion-weighted imaging

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    Ertan, Gulhan; Tekes, Aylin; Huisman, Thierry A.G.M. [Johns Hopkins Hospital, Division of Pediatric Radiology, Department of Radiology and Radiological Science, Baltimore, MD (United States); Mitchell, Sally [Johns Hopkins Hospital, Division of Cardiovascular and Interventional Radiology, Department of Radiology and Radiological Science, Baltimore (United States); Keefer, Jeffrey [Johns Hopkins Hospital, Division of Pediatric Hematology, Department of Pediatrics, Baltimore, MD (United States)

    2009-10-15

    Littoral cell angioma (LCA) is a rare primary splenic vascular tumor originating from littoral cells lining the splenic red pulp sinuses. LCAs are rarely seen in children. We present the US, CT, and MRI findings including diffusion-weighted imaging (DWI) in a 2-year-old boy with histologically proven LCA. Previous studies on liver lesions have shown that DWI allows differentiation of vascular tumors from primary neoplasms and metastatic disease. The current case indicates that increased ADC values within the splenic lesions suggest a vascular etiology, which might help narrow the differential diagnosis. (orig.)

  12. Pediatric littoral cell angioma of the spleen: multimodality imaging including diffusion-weighted imaging

    International Nuclear Information System (INIS)

    Ertan, Gulhan; Tekes, Aylin; Huisman, Thierry A.G.M.; Mitchell, Sally; Keefer, Jeffrey

    2009-01-01

    Littoral cell angioma (LCA) is a rare primary splenic vascular tumor originating from littoral cells lining the splenic red pulp sinuses. LCAs are rarely seen in children. We present the US, CT, and MRI findings including diffusion-weighted imaging (DWI) in a 2-year-old boy with histologically proven LCA. Previous studies on liver lesions have shown that DWI allows differentiation of vascular tumors from primary neoplasms and metastatic disease. The current case indicates that increased ADC values within the splenic lesions suggest a vascular etiology, which might help narrow the differential diagnosis. (orig.)

  13. Delayed splenic vascular injury after nonoperative management of blunt splenic trauma.

    Science.gov (United States)

    Furlan, Alessandro; Tublin, Mitchell E; Rees, Mitchell A; Nicholas, Dederia H; Sperry, Jason L; Alarcon, Louis H

    2017-05-01

    Delayed splenic vascular injury (DSVI) is traditionally considered a rare, often clinically occult, harbinger of splenic rupture in patients with splenic trauma that are managed conservatively. The purpose of our study was to assess the incidence of DSVI and associated features in patients admitted with blunt splenic trauma and managed nonoperatively. A retrospective analysis was conducted over a 4-y time. Patients admitted with blunt splenic trauma, managed no-operatively and with a follow-up contrast-enhanced computed tomography (CT) scan study during admission were included. The CT scans were reviewed for American Association for the Surgery of Trauma splenic injury score, amount of hemoperitoneum, and presence of DSVI. Logistic regression models were used to investigate the risk factors associated with DSVI. A total of 100 patients (60 men and 40 women) constituted the study group. Follow-up CT scan demonstrated a 23% incidence of DSVI. Splenic artery angiography validated DSVI in 15% of the total patient population. Most DSVIs were detected only on arterial phase CT scan imaging. The American Association for the Surgery of Trauma splenic injury score (odds ratio = 1.73; P = 0.045) and the amount of hemoperitoneum (odds ratio = 1.90; P = 0.023) on admission CT scan were associated with the development of DSVI on follow-up CT scan. DSVI on follow-up CT scan imaging of patients managed nonoperatively after splenic injury is common and associated with splenic injury score assessed on admission CT scan. Copyright © 2016 Elsevier Inc. All rights reserved.

  14. Chronic Stress Induces Structural Alterations in Splenic Lymphoid Tissue That Are Associated with Changes in Corticosterone Levels in Wistar-Kyoto Rats

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    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.

  15. Dental Pulp Defence and Repair Mechanisms in Dental Caries

    OpenAIRE

    Farges, Jean-Christophe; Alliot-Licht, Brigitte; Renard, Emmanuelle; Ducret, Maxime; Gaudin, Alexis; Smith, Anthony J.; Cooper, Paul R.

    2015-01-01

    Dental caries is a chronic infectious disease resulting from the penetration of oral bacteria into the enamel and dentin. Microorganisms subsequently trigger inflammatory responses in the dental pulp. These events can lead to pulp healing if the infection is not too severe following the removal of diseased enamel and dentin tissues and clinical restoration of the tooth. However, chronic inflammation often persists in the pulp despite treatment, inducing permanent loss of normal tissue and red...

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

    International Nuclear Information System (INIS)

    Foley, P. T.; Kavnoudias, H.; Cameron, P. U.; Czarnecki, C.; Paul, E.; Lyon, S. M.

    2015-01-01

    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

  17. 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.

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

    Science.gov (United States)

    Foley, P T; Kavnoudias, H; Cameron, P U; Czarnecki, C; Paul, E; Lyon, S M

    2015-10-01

    To 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. Patients 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. Of 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. IgM 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.

  19. CT of splenic trauma

    International Nuclear Information System (INIS)

    Griffiths, B.G.; Federle, M.P.; Minagi, H.; Jeffrey, R.B.

    1986-01-01

    Fifty-five consecutive cases of surgically proved splenic injuries were evaluated by CT. CT correctly identified 54 splenic injuries, with one false-negative and three false-positive studies. In the single false-negative study and in two of the three false-positive studies, CT correctly indicated the presence of a large hemoperitoneum and other abdominal visceral lacerations and so correctly indicated the need for surgery. Of the 55 proved cases of splenic injury, CT revealed hemoperitoneum in 54 (99%), perisplenic clot in 47 (85%), splenic laceration in 39 (71%), and subcapsular hematoma in 13 (24%). Perisplenic clot can be distinguished from lysed blood in the peritoneal cavity and is a sensitive and specific sign of splenic trauma, even in the absence of visible splenic laceration. The authors conclude that CT is highly reliable means of evaluating splenic trauma

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

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    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.

  1. Severe clinical presentation of visceral leishmaniasis in naturally infected dogs with disruption of the splenic white pulp.

    Science.gov (United States)

    Lima, Isadora S; Silva, Joselli S; Almeida, Valter A; Junior, Floriano G Leal; Souza, Patrício An; Larangeira, Daniela F; Moura-Neto, José P; Fraga, Deborah B M; de Freitas, Luiz A R; dos-Santos, Washington L C

    2014-01-01

    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.

  2. 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.

  3. Use of radionuclide techniques for assessment of splenic function and detection of splenic remnants

    International Nuclear Information System (INIS)

    Ganguly, S.; Sinha, S.; Sarkar, B.R.; Basu, S.; Ghosh, S.

    1998-01-01

    Full text: The spleen is often involved in hematological malignancies; it is also the site of RBC destruction in thalassemia and ITP. In latter cases, splenectomy is often performed and postoperatively, detection of functioning splenic remnants affect the prognosis adversely. In this study, we assessed the usefulness of radionuclide techniques in : a) assessment of splenic function in primarily non-splenic diseases (benign or malignant), and b) detection of splenic remnant after splenectomy. 12 patients of splenomegaly and 5 patients after splenectomy underwent splenic imaging; imaging was performed using both 99m Tc-sulphur colloid (with first pass) and 99m Tc labelled heat denatured RBCs as tracers. Thus splenic perfusion, morphology and RBC trapping functions were all assessed. The colloid images usually matched the RBC images except in 2 cases where photogenic areas (presumably infarcts) were visualized on RBC scans that were missed on colloid scans. Three of the post splenectomy cases revealed functioning splenic remnants, which was also better visualized on RBC scans. It is concluded that radionuclide imaging could be used regularly for assessing function of spleen, or detecting splenic remnants

  4. Radionuclide evaluation of hemocatheretic function in a group of thalassemic patients after splenic embolization

    International Nuclear Information System (INIS)

    Bagni, B.; Feggi, L.M.; Prandini, N.; Soriani, S.

    1987-01-01

    Seven patients with thalassemia major underwent splenic embolization in order to assess splenic mass and function before and after treatment. Red blood cells, marked ''in vitro'' and chemically denatured with BMHP were also used to assess the blood parameters related to splenic function i.e. pretransfusional haemoglobin (Nb) and mean blood consumption (BC). The results show a statistically significant difference (p<0.01) for Hb and erythrocyte clearance before and after embolization. Before embolization no statistically significant correlations were found between the parameters examined, whereas after embolization there was a linear correlation at the limit of significance between BC and clearance halftime. The radionuclide method is proposed as safe and reproducible. Unlike blood chemical tests it also provides immediate information on the effects of embolization and a reliable parameter for follow-up

  5. Multiple splenic abscesses

    Directory of Open Access Journals (Sweden)

    Harish Kumar

    2015-01-01

    Full Text Available Splenic abscess is a rare clinical entity with poor prognosis. But owing to imaging technique, diagnosis and prognosis have improved nowadays. Most patients who are presented with splenic abscess are immunocompromised due to predisposing risk factors like diabetes mellitus, intravenous drug abuse, trauma, bacterial endocarditis, human immunodeficiency virus (HIV, chemotherapy, or steroids. Here, we are presenting a rarer case of multiple splenic abscesses with its complication in an immunocompetent healthy adult male without any risk factor.

  6. Embolisation of the splenic artery

    Energy Technology Data Exchange (ETDEWEB)

    Essler, G; Duex, A

    1982-09-01

    In bleeding of oesophageal varices with resistance to common treatment embolisation of the splenic artery causes depression of the portal hypertension by forty per cent. Thrombosis of the splenic or portal vein as in splenectomies are not to be expected. The splenic vein remains open for later spleno-renal anastomosis. By occlusion of the splenic artery we were successful in stopping oesophageal bleeding. In a patient with dominant hypersplenism in portal hypertension the severity of the syndrome decreased after embolisation of the splenic artery. Thrombocytes, leukocytes and gammaglobulin increased.

  7. Selective splenic targeting of In-114m by heat-treated red blood cells for the treatment of lymphoid cell malignancy

    International Nuclear Information System (INIS)

    Sharma, H.L.; Jackson, N.C.; Jackson, H.; Smith, A.M.; Shukla, S.K.

    1998-01-01

    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)

  8. Splenic trauma: three pronged diagnosis

    International Nuclear Information System (INIS)

    Owens, M.L.; Brantigan, J.; Chang, F.

    1975-01-01

    Peritoneal lavage, splenic scan, and splenic arteriography can vastly increase the speed and accuracy of patient evaluation when splenic injury is suspected. Although certain pitfalls exist, their wider use is advocated

  9. Trypanosoma cruzi infection induces a massive extrafollicular and follicular splenic B-cell response which is a high source of non-parasite-specific antibodies.

    Science.gov (United States)

    Bermejo, Daniela A; Amezcua Vesely, María C; Khan, Mahmood; Acosta Rodríguez, Eva V; Montes, Carolina L; Merino, Maria C; Toellner, Kai Michael; Mohr, Elodie; Taylor, Dale; Cunningham, Adam F; Gruppi, Adriana

    2011-01-01

    Acute infection with Trypanosoma cruzi, the aetiological agent of Chagas' disease, results in parasitaemia and polyclonal lymphocyte activation. It has been reported that polyclonal B-cell activation is associated with hypergammaglobulinaemia and delayed parasite-specific antibody response. In the present study we analysed the development of a B-cell response within the different microenvironments of the spleen during acute T. cruzi infection. We observed massive germinal centre (GC) and extrafollicular (EF) responses at the peak of infection. However, the EF foci were evident since day 3 post-infection (p.i.), and, early in the infection, they mainly provided IgM. The EF foci response reached its peak at 11 days p.i. and extended from the red pulp into the periarteriolar lymphatic sheath. The GCs were detected from day 8 p.i. At the peak of parasitaemia, CD138(+) B220(+) plasma cells in EF foci, red pulp and T-cell zone expressed IgM and all the IgG isotypes. Instead of the substantial B-cell response, most of the antibodies produced by splenic cells did not target the parasite, and parasite-specific IgG isotypes could be detected in sera only after 18 days p.i. We also observed that the bone marrow of infected mice presented a strong reduction in CD138(+) B220(+) cells compared with that of normal mice. Hence, in acute infection with T. cruzi, the spleen appears to be the most important lymphoid organ that lodges plasma cells and the main producer of antibodies. The development of a B-cell response during T. cruzi infection shows features that are particular to T. cruzi and other protozoan infection but different to other infections or immunization with model antigens.

  10. Splenic function after angioembolization for splenic trauma in children and adults: A systematic review

    NARCIS (Netherlands)

    Schimmer, J. A. G.; van der Steeg, A. F. W.; Zuidema, W. P.

    2016-01-01

    Splenic artery embolization (SAE), proximal or distal, is becoming the standard of care for traumatic splenic injury. Theoretically the immunological function of the spleen may be preserved, but this has not yet been proven. A parameter for measuring the remaining splenic function must therefore be

  11. Splenic function after angioembolization for splenic trauma in children and adults: A systematic review.

    Science.gov (United States)

    Schimmer, J A G; van der Steeg, A F W; Zuidema, W P

    2016-03-01

    Splenic artery embolization (SAE), proximal or distal, is becoming the standard of care for traumatic splenic injury. Theoretically the immunological function of the spleen may be preserved, but this has not yet been proven. A parameter for measuring the remaining splenic function must therefore be determined in order to decide whether or not vaccinations and/or antibiotic prophylaxis are necessary to prevent an overwhelming post-splenectomy infection (OPSI). A systematic review of the literature was performed July 2015 by searching the Embase and Medline databases. Articles were eligible if they described at least two trauma patients and the subject was splenic function. Description of procedure and/or success rate of SAE was not necessary for inclusion. Two reviewers independently assessed the eligibility and the quality of the articles and performed the data extraction. Twelve studies were included, eleven with adult patients and one focusing on children. All studies used different parameters to assess splenic function. None of them reported a OPSI after splenic embolization. Eleven studies found a preserved splenic function after SAE, in both adults and children. All but one studies on the long term effects of SAE indicate a preserved splenic function. However, there is still no single parameter or test available which can demonstrate that unequivocally. Copyright © 2015 Elsevier Ltd. All rights reserved.

  12. Overview of Nonoperative Blunt Splenic Injury Management with Associated Splenic Artery Pseudoaneurysm.

    Science.gov (United States)

    Morrison, Chet A; Gross, Brian W; Kauffman, Matthew; Rittenhouse, Katelyn J; Rogers, Frederick B

    2017-06-01

    The delayed development of splenic artery pseudoaneurysm (SAP) can complicate the nonoperative management of splenic injuries. We sought to determine the utility of repeat imaging in diagnosing SAP in patients managed nonoperatively without angioembolization. We hypothesized that a significant rate of SAPs would be found in this population on repeat imaging. Patients undergoing nonoperative splenic injury management from January 2011 to June 2015 were queried from the trauma registry. Rates of repeat imaging, angioembolization, readmission, and SAP development were analyzed. Further, subanalyses investigating the incidence of SAP in patients managed nonoperatively without angioembolization were conducted. A total of 133 patients met inclusion criteria. Repeat imaging rate was 40 per cent, angioembolization rate was 26 per cent, and readmission rate was 6 per cent. Within the study population, nine SAPs were found (8/9 in patients with splenic injury grade ≥III). Of these nine SAPs, three (33%) were identified on initial scans and embolized, whereas six (67%) were found on repeat imaging in patients not initially receiving angioembolization. Splenic injuries are typically managed nonoperatively without serious complications. Our results suggest patients with splenic injuries grade ≥III managed nonoperatively without angioembolization should have repeat imaging within 48 hours to rule out the possibility of SAP.

  13. Higher incidence of major complications after splenic embolization for blunt splenic injuries in elderly patients.

    Science.gov (United States)

    Wu, Shih-Chi; Fu, Chih-Yuan; Chen, Ray-Jade; Chen, Yung-Fang; Wang, Yu-Chun; Chung, Ping-Kuei; Yu, Shu-Fen; Tung, Cheng-Cheng; Lee, Kun-Hua

    2011-02-01

    Nonoperative management (NOM) of blunt splenic injuries has been widely accepted, and the application of splenic artery embolization (SAE) has become an effective adjunct to NOM. However, complications do occur after SAE. In this study, we assess the factors leading to the major complications associated with SAE. Focusing on the major complications after SAE, we retrospectively studied patients who received SAE and were admitted to 2 major referral trauma centers under the same established algorithm for management of blunt splenic injuries. The demographics, angiographic findings, and factors for major complications after SAE were examined. Major complications were considered to be direct adverse effects arising from SAE that were potentially fatal or were capable of causing disability. There were a total of 261 patients with blunt splenic injuries in this study. Of the 261 patients, 53 underwent SAE, 11 (21%) of whom were noted to have 12 major complications: 8 cases of postprocedural bleeding, 2 cases of total infarction, 1 case of splenic abscess, and 1 case of splenic atrophy. Patients older than 65 years were more susceptible to major complications after SAE. Splenic artery embolization is considered an effective adjunct to NOM in patients with blunt splenic injuries. However, risks of major complications do exist, and being elderly is, in part, associated with a higher major complication incidence. Copyright © 2011 Elsevier Inc. All rights reserved.

  14. 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.

  15. Acute splenic sequestration in a pregnant woman with homozygous sickle-cell anemia.

    Science.gov (United States)

    Maia, Carolina Bastos; Nomura, Roseli Mieko Yamamoto; Igai, Ana Maria Kondo; Fonseca, Guilherme Hencklain; Gualandro, Sandra Menosi; Zugaib, Marcelo

    2013-01-01

    Homozygous (SS) sickle-cell anemia complicated by acute splenic sequestration in adults is a rare event, and it has never been reported during pregnancy. A 25-year-old woman with homozygous (SS) sickle-cell disease was hospitalized at 32 weeks' of gestation presenting weakness, abdominal pain, fever and hemoglobin of 2.4 g/dl. Abnormal fetal heart rate was detected by means of cardiotocography, and 5 units of packed red cells were transfused. Cesarean was performed at 37 weeks. Both mother and baby were discharged in a good general condition. This case report demonstrates the importance of immediate blood transfusion for treatment of fetal distress in cases of splenic sequestration during pregnancy. This treatment is essential for avoiding maternal and fetal complications.

  16. Hematological and splenic Doppler ultrasonographic changes in dogs sedated with acepromazine or xylazine.

    Science.gov (United States)

    Sutil, Dienifer V; Mattoso, Cláudio R S; Volpato, Julieta; Weinert, Nádia C; Costa, Ádson; Antunes, Rozyanne R; Muller, Thiago R; Beier, Suzane L; Tochetto, Ronise; Comassetto, Felipe; Saito, Mere E

    2017-07-01

    To evaluate the onset and duration of hematological changes and the use of Doppler ultrasound (spleen) in dogs sedated with acepromazine or xylazine. Clinical study. A total of 24 mixed breed dogs aged 1-4 years and weighing 15-25 kg. Dogs were randomly distributed into two groups: acepromazine group (AG) which were administered acepromazine (0.05 mg kg -1 ) intramuscularly and xylazine group (XG) administered xylazine (0.5 mg kg -1 ) intramuscularly. Sonographic evaluations (morphologic and hemodynamic splenic vascularization) and hematologic tests were performed before drug administration (baseline) and 5, 15, 30, 60, 120, 240, 360, 480 and 720 minutes after drug administration. A significant reduction occurred in erythrogram variables in AG at 15-720 minutes corresponding with a significant enlargement of the spleen. In XG, a significant reduction was observed in the erythrogram variables at 30-60 minutes without a significant enlargement of the spleen. Hilar diameter did not change over time in either group. Flow alterations were found only in the splenic artery in AG, with a decreased final diastolic velocity observed at 60-120 minutes. Administration of acepromazine resulted in decreased red blood cell count, hemoglobin, packed cell volume and an increased diameter of the spleen. Xylazine administration resulted in similar hematologic changes but of smaller magnitude and duration and without splenic changes. The absence of significant changes in the Doppler flow parameters of the splenic artery and vein and the hilar diameter suggests that the splenomegaly that was observed in AG was not due to splenic vasodilation. No splenic sequestration occurred after xylazine administration. The results indicate that acepromazine decreases the erythrocyte concentrations by splenic erythrocyte sequestration and concomitant splenomegaly. Xylazine can cause slight hematologic changes, but without splenic changes. Copyright © 2017 Association of Veterinary

  17. Isolation and Characterization of Human Dental Pulp Stem Cells from Cryopreserved Pulp Tissues Obtained from Teeth with Irreversible Pulpitis.

    Science.gov (United States)

    Malekfar, Azin; Valli, Kusum S; Kanafi, Mohammad Mahboob; Bhonde, Ramesh R

    2016-01-01

    Human dental pulp stem cells (DPSCs) are becoming an attractive target for therapeutic purposes because of their neural crest origin and propensity. Although DPSCs can be successfully cryopreserved, there are hardly any reports on cryopreservation of dental pulp tissues obtained from teeth diagnosed with symptomatic irreversible pulpitis during endodontic treatment and isolation and characterization of DPSCs from such cryopreserved pulp. The aim of this study was to cryopreserve the said pulp tissues to propagate and characterize isolated DPSCs. A medium consisting of 90% fetal bovine serum and 10% dimethyl sulfoxide was used for cryopreservation of pulp tissues. DPSCs were isolated from fresh and cryopreserved pulp tissues using an enzymatic method. Cell viability and proliferation were determined using the MTT [3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide] assay. DPSC migration and interaction were analyzed with the wound healing assay. Mesenchymal characteristics of DPSCs were verified by flow cytometric analysis of cell surface CD markers. The osteogenic and adipogenic potential of DPSCs was shown by von Kossa and oil red O staining methods, respectively, and the polymerase chain reaction method. We found no significant difference in CD marker expression and osteogenic and adipogenic differentiation potential of DPSCs obtained from fresh and cryopreserved dental pulp tissue. Our study shows that dental pulp can be successfully cryopreserved without losing normal characteristics and differentiation potential of their DPSCs, thus making them suitable for dental banking and future therapeutic purposes. Copyright © 2016 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

  18. [Splenic infarction].

    Science.gov (United States)

    Cuquerella, J; Ferrer, L; Rivera, P; Tuset, J A; Medina, E; Pamós, S; Ariete, V; Tomé, A; García, V

    1996-06-01

    A 53-year-old male suffered splenic infarction etiologically related to atrial fibrillation and non-obstructive hypertrophic cardiomyopathy. The main clinical manifestations were a one-month history of epigastric and left upper quadrant pain, with tenderness to palpation in the later zone. Laboratory tests revealed a slight leucocytosis (14.700) with left shift and a marked increase in LDH concentration (945 IU). Abdominal CAT and arteriography established the diagnosis, Echography proved normal. Patient evolution was satisfactory with conservative medical treatment. We conclude that splenic infarction should be considered in all cases of acute or chronic pain in the left hypochondrium. The diagnosis is established by CAT, arteriography and hepatosplenic gammagraphy. Medical management is initially advocated, surgery being reserved for those cases involving complications or in which diagnosis is not clear. Emphasis is placed on the main etiological, clinical, diagnostic and management characteristics of splenic infarction.

  19. 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.

  20. Embolization Therapy for Traumatic Splenic Lacerations

    International Nuclear Information System (INIS)

    Dasgupta, Niloy; Matsumoto, Alan H.; Arslan, Bulent; Turba, Ulku C.; Sabri, Saher; Angle, John F.

    2012-01-01

    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.

  1. Polyphenols profile and antioxidant activity of skin and pulp of a rare apple from Marche region (Italy).

    Science.gov (United States)

    Giomaro, Giovanna; Karioti, Anastasia; Bilia, Anna Rita; Bucchini, Anahi; Giamperi, Laura; Ricci, Donata; Fraternale, Daniele

    2014-01-01

    Apples are an important source of polyphenols in the human diet and the consumption of this fruit has been linked to the prevention of degenerative diseases. CATECHINS, PROCYANIDINS, HYDROXYCINNAMIC ACIDS, FLAVONOL GLYCOSIDES, DIHYDROCHALCONE GLYCOSIDES AND ONE ANTHOCYANIN: cyanidin-3-O-galactoside, were identified both in the peel and pulp. Procyanidins, catechins and flavonols represent the main constituents of peel. Concerning the antioxidant activity, in the reduction of the stable DPPH radical and in the inhibition of lipid peroxidation, the ethanolic extracts of red peel and red pulp showed a good similar activity comparable to ascorbic acid in the DPPH test and about ten times more active than BHT in the lipoxygenase test, and were much more active than aqueous extracts. The ORAC value of red pulp aqueous extract resulted comparable to that of red berries: vaccinium, rubus and ribes, foods appreciated for their health value. This apple contains an appreciable amount of polyphenols also in the flesh; this variety with red flesh can also be useful for researchers engaged in apples varietal innovation in addition to being used as food apple.

  2. Low CXCL13 expression, splenic lymphoid tissue atrophy and germinal center disruption in severe canine visceral leishmaniasis.

    Directory of Open Access Journals (Sweden)

    Joselli S Silva

    Full Text Available Visceral leishmaniasis is associated with atrophy and histological disorganization of splenic compartments. In this paper, we compared organized and disorganized splenic lymphoid tissue from dogs naturally infected with Leishmania infantum assessing the size of the white pulp compartments, the distribution of T, B and S100+ dendritic cells, using immunohistochemistry and morphometry and the expression of CCR7 and the cytokines, CXCL13, lymphotoxin (LT-α, LT-β, CCL19, CCL21, TNF-α, IL-10, IFN-γ and TGF-β, using by real time RT-PCR. The lymphoid follicles and marginal zones were smaller (3.2 and 1.9 times, respectively; Mann-Whitney, P<0.02 in animals with disorganized splenic tissue in comparison to those with organized splenic lymphoid tissue. In spleens with disorganized lymphoid tissue, the numbers of T cells and S100+ dendritic cells were decreased in the follicles, and the numbers of B cells were reduced in both the follicles and marginal zones. CXCL13 mRNA expression was lower in animals with disorganized lymphoid tissue (0.5±0.4 compared to those with organized lymphoid tissue (2.7±2.9, both relative to 18S expression, P = 0.01. These changes in the spleen were associated with higher frequency of severe disease (7/12 in the animals with disorganized than in animals with organized (2/13, Chi-square, P = 0.01 splenic lymphoid tissue. The data presented herein suggest that natural infection with Leishmania infantum is associated with the impairment of follicular dendritic cells, CXCL13 expression, B cell migration and germinal center formation and associates these changes with severe clinical forms of visceral leishmaniasis. Furthermore the fact that this work uses dogs naturally infected with Leishmania infantum emphasizes the relevance of the data presented herein for the knowledge on the canine and human visceral leishmaniasis.

  3. Splenic contraction in patients with various disorders

    Energy Technology Data Exchange (ETDEWEB)

    Iio, Atsushi; Murase, Kenya; Ito, Hisao; Watanabe, Yuji; Kawamura, Masashi; Hamamoto, Ken

    1986-03-01

    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 /sup 67/Ga 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 /sup 67/Ga 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.

  4. Image guided percutaneous splenic interventions

    International Nuclear Information System (INIS)

    Kang, Mandeep; Kalra, Naveen; Gulati, Madhu; Lal, Anupam; Kochhar, Rohit; Rajwanshi, Arvind

    2007-01-01

    Aim: The objective of this study is to evaluate the efficacy and safety of image-guided percutaneous splenic interventions as diagnostic or therapeutic procedures. Materials and methods: We performed a retrospective review of our interventional records from July 2001 to June 2006. Ninety-five image-guided percutaneous splenic interventions were performed after informed consent in 89 patients: 64 men and 25 women who ranged in age from 5 months to 71 years (mean, 38.4 years) under ultrasound (n = 93) or CT (n = 2) guidance. The procedures performed were fine needle aspiration biopsy of focal splenic lesions (n = 78) and aspiration (n = 10) or percutaneous catheter drainage of a splenic abscess (n = 7). Results: Splenic fine needle aspiration biopsy was successful in 62 (83.78%) of 74 patients with benign lesions diagnosed in 43 (58.1%) and malignancy in 19 (25.67%) patients. The most common pathologies included tuberculosis (26 patients, 35.13%) and lymphoma (14 patients, 18.91%). Therapeutic aspiration or pigtail catheter drainage was successful in all (100%) patients. There were no major complications. Conclusions: Image-guided splenic fine needle aspiration biopsy is a safe and accurate technique that can provide a definitive diagnosis in most patients with focal lesions in the spleen. This study also suggests that image-guided percutaneous aspiration or catheter drainage of splenic abscesses is a safe and effective alternative to surgery

  5. [Prognostic factors related to non surgical treatment failure of splenic injuries in the abdominal blunt trauma].

    Science.gov (United States)

    Carvalho, Fábio Henrique de; Romeiro, Paula Christina Marra; Collaço, Iwan Augusto; Baretta, Giorgio Alfredo Pedroso; Freitas, Alexandre Coutinho Teixeira de; Matias, Jorge Eduardo Fouto

    2009-04-01

    Identify prognostic factors related to treatment failure of blunt splenic injuries managed by non surgical treatment (NST). Fifty six adult patients submitted to NST were prospectively studied. The injuries were diagnosed by computed axial tomography scan and classified according to AAST (American Association for Surgery of Trauma) criteria. Patients were divided in success and failure groups. NST failure was defined as the need for laparotomy for any reason. NST failures (19.6%) were due to: abdominal pain (45.4%), hemodinamic instability (36.4%), splenic haematoma associated to a fall in hematocrit (9.1%) and splenic abscess (9.1%). There were no failures in grade I and II of the splenic injuries; failure rate was 17.5% in grade III and IV injuries grouped, and 80% in grade V injuries (p = 0,0008). In the success group, 31.3% patients received red cell transfusions, versus 63.6% patients in the failure group (p = 0,05). Failure rate in patients with ISS = 8 was zero; 15.9% in patients with ISS 9 to 25; and 50% in patients with ISS = 26 (p = 0,05). There were no deaths or missed bowel injuries. ISS and splenic injury grade were related to failure of NST.

  6. Acute splenic sequestration in a pregnant woman with homozygous sickle-cell anemia

    Directory of Open Access Journals (Sweden)

    Carolina Bastos Maia

    Full Text Available CONTEXT Homozygous (SS sickle-cell anemia complicated by acute splenic sequestration in adults is a rare event, and it has never been reported during pregnancy. CASE REPORT A 25-year-old woman with homozygous (SS sickle-cell disease was hospitalized at 32 weeks' of gestation presenting weakness, abdominal pain, fever and hemoglobin of 2.4 g/dl. Abnormal fetal heart rate was detected by means of cardiotocography, and 5 units of packed red cells were transfused. Cesarean was performed at 37 weeks. Both mother and baby were discharged in a good general condition. CONCLUSION This case report demonstrates the importance of immediate blood transfusion for treatment of fetal distress in cases of splenic sequestration during pregnancy. This treatment is essential for avoiding maternal and fetal complications.

  7. Splenic epithelial cyst

    International Nuclear Information System (INIS)

    Yousuf, M.; Jalali, U.

    2011-01-01

    Cysts of spleen are rare entities. Congenital splenic cysts are even more uncommon comprising of only 10% of benign non-parasitic cysts. We report a case of 22 years old female who presented with history of 2 years abdominal pain and gradual distension. Ultrasound and computed tomography (CT) both were suggestive of splenic cyst. Laboratory tests show thrombocytopenia with platelets count of 97000 per cubic millimeter and anemia with hemoglobin 8.7 gram per deciliter. Serological tests were negative for parasitic infection. Splenectomy was done and the weight of the spleen was found to be 1.5 kilogram. Histopathological findings are consistent with splenic epithelial cyst. The aetiology, diagnostic modalities and treatment options are discussed in the case report. (author)

  8. Escherichia coli clearance after splenic autotransplants

    International Nuclear Information System (INIS)

    Marques, R.G.; Petroianu, A.; Oliveira, M.B.N.; Bernardo-Filho, M.; Portela, M.C.

    2002-01-01

    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

  9. Computed tomography of splenic trauma

    Energy Technology Data Exchange (ETDEWEB)

    Jeffrey, R.B.; Laing, F.C.; Federle, M.P.; Goodman, P.C.

    1981-12-01

    Fifty patients with abdominal trauma and possible splenic injury were evaluated by computed tomography (CT). CT correctly diagnosed 21 of 22 surgically proved traumatic sesions of the spleen (96%). Twenty-seven patients had no evidence of splenic injury. This was confirmed at operation in 1 patient and clinical follow-up in 26. There were one false negative and one false positive. In 5 patients (10%), CT demonstrated other clinically significant lesions, including hepatic or renal lacerations in 3 and large retroperitoneal hematomas in 2. In adolescents and adults, CT is an accurate, noninvasive method of rapidly diagnosing splenic trauma and associated injuries. Further experience is needed to assess its usefulness in evaluating splenic injuries in infants and small children.

  10. Computed tomography of splenic trauma

    International Nuclear Information System (INIS)

    Jeffrey, R.B.; Laing, F.C.; Federle, M.P.; Goodman, P.C.

    1981-01-01

    Fifty patients with abdominal trauma and possible splenic injury were evaluated by computed tomography (CT). CT correctly diagnosed 21 of 22 surgically proved traumatic sesions of the spleen (96%). Twenty-seven patients had no evidence of splenic injury. This was confirmed at operation in 1 patient and clinical follow-up in 26. There were one false negative and one false positive. In 5 patients (10%), CT demonstrated other clinically significant lesions, including hepatic or renal lacerations in 3 and large retroperitoneal hematomas in 2. In adolescents and adults, CT is an accurate, noninvasive method of rapidly diagnosing splenic trauma and associated injuries. Further experience is needed to assess its usefulness in evaluating splenic injuries in infants and small children

  11. [Vital pulp therapy of damaged dental pulp].

    Science.gov (United States)

    Xuedong, Zhou; Dingming, Huang; Jianguo, Liu; Zhengwei, Huang; Xin, Wei; Deqin, Yang; Jin, Zhao; Liming, Chen; Lin, Zhu; Yanhong, Li; Jiyao, Li

    2017-08-01

    The development of an expert consensus on vital pulp therapy can provide practical guidance for the improvement of pulp damage care in China. Dental pulp disease is a major type of illness that adversely affects human oral health. Pulp capping and pulpotomy are currently the main methods for vital pulp therapy. Along with the development of minimal invasion cosmetic dentistry, using different treatment technologies and materials reasonably, preserving healthy tooth tissue, and extending tooth save time have become urgent problems that call for immediate solution in dental clinics. This paper summarizes the experiences and knowledge of endodontic experts. We develop a clinical path of vital pulp therapy for clinical work by utilizing the nature, approach, and degree of pulp damage as references, defense and self-repairing ability of pulp as guidance, and modern technologies of diagnosis and treatment as means.

  12. Splenic irradiation for hairy cell leukaemia

    Energy Technology Data Exchange (ETDEWEB)

    Al-Moundhri, A.; Graham, P.H. [St George Hospital, Kogarah, NSW, (Australia). Department of Radiation Oncology

    1997-11-01

    Splenic irradiation in the management of hairy cell leukaemia is previously unreported. A case is presented here to illustrate that splenic irradiation may be a useful addition to systemic therapies. It achieved local splenic and blood picture response and remission similar to splenectomy without any significant toxicity. (authors). 7 refs., 2 figs.

  13. Pseudoaneurysm of the splenic artery mimicking a solid lesion

    Directory of Open Access Journals (Sweden)

    Raffaele Pezzilli

    2016-08-01

    Full Text Available A 64-year-old man presented to the hospital because of hematemesis; on admission, he had weakness and pale skin, tachycardia and hypotension. Laboratory tests revealed severe anemia (hemoglobin 7.8 g/dL; liver, renal and pancreatic function tests were normal. An upper digestive endoscopy revealed a gastric ulcer of the cardia, treated with metallic clips and adrenalin injection. The patient was treated with fluids and was transfused with three units of red blood cells. In the previous two months, due to the presence of bloating and diarrhea, associated with abdominal distension, a colon-computed tomography (CT revealed a large retroperitoneal hypodense mass, 53x37 mm in size, without contrast enhancement localized between the body and the tail of the pancreas and the stomach, near the splenic artery and without signs of infiltration. To better define the mass, endoscopic ultrasound and biopsy were performed; however histopathology of multiple biopsies was not diagnostic, because of the presence of necrotic tissue and inflammatory cells. Since hematemesis recurred, the patient underwent a second upper digestive endoscopic examination, but no source of bleeding was found. Then a new contrast enhanced CT was performed that showed a size reduction of the mass, the presence of blood in the stomach and a small pseudoaneurysm of the splenic artery. Because of these findings an angiograpghic study was carried out; angiography confirmed a splenic artery pseudoaneurysm that was successfully embolized with metal microcoils.

  14. Primary splenic torsion in a Boston terrier

    International Nuclear Information System (INIS)

    Ohta, H.; Takagi, S.; Murakami, M.; Sasaki, N.; Yoshikawa, M.; Nakamura, K.; Hwang, S.J.; Yamasaki, M.; Takiguchi, M.

    2009-01-01

    A 7-year-old female Boston terrier was referred to Hokkaido University Veterinary Teaching Hospital with a history of hemoglobinuria and anemia for several days. Abdominal radiographs showed splenomegaly, and ultrasonography revealed a hypoechoic splenic parenchyma with interspersed linear echoes consistent with the ultrasonographic appearance of splenic torsion. Ultrasonography and computed tomography (CT) indicated a C-shaped spleen. Exploratory laparotomy confirmed the diagnosis of splenic torsion. A splenectomy was performed, and the dog recovered well without complications. This is the first report of splenic torsion in Boston terriers, and the usefulness of ultrasonographic and CT findings of the splenic torsion was also confirmed

  15. Primary splenic torsion in a Boston terrier.

    Science.gov (United States)

    OHTA, Hiroshi; TAKAGI, Satoshi; MURAKAMI, Masahiro; SASAKI, Noboru; YOSHIKAWA, Muneyoshi; NAKAMURA, Kensuke; HWANG, Shiang-Jyi; YAMASAKI, Masahiro; TAKIGUCHI, Mitsuyoshi

    2009-11-01

    A 7-year-old female Boston terrier was referred to Hokkaido University Veterinary Teaching Hospital with a history of hemoglobinuria and anemia for several days. Abdominal radiographs showed splenomegaly, and ultrasonography revealed a hypoechoic splenic parenchyma with interspersed linear echoes consistent with the ultrasonographic appearance of splenic torsion. Ultrasonography and computed tomography (CT) indicated a C-shaped spleen. Exploratory laparotomy confirmed the diagnosis of splenic torsion. A splenectomy was performed, and the dog recovered well without complications. This is the first report of splenic torsion in Boston terriers, and the usefulness of ultrasonographic and CT findings of the splenic torsion was also confirmed.

  16. Simultaneous Saccharification and Fermentation of Sugar Beet Pulp for Efficient Bioethanol Production.

    Science.gov (United States)

    Berłowska, Joanna; Pielech-Przybylska, Katarzyna; Balcerek, Maria; Dziekońska-Kubczak, Urszula; Patelski, Piotr; Dziugan, Piotr; Kręgiel, Dorota

    2016-01-01

    Sugar beet pulp, a byproduct of sugar beet processing, can be used as a feedstock in second-generation ethanol production. The objective of this study was to investigate the effects of pretreatment, of the dosage of cellulase and hemicellulase enzyme preparations used, and of aeration on the release of fermentable sugars and ethanol yield during simultaneous saccharification and fermentation (SSF) of sugar beet pulp-based worts. Pressure-thermal pretreatment was applied to sugar beet pulp suspended in 2% w/w sulphuric acid solution at a ratio providing 12% dry matter. Enzymatic hydrolysis was conducted using Viscozyme and Ultraflo Max (Novozymes) enzyme preparations (0.015-0.02 mL/g dry matter). Two yeast strains were used for fermentation: Ethanol Red ( S. cerevisiae ) (1 g/L) and Pichia stipitis (0.5 g/L), applied sequentially. The results show that efficient simultaneous saccharification and fermentation of sugar beet pulp was achieved. A 6 h interval for enzymatic activation between the application of enzyme preparations and inoculation with Ethanol Red further improved the fermentation performance, with the highest ethanol concentration reaching 26.9 ± 1.2 g/L and 86.5 ± 2.1% fermentation efficiency relative to the theoretical yield.

  17. Simultaneous Saccharification and Fermentation of Sugar Beet Pulp for Efficient Bioethanol Production

    Science.gov (United States)

    Berłowska, Joanna; Balcerek, Maria; Dziekońska-Kubczak, Urszula; Patelski, Piotr; Dziugan, Piotr

    2016-01-01

    Sugar beet pulp, a byproduct of sugar beet processing, can be used as a feedstock in second-generation ethanol production. The objective of this study was to investigate the effects of pretreatment, of the dosage of cellulase and hemicellulase enzyme preparations used, and of aeration on the release of fermentable sugars and ethanol yield during simultaneous saccharification and fermentation (SSF) of sugar beet pulp-based worts. Pressure-thermal pretreatment was applied to sugar beet pulp suspended in 2% w/w sulphuric acid solution at a ratio providing 12% dry matter. Enzymatic hydrolysis was conducted using Viscozyme and Ultraflo Max (Novozymes) enzyme preparations (0.015–0.02 mL/g dry matter). Two yeast strains were used for fermentation: Ethanol Red (S. cerevisiae) (1 g/L) and Pichia stipitis (0.5 g/L), applied sequentially. The results show that efficient simultaneous saccharification and fermentation of sugar beet pulp was achieved. A 6 h interval for enzymatic activation between the application of enzyme preparations and inoculation with Ethanol Red further improved the fermentation performance, with the highest ethanol concentration reaching 26.9 ± 1.2 g/L and 86.5 ± 2.1% fermentation efficiency relative to the theoretical yield. PMID:27722169

  18. Splenic trauma: Is splenectomy redundant?

    Directory of Open Access Journals (Sweden)

    S Tandon

    2013-01-01

    Full Text Available 41 year old male, serving air warrior sustained blunt abdominal trauma, CECT revealed grade III splenic injury. He was managed conservatively with good clinical outcome. Conservatism is the new approach to splenic trauma.

  19. CT assessment of normal splenic size in children

    International Nuclear Information System (INIS)

    Prassopoulos, P.; Cavouras, D.

    1994-01-01

    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.)

  20. Determinants of splenectomy in splenic injuries following blunt ...

    African Journals Online (AJOL)

    Introduction. The management of splenic injuries has shifted from splenectomy to splenic preservation owing to the risk of overwhelming post-splenectomy infection (OPSI). This study aimed to identify the factors that determine splenectomy in patients with isolated splenic injuries, with a view to increasing the rate of splenic ...

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

    International Nuclear Information System (INIS)

    Vlies, C. H. van der; Hoekstra, J.; Ponsen, K. J.; Reekers, J. A.; Delden, O. M. van; Goslings, J. C.

    2012-01-01

    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.

  2. A PROSPECTIVE STUDY ON SPLENIC INJURY

    Directory of Open Access Journals (Sweden)

    Palanivel Rajagopal

    2017-04-01

    Full Text Available BACKGROUND An injured spleen is a well-known entity to those involved in trauma care. The majority of individual with a splenic injury now receive nonoperative intervention and therapy. This shift from operative to nonoperative treatment over the past several decades is a tremendous success story in which clinical judgment and reason triumphed over standard surgical dogma. In emergency room, restoration of airway, breathing and circulation should be focussed on. A careful history is the most important one. Nevertheless, the severity of the splenic injury plays a dominant part in determining whether nonoperative management is appropriate or-if-not-whether splenorrhaphy or splenectomy will be the more appropriate surgical option. As a general rule, younger, healthier patients with lower grade splenic injuries and fewer associated injuries and comorbidities are usually managed nonoperatively or with splenic repair, whether unstable, actively bleeding patients with more severe splenic trauma and/or multiple associated injuries require splenectomy. The aim of the study is to evaluate- 1. The impact of blunt or penetrating abdominal trauma on spleen. 2. Various modes of injury. 3. Various modes of clinical presentation of cases. 4. The value of various available investigations employed. 5. The various methods of treatment. 6. The morbidity and mortality. MATERIALS AND METHODS This study was a prospective study of 20 cases of splenic injury admitted in the triage ward of Mahatma Gandhi Memorial Government Medical College Hospital, Trichy, over a period of 2 years from December 2014 to December 2016. Once the patient is admitted, the name, age, sex and mode of injury are noted. The time interval between splenic injury and admission and time interval between admission to hospital and surgery are recorded. After resuscitating the patient, all patients were subjected to careful clinical examination. RESULTS The total number of patients who had sustained

  3. The pathogenesis of Plasmodium falciparum malaria in humans: insights from splenic physiology

    Science.gov (United States)

    Safeukui, Innocent; Deplaine, Guillaume; Brousse, Valentine; Prendki, Virginie; Thellier, Marc; Turner, Gareth D.; Mercereau-Puijalon, Odile

    2011-01-01

    Clinical manifestations of Plasmodium falciparum infection are induced by the asexual stages of the parasite that develop inside red blood cells (RBCs). Because splenic microcirculatory beds filter out altered RBCs, the spleen can innately clear subpopulations of infected or uninfected RBC modified during falciparum malaria. The spleen appears more protective against severe manifestations of malaria in naïve than in immune subjects. The spleen-specific pitting function accounts for a large fraction of parasite clearance in artemisinin-treated patients. RBC loss contributes to malarial anemia, a clinical form associated with subacute progression, frequent splenomegaly, and relatively low parasitemia. Stringent splenic clearance of ring-infected RBCs and uninfected, but parasite-altered, RBCs, may altogether exacerbate anemia and reduce the risks of severe complications associated with high parasite loads, such as cerebral malaria. The age of the patient directly influences the risk of severe manifestations. We hypothesize that coevolution resulting in increased splenic clearance of P. falciparum–altered RBCs in children favors the survival of the host and, ultimately, sustained parasite transmission. This analysis of the RBC–spleen dynamic interactions during P falciparum infection reflects both data and hypotheses, and provides a framework on which a more complete immunologic understanding of malaria pathogenesis may be elaborated. PMID:20852127

  4. Transforming growth factor-β-induced gene product-h3 inhibits odontoblastic differentiation of dental pulp cells.

    Science.gov (United States)

    Serita, Suguru; Tomokiyo, Atsushi; Hasegawa, Daigaku; Hamano, Sayuri; Sugii, Hideki; Yoshida, Shinichiro; Mizumachi, Hiroyuki; Mitarai, Hiromi; Monnouchi, Satoshi; Wada, Naohisa; Maeda, Hidefumi

    2017-06-01

    The aim of this study was to investigate transforming growth factor-β-induced gene product-h3 (βig-h3) expression in dental pulp tissue and its effects on odontoblastic differentiation of dental pulp cells (DPCs). A rat direct pulp capping model was prepared using perforated rat upper first molars capped with mineral trioxide aggregate cement. Human DPCs (HDPCs) were isolated from extracted teeth. βig-h3 expression in rat dental pulp tissue and HDPCs was assessed by immunostaining. Mineralization of HDPCs was assessed by Alizarin red-S staining. Odontoblast-related gene expression in HDPCs was analyzed by quantitative RT-PCR. Expression of βig-h3 was detected in rat dental pulp tissue, and attenuated by direct pulp capping, while expression of interleukin-1β and tumor necrosis factor-α was increased in exposed pulp tissue. βig-h3 expression was also detected in HDPCs, with reduced expression during odontoblastic differentiation. The above cytokines reduced βig-h3 expression in HDPCs, and promoted their mineralization. Recombinant βig-h3 inhibited the expression of odontoblast-related genes and mineralization of HDPCs, while knockdown of βig-h3 gene expression promoted the expression of odontoblast-related genes in HDPCs. The present findings suggest that βig-h3 in DPCs may be involved in reparative dentin formation and that its expression is likely to negatively regulate this process. Copyright © 2017 Elsevier Ltd. All rights reserved.

  5. Temporal changes in hematologic markers after splenectomy, splenic embolization, and observation for trauma.

    Science.gov (United States)

    Wernick, B; Cipriano, A; Odom, S R; MacBean, U; Mubang, R N; Wojda, T R; Liu, S; Serres, S; Evans, D C; Thomas, P G; Cook, C H; Stawicki, S P

    2017-06-01

    The spleen is one of the most commonly injured abdominal solid organs during blunt trauma. Modern management of splenic trauma has evolved to include non-operative therapies, including observation and angioembolization to preclude splenectomy in most cases of blunt splenic injury. Despite the shift in management strategies, relatively little is known about the hematologic changes associated with these various modalities. The aim of this study was to determine if there are significant differences in hematologic characteristics over time based on the treatment modality employed following splenic trauma. We hypothesized that alterations seen in hematologic parameters would vary between observation (OBS), embolization (EMB), and splenectomy (SPL) in the setting of splenic injury. An institutional review board-approved, retrospective study of routine hematologic indices examined data between March 2000 and December 2014 at three academic trauma centers. A convenience sample of patients with splenic trauma and admission lengths of stay >96 h was selected for inclusion, resulting in a representative sample of each sub-group (OBS, EMB, and SPL). Basic demographics and injury severity data (ISS) were abstracted. Platelet count, red blood cell (RBC) count and RBC indices, and white blood cell (WBC) count with differential were analyzed between the time of admission and a maximum of 1080 h (45 days) post-injury. Comparisons between OBS, EMB, and SPL groups were then performed using non-parametric statistical testing, with statistical significance set at p splenic injury grade varied by interventional modality (grade 4 for SPL, 3 for EMB, and 2 for OBS, p splenic injuries managed with SPL, EMB, or OBS. As expected, observed WBC counts were highest following SPL, then EMB, and finally OBS. No differences were noted in RBC count between the three groups, but RDW was significantly greater following SPL compared to EMB and OBS. We also found that MCV was highest following OBS

  6. Effects of xylazine, romifidine, or detomidine on hematology, biochemistry, and splenic thickness in healthy horses.

    Science.gov (United States)

    Kullmann, Annie; Sanz, Macarena; Fosgate, Geoffrey T; Saulez, Montague N; Page, Patrick C; Rioja, Eva

    2014-04-01

    Alpha-2 agonist-induced changes in packed cell volume (PCV), total solids (TS), selected biochemical parameters, and splenic thickness were investigated in horses. Four healthy mares were treated in a blinded, randomized, cross-over design with a dose of xylazine (0.5 mg/kg), romifidine (0.04 mg/kg), or detomidine (0.01 mg/kg) IV, and detomidine (0.02 mg/kg) IM. Hematology, TS, colloid osmotic pressure (COP), plasma osmolality; glucose, lactate, urea (BUN) and electrolyte concentrations; venous blood pH and ultrasonographic splenic thickness were evaluated at intervals for 300 min. Repeated measures analysis of variance (ANOVA) were performed with P < 0.05. There was a significant change over time in PCV and TS following each treatment (P < 0.001), with median (range) reductions of 20.9% (12.9% to 27.3%) and 5.8% (3.0% to 10.3%), respectively. Red blood cell count, BUN, and COP decreased while osmolality, glucose, Na(+), and splenic thickness increased. Treatments induced clinically significant transient changes in PCV, TS, and other biochemical parameters, which should be considered when assessing horses that received these drugs.

  7. CD146 positive human dental pulp stem cells promote regeneration of dentin/pulp-like structures.

    Science.gov (United States)

    Matsui, Mikiko; Kobayashi, Tomoko; Tsutsui, Takeo W

    2018-04-01

    CD146 and STRO-1 are endothelial biomarkers that are co-expressed on the cellular membranes of blood vessels within human dental pulp tissue. This study characterized the percentage of dentin-like structures produced by CD146-positive (CD146 + ) human dental pulp stem cells (DPSCs), compared with their CD146-negative (CD146 - ) counterparts. DPSC populations were enriched using magnetic-activated cell sorting (MACS), yielding CD146 + and CD146 - cells, as well as mixtures composed of 25% CD146 + cells and 75% CD146 - cells (CD146 +/- ). Cell growth assays indicated that CD146 + cells exhibit an approximate 3-4 h difference in doubling time, compared with CD146 - cells. Cell cycle distributions were determined by flow cytometry analysis. The low percentage of CD146 + cells' DNA content in G 0 /G 1 phase were compared with CD146 - and non-separated cells. In contrast to CD146 - and non-separated cells, prompt mineralization was observed in CD146 + cells. Subsequently, qRT-PCR revealed high mRNA expression of CD146 and Alkaline phosphatase in mineralization-induced CD146 + cells. CD146 + cells were also observed high adipogenic ability by Oil red O staining. Histological examinations revealed an increased area of dentin/pulp-like structures in transplanted CD146 + cells, compared with CD146 - and CD146 +/- cells. Immunohistochemical studies detected dentin matrix protein-1 (DMP1) and dentin sialophosphoprotein (DSPP), as well as human mitochondria, in transplanted DPSCs. Co-expression of CD146 and GFP indicated that CD146 was expressed in transplanted CD146 + cells. CD146 + cells may promote mineralization and generate dentin/pulp-like structures, suggesting a role in self-renewal of stem cells and dental pulp regenerative therapy.

  8. Splenic trauma management in relation to mode and grade

    International Nuclear Information System (INIS)

    Gangat, S.A.; Khaskhali, A.A.; Memon, I.A.

    2008-01-01

    To study the prevalence and management of splenic trauma in relation to its mode and grade. All cases admitted in emergency with abdominal trauma and splenic injury. The data of all the patients who had splenic trauma was entered on a proforma and analyzed. A total of 44 patients with ages between 20-40 years presented with splenic injury; 32(72.7%) were male. The commonest mode of splenic trauma was blunt abdominal injury (50%), and most (47%) patients had Grade- III injury. Splenectomy was carried out in 84% patients, while 9% underwent splenic salvage. Seven (15.9%) patients with splenectomy died in the series. Splenic injury was mostly caused by blunt abdominal trauma. Proper assessment of the grade of injury at the time of laparotomy resulted in more splenic salvage procedures with decreased risk of complications. (author)

  9. Characterization of active paper packaging incorporated with ginger pulp oleoresin

    Science.gov (United States)

    Wiastuti, T.; Khasanah, L. U.; Atmaka Kawiji, W.; Manuhara, G. J.; Utami, R.

    2016-02-01

    Utilization of ginger pulp waste from herbal medicine and instant drinks industry in Indonesia currently used for fertilizer and fuel, whereas the ginger pulp still contains high oleoresin. Active paper packaging were developed incorporated with ginger pulp oleoresin (0%, 2%, 4%, and 6% w/w). Physical (thickness, tensile strength, and folding endurance, moisture content), sensory characteristics and antimicrobial activity of the active paper were evaluated. Selected active paper then were chemically characterized (functional groups). The additional of ginger pulp oleoresin levels are reduced tensile strength, folding endurance and sensory characteristic (color, texture and overall) and increased antimicrobial activity. Due to physical, sensory characteristic and antimicrobial activity, active paper with 2% ginger pulp oleoresin incorporation was selected. Characteristics of selected paper were 9.93% of water content; 0.81 mm of thickness; 0.54 N / mm of tensile strength; 0.30 of folding endurance; 8.43 mm inhibits the growth of Pseudomonas fluorescence and 27.86 mm inhibits the growth of Aspergillus niger (antimicrobial activity) and neutral preference response for sensory properties. For chemical characteristic, selected paper had OH functional group of ginger in 3422.83 cm-1 of wave number and indicated contain red ginger active compounds.

  10. 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.

  11. Different Anthocyanin Profiles of the Skin and the Pulp of Yan73 (Muscat Hamburg × Alicante Bouschet Grape Berries

    Directory of Open Access Journals (Sweden)

    Chang-Qing Duan

    2010-03-01

    Full Text Available Yan73 is a “teinturier” red wine variety cultivated in China and used in winemaking to strengthen red wine color. Here, the anthocyanin profile in both the skin and pulp of this grape variety was analyzed by HPLC-MS. The results showed that 18 anthocyanins were detected in both the skin and the pulp, and pelargonidin-3-O-glucoside, an anthocyanin compound hardly detected in most other Vitis viniferaberries, was found. However, the contents of individual anthocyanins in the skin and the pulp were significantly different. Compared with the skin, the pulp exhibited much lower ratio of 3’,5’-substituted to 3’-substituted anthocyanins and much higher ratio of methoxylation of anthocyanin B-ring to non methoxylation, and with regard to the aromatic acylated and aliphatic acylated anthocyanins, both their contents in the skin are higher than in the pulp. The findings will provide some new insight for the tissue-specific expression and regulation of the genes involving in anthocyanin biosynthesis in grape berries.

  12. Management of splenic trauma--changing concepts.

    Science.gov (United States)

    Reihneŕ, E; Brismar, B

    1995-03-01

    During the last two decades the reported risk of overwhelming postsplenectomy infection (OPSI) has resulted in a conservative approach to splenic trauma, with the aim of splenic salvage. The appropriateness of this strategy is now questioned. The risk of OPSI varies with age and indication for splenectomy from less than 1% in adults to more than 4% in children. Pneumococcus is the causative agent in about 60% of cases. A prerequisite for splenic preservation procedures should be a haemodynamically stable patient without other intraabdominal injuries. The benefits derived from non-operative treatment of splenic salvage procedures may be overshadowed by the potential risk of transfusion-related bacterial and viral diseases. Polyvalent pneumococcal vaccines given early after splenectomy appear to reduce the incidence of OPSI substantially.

  13. CD44 is involved in mineralization of dental pulp cells.

    Science.gov (United States)

    Chen, Kuan-Liang; Huang, Yu-Yuan; Lung, Jrhau; Yeh, Ying-Yi; Yuan, Kuo

    2013-03-01

    CD44 is a transmembrane glycoprotein with various biological functions. Histologic studies have shown that CD44 is strongly expressed in odontoblasts at the appositional stage of tooth development. We investigated whether CD44 is involved in the mineralization of dental pulp cells. Ten human third molars with incomplete root formation were collected and processed for immunohistochemistry of CD44. Dental pulp cells isolated from another 5 human third molars were assayed for their viability, alkaline phosphatase activity, and alizarin red staining in vitro after silencing stably their expression of CD44 by using the short hairpin RNA technique. The CD44 knockdown cells were cultured on a collagen sponge and transplanted subcutaneously into the dorsal surfaces of immunocompromised mice. After 6 weeks, the subcutaneous tissues were processed for alizarin red staining and immunohistochemistry of human specific antigen. The dental pulp cells transduced with control short hairpin RNA were used as the control in all assays. CD44 is expressed in odontogenic cells with active mineral deposition during tooth development. Odontoblasts in the root ends of immature teeth express a stronger CD44 signal compared with those in the crown portion. When CD44 expression was stably suppressed in dental pulp cells, their mineralization activities were substantially decreased in both in vitro and in vivo assays. CD44 may play a crucial role in the initial mineralization of tooth-associated structures. However, further studies are required to clarify the underlying mechanisms. Copyright © 2013 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

  14. Juvenile colon cancer at the splenic flexure with a splenic abscess developing 22 years after irradiation for a neuroblastoma

    International Nuclear Information System (INIS)

    Tamura, Toshihisa; Higure, Aiichiro; Akiyama, Masaki; Nagata, Naoki; Hirata, Keiji; Yamaguchi, Koji

    2010-01-01

    A 23-year-old woman who had an operation and chemo-radiation therapy for a neuroblastoma of the left adrenal gland at the age of five months developed a fever and left hypochondralgia when she was 22 years old. A splenic abscess was noted. Percutaneous drainage was done, but the splenic abscess recurred. There was no recurrence of the neuroblastoma. Conservative therapy was unsuccessful and a laparotomy was performed. Operative findings included a bulky mass at the splenic flexure which involved the spleen, pancreas tail, and jejunum. Colectomy at the splenic flexure was performed with coresection of the spleen, pancreas tail, and jejunum. The surgical specimen showed mucinous carcinoma of the splenic flexure which invaded the spleen. This case was considered to be an radiation-induced secondary colon cancer. (author)

  15. Decellularized Swine Dental Pulp as a Bioscaffold for Pulp Regeneration.

    Science.gov (United States)

    Hu, Lei; Gao, Zhenhua; Xu, Junji; Zhu, Zhao; Fan, Zhipeng; Zhang, Chunmei; Wang, Jinsong; Wang, Songlin

    2017-01-01

    Endodontic regeneration shows promise in treating dental pulp diseases; however, no suitable scaffolds exist for pulp regeneration. Acellular natural extracellular matrix (ECM) is a favorable scaffold for tissue regeneration since the anatomical structure and ECM of the natural tissues or organs are well-preserved. Xenogeneic ECM is superior to autologous or allogeneic ECM in tissue engineering for its unlimited resources. This study investigated the characteristics of decellularized dental pulp ECM from swine and evaluated whether it could mediate pulp regeneration. Dental pulps were acquired from the mandible anterior teeth of swine 12 months of age and decellularized with 10% sodium dodecyl sulfate (SDS) combined with Triton X-100. Pulp regeneration was conducted by seeding human dental pulp stem cells into decellularized pulp and transplanted subcutaneously into nude mice for 8 weeks. The decellularized pulp demonstrated preserved natural shape and structure without any cellular components. Histological analysis showed excellent ECM preservation and pulp-like tissue, and newly formed mineralized tissues were regenerated after being transplanted in vivo. In conclusion, decellularized swine dental pulp maintains ECM components favoring stem cell proliferation and differentiation, thus representing a suitable scaffold for improving clinical outcomes and functions of teeth with dental pulp diseases.

  16. Splenic Infarction: An Under-recognized Complication of Infectious Mononucleosis?

    Science.gov (United States)

    Li, Yan; George, Ann; Arnaout, Sami; Wang, Jennifer P; Abraham, George M

    2018-03-01

    Splenic infarction is a rare complication of infectious mononucleosis. We describe 3 cases of splenic infarction attributed to infectious mononucleosis that we encountered within a 2-month period. We underscore the awareness of this potential complication of infectious mononucleosis and discuss the differential diagnosis of splenic infarction, including infectious etiologies. While symptomatic management is usually sufficient for infectious mononucleosis-associated splenic infarction, close monitoring for other complications, including splenic rupture, is mandated.

  17. Morphophysiological changes in the splenic extracellular matrix of Leishmania infantum-naturally infected dogs is associated with alterations in lymphoid niches and the CD4+ T cell frequency in spleens.

    Directory of Open Access Journals (Sweden)

    Aurea Virginia Andrade da Silva

    2018-04-01

    Full Text Available The spleen is one of the main affected organs in canine visceral leishmaniasis (CVL. Disorganization of the splenic white pulp (SWP has been associated with immunosuppression and disease progression. This study aims to assess structural and cellular changes in the splenic extracellular matrix of dogs with CVL, correlating these changes with the parasite load and clinical signs. Splenic fragments were collected from 41 naturally infected animals for parasite load quantification by quantitative PCR, histopathological analysis and immunohistochemistry for CD3+, CD4+, and CD8+ T cells; CD21+ B cells; Ki-67+, IFN-γ+, and IL-10+ cells; and the MMP-9 and ADAM-10 enzymes. Laminin, collagen and fibronectin deposition were also evaluated. The animals were grouped according to the level of SWP organization. SWP disorganization was accompanied by a reduction in the quantity of lymphoid follicles/mm2 (p > 0.0001. Animals with moderate to intense SWP disorganization showed more clinical signs (p = 0.021, higher laminin (p = 0.045 and collagen deposition (p = 0.036, higher MMP-9 expression (p = 0.035 and lower numbers of CD4+ T cells (p = 0.027 in the spleen than the animals with organized SWP. These data suggest that splenic structure and function are drastically altered and compromised during CVL.

  18. Computed tomographic diagnosis of the splenic trauma

    International Nuclear Information System (INIS)

    Suzuki, Masayuki; Takashima, Tsutomu; Funaki, Hiromi; Uogishi, Makoto; Isobe, Tsugimasa; Kanno, Shoichi; Ushitani, Kenji; Fuchuh, Kosei; Sakita, Tsuyoshi.

    1985-01-01

    Three cases (3-year-old, 51-year-old and 17-year-old males) in which splenic trauma was diagnosed by plain computed tomography (CT) are presented. CT images revealed retention of fluid in the abdominal cavity in all cases and clear splenic hematoma and laceration in one case. CT is superior in the visualization of splenic hematoma and hemorrhage in the abdominal cavity accompanied by splenic trauma. It should, however, be noted that the presence of laceration is frequently difficult to detect due to artifacts. Indication for surgery should be decided by evaluating the severity of clinical symptoms. (Namekawa, K.)

  19. Computed tomographic diagnosis of the splenic trauma

    Energy Technology Data Exchange (ETDEWEB)

    Suzuki, Masayuki; Takashima, Tsutomu; Funaki, Hiromi; Uogishi, Makoto; Isobe, Tsugimasa; Kanno, Shoichi; Ushitani, Kenji; Fuchuh, Kosei; Sakita, Tsuyoshi

    1985-01-01

    Three cases (3-year-old, 51-year-old and 17-year-old males) in which splenic trauma was diagnosed by plain computed tomography (CT) are presented. CT images revealed retention of fluid in the abdominal cavity in all cases and clear splenic hematoma and laceration in one case. CT is superior in the visualization of splenic hematoma and hemorrhage in the abdominal cavity accompanied by splenic trauma. It should, however, be noted that the presence of laceration is frequently difficult to detect due to artifacts. Indication for surgery should be decided by evaluating the severity of clinical symptoms. (Namekawa, K.).

  20. Scintigraphic evaluation of traumatic splenic lesions in children

    International Nuclear Information System (INIS)

    Erasmie, U.; Mortensson, W.; Persson, U.; Laennergren, K.; St. Goerans Children's Hospital, Stockholm

    1988-01-01

    Ninety-eight children with recent blunt abdominal trauma which initially evoked clinical suspicion of splenic injury were examined with colloid scintigraphy of the spleen and the liver using multiple imaging views and with abdominal survey. Nineteen children were, in addition, examined with tomographic scintigraphy. The clinical findings and the course of the disorder were reanalysed. Scintigraphy indicated splenic injury in 56 children and hepatic injury in another 5 children. The left lateral and the left oblique were the optimum imaging views for detecting splenic ruptures. Tomographic scintigraphy did not improve the diagnostic yield. Abdominal survey failed to indicate almost every second case of splenic rupture and provided no additional information of significance. The clinical review agreed with the scintigraphic diagnosis of splenic lesions but, in addition, it suggested possible splenic lesions in another 10 children with normal scintigraphy. This discrepancy cannot be explained as surgery was not employed; the occurrence of splenic lesions too small to become detectable at scintigraphy or to provoke clinically evident symptoms may be supposed. (orig.)

  1. Splenectomy for solitary splenic metastasis of ovarian cancer

    International Nuclear Information System (INIS)

    Koh, Yang Seok; Kim, Jung Chul; Cho, Chol Kyoon

    2004-01-01

    Splenic metastases occur in rare cases with a few case reports of patients in the literature. Generally, splenic metastases mean late dissemination of a disease. Solitary splenic metastases from solid tumors are extremely unusual. We report a case of a patient with ovarian mucinous cystadenocarcinoma who underwent splenectomy for isolated parenchymal metastasis. Ovarian epithelial tumors comprised most of isolated splenic metastases from gynecologic tumor. When isolated splenic recurrence is suspected on image studies and serum tumor markers, intraabdominal gross findings should be examined to exclude peritoneal carcinomatosis. If only spleen was under suspicion of recurrence of ovarian cancer, splenectomy may play a therapeutic role

  2. Splenic injury diagnosis & splenic salvage after trauma

    NARCIS (Netherlands)

    Olthof, D.C.

    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

  3. Decellularized Swine Dental Pulp as a Bioscaffold for Pulp Regeneration

    Directory of Open Access Journals (Sweden)

    Lei Hu

    2017-01-01

    Full Text Available Endodontic regeneration shows promise in treating dental pulp diseases; however, no suitable scaffolds exist for pulp regeneration. Acellular natural extracellular matrix (ECM is a favorable scaffold for tissue regeneration since the anatomical structure and ECM of the natural tissues or organs are well-preserved. Xenogeneic ECM is superior to autologous or allogeneic ECM in tissue engineering for its unlimited resources. This study investigated the characteristics of decellularized dental pulp ECM from swine and evaluated whether it could mediate pulp regeneration. Dental pulps were acquired from the mandible anterior teeth of swine 12 months of age and decellularized with 10% sodium dodecyl sulfate (SDS combined with Triton X-100. Pulp regeneration was conducted by seeding human dental pulp stem cells into decellularized pulp and transplanted subcutaneously into nude mice for 8 weeks. The decellularized pulp demonstrated preserved natural shape and structure without any cellular components. Histological analysis showed excellent ECM preservation and pulp-like tissue, and newly formed mineralized tissues were regenerated after being transplanted in vivo. In conclusion, decellularized swine dental pulp maintains ECM components favoring stem cell proliferation and differentiation, thus representing a suitable scaffold for improving clinical outcomes and functions of teeth with dental pulp diseases.

  4. Measurement of cellulose content, Kraft pulp yield and basic density ...

    African Journals Online (AJOL)

    Previous descriptions of multisite and multispecies near infra-red (NIR) spectroscopic calibrations for predicting cellulose content (CC) and Kraft pulp yield (KPY) in eucalypt woodmeal demonstrated that large, single calibrations provide precise predictions for a wide range of sites and species. These have since been used ...

  5. Molecular detection of vector-borne pathogens in blood and splenic samples from dogs with splenic disease.

    Science.gov (United States)

    Movilla, Rebeca; Altet, Laura; Serrano, Lorena; Tabar, María-Dolores; Roura, Xavier

    2017-03-13

    The spleen is a highly perfused organ involved in the immunological control and elimination of vector-borne pathogens (VBP), which could have a fundamental role in the pathogenesis of splenic disease. This study aimed to evaluate certain VBP in samples from dogs with splenic lesions. Seventy-seven EDTA-blood and 64 splenic tissue samples were collected from 78 dogs with splenic disease in a Mediterranean area. Babesia spp., Bartonella spp., Ehrlichia/Anaplasma spp., Hepatozoon canis, Leishmania infantum, hemotropic Mycoplasma spp. and Rickettsia spp. were targeted using PCR assays. Sixty EDTA-blood samples from dogs without evidence of splenic lesions were included as a control group. More than half (51.56%) of the biopsies (33/64) were consistent with benign lesions and 48.43% (31/64) with malignancy, mostly hemangiosarcoma (25/31). PCR yielded positive results in 13 dogs with spleen alterations (16.67%), for Babesia canis (n = 3), Babesia gibsoni (n = 2), hemotropic Mycoplasma spp. (n = 2), Rickettsia massiliae (n = 1) and "Babesia vulpes" (n = 1), in blood; and for B. canis, B. gibsoni, Ehrlichia canis and L. infantum (n = 1 each), in spleen. Two control dogs (3.3%) were positive for B. gibsoni and H. canis (n = 1 each). Benign lesions were detected in the 61.54% of infected dogs (8/13); the remaining 38.46% were diagnosed with malignancies (5/13). Infection was significantly associated to the presence of splenic disease (P = 0.013). There was no difference in the prevalence of infection between dogs with benign and malignant splenic lesions (P = 0.69); however B. canis was more prevalent in dogs with hemangiosarcoma (P = 0.006). VBP infection could be involved in the pathogenesis of splenic disease. The immunological role of the spleen could predispose to alterations of this organ in infected dogs. Interestingly, all dogs with B. canis infection were diagnosed with hemangiosarcoma in the present survey. As previously

  6. Non-operative management for penetrating splenic trauma : how far can we go to save splenic function?

    NARCIS (Netherlands)

    Spijkerman, Roy; Teuben, Michel Paul Johan; Hoosain, Fatima; Taylor, Liezel Phyllis; Hardcastle, Timothy Craig; Blokhuis, Taco Johan; Warren, Brian Leigh; Leenen, Luke Petrus Hendrikus

    2017-01-01

    BACKGROUND: Selective non-operative management (NOM) for the treatment of blunt splenic trauma is safe. Currently, the feasibility of selective NOM for penetrating splenic injury (PSI) is unclear. Unfortunately, little is known about the success rate of spleen-preserving surgical procedures. The aim

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

    International Nuclear Information System (INIS)

    Uflacker, Renan; Selby, J. Bayne; Chavin, Kenneth; Rogers, Jeffrey; Baliga, Prabhakar

    2002-01-01

    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

  8. Contrast enhanced ultrasound of splenic lymphoma involvement

    International Nuclear Information System (INIS)

    Goerg, Christian; Faoro, Charis; Bert, Tillmann; Tebbe, Johannes; Neesse, Albrecht; Wilhelm, Christian

    2011-01-01

    Objective: The aim of this study was to compare the value of contrast-enhanced ultrasonography (CEUS) with standard B-mode ultrasound (US) for diagnosis of splenic lymphoma involvement. Methods: From 04/2005 to 10/2008 n = 250 lymphoma patients were investigated by standard B-mode US. A homogeneous splenic echotexture was found in 199 patients (79%). To clarify the benefit of CEUS in this group a pilot series was performed with 16 of the 199 lymphoma patients. All patients with an abnormal splenic echotexture on standard B-Mode US (n = 51) including focal hypoechoic splenic lesions (n = 41) and an inhomogeneous splenic texture (n = 10) were studied by CEUS. CEUS data were retrospectively evaluated. The diagnoses included indolent lymphoma (n = 27), aggressive lymphoma (n = 14), and Hodgkin's disease (n = 10). Number and size of lesions were determined by B-mode US and CEUS. The visualisation of splenic lymphoma involvement by CEUS in comparison to B-mode US was classified as worse, equal, or better. Results: All patients with a homogeneous spleen on B-mode US (n = 16) had no visible focal lesions on CEUS. Study patients with focal lesions (n = 41) had a hypoechoic (n = 22) or isoechoic (n = 19) enhancement during the arterial phase, and a hypoechoic enhancement during the parenchymal phase (n = 41). The visualisation of focal splenic lymphoma was equal (n = 32), better (n = 6), or worse (n = 3). In all study patients with an inhomogeneous spleen on B-mode US (n = 10) no focal lesions were found by CEUS and the value of CEUS therefore was classified as worse. Conclusion: CEUS has no clear advantage for diagnosis of splenic lymphoma involvement.

  9. Contrast enhanced ultrasound of splenic lymphoma involvement

    Energy Technology Data Exchange (ETDEWEB)

    Goerg, Christian, E-mail: goergc@med.uni-marburg.de [Medizinische Universitaetsklinik, Baldingerstrasse, 35033 Marburg/Lahn (Germany); Faoro, Charis [Medizinische Universitaetsklinik, Baldingerstrasse, 35033 Marburg/Lahn (Germany); Bert, Tillmann [Zentralklinik Bad Berka GmbH, Robert-Koch-Allee 9, 99437 Bad Berka (Germany); Tebbe, Johannes [Klinikum Lippe-Detmold, Roentgenstrasse 18, 32756 Detmold (Germany); Neesse, Albrecht; Wilhelm, Christian [Medizinische Universitaetsklinik, Baldingerstrasse, 35033 Marburg/Lahn (Germany)

    2011-11-15

    Objective: The aim of this study was to compare the value of contrast-enhanced ultrasonography (CEUS) with standard B-mode ultrasound (US) for diagnosis of splenic lymphoma involvement. Methods: From 04/2005 to 10/2008 n = 250 lymphoma patients were investigated by standard B-mode US. A homogeneous splenic echotexture was found in 199 patients (79%). To clarify the benefit of CEUS in this group a pilot series was performed with 16 of the 199 lymphoma patients. All patients with an abnormal splenic echotexture on standard B-Mode US (n = 51) including focal hypoechoic splenic lesions (n = 41) and an inhomogeneous splenic texture (n = 10) were studied by CEUS. CEUS data were retrospectively evaluated. The diagnoses included indolent lymphoma (n = 27), aggressive lymphoma (n = 14), and Hodgkin's disease (n = 10). Number and size of lesions were determined by B-mode US and CEUS. The visualisation of splenic lymphoma involvement by CEUS in comparison to B-mode US was classified as worse, equal, or better. Results: All patients with a homogeneous spleen on B-mode US (n = 16) had no visible focal lesions on CEUS. Study patients with focal lesions (n = 41) had a hypoechoic (n = 22) or isoechoic (n = 19) enhancement during the arterial phase, and a hypoechoic enhancement during the parenchymal phase (n = 41). The visualisation of focal splenic lymphoma was equal (n = 32), better (n = 6), or worse (n = 3). In all study patients with an inhomogeneous spleen on B-mode US (n = 10) no focal lesions were found by CEUS and the value of CEUS therefore was classified as worse. Conclusion: CEUS has no clear advantage for diagnosis of splenic lymphoma involvement.

  10. Spontaneous splenic rupture. Radiological findings in three cases

    International Nuclear Information System (INIS)

    Arenal, F.; Barrera, J.; Merino, S.; Pedrosa, C. S.

    1999-01-01

    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

  11. 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.)

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

    International Nuclear Information System (INIS)

    Santos, Allan; Pinheiro, Vitoria; Anjos, Ana Claudia; Brandalise, Silvia; Fahel, Fernanda; Lima, Mariana; Etchebehere, Elba; Ramos, Celso; Camargo, Edwaldo E.

    2002-01-01

    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 Sβ 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 Sβ 0 patient and impaired splenic function in five SS patients and six Sβ 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.)

  13. Determinants of splenectomy in splenic injuries following blunt abdominal trauma.

    Science.gov (United States)

    Akinkuolie, A A; Lawal, O O; Arowolo, O A; Agbakwuru, E A; Adesunkanmi, A R K

    2010-02-01

    The management of splenic injuries has shifted from splenectomy to splenic preservation owing to the risk of overwhelming post-splenectomy infection (OPSI). This study aimed to identify the factors that determine splenectomy in patients with isolated splenic injuries, with a view to increasing the rate of splenic preservation. Files of 55 patients managed for isolated splenic injuries from blunt abdominal trauma between 1998 and 2007 were retrospectively analysed using a pro forma. Management options were classified into nonoperative, operative salvage and splenectomy. The majority of patients suffered splenic injury as a result of motor vehicle accident (MVA) trauma or falls. Splenectomy was undertaken in 33 (60%) patients, 12 (22%) had non-operative management, and operative salvage was achieved in 10 (18%) patients. Significant determinants of splenectomy were grade of splenic injury, hierarchy of the surgeon, and hierarchy of the assistant. MVA injury and falls accounted for the vast majority of blunt abdominal trauma in this study. The rate and magnitude of energy transferred versus splenic protective mechanisms at the time of blunt abdominal trauma seems to determine the grade of splenic injury. Interest in splenic salvage surgery, availability of technology that enables splenic salvage surgery, and the experience of the surgeon and assistant appear to determine the surgical management. Legislation on vehicle safety and good parental control may reduce the severity of splenic injury in blunt abdominal trauma. When surgery is indicated, salvage surgery should be considered in intermediate isolated splenic injury to reduce the incidence of OPSI.

  14. Splenic injuries in athletes: a review.

    Science.gov (United States)

    Gannon, Elizabeth H; Howard, Thomas

    2010-01-01

    Splenic injuries can be challenging to the sports medicine physician. While these injuries are not common among athletes, they can have serious, potentially fatal consequences if not properly diagnosed and managed in a prompt and timely fashion. Currently, there are no evidence-based guidelines on returning athletes to previous levels of activity after sustaining a splenic injury. In addition, there is no consensus on follow-up imaging after injury. This article discusses the evaluation of athletes with blunt abdominal trauma for splenic injury, including the imaging, management, and current return-to-play guidelines.

  15. Splenic abscess in cancer chemotherapy.

    Science.gov (United States)

    Ismail, Essadi; El Barni, Rachid; Lahkim, Mohamed; Rokhsi, Redouane; Atmane, Elmehdi; El Fikri, Abdelghani; Bouchama, Rachid; Achour, Abdessamad; Zyani, Mohamed

    2015-11-11

    Splenic abcess is an uncommon complication for cancer treatment. It occurs more frequently in immunocompromised patients. They are characterized by high mortality. The classic triad (fever, pain of the left hypochondrium, and sensitive mass left) is only present in one-third of cases the clinical spectrum ranging from no symptoms to events such as fever, nausea, vomiting, weight loss, abdominal pain left, splenomegaly. Treatment options are limited, but must be discussed and adapted to the patient profile. We report the case of a 62-year-old Arabic male, diagnosed with metastatic lung adenocarcinoma, who, after several cycles of chemotherapy, presented symptoms and signs of splenic abcess. Splenic abcess is rare situation, which must be actively researched, to have access to an optimal therapeutic approach.

  16. [A case of infectious mononucleosis with splenic infarction].

    Science.gov (United States)

    Kobe, Daisuke; Nakatani, Toshiya; Fujinaga, Yukihisa; Seki, Kenichiro; Saikawa, Soichiro; Sawada, Yasuhiko; Sato, Yoshiki; Nagamatsu, Shinsaku; Matsuo, Hideki; Kikuchi, Eiryo

    2013-08-01

    A 22-year-old man complaining of persisting high fever and right hypochondralgia was admitted to our hospital for infectious mononucleosis with splenic infarction detected by computed tomography. The splenic infarction deteriorated with a marked elevation of inflammatory parameters. This necessitated the commencement of methylprednisolone pulse therapy, resulting in prompt amelioration of inflammation and a reduction in cytokine levels. Including our case, only 9 cases of mononucleosis with splenic infarction have been reported to date; however, splenic infarction should be considered because it is a significant complication of infectious mononucleosis.

  17. Littoral cell angioma mimicking metastatic tumors

    Directory of Open Access Journals (Sweden)

    Szumilo Justyna

    2015-12-01

    Full Text Available Littoral cell angioma is a rare primary, vascular tumor thought to originate from the endothelial cells lining the sinuses of the splenic red pulp (the “littoral cells”. It is a benign, usually asymptomatic lesion diagnosed incidentally. Ultrasound and tomography appearance is not characteristic and histopathological examination is required. This work provides a case-study of littoral cell angioma which was seen in a 55-year-old female who complained of non-specific upper abdominal pain. Computed tomography revealed multiple hypo-attenuated splenic lesions suggestive for metastasis. A splenectomy was performed and routine microscopic examination supported by immunohistochemistry reactions with CD68, CD34 and CD31 showed littoral cell angioma.

  18. Splenic tuberculosis. Report of twelve cases

    International Nuclear Information System (INIS)

    Adil, A.; Chikhaoui, N.; Ousehal, A.; Kadiri, R.

    1995-01-01

    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

  19. Comparative analysis of CT and DSA in traumatic splenic salvage

    International Nuclear Information System (INIS)

    Liu Tie; Mao Xinfeng; Pan Feng

    2005-01-01

    Objective: To explore the better diagnostic method for acute splenic artery injury through comparative analysis of CT and DSA. Methods: Fifty-seven patients with acute splenic injury were examined by CT and DSA, treated with splenic arterial embolization and then undertook follow up. Results: CT examination possessed higher sensitivity and accuracy than DSA in demonstrating splenic parenchymal laceration, intrasplenic hematoma, subcapsular hematoma, rupture of splenic capsule and combined injury of intra-abdominal organs, especially in localizing splenic laceration. And there was a high significant difference statistically between the two kinds of examination (χ 2 =10.71, P 2 =12.57, P<0.005). Conclusions: CT and DSA are complementary in the diagnosis of splenic injury. After CT confirmation of splenic injury and the patient vital signs being stable, DSA should be referred to as soon as possible for further detail information as well as for possible interventional embolization and reduction of surgical complications. (authors)

  20. The value of MDCT in diagnosis of splenic artery aneurysms

    International Nuclear Information System (INIS)

    Sun Cong; Liu Cheng; Wang Ximing; Wang Daoping

    2008-01-01

    Objective: To evaluate the clinical value of multiple detector computed tomography (MDCT) in the diagnosis and planning the treatment of splenic aneurysms. Methods: Eight cases with splenic artery aneurysms (SAA) were retrospectively reviewed. Sixty four-slice spiral CT scans were performed. Intravenous contrast material was injected at 4 ml/s, and arterial and venous phase images were obtained. Subsequently, arterial phase images were analyzed and made for CT angiography. The diagnosis was made by using axial and reconstructive images. All of the patients were also performed Doppler color echocardiography. Results: All patients showed splenic artery and splenic artery aneurysms clearly with CT arterial phase images. Among them, six patients had splenic artery aneurysms, one had giant splenic artery aneurysms (GSAA) and one had splenic artery pseudoaneurysms. Ultrasound examination only diagnosed six of them. Conclusion: MDCT is a noninvasive and valuable method in diagnosis of splenic artery aneurysms and has high value in determination of treatment plan

  1. The value of MDCT in diagnosis of splenic artery aneurysms

    Energy Technology Data Exchange (ETDEWEB)

    Sun Cong [Shandong University, Shandong Provincial Medical Imaging Institute, Road jing-wu No. 324, Jinan, Shandong 250021 (China)], E-mail: suncong03@163.com; Liu Cheng; Wang Ximing; Wang Daoping [Shandong University, Shandong Provincial Medical Imaging Institute, Road jing-wu No. 324, Jinan, Shandong 250021 (China)

    2008-03-15

    Objective: To evaluate the clinical value of multiple detector computed tomography (MDCT) in the diagnosis and planning the treatment of splenic aneurysms. Methods: Eight cases with splenic artery aneurysms (SAA) were retrospectively reviewed. Sixty four-slice spiral CT scans were performed. Intravenous contrast material was injected at 4 ml/s, and arterial and venous phase images were obtained. Subsequently, arterial phase images were analyzed and made for CT angiography. The diagnosis was made by using axial and reconstructive images. All of the patients were also performed Doppler color echocardiography. Results: All patients showed splenic artery and splenic artery aneurysms clearly with CT arterial phase images. Among them, six patients had splenic artery aneurysms, one had giant splenic artery aneurysms (GSAA) and one had splenic artery pseudoaneurysms. Ultrasound examination only diagnosed six of them. Conclusion: MDCT is a noninvasive and valuable method in diagnosis of splenic artery aneurysms and has high value in determination of treatment plan.

  2. Transcriptomic analysis reveals key genes related to betalain biosynthesis in pulp coloration of Hylocereus polyrhizus

    Directory of Open Access Journals (Sweden)

    Hua eQingzhu

    2016-01-01

    Full Text Available Betalains have high nutritional value and bioactivities. Red pulp pitaya (Hylocereus polyrhizus is the only fruit containing abundant betalains for consumer. However, no information is available about genes involved in betalain biosynthesis in H. polyrhizus. Herein, two cDNA libraries of pitaya pulps with two different coloration stages (white and red pulp stages of Guanhuahong (H. polyrhizus were constructed. A total of about 12 Gb raw RNA-Seq data was generated and was de novo assembled into 122,677 transcripts with an average length of 1,183 bp and an N50 value of 2008. Approximately 99.99% of all transcripts were annotated based on seven public databases. A total of 8,871 transcripts were significantly regulated. Thirty-three candidate transcripts related to betalain biosynthesis were obtained from the transcriptome data. Transcripts encoding enzymes involved in betalain biosynthesis were analyzed using RT-qPCR at the whole pulp coloration stages of H. Polyrhizus (7-1 and H. Undatus (132-4. Nine key transcripts of betalain biosynthesis were identified. They were assigned to four kinds of genes in betalain biosynthetic pathway, including tyrosinase, 4, 5-DOPA dioxygenase extradiol, cytochrome P450 and glucosyltransferase. Ultimately, a preliminary betalain biosynthetic pathway for pitaya was proposed based on betalain analyses and gene expression profiles.

  3. Pulpal blood flow recorded from exposed dentine with a laser Doppler flow meter using red or infrared light.

    Science.gov (United States)

    Kijsamanmith, Kanittha; Vongsavan, Noppakun; Matthews, Bruce

    2018-03-01

    To determine the percentage of the blood flow signal that is derived from dental pulp when recording from exposed dentine in a human premolar. Recordings were made from 7 healthy teeth in 5 subjects (aged 22-33 yr.) with a laser Doppler flow meter (Periflux 4001) using either a red (635 nm) or an infrared (780 nm) laser. After exposing dentine above the buccal pulpal horn (cavity diam. 1.6 mm, depth 3 mm) and isolating the crown with opaque rubber dam, blood flow was recorded alternately with infrared or red light from the exposed dentine under four conditions: before and after injecting local anaesthetic (3% Mepivacaine without vasoconstrictor) (LA) over the apex of the root of the tooth; after exposing the pulp by cutting a buccal, class V cavity in the tooth; and after sectioning the coronal pulp transversely through the exposure. There was no significant change in mean blood flow recorded with either light source when the tooth was anaesthetized or when the pulp was exposed. After the pulp had been sectioned, the blood flow recorded with infrared light fell by 67.8% and with red light, by 68.4%. The difference between these effects was not significant. When recording blood flow from exposed coronal dentine with either infrared or red light in a tooth isolated with opaque rubber dam, about 68% to the signal was contributed by the pulp. The signal:noise ratio was better with infrared than red light, and when recording from dentine than enamel. Copyright © 2017 Elsevier Ltd. All rights reserved.

  4. Laparoscopic splenic hilar lymphadenectomy for advanced gastric cancer.

    Science.gov (United States)

    Hosogi, Hisahiro; Okabe, Hiroshi; Shinohara, Hisashi; Tsunoda, Shigeru; Hisamori, Shigeo; Sakai, Yoshiharu

    2016-01-01

    Laparoscopic distal gastrectomy has recently become accepted as a surgical option for early gastric cancer in the distal stomach, but laparoscopic total gastrectomy (LTG) has not become widespread because of technical difficulties of esophagojejunal anastomosis and splenic hilar lymphadenectomy. Splenic hilar lymphadenectomy should be employed in the treatment of advanced proximal gastric cancer to complete D2 dissection, but laparoscopically it is technically difficult even for skilled surgeons. Based on the evidence that prophylactic combined resection of spleen in total gastrectomy increased the risk of postoperative morbidity with no survival impact, surgeons have preferred laparoscopic spleen-preserving splenic hilar lymphadenectomy (LSPL) for advanced tumors without metastasis to splenic hilar nodes or invasion to the greater curvature of the stomach, and reports with LSPL have been increasing rather than LTG with splenectomy. In this paper, recent reports with laparoscopic splenic hilar lymphadenectomy were reviewed.

  5. Proliferation and mineralization ability of dental pulp cells derived from primary and permanent teeth

    Directory of Open Access Journals (Sweden)

    Suttatip Kamolmatyakul

    2011-04-01

    Full Text Available The aims of this study were to compare the proliferation and mineralization ability of CFU-F selected dental pulp cellsderived from primary and permanent teeth. Those cells were isolated by enzyme digestion and analyzed for their colonyformingcapacity. The cell proliferation was measured by the MTT assay on day 1, day 7, and day14. Alizarin Red S stainingwas used to detect mineralized nodule formation of the cells on day 7, 14, 21, and 28. Proliferation of CFU-F selected pulpcells from primary teeth was significantly higher than that of CFU-F selected pulp cells from permanent teeth in all periods ofthe experiment. Upon cultured cells in mineralization inducing media, the mineralized nodules appeared as early as day 14 inCFU-F selected pulp cells from primary teeth and MG-63, whereas those of CFU-F selected pulp cells from permanent teethcan be found at day 21. On day 21 and day 28, the mineralized nodules of the CFU-F selected pulp cells from the primaryteeth group were more than those in the CFU-F selected pulp cells from the permanent teeth group. Mineralized noduleformation in the CFU-F selected pulp cells from the permanent teeth group appeared later and were less than those ofCFU-F selected pulp cells from primary teeth. However, mineralized nodules in CFU-F selected pulp cells from the permanentteeth group increased very fast after their appearance. Those results suggest that CFU-F selected pulp cells from primaryteeth had a higher proliferation rate and mineralization rate when compared to CFU-F selected pulp cells from permanentteeth.

  6. Complicated congenital splenic cyst: Saved by a splenunculus

    Directory of Open Access Journals (Sweden)

    Karia Nina

    2011-01-01

    Full Text Available A 12-year-old girl presented with a large congenital splenic cyst complicated by Salmonella organisms. After failure of conservative management and percutaneous drainage, a splenectomy was performed. An incidental splenunculus was preserved. On follow up the splenunculus had increased to normal splenic size and there was no evidence of Howell-Jolly bodies, suggesting normal splenic function.

  7. 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.

  8. A Comparison of Total Antioxidant Capacities of Concord, Purple, Red, and Green Grapes Using the CUPRAC Assay

    Directory of Open Access Journals (Sweden)

    Connor M. Callaghan

    2013-10-01

    Full Text Available Considering how popular grapes are in terms of their antioxidant benefits, we compared concord, purple, red, and green grapes for total antioxidant capacity (TAC and carbohydrate concentration. All grapes were acquired from commercial sources and samples of each were separated into skinned and not skinned groups. Each whole grape and the skins were individually homogenized and then separated into pulp and supernatant fractions. Each fraction was analyzed for total TAC and carbohydrates. The concord grapes and purple grapes had significantly higher TAC in the homogenates than did the red or green grapes. The concord grapes and green grapes had significantly higher TAC in the pulp than in the cytosol whereas the red and purple grapes had approximately the same amount. The majority of the TAC of the purple and red grapes was in the skin whereas the concord and green grapes had approximately the same TAC in the skin and pulp. The concord and purple grapes had the highest TAC when compared to the red and green grapes, whereas the red and green grapes had approximately the same total TAC.

  9. Delayed splenic rupture presenting 70 days following blunt abdominal trauma.

    Science.gov (United States)

    Resteghini, Nancy; Nielsen, Jonpaul; Hoimes, Matthew L; Karam, Adib R

    2014-01-01

    Delayed splenic rupture following conservative management of splenic injury is an extremely rare complication. We report a case of an adult patient who presented with delayed splenic rupture necessitating splenectomy, 2 months following blunt abdominal trauma. Imaging at the initial presentation demonstrated only minimal splenic contusion and the patient was discharge following 24 hours of observation. © 2014.

  10. Decreased splenic enhancement on CT in traumatized hypotensive patients

    International Nuclear Information System (INIS)

    Berland, L.L.; VanDyke, J.A.

    1985-01-01

    Three patients with transient episodes of hypotension following blunt abdominal trauma incurred in motor vehicle accidents were examined by computed tomography within 6 hours of injury. None of the patients had splenic injury evident on autopsy, surgery, or clinical follow-up study (one case each), nor did they have other characteristic features of splenic infarction. However, in each case the spleen was less enhanced than the liver, leading to an erroneous impression in one patient that the splenic artery had been disrupted. Physiologic studies have shown that splenic perfusion decreases with sympathetic stimulation; this may have been the cause of the diminished enhancement. Decreased splenic enhancement should be interpreted cautiously in traumatized hypotensive patients

  11. Decreased splenic enhancement on CT in traumatized hypotensive patients

    Energy Technology Data Exchange (ETDEWEB)

    Berland, L.L.; VanDyke, J.A.

    1985-08-01

    Three patients with transient episodes of hypotension following blunt abdominal trauma incurred in motor vehicle accidents were examined by computed tomography within 6 hours of injury. None of the patients had splenic injury evident on autopsy, surgery, or clinical follow-up study (one case each), nor did they have other characteristic features of splenic infarction. However, in each case the spleen was less enhanced than the liver, leading to an erroneous impression in one patient that the splenic artery had been disrupted. Physiologic studies have shown that splenic perfusion decreases with sympathetic stimulation; this may have been the cause of the diminished enhancement. Decreased splenic enhancement should be interpreted cautiously in traumatized hypotensive patients.

  12. Proximal splenic angioembolization does not improve outcomes in treating blunt splenic injuries compared with splenectomy: a cohort analysis.

    Science.gov (United States)

    Duchesne, Juan C; Simmons, Jon D; Schmieg, Robert E; McSwain, Norman E; Bellows, Charles F

    2008-12-01

    Although splenic angioembolization (SAE) has been introduced and adopted in many trauma centers, the appropriate selection for and utility of SAE in trauma patients remains under debate. This study examined the outcomes of proximal SAE as part of a management algorithm for adult traumatic splenic injury compared with splenectomy. A retrospective cohort analysis was performed on all hemodynamically stable (HDS) blunt trauma patients with isolated splenic injury and computed tomographic (CT) evidence of active contrast extravasation that presented to a level 1 Trauma Center over a period of 5 years. The cohorts were defined by two separate 30 month periods and included 78 patients seen before (group I) and 76 patients seen after (group II) the introduction of an institutional SAE protocol. Demographics, splenic injury grade, and outcomes of the two groups were compared using Student's t test, or chi2 test. Analysis was by intention-to-treat. Six hundred eighty-two patients with blunt splenic injury were identified; 154 patients (29%) were HDS with CT evidence of active contrast extravasation. Group I (n = 78) was treated with splenectomy and group II (n = 76) was treated with proximal SAE. There was no difference in age (33 +/- 14 vs. 37 +/- 17 years), Injury Severity Score (31 +/- 13 vs. 29 +/- 11), or mortality (18% vs. 15%) between the two groups. However, the incidence of Adult Respiratory Distress Syndrome (ARDS) was 4-fold higher in those patients that underwent proximal SAE compared with those that underwent splenectomy (22% vs. 5%, p = 0.002). Twenty two patients failed nonoperative management (NOM) after SAE. This failure appeared to be directly related to the grade of splenic organ injury (grade I and II: 0%; grade III: 24%; grade IV: 53%; and grade V: 100%). Introduction of proximal SAE in NOM of HDS splenic trauma patients with active extravasation did not alter mortality rates at a Level 1 Trauma Center. Increased incidence of ARDS and association of

  13. Splenic irradiation in HIV-related thrombocytopenia

    International Nuclear Information System (INIS)

    Leung, J.T.; Kuan, R.

    1996-01-01

    Splenic irradiation has been used in patients with HIV-related thrombocytopenia. This retrospective review deals with four patients treated with low dose splenic irradiation. All patients had an increase in platelet count and tolerated the treatment without side effects. However, the treatment response lasted for several months only. 9 refs., 1 tab

  14. 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.

  15. CT of splenic and perisplenic abnormalities in septic patients

    Energy Technology Data Exchange (ETDEWEB)

    Balthazar, E.J.; Hilton, S.; Naidich, D.; Megibow, A.; Levine, R.

    1985-01-01

    Splenic and perisplenic pathology, demonstrated by CT examination in 14 septic patients, was correlated with the clinical course and with surgical and pathologic findings available. Twelve patients were intravenous drug addicts and two patients developed bacteremia associated with bacterial endocarditis. The CT fingings were divided into three groups: (1) Single wedge-shaped peripherally located defects were seen in five patients; there was good response to medical therapy without other complications. (2) Larger and/or multiple, rounded or oval lesions were present in five patients; two of these patients had splenic abscesses proven on subsequent splenectomy. (3) Multiple splenic lesions and fissures associated with perisplenic and subphrenic fluid collections were seen in four patients; infected splenic infarcts, splenic fractures, and infected perisplenic hemorrhagic fluid collections were found in this group of patients. The CT examination in septic patients can reliably demonstrate splenic and perisplenic pathology, and its appearance contributes greatly to the overall clinical assessment and surgical approach.

  16. CT of splenic and perisplenic abnormalities in septic patients

    International Nuclear Information System (INIS)

    Balthazar, E.J.; Hilton, S.; Naidich, D.; Megibow, A.; Levine, R.

    1985-01-01

    Splenic and perisplenic pathology, demonstrated by CT examination in 14 septic patients, was correlated with the clinical course and with surgical and pathologic findings available. Twelve patients were intravenous drug addicts and two patients developed bacteremia associated with bacterial endocarditis. The CT fingings were divided into three groups: (1) Single wedge-shaped peripherally located defects were seen in five patients; there was good response to medical therapy without other complications. (2) Larger and/or multiple, rounded or oval lesions were present in five patients; two of these patients had splenic abscesses proven on subsequent splenectomy. (3) Multiple splenic lesions and fissures associated with perisplenic and subphrenic fluid collections were seen in four patients; infected splenic infarcts, splenic fractures, and infected perisplenic hemorrhagic fluid collections were found in this group of patients. The CT examination in septic patients can reliably demonstrate splenic and perisplenic pathology, and its appearance contributes greatly to the overall clinical assessment and surgical approach

  17. Symptomatic heterotopic suprarenal splenic tissue

    International Nuclear Information System (INIS)

    Heider, J.; Kreft, B.; Winter, P.

    1998-01-01

    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.) [de

  18. Transcatheter Embolization for Delayed Hemorrhage Caused by Blunt Splenic Trauma

    International Nuclear Information System (INIS)

    Krohmer, Steven J.; Hoffer, Eric K.; Burchard, Kenneth W.

    2010-01-01

    Although the exact benefit of adjunctive splenic artery embolization (SAE) in the nonoperative management (NOM) of patients with blunt splenic trauma has been debated, the role of transcatheter embolization in delayed splenic hemorrhage is rarely addressed. The purpose of this study was to evaluate the effectiveness of SAE in the management of patients who presented at least 3 days after initial splenic trauma with delayed hemorrhage. During a 24-month period 4 patients (all male; ages 19-49 years) presented with acute onset of pain 5-70 days after blunt trauma to the left upper quadrant. Two had known splenic injuries that had been managed nonoperatively. All had computed axial tomography evidence of active splenic hemorrhage or false aneurysm on representation. All underwent successful SAE. Follow-up ranged from 28 to 370 days. These cases and a review of the literature indicate that SAE is safe and effective for NOM failure caused by delayed manifestations of splenic arterial injury.

  19. Drainage of Splenic Abscess: A Case Report | Kombo | Nigerian ...

    African Journals Online (AJOL)

    ... and was managed by tube drainage. His post operative recovery was uneventful. Conclusion: Tube drainage of the splenic abscess is encouraged if there is easy access to the abscess and there is evidence of residual splenic tissue in the critically ill patient. Key Word: Tube drainage, splenic abscess, splenectomy.

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

    International Nuclear Information System (INIS)

    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

  1. Nonsurgical drainage of splenic abscess

    International Nuclear Information System (INIS)

    Berkman, W.A.; Harris, S.A. Jr.; Bernardino, M.E.

    1983-01-01

    The mortality associated with intraabdominal abscess remains high despite modern surgical methods and antibiotics. Draingae of abscesses of the abdomen, retroperitoneum, pelvis, pancreatic pseudocyst, mediastinum, and lung may be treated effectively by percutaneous catheter placement. In several reports of percutaneous abdominal abscess drainage, only three cases of splenic abscess drainage have been reported. The authors have recently drained two splenic abscesses with the aid of computed tomography (CT) and emphasize several advantages of the percutaneous guided approach

  2. Management and treatment of splenic trauma in children.

    Science.gov (United States)

    Arslan, Serkan; Guzel, Mahmut; Turan, Cuneyt; Doğanay, Selim; Kopru, Mehmet

    2015-01-01

    To assess types of splenic traumas, accompanying injuries, their management and results. We studied the reports of 90 patients (64 boys, 26 girls) who were treated for splenic injuries as a result of blunt abdominal trauma between 2005-2012. Age, sex, hospitalization time, mechanisms of traumas, accompanying injuries and management methods were recorded. Causes of trauma were falls from height (46 patients, 51%), pedestrian traffic accidents (17 patients, 19%), passenger traffic accidents (11 patients, 12%), bicycle accidents (10 patients, 11%) and falling objects from height (6 patients, 6.6%). Splenic injury alone was observed in 57 patients (63.3%) and other organ injuries together with splenic injury in 33 patients (36.7%). Splenectomy was performed in six patients (6.6%) due to hemodynamic instability and small intestine repair due to small intestine injury in one patient (1.1%). None of these patients died from their injuries. A large proportion of splenic injuries recover with conservative therapy. Some of the advantages of conservative therapy include short hospitalization time, less need for blood transfusion, and less morbidity and mortality. Falls from height and traffic accidents are important factors in etiology. The possibility of other organ injuries together with splenic injuries should be considered.

  3. The contemporary management of penetrating splenic injury.

    Science.gov (United States)

    Berg, Regan J; Inaba, Kenji; Okoye, Obi; Pasley, Jason; Teixeira, Pedro G; Esparza, Michael; Demetriades, Demetrios

    2014-09-01

    Selective non-operative management (NOM) is standard of care for clinically stable patients with blunt splenic trauma and expectant management approaches are increasingly utilised in penetrating abdominal trauma, including in the setting of solid organ injury. Despite this evolution of clinical practice, little is known about the safety and efficacy of NOM in penetrating splenic injury. Trauma registry and medical record review identified all consecutive patients presenting to LAC+USC Medical Center with penetrating splenic injury between January 2001 and December 2011. Associated injuries, incidence and nature of operative intervention, local and systemic complications and mortality were determined. During the study period, 225 patients experienced penetrating splenic trauma. The majority (187/225, 83%) underwent emergent laparotomy. Thirty-eight clinically stable patients underwent a deliberate trial of NOM and 24/38 (63%) were ultimately managed without laparotomy. Amongst patients failing NOM, 3/14 (21%) underwent splenectomy while an additional 6/14 (42%) had splenorrhaphy. Hollow viscus injury (HVI) occurred in 21% of all patients failing NOM. Forty percent of all NOM patients had diaphragmatic injury (DI). All patients undergoing delayed laparotomy for HVI or a splenic procedure presented symptomatically within 24h of the initial injury. No deaths occurred in patients undergoing NOM. Although the vast majority of penetrating splenic trauma requires urgent operative management, a group of patients does present without haemodynamic instability, peritonitis or radiologic evidence of hollow viscus injury. Management of these patients is complicated as over half may remain clinically stable and can avoid laparotomy, making them potential candidates for a trial of NOM. HVI is responsible for NOM failure in up to a fifth of these cases and typically presents within 24h of injury. Delayed laparotomy, within this limited time period, did not appear to increase

  4. Pulpal blood flow recorded from human premolar teeth with a laser Doppler flow meter using either red or infrared light.

    Science.gov (United States)

    Kijsamanmith, Kanittha; Timpawat, Siriporn; Vongsavan, Noppakun; Matthews, Bruce

    2011-07-01

    To compare red (635 nm) and infrared (780 nm) light for recording pulpal blood flow from human premolar teeth. Recordings were made from 11 healthy teeth in 9 subjects (aged 16-30 years) using a laser Doppler flow meter (Periflux 4001) equipped with both red and infrared lasers. Average blood flow signals were obtained with both light sources alternately from each tooth under five conditions: intact tooth without opaque rubber dam, intact tooth with dam, after injecting local anaesthetic (3% Mepivacaine) (LA) over the apex of the tooth and cavity preparation to almost expose the pulp, after removal and replacement of the pulp, and with the root canal empty. With infrared light, the dam significantly decreased the mean blood flow by 80%. Injecting LA and cavity preparation had no significant effect. Removal and replacement of the pulp reduced the mean blood flow by 58%. There was no further change when the pulp was removed. With red light, the dam reduced the signal from intact teeth by 60%. Injecting LA and cavity preparation had no significant effect. The signal fell by 67% after pulp removal and replacement and did not change significantly when the pulp was removed. Opaque rubber dam minimises the contribution of non-pulpal tissues to the laser Doppler signal recorded from premolars. Using dam, the pulp contributed about 60% to the blood flow signal with both red and infrared light. The difference between them in this respect was not significant. Copyright © 2010 Elsevier Ltd. All rights reserved.

  5. Iatrogenic splenic injury: review of the literature and medico-legal issues

    Directory of Open Access Journals (Sweden)

    Feola Alessandro

    2016-01-01

    Full Text Available Iatrogenic splenic injury is a recognized complication in abdominal surgery. The aim of this paper is to understand the medico-legal issues of iatrogenic splenic injuries. We performed a literature review on PubMed and Scopus using iatrogenic splenic or spleen injury and iatrogenic splenic rupture as keywords. Iatrogenic splenic injury cases were identified. Most cases were related to colonoscopy, but we also identified cases related to upper gastrointestinal procedures, colonic surgery, ERCP, left nephrectomy and/or adrenalectomy, percutaneous nephrolithotomy, vascular operations involving the abdominal aorta, gynecological operation, left lung biopsy, chest drain, very rarely spinal surgery and even cardiopulmonary resuscitation. There are several surgical procedures that can lead to a splenic injury. However, from a medico-legal point of view, it is important to assess whether the cause can be attributed to a technical error of the operator rather than being an unpredictable and unpreventable complication. It is important for the medico-legal expert to have great knowledge on iatrogenic splenic injuries because it is important to evaluate every step of the first procedure performed, how a splenic injury is produced, and whether the correct treatment for the splenic injury was administered in a judgment.

  6. Acute Gastric Volvulus Causing Splenic Avulsion and Hemoperitoneum

    Directory of Open Access Journals (Sweden)

    Yana Cavanagh

    2018-01-01

    Full Text Available Gastric volvulus is an abnormal, potentially life-threatening, torsion of the stomach. The presence of complications such as hemoperitoneum increases the diagnostic urgency; however it can also mask the presentation of gastric volvulus. We encountered a 66-year-old female who presented with symptomatic gastric outlet obstruction and was found to have hemoperitoneum and splenic avulsion on imaging. In our case, hemoperitoneum was a clinical red herring as initial imaging concentrated on the presence of hemoperitoneum and was nondiagnostic of gastric volvulus. Interestingly, our patient experienced complete resolution of her presenting symptomatology following placement of a nasogastric tube. Furthermore, endoscopic evaluation revealed no overt pathology to explain outlet obstruction. In light of these findings, gastric torsion was strongly suspected. A repeat CT scan was confirmatory, elucidated reduction of the stomach to its anatomic position, retroactively diagnosing a gastric volvulus. This case is unusual in its presentation and setting. The patient presented with two rare complications of gastric volvulus, hemoperitoneum and splenic avulsion. Additionally, ten years prior to this presentation the patient had a temporary gastrostomy tube. Gastropexy with a gastrostomy is the treatment for gastric volvulus and should have been preventative of her presentation with torsion. Furthermore, the gastric volvulus was not initially recognized radiographically due to the presence of masking radiographic findings. This case serves to highlight the utility of clinical acumen and maintain a high index of suspicion for gastric volvulus in all cases presenting with Borchardt’s triad.

  7. Twenty-years of splenic preservation at a level 1 pediatric trauma center.

    Science.gov (United States)

    Bairdain, Sigrid; Litman, Heather J; Troy, Michael; McMahon, Maria; Almodovar, Heidi; Zurakowski, David; Mooney, David P

    2015-05-01

    Splenic preservation is the standard of care for hemodynamically stable children with splenic injuries. We report a 20-year single-institutional series of children with splenic injuries managed without a splenectomy. Children evaluated and treated for blunt splenic injury at Boston Children's Hospital from 1994 to 2014 were extracted from the trauma registry. Demographics, clinical characteristics, complications, and outcomes were reviewed. Three time-periods were evaluated based upon the development and modification of splenic injury clinical pathway guidelines (CPGs). Survival was defined as being discharged from the hospital alive. 502 suffered isolated splenic injuries. The median AAST grade of splenic injury increased across the three CPG time periods (psplenic-injury related mortalities occurred. Hospital length of stay decreased significantly secondary to splenic injury CPGs (psplenic injury, no patient died or underwent splenectomy. Hospital length of stay decreased across time, despite an increase in the severity of splenic injuries encountered. Splenectomy has become so unusual in the management of hemodynamically stable children with a splenic injury that it may no longer be a legitimate outcome marker. Copyright © 2015 Elsevier Inc. All rights reserved.

  8. Association of splenic and renal infarctions in acute abdominal emergencies

    Energy Technology Data Exchange (ETDEWEB)

    Romano, Stefania E-mail: stefromano@libero.it; Scaglione, Mariano; Gatta, Gianluca; Lombardo, Patrizia; Stavolo, Ciro; Romano, Luigia; Grassi, Roberto

    2004-04-01

    Introduction: Splenic and renal infarctions are usually related to vascular disease or haematologic abnormalities. Their association is infrequent and rarely observed in trauma. In this study, we analyze our data to look at the occurrence of renal and splenic infarctions based on CT findings in a period of 4 years. Materials and Methods: We retrospectively reviewed the imaging findings of 84 patients admitted to our Department of Diagnostic Imaging from June 1998 to December 2002, who underwent emergency abdominal spiral CT examination and in whom there was evidence of splenic and/or renal infarction. Results: We found 40 cases of splenic infarction and 54 cases of renal infarction, associated in 10 patients. In 26 patients, there was also evidence of intestinal infarction. A traumatic origin was found in 19 cases; non-traumatic causes were found in 65 patients. Association between renal and splenic infarction in the same patient was related to trauma in two cases. Conclusions: Although renal and splenic infarctions are a common manifestation of cardiac thromboembolism, other systemic pathologies, infections or trauma may lead to this occurrence. Renal infarction may be clinically and/or surgically managed with success in most cases. There are potential complications in splenic infarction, such as development of pseudocysts, abscesses, hemorrhage, subcapsular haematoma or splenic rupture; splenectomy in these cases may be necessary. Some patients with splenic and/or renal infarction may be clinically asymptomatic. The high accuracy of CT examination is needed to allow a correct evaluation of infarcted organs.

  9. Association of splenic and renal infarctions in acute abdominal emergencies

    International Nuclear Information System (INIS)

    Romano, Stefania; Scaglione, Mariano; Gatta, Gianluca; Lombardo, Patrizia; Stavolo, Ciro; Romano, Luigia; Grassi, Roberto

    2004-01-01

    Introduction: Splenic and renal infarctions are usually related to vascular disease or haematologic abnormalities. Their association is infrequent and rarely observed in trauma. In this study, we analyze our data to look at the occurrence of renal and splenic infarctions based on CT findings in a period of 4 years. Materials and Methods: We retrospectively reviewed the imaging findings of 84 patients admitted to our Department of Diagnostic Imaging from June 1998 to December 2002, who underwent emergency abdominal spiral CT examination and in whom there was evidence of splenic and/or renal infarction. Results: We found 40 cases of splenic infarction and 54 cases of renal infarction, associated in 10 patients. In 26 patients, there was also evidence of intestinal infarction. A traumatic origin was found in 19 cases; non-traumatic causes were found in 65 patients. Association between renal and splenic infarction in the same patient was related to trauma in two cases. Conclusions: Although renal and splenic infarctions are a common manifestation of cardiac thromboembolism, other systemic pathologies, infections or trauma may lead to this occurrence. Renal infarction may be clinically and/or surgically managed with success in most cases. There are potential complications in splenic infarction, such as development of pseudocysts, abscesses, hemorrhage, subcapsular haematoma or splenic rupture; splenectomy in these cases may be necessary. Some patients with splenic and/or renal infarction may be clinically asymptomatic. The high accuracy of CT examination is needed to allow a correct evaluation of infarcted organs

  10. Comparative analysis of pigments in red and yellow banana fruit.

    Science.gov (United States)

    Fu, Xiumin; Cheng, Sihua; Liao, Yinyin; Huang, Bingzhi; Du, Bing; Zeng, Wei; Jiang, Yueming; Duan, Xuewu; Yang, Ziyin

    2018-01-15

    Color is an important characteristic determining the fruit value. Although ripe bananas usually have yellow peels, several banana cultivars have red peels. As details of the pigments in banana fruits are unknown, we investigated these pigments contents and compositions in the peel and pulp of red cultivar 'Hongjiaowang' and yellow cultivar 'Baxijiao' by UPLC-PDA-QTOF-MS and HPLC-PDA techniques. The 'Hongjiaowang' peel color was mainly determined by the presence of anthocyanin-containing epidermal cells. Rutinoside derivatives of cyanidin, peonidin, petunidin, and malvidin were unique to the red peel, and possibly responsible for the red color. 'Hongjiaowang' contained higher total content of carotenoids than 'Baxijiao' in both pulp and peel. Lutein, α-carotene, and β-carotene were main carotenoids, which might play a more important role than flavonoids in producing the yellow banana color owing to the properties and distribution in the fruit. The information will help us understand a complete profile of pigments in banana. Copyright © 2017 Elsevier Ltd. All rights reserved.

  11. Radioisotope spleen scan in patients with splenic injury

    International Nuclear Information System (INIS)

    Mishalany, H.G.; Miller, J.H.; Woolley, M.M.

    1982-01-01

    The technetium /sup 99m/Tc sulfur colloid liver-spleen scan is a valuable aid in diagnosis and treatment of patients with splenic injury. After reviewing the charts of 47 patients who were ill as a result of splenic trauma, we came to the following conclusions: (1) the scan identified the injury, accurately mapped its extent, and indicated the presence or absence of associated liver injuries; (2) the scans were useful in following the extent and rate of healing of the splenic injury; (3) the scan is an indirect measurement of of return of splenic fuction; (4) the procedure can be performed in a reasonable time frame with no serious morbidity; and (5) the indications, contraindications, and timing of scans are now reasonably well established

  12. Radioisotope spleen scan in patients with splenic injury

    Energy Technology Data Exchange (ETDEWEB)

    Mishalany, H.G.; Miller, J.H.; Woolley, M.M.

    1982-09-01

    The technetium /sup 99m/Tc sulfur colloid liver-spleen scan is a valuable aid in diagnosis and treatment of patients with splenic injury. After reviewing the charts of 47 patients who were ill as a result of splenic trauma, we came to the following conclusions: (1) the scan identified the injury, accurately mapped its extent, and indicated the presence or absence of associated liver injuries; (2) the scans were useful in following the extent and rate of healing of the splenic injury; (3) the scan is an indirect measurement of of return of splenic fuction; (4) the procedure can be performed in a reasonable time frame with no serious morbidity; and (5) the indications, contraindications, and timing of scans are now reasonably well established.

  13. Aging of in vitro pulp illustrates change of inflammation and dentinogenesis.

    Science.gov (United States)

    Lee, Young-Hee; Kim, Go-Eun; Cho, Hye-Jin; Yu, Mi-Kyoung; Bhattarai, Govinda; Lee, Nan-Hee; Yi, Ho-Keun

    2013-03-01

    Dental pulp functions include pulp cell activity involvement in dentin formation. In this study we investigated the age-related changes in dental pulp cells that may influence pulp cell activity for restoring pulp function. Human dental pulp cells (HDPCs) were serially subcultured until spontaneously arrested. Altered expression of chronic inflammatory molecules and age-related molecules were determined by Western blotting. Odontogenic functions impaired by senescence were assayed by Western blotting, reverse transcriptase polymerase chain reaction, alkaline phosphatase activity, and alizarin red S staining. To understand the mechanism of aging process by stress-induced premature senescence (SIPS), the cells were treated with H(2)O(2). Replicative senescence and SIPS were also compared. Replicative senescence of HDPCs was characterized by senescence-associated β-galactosidase activity and reactive oxygen species formation. These cells exhibited altered expression of chronic inflammatory molecules such as intracellular adhesion molecule-1, vascular cell adhesion molecule-1, peroxisome proliferator activated receptor-gamma, and heme oxygenase-1 and age-related molecules such as p53, p21, phosphorylated-extracellular signal-regulated kinase, and c-myb. SIPS cell results were similar to replicative senescence. Furthermore, HDPCs decreased odontogenic markers such as dentin sialophosphoprotein and dentin matrix-1 and osteogenic markers such as bone morphogenetic protein-2 and -7, runt-related transcription factor-2, osteopontin, alkaline phosphatase activity, and mineralized nodule formation by replicative senescence and SIPS. This study suggests that development of aging-related molecules in pulp cells offers understanding of cellular mechanisms and biological events responsible for tooth preservation and maintenance strategies for healthy teeth across the life span. Copyright © 2013 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

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

    International Nuclear Information System (INIS)

    Weinmann, M.; Becker, G.; Einsele, H.; Bamberg, M.

    2001-01-01

    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.) [de

  15. [Splenic abscesses: From diagnosis to therapy].

    Science.gov (United States)

    Davido, B; Dinh, A; Rouveix, E; Crenn, P; Hanslik, T; Salomon, J

    2017-09-01

    Splenic abscess is septic collection which occurs after haematogenous spread or local dissemination. Splenic abscess is an uncommon and rare condition, more frequently affecting male and immunocompromised patients. There are no guidelines regarding its diagnosis and management. Computed tomography (CT) scan is highly sensitive and specific (95% and 92%, respectively) in the diagnosis of splenic abscess. Diagnosis is based on blood cultures which are positive in 24 to 80% of cases. Bacterial growth culture of abscess after drainage is more efficient (50-80%) and can be performed after surgery or percutaneous drainage under imaging, including CT scan. Microorganisms involved are frequently enterobacteriaceae, gram-positive cocci and anaerobes. This particular ecology leads to an empiric broad-spectrum antibiotic therapy, with a variable duration, from 10days to more than one month. Management remains very close to the one applied in case of liver abscesses. The role of splenectomy in the prevention of recurrence remains controversial. We reviewed the literature regarding splenic abscesses, from diagnosis to therapy. Copyright © 2017 Société Nationale Française de Médecine Interne (SNFMI). Published by Elsevier SAS. All rights reserved.

  16. 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.

  17. Kinetics of heat damage autologous red blood cells. Mechanism of clearance from blood

    Energy Technology Data Exchange (ETDEWEB)

    Peters, A.M.; Ryan, P.F.J.; Klonizakis, I.; Elkon, K.B.; Lewis, S.M.; Hughes, G.R.V.; Lavender, J.P. (Hammersmith Hospital, London (UK))

    1982-01-01

    The kinetics of radiolabelled heat damage red cell (HDRBC) distribution have been studied in humans using a gamma camera, and compared with the kinetics of other blood cells. Liver uptake of /sup 111/In labelled HDRBC was completed within about 10 min of injection; splenic uptake was biphasic with a half time of about 5 min over the first 20 min in following injection, and a later half time much longer than this. Activity initially present in the lung fields cleared within 24 h. The rate constant of liver uptake of sup(99m)Tc labelled HDRBC and of /sup 111/In labelled platelets were very similar; the rate constants of splenic uptake of these 2 particles were also very similar up to about 20 min following injection when the splenic platelet levels became constant and the HDRBC level continued to slowly rise. Splenic uptake and blood clearance of red cells coated with IgG (IgG-RBC), in contrast to HDRBC, were monoexponential. It was concluded that: (1) the blood clearance of HDRBC was due to pooling within, and to irreversible extraction by, the spleen; (2) liver uptake of HDRBC, which was irreversible, was completed within 10 min of injection; (3) IgG-RBC clearance was due to irreversible extraction by the spleen; (4) HDRBC uptake in the lung was unrelated to reticuloendothelial function, and represented prolonged transit through the lung microvasculature.

  18. Isolated splenic calcifications in two patients with portal hypertension

    International Nuclear Information System (INIS)

    Aleixandre, A.; Cugat, A.; Ruiz, A.; Marti-Bonmati, L.; Tardaguila, F.

    2002-01-01

    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

  19. Comparison of Gingiva, Dental Pulp, and Periodontal Ligament Cells From the Standpoint of Mesenchymal Stem Cell Properties

    Science.gov (United States)

    Otabe, Koji; Muneta, Takeshi; Kawashima, Nobuyuki; Suda, Hideaki; Tsuji, Kunikazu; Sekiya, Ichiro

    2012-01-01

    The specific properties of mesenchymal stem cells (MSCs) in oral tissues still remain unknown though their existence has been previously reported. We collected gingiva, dental pulp, and periodontal ligament tissues from removed teeth and isolated MSCs. These MSCs were compared in terms of their yields per tooth, surface epitopes, and differentiation potentials by patient-matched analysis. For in vivo calcification analysis, rat gingival and dental pulp cells mounted on β-tricalcium phospateTCP were transplanted into the perivertebral muscle of rats for 6 weeks. Gingival cells and dental pulp cells showed higher yield per tooth than periodontal ligament cells (n=6, ppulp cells expressed MSC markers such as CD44, CD90, and CD166. Gingival and dental pulp cells obtained phenotypes of chondrocytes and adipocytes in vitro. Approximately 60% of the colonies of gingival cells and 40% of the colonies of dental pulp cells were positively stained with alizarin red in vitro, and both gingival and dental pulp cells were calcified in vivo. We clarified properties of MSCs derived from removed teeth. We could obtain a high yield of MSCs with osteogenic potential from gingiva and dental pulp. These results indicate that gingiva and dental pulp are putative cell sources for hard tissue regeneration. PMID:26858852

  20. Transcatheter Coil Embolization of Splenic Artery Aneurysm

    International Nuclear Information System (INIS)

    Yamamoto, Satoshi; Hirota, Shozo; Maeda, Hiroaki; Achiwa, Sachiko; Arai, Keisuke; Kobayashi, Kaoru; Nakao, Norio

    2008-01-01

    The purpose of this study was to evaluate clinical results and technical problems of transcatheter coil embolization for splenic artery aneurysm. Subjects were 16 patients (8 men, 8 women; age range, 40-80 years) who underwent transcatheter embolization for splenic artery aneurysm (14 true aneurysms, 2 false aneurysms) at one of our hospitals during the period January 1997 through July 2005. Two aneurysms (12.5%) were diagnosed at the time of rupture. Multiple splenic aneurysms were found in seven patients. Aneurysms were classified by site as proximal (or strictly ostial) (n = 3), middle (n = 3), or hilar (n = 10). The indication for transcatheter arterial embolization was a false or true aneurysm 20 mm in diameter. Embolic materials were fibered coils and interlocking detachable coils. Embolization was performed by the isolation technique, the packing technique, or both. Technically, all aneurysms were devascularized without severe complications. Embolized aneurysms were 6-40 mm in diameter (mean, 25 mm). Overall, the primary technical success rate was 88% (14 of 16 patients). In the remaining 2 patients (12.5%), partial recanalization occurred, and re-embolization was performed. The secondary technical success rate was 100%. Seven (44%) of the 16 study patients suffered partial splenic infarction. Intrasplenic branching originating from the aneurysm was observed in five patients. We conclude that transcatheter coil embolization should be the initial treatment of choice for splenic artery aneurysm

  1. Sonographic Measurement of Normal Splenic Length in Korean Adults

    Energy Technology Data Exchange (ETDEWEB)

    Shin, Sang Bum; Cheon, Byung Kook; Kim, Jong Min; Oh, Kyung Seoung; Jung, Gyoo Sik; Huh, Jin Do; Joh, Young Duk [Kosin University College of Medicine, Busan (Korea, Republic of)

    1996-12-15

    To establish upper limit of normal splenic length of Korean adults on ultrasonography and to determice the degree of interobserver and intraobserver variation. Ultrasonographic scans were performed to measure the maximum length of spleen in 105 of 150 adults selected by convenience sampling. Remained 45 cases with any conditions that could alter splenic size were excluded from this study. The maximum length of spleen was measured and correlated with body surface area, patient height, weight, age and sex. In 31 of the 105 adults we evaluated the interobserver and intraobserver variations in sonographic measurements of splenic length obtained by three radiologists in blind fashion. The mean splenic length in 105 adults was 8.56cm ({+-} 0.95). The splenic length positively correlated with body surface area, patient height and weight (P <0.001), and negatively correlated with patient age (P < 0.01). Male spleen (8.87 cm {+-} 1.07) was longer than female spleen (8.35 cm {+-} 0.81) (P < 0.05). The following guidelines are proposed for the upper limit of normal splenic length at different groups of body surface area: no longer than 10 cm at 1.20{approx}1.59 m{sup 2}, 11 cm at1.60{approx}1.79 m{sup 2}, and 12 cm at 1.80{approx}1.99 m{sup 2}. The mean interobserver variation between any two radiologists ranged from 0.32 cm ({+-} 0.29) to 0.39 cm ({+-} 0.33) and interobserver variations were within 1 cm in 96%. The mean intraobserver variations were within 0.5 cm in 91%. The splenic length closely correlated with body surface area, patient height, weight and age. Particularly the upper limit of normal splenic length changed according to body surface area. Interobserver variation about 1 cm and intraobserver variation about 0.5 cm should be considered in the measurement of the splenic length on ultrasonography

  2. Radionuclide scan findings in delayed splenic rupture

    International Nuclear Information System (INIS)

    Flickinger, F.W.; Jackson, G.L.

    1978-01-01

    An initial liver/spleen scan performed on a patient with blunt abdominal trauma was negative 3 days following the accident. A follow-up scan 7 days later showed definite evidence of splenic rupture, proved surgically. The authors conclude that, in such cases, spleen scans may be negative initially because of delayed splenic ruptures

  3. Is Pulp Inflammation a Prerequisite for Pulp Healing and Regeneration?

    Directory of Open Access Journals (Sweden)

    Michel Goldberg

    2015-01-01

    Full Text Available The importance of inflammation has been underestimated in pulpal healing, and in the past, it has been considered only as an undesirable effect. Associated with moderate inflammation, necrosis includes pyroptosis, apoptosis, and nemosis. There are now evidences that inflammation is a prerequisite for pulp healing, with series of events ahead of regeneration. Immunocompetent cells are recruited in the apical part. They slide along the root and migrate toward the crown. Due to the high alkalinity of the capping agent, pulp cells display mild inflammation, proliferate, and increase in number and size and initiate mineralization. Pulp fibroblasts become odontoblast-like cells producing type I collagen, alkaline phosphatase, and SPARC/osteonectin. Molecules of the SIBLING family, matrix metalloproteinases, and vascular and nerve mediators are also implicated in the formation of a reparative dentinal bridge, osteo/orthodentin closing the pulp exposure. Beneath a calciotraumatic line, a thin layer identified as reactionary dentin underlines the periphery of the pulp chamber. Inflammatory and/or noninflammatory processes contribute to produce a reparative dentinal bridge closing the pulp exposure, with minute canaliculi and large tunnel defects. Depending on the form and severity of the inflammatory and noninflammatory processes, and according to the capping agent, pulp reactions are induced specifically.

  4. Vital Pulp Therapy—Current Progress of Dental Pulp Regeneration and Revascularization

    Directory of Open Access Journals (Sweden)

    Weibo Zhang

    2010-01-01

    Full Text Available Pulp vitality is extremely important for the tooth viability, since it provides nutrition and acts as biosensor to detect pathogenic stimuli. In the dental clinic, most dental pulp infections are irreversible due to its anatomical position and organization. It is difficult for the body to eliminate the infection, which subsequently persists and worsens. The widely used strategy currently in the clinic is to partly or fully remove the contaminated pulp tissue, and fill and seal the void space with synthetic material. Over time, the pulpless tooth, now lacking proper blood supply and nervous system, becomes more vulnerable to injury. Recently, potential for successful pulp regeneration and revascularization therapies is increasing due to accumulated knowledge of stem cells, especially dental pulp stem cells. This paper will review current progress and feasible strategies for dental pulp regeneration and revascularization.

  5. Splenic radionuclide angiography in the portal hypertension assessment

    International Nuclear Information System (INIS)

    Artiko, V.; Kostic, K.; Perisic-Savic, M.; Janosevic, S.; Obradovic, V.

    2004-01-01

    The aim of this study is the presentation of the hepatic and splenic radionuclide angiograms (SRA) in various portal blood flow disturbances, as well as an analysis of the splenic arterio-venous ratio (SAVR) results, obtained as a slope ratio between inflow, arterial and the outflow, venous phases on the splenic TA curve. Splenic radionuclide angiography was performed after bolus injection of 740 MBq of 99m-Tc-pertechnetate, using ROTA scintillation camera (Siemens) and MicroDelta computer'. Four types of the SRA were established: a) very acute descendent slope (DS) in the controls; b) less acute DS in the patients with LC; c) horisontal venous phase caused by impaired outflow to the portal vein in LC with expressed portal hypertension, collateral circulation and LCEV; d) ascending outflow phase, characterizing the splenic and/or portal venous thrombosis. SAVR values were increased in liver cirrhosis (LC) with esophageal vahces (LCEV, n=10) (6.1 +/- 3.4) in comparison to the controls (n=10)(3.7 +/- 1.3)(U=25, p 0.05). However, in another two patients with LC and in 8 with LCEV it was not possible to access SAVR because of the appearance of the horisontal or rising venous phase on the splenic TA curve, instead of descendent. SRA and increased SAVR values reflect various blood flow alterations in the portal system and give additional data to the more accurate interpretation of the results obtained by hepatic radionuclide angiography. (authors)

  6. 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.

  7. [Giant splenic cyst in a teenager girl: Case report].

    Science.gov (United States)

    Martínez Torres, Beatriz; Medina García, Manuel; Zafra Anta, Miguel Ángel; García Muñoz-Najar, Alejandro José; Tardío Dovao, Juan C

    2017-06-01

    Giant nonparasitic splenic epidermoid cysts are relatively uncommon. These lesions can lead abdominal pain, but most of then are asymptomatic, and they are discovered incidentally. We report a 13-y old female with a giant splenic epidermoid cystic, given the special interest of diagnostic and therapeutic decision-making of this rare entity. A 13-y old female with clinical history of abdominal pain since the last two months. On physical examination a firm, tender mass was palpable in left hypochondrium. Diagnosis of a large cystic splenic mass was made based on ultrasound and abdominal computed tomography scan. Splenectomy was performed, and histopathological-immunohistochemistry studies revealed findings suggestive of primary epithelial cyst. The post-operative clinical course was satisfactory and uneventful. Treatment of giant nonparasitic splenic cysts is surgical. Preserve splenic parenchyma must be the aim in an individualized decision-making. The different types of surgical modalities will be according to the diagnosis and clinical situation (cyst size, age, comorbidities).

  8. Changing treatment of pediatric splenic trauma

    International Nuclear Information System (INIS)

    Kakkasseril, J.S.; Stewart, D.; Cox, J.A.; Gelfand, M.

    1982-01-01

    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

  9. Changing treatment of pediatric splenic trauma

    Energy Technology Data Exchange (ETDEWEB)

    Kakkasseril, J.S.; Stewart, D.; Cox, J.A.; Gelfand, M.

    1982-06-01

    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.

  10. PDGFRβ+/c-kit+ pulp cells are odontoblastic progenitors capable of producing dentin-like structure in vitro and in vivo.

    Science.gov (United States)

    Cai, Shiwei; Zhang, Wenjian; Chen, Wei

    2016-10-28

    Successful pulp regeneration depends on identification of pulp stem cells capable of differentiation under odontoblastic lineage and producing pulp-dentinal like structure. Recent studies demonstrate that platelet-derived growth factor (PDGF) plays an important role in damage repair and tissue regeneration. The aim of this study was to identify a subpopulation of dental pulp cells responsive to PDGF and with dentin regeneration potential. Pulp tissues were isolated from 12 freshly extracted human impacted third molars. Pulp cells were sorted by their expression of PDGFRβ and stem cell marker genes via flow cytometry. For the selected cells, proliferation was analyzed by a colorimetric cell proliferation assay, differentiation was assessed by real time PCR detection the expression of odontoblast marker genes, and mineralization was evaluated by Alizarin Red S staining. GFP marked PDGFRβ + /c-kit + pulp cells were transplanted into emptied root canals of nude rat lower left incisors. Pulp-dentinal regeneration was examined by immunohistochemistry. PDGFRβ + /c-kit + pulp cells proliferated significantly faster than whole pulp cells. In mineralization media, PDGFRβ + /c-kit + pulp cells were able to develop under odontoblastic linage as demonstrated by a progressively increased expression of DMP1, DSPP, and osteocalcin. BMP2 seemed to enhance whereas PDGF-BB seemed to inhibit odontoblastic differentiation and mineralization of PDGFRβ + /c-kit + pulp cells. In vivo root canal transplantation study revealed globular dentin and pulp-like tissue formation by PDGFRβ + /c-kit + cells. PDGFRβ + /c-kit + pulp cells appear to have pulp stem cell potential capable of producing dentinal like structure in vitro and in vivo.

  11. Spontaneous splenic artery aneurysm rupture in a 38-year old female: a case report.

    Science.gov (United States)

    Koutserimpas, C; Papachristou, E; Nikitakis, N; Zannes, N; Tellos, A; Velimezis, G

    2017-01-01

    Splenic artery aneurysm (SAA) is a rare and extremely difficult diagnosis. A rare case of a ruptured SAA in a 38-year old female, firstly treated with endovascular embolization and then with splenectomy, is presented. A 38-year old female presented to the emergency department with epigastric pain and fainting episodes. Direct catheter angiography revealed a ruptured SAA and distal, as well as proximal coil embolization was performed. Due to abdominal compartment syndrome the patient underwent open surgery with splenic artery ligation and splenectomy. Postoperative she showed signs of sepsis and was treated with i.v. fluids, steroids, packed red blood cells, platelets, fresh frozen plasma and antimicrobial treatment. Additionally, a multidrug resistant Acinetobacter baumanni was yielded from the urine culture. She had a satisfactory recovery. She is followed up a total of 5 years with no signs of overwhelming post-splenectomy infection syndrome. Direct catheter angiography is a very helpful option in diagnosis, as well as treatment, but a close monitoring after embolization is essential. Furthermore, post-splenectomy sepsis is a severe disease with high mortality rates that requires immediate appropriate treatment.

  12. Imaging and transcatheter arterial embolization for traumatic splenic injuries: review of the literature.

    Science.gov (United States)

    Raikhlin, Antony; Baerlocher, Mark Otto; Asch, Murray R; Myers, Andy

    2008-12-01

    The spleen is the most commonly injured visceral organ in blunt abdominal trauma in both adults and children. Nonoperative management is the current standard of practice for patients who are hemodynamically stable. However, simple observation alone has been reported to have a failure rate as high as 34%; the rate is even higher among patients with high-grade splenic injuries (American Association for the Surgery of Trauma [AAST] grade III-V). Over the past decade, angiography with transcatheter splenic artery embolization, an alternative nonoperative treatment for splenic injuries, has increased splenic salvage rates to as high as 97%. With the help of splenic artery embolization, success rates of more than 80% have also been described for high-grade splenic injuries. We discuss the role of computed tomography and transcatheter splenic artery embolization in the diagnosis and treatment of blunt splenic trauma. We review technical considerations, indications, efficacy and complication rates. We also propose an algorithm to guide the use of angiography and splenic embolization in patients with traumatic splenic injury.

  13. Effect of radiopaque Portland cement on mineralization in human dental pulp cells.

    Science.gov (United States)

    Min, Kyung-San; Lee, Sang-Im; Lee, Yoon; Kim, Eun-Cheol

    2009-10-01

    The aim of this study was to investigate whether radiopaque Portland cement (RPC) facilitates the mineralization process in human dental pulp cells (HDPCs) compared with pure Portland cement (PC). Under a scanning electron microscope (SEM), cellular morphology was evaluated. Alkaline phosphatase (ALP) activity was analyzed, and nodule formation was assessed by performing Alizarin Red S staining. In addition, the mRNA expressions of mineralization-related proteins were evaluated by performing a real-time polymerase chain reaction. On SEM evaluation, healthy HDPCs were found adhering to the surfaces of PC and RPC. The ALP activity increased in the PC and RPC groups compared with the control group at 1 day. Alizarin Red stain increased in the PC and RPC groups compared with the control group at 2 and 3 weeks. The mRNA expression of dentin sialophosphoprotein increased at 14 days in the PC and RPC groups. These results show that PC and RPC have similar effects in terms of mineralization and suggest that RPC also has the potential to be used as a clinically suitable pulp-capping material.

  14. Splenic arteriovenous fistula treated with percutaneous transarterial embolization

    DEFF Research Database (Denmark)

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

    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...

  15. Embolization of a large, symptomatic splenic artery pseudoaneurysm

    International Nuclear Information System (INIS)

    Kukliński, Adam; Batycki, Krzysztof; Matuszewski, Wiesław; Ostrach, Andrzej; Kupis, Zbigniew; Łęgowik, Tomasz

    2014-01-01

    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

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

    International Nuclear Information System (INIS)

    Mubashar, M.

    1993-01-01

    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)

  17. Splenic conservation in children with splenic injury at Nnewi - South ...

    African Journals Online (AJOL)

    Hitherto, the mode of treatment has been towards resuscitation and splenectomy but over the past one and half decades, the trend moved to conserve. Objective: We therefore review the management of splenic injuries in children over the past ten years as well as highlight management problems. Patients and Methods: ...

  18. Splenic artery aneurysm rupture in pregnancy

    International Nuclear Information System (INIS)

    Khan, H.R.; Low, S.; Selinger, M.; Nelson, N.

    2004-01-01

    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)

  19. Melioidosis Presenting with Isolated Splenic Abscesses: A Case Report

    Directory of Open Access Journals (Sweden)

    Chun-Yu Lin

    2007-08-01

    Full Text Available Splenic abscesses caused by Burkholderia pseudomallei are rarely reported in Taiwan. Here we report a middle-aged man who presented with fever, chills, and general malaise for several days. Abdominal echo revealed isolated splenic abscesses and he received antibiotics treatment according to the initial blood culture result, Serratia marcescens. However, fever did not subside. Then he was referred to our hospital and meropenem was prescribed. Fever subsided 5 days after the beginning of meropenem administration. Repeated fine-needle aspiration of splenic abscesses drained out the pus, which was cultured as B. pseudomallei. He was finally diagnosed as a case of melioidosis based on microbiological evidence. Physicians must take melioidosis into consideration when splenic abscesses are encountered clinically.

  20. Nonoperative Management of Splenic Injury in Combat: 2002-2012

    Science.gov (United States)

    2015-03-01

    recognized as the defini- tive treatment for splenic injury when Dr. Johnston reported 150 splenectomies for trauma in 1908.4 However, in 1968, Upadhyaya...management safe and effective for all splenic blunt trauma ? A systematic review. Crit Care 2013; 17(5): R185. 6. Joint Theater Trauma System Clinical Practice...2014. 7. Zonies D, Eastridge B: Combat management of splenic injury: trends during a decade of conflict. J Trauma Acute Care Surg 2012; 73(2 Suppl 1

  1. Splenic Abscess: An Uncommon Entity with Potentially Life-Threatening Evolution

    Directory of Open Access Journals (Sweden)

    Mei-Chun Lee

    2018-01-01

    Full Text Available Background/Purpose. Splenic abscess is rare with potentially life-threatening evolution. The aim of this study is to review the clinical features, microbiological etiologies, treatment, and outcomes of patients with splenic abscess. Methods. We reviewed the admitted patients with suspected splenic abscess and made the diagnosis of splenic abscess. The clinical characteristics, underlying diseases, treatment course, organism spectra, abscess number and size, therapeutic methods, and clinical outcome at a tertiary medical center in Taiwan over a period of 5 years were analyzed. Results. Of 16 patients with splenic abscess, the male to female ratio was 1 : 1. Common presentations were fever (11 patients, 68.7%, diffuse abdominal pain (6 patients, 37.5%, left upper quadrant pain or tenderness (6 patients, 37.5%, and left-sided pleural effusions (8 patients, 50%. Antimicrobial therapy was administered in all patients. Fourteen (87.5% patients recovered under medical treatment. One (6.2% patient underwent splenectomy, four (25% patients performed percutaneous drainage of their splenic abscess, and 11 (68.7% patients received antimicrobial therapy alone. Conclusion. We noted that mortality may be more related to patients with underlying immunodeficiency. Patients with splenic abscesses receiving antimicrobial therapy alone were in a relatively high proportion and got a good prognosis especially in patients with small and multiple abscesses.

  2. Activated carbon prepared from coffee pulp: potential adsorbent of organic contaminants in aqueous solution.

    Science.gov (United States)

    Gonçalves, Maraisa; Guerreiro, Mário César; Ramos, Paulize Honorato; de Oliveira, Luiz Carlos Alves; Sapag, Karim

    2013-01-01

    The processing of coffee beans generates large amounts of solid and liquid residues. The solid residues (pulp, husk and parchment) represent a serious environmental problem and do not have an adequate disposal mechanism. In this work, activated carbons (ACs) for adsorption of organic compounds were prepared from coffee pulp by controlled temperature at different pulp/Na2HPO4 ratios (4:1, 2:1, 5:4 and 1:1). The N2 adsorption/desorption isotherms showed ACs with high quantities of mesopores and micropores and specific surface areas of 140, 150, 450 and 440 m(2)g(-1) for AC 4:1, AC 2:1, AC 5:4 and AC 1:1, respectively. The prepared material AC 5:4 showed a higher removal capacity of the organic contaminants methylene blue (MB), direct red (DR) and phenol than did a Merck AC. The maximum capacities for this AC are approximately 150, 120 and 120 mg g(-1) for MB, DR and phenol, respectively. Thus, a good adsorbent was obtained from coffee pulp, an abundant Brazilian residue.

  3. Scintigraphic assessment of ectopic splenic tissue localization and function following splenectomy for trauma

    Energy Technology Data Exchange (ETDEWEB)

    Zwas, S.T.; Samra, D.; Samra, Y.; Sibber, G.R.

    1986-07-01

    Twenty-three subjects who had a splenectomy as a result of trauma underwent scintigraphic evaluation with a sensitive heat-denatured sup(99m)Tc-labeled red blood cells (DRBC). This method enabled detection of ectopic splenic tissue foci (ESTF) as small as 1x1 cm in diameter. ESTF splenosis or accessory spleen was detected in 15 cases (65%), a higher incidence than previously reported. The size of the ESTF ranged from 1x1 to 5x10 cm (0.8-40 cm/sup 2/), and 53% were less than 2x2 cma (3 cm/sup 2/). A new multiparametric scintigraphic evaluating technique is described, which estimates the quantity of ESTF and its grade of activity, relative to that of the liver. The technique is a highly efficient assessor of ESTF function. Good correlation was found between the size and activity of the ESTF and the presence of Howell-Jolly bodies (HJB), but with a low sensitivity for detecting small ESTF. Correlation was low between residual splenic tissue and concentrations of IgM, IgA and IgG immunoglobulins. The sup(99m)Tc-DRBC method described is recommended for verification of ESTF existence, localization, and function.

  4. Scintigraphic assessment of ectopic splenic tissue localization and function following splenectomy for trauma

    International Nuclear Information System (INIS)

    Zwas, S.T.

    1986-01-01

    Twenty-three subjects who had a splenectomy as a result of trauma underwent scintigraphic evaluation with a sensitive heat-denatured sup(99m)Tc-labeled red blood cells (DRBC). This method enabled detection of ectopic splenic tissue foci (ESTF) as small as 1x1 cm in diameter. ESTF splenosis or accessory spleen was detected in 15 cases (65%), a higher incidence than previously reported. The size of the ESTF ranged from 1x1 to 5x10 cm (0.8-40 cm 2 ), and 53% were less than 2x2 cma (3 cm 2 ). A new multiparametric scintigraphic evaluating technique is described, which estimates the quantity of ESTF and its grade of activity, relative to that of the liver. The technique is a highly efficient assessor of ESTF function. Good correlation was found between the size and activity of the ESTF and the presence of Howell-Jolly bodies (HJB), but with a low sensitivity for detecting small ESTF. Correlation was low between residual splenic tissue and concentrations of IgM, IgA and IgG immunoglobulins. The sup(99m)Tc-DRBC method described is recommended for verification of ESTF existence, localization, and function. (orig.)

  5. Surgical management of splenic echinococcal disease

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    Meimarakis G

    2009-04-01

    Full Text Available Abstract Background Infection of the spleen with echinococcus is a rare clinical entity. Because the diagnosis of a splenic infestation with echinococcus is sometimes delayed, large hydatid cysts or pseudotumors may develop, demanding a differential surgical approach to cure the disease. Methods In a retrospective study 10 patients out of 250 with abdominal echinococcosis (4% were identified to have splenic infestation, either limited to the spleen (n = 4 or with synchronous involvement of the liver (n = 4, major omentum (n = 1, or the liver and lung (n = 1. Only one patient had alveolar echinococcosis whereas the others showed hydatid cysts of the spleen. Surgical therapy included splenectomy in 7 patients or partial cyst excision combined with omentoplasty in 3 patients. In case of liver involvement, pericystectomy was carried out simultaneously. Results There was no mortality. Postoperative complications were observed in 4 patients. Hospital stay and morbidity were not influenced when splenic procedures were combined with pericystectomies of the liver. Mean follow- up was 8.8 years and all of the patients are free of recurrence at this time. Conclusions Splenectomy should be the preferred treatment of hydatid cysts but partial cystectomy is suitable when the cysts are located at the margins of the spleen. Due to low morbidity rates, simultaneous treatment of splenic and liver hydatid cysts is recom mended.

  6. Effect of organosolv and soda pulping processes on the metals content of non-woody pulps.

    Science.gov (United States)

    González, M; Cantón, L; Rodríguez, A; Labidi, J

    2008-09-01

    In this work the effect of different pulping processes (ethyleneglycol, diethyleneglycol, ethanolamine and soda) of tow abounded raw materials (empty fruit bunches - EFB and rice straw) on the ash, silicates and metals (Fe, Zn, Cu, Pb, Mn, Ni and Cd) content of the obtained pulps have been studied. Results showed that pulps obtained by diethyleneglycol pulping process presented lower metals content (756 microg/g and 501 microg/g for EFB and rice straw pulp, respectively) than soda pulps (984 microg/g and 889 microg/g). Ethanolamine pulps presented values of holocellulose (74% and 77% for EFB and rice straw pulp, respectively), alpha-cellulose (74% and 69%), kappa number (18.7 and 18.5) and viscosity (612 and 90 6ml/g) similar to those of soda pulp, and lower lignin contents (11% and 12%).

  7. Complicated congenital splenic cyst: Saved by a splenunculus ...

    African Journals Online (AJOL)

    A 12-year-old girl presented with a large congenital splenic cyst complicated by Salmonella organisms. After failure of conservative management and percutaneous drainage, a splenectomy was performed. An incidental splenunculus was preserved. On follow up the splenunculus had increased to normal splenic size and ...

  8. Spontaneous resolution of splenic infarcts after distal splenorenal ...

    African Journals Online (AJOL)

    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 ...

  9. Splenic irradiation in chronic myeloid leukemia

    Energy Technology Data Exchange (ETDEWEB)

    Hukku, S.; Baboo, H.A.; Venkataratnam, S.; Vidyasagar, M.S.; Patel, N.L. (Department of Radiation Therapy, Gujarat Cancer Research Institute, Ahmedabad, India)

    1983-01-01

    Results of splenic irradiation as the initial and only method of treatment are reported in 25 patients with chronic myeloid leukemia. Peripheral remission was induced in all the patients. Induction was achieved after a short period of 11 to 30 days in the majority of the patients, the longest period being 40 days. Several patients were in remission 9 months after treatment. The results are compared with those obtained by chemotherapy. Some advantages of splenic irradiation over chemotherapy are emphasized.

  10. Magnetic resonance imaging of splenic iron overload

    International Nuclear Information System (INIS)

    Arrive, L.; Thurnher, S.; Hricak, H.; Price, D.C.

    1990-01-01

    The value of magnetic resonance (MR) imaging in assessing iron overload in the spleen was retrospectively investigated in 40 consecutive patients. MR appearance, mesaure of signal intensity and T1-and T2-relaxation times were correlated with the histologically determined level of iron in the spleen in each patient. Histologic examination revealed no iron overload in 19 patients, mild iron overload in seven, moderate iron overload in six, and severe iron overload in eight. All 19 patients with no splenic iron overload and 11 of the other 21 patients with splenic iron overload were correctly identified by MR imaging (sensitivity 52%, specificity 100%, accuracy 75%). Splenic iron overload was diagnosed when a decrease of signal intensity of the spleen compared with those of adipose tissue and renal cortex was demonstrated. MR images demonstrated all eight cases of severe, three of the six cases of moderate, and none of the seven cases of mild iron overload. Only spleens with severe iron overload had a significant mean decrease in signal intensity and T1- and T2-relaxation times. Although specific, MR imaging is poorly sensitive to splenic iron overload. (author). 15 refs.; 5 figs.; 3 tabs

  11. Blunt splenic trauma in children: are we too careful?

    Science.gov (United States)

    De Jong, W J J; Nellensteijn, D R; Ten Duis, H J; Albers, M J I J; Moumni, M El; Hulscher, J B F

    2011-08-01

    There has been a shift from operative treatment (OT) to non-operative treatment (NOT) of splenic injury. We evaluated the outcomes of treatment of pediatric patients with blunt splenic trauma in our hospital, with special focus on the outcomes after NOT. The data of all patients splenic injury admitted between 1988 and 2007 were retrospectively analyzed. Mechanism of injury, type of treatment, ICU stay, total hospital stay, morbidity and mortality were assessed. Patients suffering isolated splenic injuries were assessed separately from patients with multiple injuries. Patients were subsequently divided into those admitted before and after 2000. There were 64 patients: 49 males and 15 females with a mean age of 13 years (range 0-18). 3 patients died shortly after admission due to severe neurological injury and were excluded. In the remaining 61 patients concomitant injuries, present in 62%, included long bone fractures (36%), chest injuries (16%), abdominal injuries (33%) and head injuries (30%). Mechanisms of injury were: car accidents (26%), motorcycle (20%), bicycle (19%), fall from height (17%) and pedestrians struck by a moving vehicle (8%). A change in treatment strategy was evident for the pre- and post-2000 periods. Significantly more patients had NOT after 2000 in both the isolated splenic injury group and the multi-trauma group [4/11 (36%) before vs. 10/11 (91%) after (p=0.009); 15/19 (79%) before vs. 8/20 (40%) after 2000 (p=0.03)]. There was also a significant shift to spleen-preserving operations. All life-threatening complications occurred within trauma group. Splenic injury in children is associated with substantial mortality. This is due to concomitant injuries and not to the splenic injury. Non-operative treatment is increasingly preferred to operative procedures when treating splenic injuries in hemodynamically, stable children. ICU and hospital stay have, despite the change from OT to NOT, remained the same. Complications after NOT are rare. We

  12. Diagnostic problems with parasitic and non-parasitic splenic cysts

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    Adas Gokhan

    2009-05-01

    Full Text Available Abstract Background The splenic cysts constitute a very rare clinical entity. They may occur secondary to trauma or even being more seldom due to parasitic infestations, mainly caused by ecchinocccus granulosus. Literature lacks a defined concencus including the treatment plans and follow up strategies, nor long term results of the patients. In the current study, we aimed to evaluate the diagnosis, management of patients with parasitic and non-parasitic splenic cysts together with their long term follow up progresses. Methods Twenty-four patients with splenic cysts have undergone surgery in our department over the last 9 years. Data from eighteen of the twenty-four patients were collected prospectively, while data from six were retrospectively collected. All patients were assessed in terms of age, gender, hospital stay, preoperative diagnosis, additional disease, serology, ultrasonography, computed tomography (CT, cyst recurrences and treatment. Results In this study, the majority of patients presented with abdominal discomfort and palpable swelling in the left hypochondrium. All patients were operated on electively. The patients included 14 female and 10 male patients, with a mean age of 44.77 years (range 20–62. Splenic hydatid cysts were present in 16 patients, one of whom also had liver hydatid cysts (6.25%. Four other patients were operated on for a simple cyst (16% two patients for an epithelial cyst, and the last two for splenic lymphangioma. Of the 16 patients diagnosed as having splenic hydatit cysts, 11 (68.7% were correctly diagnosed. Only two of these patients were administered benzimidazole therapy pre-operatively because of the risk of multicystic disease The mean follow-up period was 64 months (6–108. There were no recurrences of splenic cysts. Conclusion Surgeons should keep in mind the possibility of a parasitic cyst when no definitive alternative diagnosis can be made. In the treatment of splenic hydatidosis, benzimidazole

  13. Evaluation of a value prior to pulping-thermomechanical pulp business concept. Part 2.

    Science.gov (United States)

    Ted Bilek; Carl Houtman; Peter Ince

    2011-01-01

    Value Prior to Pulping (VPP) is a novel biorefining concept for pulp mills that includes hydrolysis extraction of hemicellulose wood sugars and acetic acid from pulpwood prior to pulping. The concept involves conversion of wood sugars via fermentation to fuel ethanol or other chemicals and the use of remaining solid wood material in the pulping process. This paper...

  14. Thermal ablation for partial splenectomy hemostasis, spleen trauma, splenic metastasis and hypersplenism.

    Science.gov (United States)

    Duan, Ya-Qi; Liang, Ping

    2013-05-01

    Many studies have been conducted on splenic thermal ablation for partial splenectomy hemostasis, spleen trauma, splenic metastasis and hypersplenism. In this article, we review the evolution and current status of radiofrequency and microwave ablation in the treatment of spleen diseases. All publications from 1990 to 2011 on radiofrequency and microwave ablation for partial splenectomy hemostasis, spleen trauma, splenic metastasis and hypersplenism were retrieved by searching PubMed. Thermal ablation in the spleen for partial splenectomy hemostasis, spleen trauma, splenic metastasis and hypersplenism can preserve part of the spleen and maintain splenic immunologic function. Thermal ablation for assisting hemostasis in partial splenectomy minimizes blood loss during operation. Thermal ablation for spleen trauma reduces the number of splenectomy and the amount of blood transfusion. Thermal ablation for splenic metastasis is minimally invasive and can be done under the guidance of an ultrasound, which helps shorten the recovery time. Thermal ablation for hypersplenism increases platelet (PLT) and white blood cell (WBC) counts and improves liver function. It also helps to maintain splenic immunologic function and even improves splenic immunologic function in the short-term. In conclusion, thermal ablative approaches are promising for partial splenectomy hemostasis, spleen trauma, splenic metastasis and hypersplenism. In order to improve therapeutic effects, directions for future studies may include standardized therapeutic indications, prolonged observation periods and enlarged sample sizes.

  15. Radiologic viewpoint of splenic abscess

    International Nuclear Information System (INIS)

    Chang, Jae Chun; Jung, Kyung Hwa; Byun, Woo Mok; Kim, Sun Yong; Hwang, Mi Soo; Park, Bok Hwan

    1988-01-01

    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.

  16. Evaluation of a 15-year experience with splenic injuries in a state trauma system.

    Science.gov (United States)

    Harbrecht, Brian G; Zenati, Mazen S; Ochoa, Juan B; Puyana, Juan C; Alarcon, Louis H; Peitzman, Andrew B

    2007-02-01

    The management of splenic injuries has evolved with a greater emphasis on nonoperative management. Although several institutions have demonstrated that nonoperative management of splenic injuries can be performed with an increasing degree of success, the impact of this treatment shift on outcome for all patients with splenic injuries remains unknown. We hypothesized that outcomes for patients with splenic injuries have improved as the paradigm for splenic injury treatment has shifted. Consecutive patients from 1987 to 2001 with splenic injuries who were entered into a state trauma registry were reviewed. Demographic variables, injury characteristics, and outcome data were collected. The number of patients who were diagnosed with splenic injuries increased from 1987 through 2001, despite a stable number of institutions submitting data to the registry. The number of minor injuries and severe splenic injuries remained stable, and the number of moderately severe injuries significantly increased over time. Overall mortality rate improved but primarily reflected the decreased mortality rates of moderately severe injuries; the mortality rate for severe splenic injuries was unchanged. Trauma centers are seeing increasing numbers of splenic injuries that are less severe in magnitude, although the number of the most severe splenic injuries is stable. The increased proportion of patients with less severe splenic injuries who are being admitted to trauma centers is a significant factor in the increased use and success rate of nonoperative management.

  17. Splenic Infarct: A Rare Presentation in a Pediatric Patient

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    Palla Bhattarai

    2014-12-01

    Full Text Available A previously healthy 16-year-old male presented with a two day history of persistent epigastric pain. His physical examination was significant for tenderness in the left hypochondriac region with a palpable spleen 2cm below the left sub-costal margin. A CT scan of the abdomen showed a splenic infarct. Heterophile and EBV VCA IgM antibody test were positive. This is a rare case of infectious mononucleosis presenting with splenic infarct in an adolescent male without comorbidities. Keywords: infectious mononucleosis; splenic infarct.

  18. A comparison between red and infrared light for recording pulpal blood flow from human anterior teeth with a laser Doppler flow meter.

    Science.gov (United States)

    Kijsamanmith, Kanittha; Timpawat, Siriporn; Vongsavan, Noppakun; Matthews, Bruce

    2011-06-01

    To compare red (635 nm) and infrared (780 nm) light for recording pulpal blood flow from human anterior teeth with a laser Doppler flow meter. Recordings were made from 7 healthy teeth in 5 subjects (aged 22-55 years) using a laser Doppler flow meter (Periflux 4001) equipped with both red and infrared lasers. Average blood flow signals were obtained with both light sources alternately from each tooth under five conditions: intact tooth without opaque rubber dam, intact tooth with dam, after injecting local anaesthetic (3% Mepivacaine) (LA) over the apex of the tooth and cavity preparation to almost expose the pulp, after removal and replacement of the pulp, and with the root canal empty. With infrared light, because of technical limitations, data were obtained for the first three conditions only. The dam significantly decreased the mean blood flow by 82%. Injecting LA and cavity preparation had no significant effect. With red light, dam produced a decrease of 56%, and the resulting signal was reduced by 33% after LA and cavity preparation. The remaining signal fell by 46% after pulp removal and replacement. This contribution of the pulp is similar to that recorded previously with infrared light. There was no significant further change when the pulp was finally removed. The importance of using opaque rubber dam is confirmed. With dam, there is no advantage to using red rather than infrared light, and in each case the pulp contributes less than 50% to the blood flow signal. Copyright © 2011 Elsevier Ltd. All rights reserved.

  19. MANAGEMENT OF SPLENIC INJURY AFTER BLUNT INJURY TO ABDOMEN

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    J. Bharath Prakash Reddy

    2016-07-01

    Full Text Available BACKGROUND The spleen is an important organ in the body’s immune system. It is the most frequently injured organ in blunt abdominal trauma. 1 Over the past several decades, diagnosis and management of splenic trauma has been evolved. The conservative, operative approach has been challenged by several reports of successful non-operative management aided by the power of modern diagnostic imaging. The aim of our prospective study was to compare non-operative management with surgery for cases of splenic injury. METHODS We conducted a prospective study of patients admitted with blunt splenic injury to our regional hospital over a three-year period (2012-2015. Haemodynamic status upon admission, FAST examination, computed tomography 2 grade of splenic tear, presence and severity of associated injuries have been taken into account to determine the treatment of choice. Therapeutic options were classified into non-operative and splenectomy. RESULTS Over a 3-year period, 24 patients were admitted with blunt splenic injury. Sixteen patients were managed operatively and eight patients non-operatively. 3,4 Non-operative management failed in one patient due to continued bleeding. The majority of grades I, II, and III splenic injuries were managed non-operatively and grades IV and V were managed operatively. Blood transfusion requirement was significantly higher among the operative group, but the operative group had a significantly longer hospital stay. Among those managed non-operatively (median age 24.5 years, a number of patients were followed up with CT scans with significant radiation exposure and unknown longterm consequences. CONCLUSION In our experience, NOM is the treatment of choice for grade I, II and III blunt splenic injuries. Splenectomy was the chosen technique in patients who met exclusion criteria for NOM, as well as for patients with grade IV and V injury.

  20. [Isolated splenic metastases from cervical cancer: a rare entity].

    Science.gov (United States)

    Villalón-López, José Sebastián; Souto-del Bosque, Rosalía; Montañez-Lugo, Juan Ignacio; Chávez-González, Bruno

    2014-01-01

    Splenic metastases from solid tumors are a rare event with an incidence of only 2.9% to 9%. Splenic metastases from cervical cancer are a rare entity. Only a few cases have been reported of isolated spleen metastases from cervical cancer. We present the case of a 76-year-old woman with moderately differentiated endocervical adenocarcinoma stromal and endocervical invasion. Clinical stage was Ib1 and Ca-125 values of 150 U. She was managed with hysterectomy and pelvic lymphadenectomy. She received pelvic radiotherapy (45 Gy) followed 24 Gy of brachytherapy. Two years later she presented with abdominal pain. Abdominal computed tomography showed two splenic parenchymal lesions without disease in the remainder of the abdominal cavity and chest with a Ca-125 of 2,733 U. The patient is submitted to splenectomy. Histopathology demonstrates splenic metastases of well-differentiated adenocarcinoma from the endocervix. Immunohistochemical stain showed positivity from carcinoembryonic antigen; estrogen and progesterone receptors are negative. Ca-125 level 8 weeks after surgery was 16 U/ml. The patient received six cycles of adjuvant chemotherapy with paclitaxel and cisplatin. At 12 months follow-up the patient is alive and without evidence of tumor activity. The spleen is an uncommon site of metastasis. Splenectomy is considered the appropriate treatment in order to avoid complications such as splenic rupture and splenic vein thrombosis as well as to improve pain control from splenomegaly. Twelve months after surgery our patient is alive and without evidence of tumor activity.

  1. Recruitment of dental pulp cells by dentine and pulp extracellular matrix components.

    Science.gov (United States)

    Smith, J G; Smith, A J; Shelton, R M; Cooper, P R

    2012-11-01

    The present study aimed to determine whether dentine tissue and preparations of extracellular matrix (ECM) from pulp (pECM) and dentine (dECM), and breakdown products, influenced pulp cell migration. Chemotaxis transwell and agarose spot assays demonstrated that both dentine and pulp ECM molecules acted as chemoattractants for primary pulp cells. Chemoattractant activities of dECM and pECM were enhanced when subjected to acid and enzymatic breakdown, respectively. This enhanced activity following physiologically relevant breakdown may be pertinent to the disease environment. Pulp cell migration in response to dental ECMs was dependent on an active rho pathway. Recruited cells exhibited increased stem cell marker expression indicating that dental ECMs and their breakdown products selectively attract progenitor cells that contribute to repair processes. In conclusion, combined these results indicate that ECM molecules contribute to cell recruitment necessary for regeneration of the dentine-pulp complex after injury. Copyright © 2012 Elsevier Inc. All rights reserved.

  2. Radiation -adsorption treatment of pesticides by using wood pulp and bagasse pulp

    International Nuclear Information System (INIS)

    Abd El-Aal, S.E.; Sokker, S.S.; Dessooki, A.M.

    2005-01-01

    Alkaline pulping of pulp wood and bagasse using sodium hydroxide resulted in the reduction of lignin from the wood and bagasse fibers and consequently increase adsorption of the pesticide pollutants to these fibers. Three different types of pesticides were used in this study namely, metalaxyl, dicloran and arelon. which were irradiated at a dose of 4 kGy before adsorption treatment.The results show that moderate adsorption was observed for all pesticides when adsorption was carried out without alkaline pulping and irradiation. This is due to the presence of lignin which retard the adsorption process. Batch sorption experiments at different pH values (3, 7, 9) for the retention of these pesticides by pulp wood and pulp bagasse fibers indicated that sorption is governed by the interaction of the ionized form of these compounds with the polyhydroxyl structure of cellulose. The study shows that alkaline pulping of pulpwood and bagasse improves its ability towards adsorption of the radiation degraded pesticide molecules

  3. Morfologia e função fagocitária de implante esplênico autógeno regenerado em ratos Morphology and phagocytic function of regenerated autogenous splenic implant in rats

    Directory of Open Access Journals (Sweden)

    Ruy Garcia Marques

    2004-12-01

    autotransplantation in the greater omentum of slices of the whole mass of spleen. Sixteen weeks later animals were intravenously inoculated with a suspension of Escherichia coli AB1157, and twenty minutes later killed with lethal dose of halothane and submitted to laparotomy for splenic autotransplants retrieval. Data were analyzed statistically by de Student-t test, with emphasis on the comparison of the extent level of autotransplanted splenic mass regeneration between young and adult animals of both sexes. Results: There was regeneration of autotransplanted splenic tissue in all animals. Young males and adult females presented greater regeneration. A similar morphological aspect among all animals was observed, with splenic tissue showing red and white pulps with a moderate architectural disarrangement, as well as lymphoid follicles. Blood vessels showed preserved walls, with no signs of vasculitis or thrombosis. Macrophages containing bacterial aggregates were observed, as well as macrophages with hemosiderin pigments inside the cytoplasm. Conclusion: The present results suggest that splenic autotransplant in the greater omentum of the rat acquires the macro- and microscopic architecture of a normal spleen, with reduced dimensions, and preserves bacterial phagocyte function.

  4. Open splenectomy for Varicella zoster induced spontaneous splenic rupture

    Directory of Open Access Journals (Sweden)

    Mark Christopher Sykes

    2018-01-01

    Conclusion: Atraumatic splenic rupture should be considered as an important differential in those presenting with abdominal pain and peritonism without a history of preceding trauma. Haematological and infectious diagnoses should be sought to identify causation for the splenic rupture.

  5. Imaging of nontraumatic benign splenic lesions

    Energy Technology Data Exchange (ETDEWEB)

    Choi, Jin Young; Kim, Eun Kyung; Chung, Jae Joon; Kim, Myeong Jin; Lee, Jong Tae; Yoo, Hyung Sik; Kim, Seong Joon [Yonsei Univ. College of Medicine Research Institute of Radiological Science, Seoul (Korea, Republic of); Kim, Lu Ci A [Yonsei Univ. College of Medicine, Seoul (Korea, Republic of)

    1999-04-01

    The spleen is one of the largest organ in the reticuloendothelial system and plays an important role in the activation of immune response. It is the organ most commonly injured after blunt abdominal trauma, and malignant lesions such as lymphoma, or these due to metastasis, occur not infrequently. Even so, it is ignored even in abdominal ultrasonography. Some benign splenic lesions, however can cause severe symptoms and result in high mortality, and their accurate diagnosis is therefore essential. This study describes the imaging findings and histopathologic features of various nontraumatic benign splenic lesions.

  6. Imaging of nontraumatic benign splenic lesions

    International Nuclear Information System (INIS)

    Choi, Jin Young; Kim, Eun Kyung; Chung, Jae Joon; Kim, Myeong Jin; Lee, Jong Tae; Yoo, Hyung Sik; Kim, Seong Joon; Kim, Lu Ci A

    1999-01-01

    The spleen is one of the largest organ in the reticuloendothelial system and plays an important role in the activation of immune response. It is the organ most commonly injured after blunt abdominal trauma, and malignant lesions such as lymphoma, or these due to metastasis, occur not infrequently. Even so, it is ignored even in abdominal ultrasonography. Some benign splenic lesions, however can cause severe symptoms and result in high mortality, and their accurate diagnosis is therefore essential. This study describes the imaging findings and histopathologic features of various nontraumatic benign splenic lesions

  7. Integrated Bioethanol Fermentation/Anaerobic Digestion for Valorization of Sugar Beet Pulp

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    Joanna Berlowska

    2017-08-01

    Full Text Available Large amounts of waste biomass are generated in sugar factories from the processing of sugar beets. After diffusion with hot water to draw the sugar from the beet pieces, a wet material remains called pulp. In this study, waste sugar beet pulp biomass was enzymatically depolymerized, and the obtained hydrolyzates were subjected to fermentation processes. Bioethanol, biomethane, and biohydrogen were produced directly from the substrate or in combined mode. Stillage, a distillery by-product, was used as a feedstock for anaerobic digestion. During biosynthesis of ethanol, most of the carbohydrates released from the sugar beet pulp were utilized by a co-culture of Saccharomyces cerevisiae Ethanol Red, and Scheffersomyces stipitis LOCK0047 giving 12.6 g/L of ethanol. Stillage containing unfermented sugars (mainly arabinose, galactose and raffinose was found to be a good substrate for methane production (444 dm3 CH4/kg volatile solids (VS. Better results were achieved with this medium than with enzymatic saccharified biomass. Thermal pre-treatment and adjusting the pH of the inoculum resulted in higher hydrogen production. The largest (p < 0.05 hydrogen yield (252 dm3 H2/kg VS was achieved with sugar beet stillage (SBS. In contrast, without pre-treatment the same medium yielded 35 dm3 H2/kg VS. However, dark fermentation of biohydrogen was more efficient when sugar beet pulp hydrolyzate was used.

  8. Blunt splenic trauma: Assessment, management and outcomes.

    Science.gov (United States)

    El-Matbouly, Moamena; Jabbour, Gaby; El-Menyar, Ayman; Peralta, Ruben; Abdelrahman, Husham; Zarour, Ahmad; Al-Hassani, Ammar; Al-Thani, Hassan

    2016-02-01

    The approach for diagnosis and management of blunt splenic injury (BSI) has been considerably shifted towards non-operative management (NOM). We aimed to review the current practice for the evaluation, diagnosis and management of BSI. A traditional narrative literature review was carried out using PubMed, MEDLINE and Google scholar search engines. We used the keywords "Traumatic Splenic injury", "Blunt splenic trauma", "management" between December 1954 and November 2014. Most of the current guidelines support the NOM or minimally approaches in hemodynamically stable patients. Improvement in the diagnostic modalities guide the surgeons to decide the timely management pathway Though, there is an increasing shift from operative management (OM) to NOM of BSI; NOM of high grade injury is associated with a greater rate of failure, prolonged hospital stay, risk of delayed hemorrhage and transfusion-associated infections. Some cases with high grade BSI could be successfully treated conservatively, if clinically feasible, while some patients with lower grade injury might end-up with delayed splenic rupture. Therefore, the selection of treatment modalities for BSI should be governed by patient clinical presentation, surgeon's experience in addition to radiographic findings. About one-fourth of the blunt abdominal trauma accounted for BSI. A high index of clinical suspicion along with radiological diagnosis helps to identify and characterize splenic injuries with high accuracy and is useful for timely decision-making to choose between OM or NOM. Careful selection of NOM is associated with high success rate with a lower rate of morbidity and mortality. Copyright © 2015 Royal College of Surgeons of Edinburgh (Scottish charity number SC005317) and Royal College of Surgeons in Ireland. Published by Elsevier Ltd. All rights reserved.

  9. Management of pediatric splenic injuries in Canada.

    Science.gov (United States)

    McDonald, Lindsay A; Yanchar, Natalie L

    2012-03-01

    Nonoperative management (NOM) of blunt splenic injuries has become the standard of care in hemodynamically stable children. This study compares the management of these injuries between pediatric and nonpediatric hospitals in Canada. Data were obtained from the Canadian Institute of Health Information trauma database on all patients aged 2 to 16 years, admitted to a Canadian hospital with a diagnosis of splenic injury between May 2002 and April 2004. Variables included age, sex, associated major injuries, splenic procedures, intensive care unit (ICU) admissions, blood transfusions, and length of stay. Hospitals were coded as pediatric or nonpediatric. Univariate analysis and logistic regression were used to determine associations between hospital type and outcomes. Of 1284 cases, 654 were managed at pediatric hospitals and 630 at nonpediatric centers. Patients at pediatric centers tended to be younger and more likely to have associated major injuries. Controlling for covariates, including associated major injuries, patients managed at pediatric centers were less likely to undergo splenectomy compared with those managed at nonpediatric centers (odds ratio [OR], 0.2; 95% confidence interval, 0.1-0.4). The risk of receiving blood products, admission to the ICU, and staying in hospital for more than 5 days was associated only with having associated major injuries. Even in the presence of other major injuries, successful NOM of blunt splenic injuries occurs more frequently in pediatric hospitals in Canada. This has policy relevance regarding education of adult surgeons about the appropriateness of NOM in children and developing guidelines on appropriate regional triaging of pediatric patients with splenic injury in Canada. Copyright © 2012 Elsevier Inc. All rights reserved.

  10. Spontaneous occlusion of post-traumatic splenic pseudoaneurysm: report of two cases in children

    Energy Technology Data Exchange (ETDEWEB)

    Raghavan, Ashok; Wong, Christopher Kah Fook; Lam, Albert; Stockton, Vivienne [Department of Medical Imaging, The Children' s Hospital at Westmead, Sydney (Australia)

    2004-04-01

    Conservative therapy for splenic injuries is widely advocated. The advantages of conservative therapy for splenic injuries include the preservation of splenic immune function, prevention of overwhelming post-splenectomy sepsis, and avoidance of laparotomy and its associated early and late complications. Pseudoaneurysms of the splenic artery branch are encountered because of the prevalence of conservative management and widespread use of imaging techniques in the follow-up of these cases. We report two cases of post-traumatic splenic pseudoaneurysm in children which thrombosed spontaneously, one during the diagnostic angiogram examination and another on follow-up studies. (orig.)

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

    International Nuclear Information System (INIS)

    Choi, Jin Woo; Kim, Hyo-Cheol; Chung, Jin Wook; Kim, Ji Dae; Kim, Gyoung Min; Lee, In Joon; Jae, Hwan Jun; Park, Jae Hyung

    2012-01-01

    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.

  12. Splenic Trauma during Colonoscopy: The Role of Intra-Abdominal Adhesions

    OpenAIRE

    Chime, Chukwunonso; Ishak, Charbel; Kumar, Kishore; Kella, Venkata; Chilimuri, Sridhar

    2018-01-01

    Splenic rupture following colonoscopy is rare, first reported in 1974, with incidence of 1–21/100,000. It is critical to anticipate splenic trauma during colonoscopy as one of the causes of abdominal pain after colonoscopy especially when located in the left upper quadrant or left shoulder. Postoperative adhesions is a predisposing factor for splenic injury, and management is either operative or nonoperative, based on hemodynamic stability and/or extravasation which can be seen on contrast-en...

  13. Growth of Murine Splenic Tissue Is Suppressed by Lymphotoxin β-Receptor Signaling (LTβR) Originating from Splenic and Non-Splenic Tissues

    DEFF Research Database (Denmark)

    Milićević, Novica M; Nohroudi, Klaus; Schmidt, Friederike

    2016-01-01

    LTβR signaling. Two-dimensional differential gel electrophoresis and subsequent mass spectrometry of stromal splenic tissue was applied to screen for potential factors mediating the LTβR dependent suppressive activity. Thus, LTβR dependent growth suppression is involved in regulating the size...

  14. Gastric dilatation-volvulus after splenic torsion in two dogs.

    Science.gov (United States)

    Millis, D L; Nemzek, J; Riggs, C; Walshaw, R

    1995-08-01

    Two dogs developed gastric dilatation-volvulus 2 and 17 months, respectively, after splenectomy for treatment of splenic torsion. Splenic displacement and torsion may stretch the gastric ligaments, allowing increased mobility of the stomach. After splenectomy, an anatomic void may be created in the cranioventral part of the abdomen, contributing to the mobility of the stomach. Veterinarians treating dogs with isolated splenic torsion may wish to consider prophylactic gastropexy at splenectomy, to reduce the chance of future gastric dilatation-volvulus. Prophylactic gastropexy should be done only if the dog's hemodynamic status is stable enough to allow for performance of the additional surgery.

  15. Ultrasound-guided percutaneous core needle biopsy of splenic lesions

    Energy Technology Data Exchange (ETDEWEB)

    Park, SangIk; Shin, Yong Moon; Won, Hyung Jin; Kim, Pyo Nyun; Lee, Moon Gyu [Dept. of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul (Korea, Republic of)

    2017-05-15

    To evaluate the safety and efficacy of ultrasound-guided percutaneous core needle biopsy of splenic lesions. This retrospective study included 30 patients who underwent percutaneous core needle biopsy of their splenic lesions using 18- or 20-gauge needles between January 2001 and July 2016 in a single tertiary care center. The characteristics of the splenic lesions were determined by reviewing the ultrasound and computed tomography examinations. Acquisition rate and diagnostic accuracy were calculated, using pathologic results of the splenectomy specimen, clinical course and/or imaging follow-up as a reference standard. Post-procedure complications were identified from electronic medical records, laboratory findings and computed tomography images. Seventy-three specimens were obtained from the 30 patients and splenectomy was performed in 2 patients. Twenty-nine of the 30 patients had focal splenic lesions, while the remaining patient had homogeneous splenomegaly. Acquisition rate and diagnostic accuracy were 80.0% (24/30) and 76.7% (23/30), respectively. Perisplenic hemorrhage without hemodynamic instability developed in one patient. Ultrasound-guided percutaneous core needle biopsy of splenic lesions is a safe method for achieving a histopathologic diagnosis and can be considered as an alternative to splenectomy in patients with a high risk of splenectomy-related complications.

  16. Ultrasound-guided percutaneous core needle biopsy of splenic lesions

    International Nuclear Information System (INIS)

    Park, SangIk; Shin, Yong Moon; Won, Hyung Jin; Kim, Pyo Nyun; Lee, Moon Gyu

    2017-01-01

    To evaluate the safety and efficacy of ultrasound-guided percutaneous core needle biopsy of splenic lesions. This retrospective study included 30 patients who underwent percutaneous core needle biopsy of their splenic lesions using 18- or 20-gauge needles between January 2001 and July 2016 in a single tertiary care center. The characteristics of the splenic lesions were determined by reviewing the ultrasound and computed tomography examinations. Acquisition rate and diagnostic accuracy were calculated, using pathologic results of the splenectomy specimen, clinical course and/or imaging follow-up as a reference standard. Post-procedure complications were identified from electronic medical records, laboratory findings and computed tomography images. Seventy-three specimens were obtained from the 30 patients and splenectomy was performed in 2 patients. Twenty-nine of the 30 patients had focal splenic lesions, while the remaining patient had homogeneous splenomegaly. Acquisition rate and diagnostic accuracy were 80.0% (24/30) and 76.7% (23/30), respectively. Perisplenic hemorrhage without hemodynamic instability developed in one patient. Ultrasound-guided percutaneous core needle biopsy of splenic lesions is a safe method for achieving a histopathologic diagnosis and can be considered as an alternative to splenectomy in patients with a high risk of splenectomy-related complications

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

    International Nuclear Information System (INIS)

    Park, Si Kyun; Kim, Young Ju; Kwon, Taek Sang; Kim, Jong Jin; Ko, Sung Min; Sung, Ki Joon

    1998-01-01

    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 09m Tc-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

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

    Energy Technology Data Exchange (ETDEWEB)

    Park, Si Kyun; Kim, Young Ju; Kwon, Taek Sang; Kim, Jong Jin; Ko, Sung Min; Sung, Ki Joon [Yonsei University, Wonju (Korea, Republic of). Wonju Coll. of Medicine

    1998-06-01

    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 {sup 09m}Tc-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.

  19. EVALUATION OF LINERBOARD PROPERTIES FROM MALAYSIAN CULTIVATED KENAF SODA-ANTHRAQUINONE PULPS VERSUS COMMERCIAL PULPS

    Directory of Open Access Journals (Sweden)

    Ahmad Azizi Mossello

    2010-06-01

    Full Text Available Malaysian cultivated kenaf has been identified as a suitable raw material for linerboard production. This study examines the soda-antraquinone (soda-AQ pulp of kenaf fibers versus old corrugated container (OCC and unbleached softwood kraft pulps as the main sources for linerboard production. The results showed significant differences among the pulp properties. The unbleached kraft pulp with very high freeness required high beating to reach an optimized freeness and produced paper with the highest strength properties, except for tear resistance. The OCC gave paper with the lowest strength properties. In the case of kenaf fractions, bast pulp with high freeness needed less beating than softwood and produced paper with high tear resistance. Core fiber, which had the lowest freeness and highest drainage time, led to paper with high strength but very low tear resistance. Kenaf whole stem pulp showed intermediate properties between core and bast and close to those of unbleached softwood pulp, but with very lower beating requirement. Finally, kenaf whole stem, due to its strength properties, moderate separation cost, and simple pulping process, was judged to be more suitable for commercialization for linerboard production in Malaysia.

  20. Radionuclide diagnosis of splenic rupture in infectious mononucleosis

    International Nuclear Information System (INIS)

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

    1984-01-01

    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

  1. Effects of Soda-Anthraquinone Pulping Variables on the Durian Rind Pulp and Paper Characteristics: A Preliminary Test

    Science.gov (United States)

    Rizal Masrol, Shaiful; Irwan Ibrahim, Mohd Halim; Adnan, Sharmiza; Rahmad Talib, Mohd; Sian, Lau Lee

    2017-08-01

    Good combination of pulping variables is required to obtain the quality pulp and paper characteristics. Thus, in this preliminary work, naturally dried durian rind were pulped under Soda-Anthraquinone (Soda-AQ) pulping process with 18% to 22% alkali charge, 0% to 0.1% Anthraquinone (AQ) charge, 90 minutes to 150 minutes of cooking time and 150°C to 170°C to investigate the effect of pulping variables on the characteristics of the pulp and paper. Pulping condition with 0% of AQ charge was also conducted for comparison. Results indicated that the best screen yield percentage, reject yield percentage, freeness, drainage time, tear index, number of folds and optical properties were shown by the pulp produced with combination of the highest active alkali (22%), AQ charge (0.1%), cooking time (150 minutes) and cooking temperature (170°C) except apparent density, tensile index and burst index. This preliminary result shows that the optimum quality of durian rind pulp as a potential papermaking raw material pulp could be produced by selecting the good combination of pulping variables which influences the pulp and paper characteristics.

  2. Blunt Splenic Trauma in Children : Are We Too Careful?

    NARCIS (Netherlands)

    De Jong, W. J. J.; Nellensteijn, D. R.; ten Duis, H. J.; Albers, M. J. I. J.; El Moumni, M.; Hulscher, J. B. F.

    Introduction: There has been a shift from operative treatment (OT) to non-operative treatment (NOT) of splenic injury. We evaluated the outcomes of treatment of pediatric patients with blunt splenic trauma in our hospital, with special focus on the outcomes after NOT. Patients and Methods: The data

  3. Splenic injury after colonoscopy

    DEFF Research Database (Denmark)

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

    2008-01-01

    the colonoscopy, ranging from 4 hours to 7 days, before presenting with signs of splenic injury. In all cases the spleen was torn, and the amount of blood in the peritoneal cavity ranged from 1500 mL to 5000 mL. Two patients died postoperatively. The number of cases reported after 2000 indicates......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...... that this 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...

  4. Characterization of Coronal Pulp Cells and Radicular Pulp Cells in Human Teeth.

    Science.gov (United States)

    Honda, Masaki; Sato, Momoko; Toriumi, Taku

    2017-09-01

    Dental pulp has garnered much attention as an easily accessible postnatal tissue source of high-quality mesenchymal stem cells (MSCs). Since the discovery of dental pulp stem cells (DPSCs) in permanent third molars, stem cells from human exfoliated deciduous teeth and from supernumerary teeth (mesiodentes) have been identified as a population distinct from DPSCs. Dental pulp is divided into 2 parts based on the developing stage: the coronal pulp and the radicular pulp. Root formation begins after the crown part is completed. We performed a sequential study to examine the differences between the characteristics of coronal pulp cells (CPCs) and radicular pulp cells (RPCs) from permanent teeth, mesiodentes, and deciduous teeth. Interestingly, although we have not obtained any data on the difference between CPCs and RPCs in permanent teeth, there are some differences between the characteristics of CPCs and RPCs from mesiodentes and deciduous teeth. The MSC characteristics differed between the RPCs and CPCs, and the reprogramming efficiency for the generation of induced pluripotent stem cells was greater in RPCs than in CPCs from deciduous teeth. The proportion of CD105 + cells in CPCs versus that in RPCs varied in mesiodentes but not in permanent teeth. The results indicate that the proportion of CD105 + cells is an effective means of characterizing dental pulp cells in mesiodentes. Taken together, the stem cells in deciduous and supernumerary teeth share many characteristics, such as a high proliferation rate and an immunophenotype similar to that of DPSCs. Thus, mesiodentes accidentally encountered on radiographs by the general dental practitioner might be useful for stem cell therapy. Copyright © 2017 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

  5. A Case of Multiple Splenic Lymph angiomas Diagnosed by Percutaneous Needle Biopsy

    Energy Technology Data Exchange (ETDEWEB)

    Ki, Seung Seog; Jeong, Sook Hyang; Yoon, Chang Jin; Chang, Se Jung; Choi, Joon Hyuk; Ha, Ji Su; Kim, Soon Je [KEPCO Medical foundation Hanil General Hospital, Seoul (Korea, Republic of); Lee, Hye Seung [Seoul National University Bundang Hospital, Seongnam (Korea, Republic of)

    2007-06-15

    Lymphangioma of the spleen is an extremely rare disease in adults, and performing splenectomy has been considered necessary for its diagnosis and treatment, but the diagnosis of an isolated splenic mass lesion without performing splenectomy is a challenging problem. Herein, we report on a case of multiple splenic lymphangiomas that were found incidentally in a 56-year-old female; these lesions were diagnosed by percutaneous splenic biopsy without splenectomy. We suggest that this approach is a reasonable option for benign looking-appearing splenic tumors because splenectomy and its postsplenectomy complications can be avoided

  6. A Case of Multiple Splenic Lymph angiomas Diagnosed by Percutaneous Needle Biopsy

    International Nuclear Information System (INIS)

    Ki, Seung Seog; Jeong, Sook Hyang; Yoon, Chang Jin; Chang, Se Jung; Choi, Joon Hyuk; Ha, Ji Su; Kim, Soon Je; Lee, Hye Seung

    2007-01-01

    Lymphangioma of the spleen is an extremely rare disease in adults, and performing splenectomy has been considered necessary for its diagnosis and treatment, but the diagnosis of an isolated splenic mass lesion without performing splenectomy is a challenging problem. Herein, we report on a case of multiple splenic lymphangiomas that were found incidentally in a 56-year-old female; these lesions were diagnosed by percutaneous splenic biopsy without splenectomy. We suggest that this approach is a reasonable option for benign looking-appearing splenic tumors because splenectomy and its postsplenectomy complications can be avoided

  7. Bacterial clearance after total splenectomy and splenic autotransplantation in rats

    Energy Technology Data Exchange (ETDEWEB)

    Marques, R.G. E-mail: rmarques@uerj.br; Petroianu, Andy; Oliveira, M.B.N. de; Bernardo-Filho, M.; Boasquevisque, E.M.; Portela, M.C

    2002-12-01

    Wistar rats submitted to isolated total splenectomy or total splenectomy combined with splenic autotransplantation were inoculated with {sup 99m}technetium-labeled Escherichia coli. Measurement of isotope uptake in the organs of the mononuclear phagocytic system showed a greater bacterial bloodstream clearance in rats with splenic autotransplantation. Although uptake of bacteria in the spleen was higher in the control group, the number of bacteria remaining in the bloodstream did not differ between groups. These results indicate that splenic autotransplantation preserves the phagocytic function of the spleen.

  8. Bacterial clearance after total splenectomy and splenic autotransplantation in rats

    International Nuclear Information System (INIS)

    Marques, R.G.; Petroianu, Andy; Oliveira, M.B.N. de; Bernardo-Filho, M.; Boasquevisque, E.M.; Portela, M.C.

    2002-01-01

    Wistar rats submitted to isolated total splenectomy or total splenectomy combined with splenic autotransplantation were inoculated with 99m technetium-labeled Escherichia coli. Measurement of isotope uptake in the organs of the mononuclear phagocytic system showed a greater bacterial bloodstream clearance in rats with splenic autotransplantation. Although uptake of bacteria in the spleen was higher in the control group, the number of bacteria remaining in the bloodstream did not differ between groups. These results indicate that splenic autotransplantation preserves the phagocytic function of the spleen

  9. The Straightened Splenic Vessels Method Improves Surgical Outcomes of Laparoscopic Distal Pancreatectomy.

    Science.gov (United States)

    Nagakawa, Yuichi; Sahara, Yatsuka; Hosokawa, Yuichi; Takishita, Chie; Kasuya, Kazuhiko; Tsuchida, Akihiko

    2017-01-01

    In laparoscopic distal pancreatectomy (LDP), isolating the splenic artery and vein requires advanced techniques. This study aimed to assess the efficacy of a novel method termed the 'straightened splenic vessels' (SSV) method for isolating the splenic vessels in LDP. In SSV, to adjust the instrument axis, the splenic artery was straightened by grasping 2 points of its nerve sheath. Then, the layer between the splenic artery's nerve sheath and the pancreatic parenchyma was dissected. Next, the pancreas was mobilized from body to tail, and the splenic vein was straightened by 3-point retraction before isolation. To evaluate this method's efficacy, we investigated 51 patients who underwent LDP. In 39 patients who underwent LDP with splenectomy, the mean operating time was significantly shorter in the SSV group than in the conventional group (p = 0.004). In 12 patients who underwent LDP with preserving the splenic vessels, the mean intraoperative blood loss in the SSV group was 27.6 ml, which was significantly lower than that in the conventional group (p = 0.012). This method may be applied as a standard procedure with little blood loss and short operation time for LDP. Larger prospective studies are needed to further evaluate the feasibility. © 2017 S. Karger AG, Basel.

  10. FEASIBILITY OF THE CONSERVATIVE TREATMENT OF SPLENIC INJURIES IN BLUNT ABDOMINAL TRAUMA

    Directory of Open Access Journals (Sweden)

    M. M. Abakumov

    2013-01-01

    Full Text Available ABSTRACT. In blunt trauma, the structural features of the splenic parenchyma usually predispose to a significant intra-abdominal bleeding, so the excision of the damaged spleen is considered a main treatment technique in a majority of cases. However, a number of recent clinical studies have proved the necessity of a differentiated approach to making the treatment decisions and demonstrated the possibility of spleen salvage in certain cases.The most debatable issue is the management tactics in splenic injury associated with the formation of subcapsular hematoma. It is necessary to emphasize that the conservative treatment of such splenic injury implies a persisting risk of double-stage splenic rupture with following intra-abdominal bleeding.The Sklifosovsky Research Institute traditionally deals with injury management in all aspects and has gained a wide experience in splenic injury treatment that makes possible to demonstrate the choice of treatment tactics with regard to the splenic injury severity, and patient’s condition. A conservative management of spleen injury is reasonable only in stable patients and requires an additional use of instrumental diagnostic techniques. Morphological studies suggest that reparation processes around the splenic hematoma arise early enough and proceed, as a rule, with no signs of a purulent inflammation. 

  11. Splenic simulation by left hepatic lobe following splenectomy

    International Nuclear Information System (INIS)

    Noel, A.; Harbert, J.C.

    1984-01-01

    Remodeling of the liver following splenectomy may simulate hypertrophy of an accessory spleen on sulfur colloid scans. Two patients are reported. In one case splenic simulation is attributed to unusual hepatic scarring confirmed at autopsy. In the second the unusual configuration appears to have been caused by molding of the liver. The clinician should be aware of possible splenic simulation in postsplenectomy patients suspected of hypersplenism

  12. Splenic rupture in a neonate – a rare complication

    African Journals Online (AJOL)

    differential diagnosis of a hypovolaemic shocked infant with an abdominal mass. The symptoms of splenic rupture are ... A diagnosis of splenic rupture due to possible birth trauma was made. The mother admitted a month later ... parenchyma, e.g. erythroblastosis fetalis and congenital syphilis, as an enlarged spleen is more ...

  13. The pathologic splenic rupture of a patient with scrub typhus: a case report

    International Nuclear Information System (INIS)

    Kim, Kum Rae; Park, Won Kyu; Chang, Jay Chun; Cho, Jae Ho; Kim, Jae Woon; Hwang, Mi Soo; Park, Bok Hwan

    2008-01-01

    A pathologic splenic rupture is rare, occurring primarily in a spleen affected by infective, hematological, and neoplastic disease. To the best of our knowledge, no prior reports of a pathologic splenic rupture due to scrub typhus exist. Intrasplenic pseudoaneurysms and focal infarctions are visible on an initial CT scan. Moreover, the spontaneous splenic rupture occurred a week later. We report a case of nontraumatic-splenic rupture in a patient with scrub typhus

  14. The pathologic splenic rupture of a patient with scrub typhus: a case report

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Kum Rae; Park, Won Kyu; Chang, Jay Chun; Cho, Jae Ho; Kim, Jae Woon; Hwang, Mi Soo; Park, Bok Hwan [College of Medicine, Yeungnam University, Daegu (Korea, Republic of)

    2008-01-15

    A pathologic splenic rupture is rare, occurring primarily in a spleen affected by infective, hematological, and neoplastic disease. To the best of our knowledge, no prior reports of a pathologic splenic rupture due to scrub typhus exist. Intrasplenic pseudoaneurysms and focal infarctions are visible on an initial CT scan. Moreover, the spontaneous splenic rupture occurred a week later. We report a case of nontraumatic-splenic rupture in a patient with scrub typhus.

  15. EVALUATION OF LINERBOARD PROPERTIES FROM MALAYSIAN CULTIVATED KENAF SODA-ANTHRAQUINONE PULPS VERSUS COMMERCIAL PULPS

    OpenAIRE

    Ahmad Azizi Mossello; Jalaluddin Harun; Rushdan Ibrahim; Hossien Resalati; Seyed Rashid Fallah Shamsi; Paridah Md Tahir; Mohd Nor Mohad Yusoff

    2010-01-01

    Malaysian cultivated kenaf has been identified as a suitable raw material for linerboard production. This study examines the soda-antraquinone (soda-AQ) pulp of kenaf fibers versus old corrugated container (OCC) and unbleached softwood kraft pulps as the main sources for linerboard production. The results showed significant differences among the pulp properties. The unbleached kraft pulp with very high freeness required high beating to reach an optimized freeness and produced paper with the h...

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

    Energy Technology Data Exchange (ETDEWEB)

    Badrawi, H. S.; Razzak, M. A.; Guirgis, B. [Department of Medicine and Division of Nuclear Medicine, Faculty of Medicine, Cairo University, Cairo, United Arab Republic (Egypt)

    1971-02-15

    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 {sup 51}Cr-labelled erythrocytes heated at 50 Degree-Sign 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 (T{sub Vulgar-Fraction-One-Half} 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

  17. The reevaluation of plain roentgenological study in isolated splenic injury

    International Nuclear Information System (INIS)

    Kang, Seong Ihn; Ko, Seung Sook; Kim, Kil Jeong; Oh, Jae Hee; Kim, Young Chul

    1986-01-01

    The spleen is the most common intraabdominal organ injured in blunt trauma. Although physical signs and symptoms, coupled with abdominal paracentesis and peritoneal lavage confirm intraabdominal injury, but isolated splenic injury especially delayed rupture, the diagnosis and clinical course is variable. We are reevaluation of plain roentgenologic findings for the light of early diagnosis of isolated splenic injury. 24 patients of the autopsy and surgically proven isolated splenic injury at Chosun University Hospital in the period from 1980 January to 1986 June were analyzed plain roentgenogram retrospectively. The results were as follows: 1. Male patients predominate, constitution 87.5%. Incidence has been greatest in second to fourth decade. 2. Mode of trauma causing isolated splenic injury is most common in motor vehicle accident and others are fall down, struck by fist, blow to object, uncertain blunt trauma. 3. Delayed rupture of spleen occurred in 2 cases (8.3%). 4. Common patterns of splenic injury is simple laceration that involves both the capsule and the parenchyma and a laceration that involves the splenic pedicle. 5. Plain chest roentgenographic findings were abnormal in 4 cases (16.7%). The most common plain abdominal roentgenographic findings was the evidence of intaabdominal fluid in 21 cases (87.5%). The others are included in order of frequency; gastric dilatation, prominent mucosal folds on greater curvature of the stomach, evidence of pelvic fluid, displacement of stomach to the right or downward, mass density in the region of spleen. 6. No relationship can be shown between patterns of injury, time lapse after trauma and plain roentgenological findings. But the evidence of intraabdominal fluid is most important in the light of early diagnosis. 7. Diagnosis of splenic injury may be most helpful that in combination with clinical history, clinical symptoms and signs and plain film findings. In delayed rupture, diagnostic value of serial examination

  18. The reevaluation of plain roentgenological study in isolated splenic injury

    Energy Technology Data Exchange (ETDEWEB)

    Kang, Seong Ihn; Ko, Seung Sook; Kim, Kil Jeong; Oh, Jae Hee; Kim, Young Chul [Chosun University College of Medicine, Gwangju (Korea, Republic of)

    1986-10-15

    The spleen is the most common intraabdominal organ injured in blunt trauma. Although physical signs and symptoms, coupled with abdominal paracentesis and peritoneal lavage confirm intraabdominal injury, but isolated splenic injury especially delayed rupture, the diagnosis and clinical course is variable. We are reevaluation of plain roentgenologic findings for the light of early diagnosis of isolated splenic injury. 24 patients of the autopsy and surgically proven isolated splenic injury at Chosun University Hospital in the period from 1980 January to 1986 June were analyzed plain roentgenogram retrospectively. The results were as follows: 1. Male patients predominate, constitution 87.5%. Incidence has been greatest in second to fourth decade. 2. Mode of trauma causing isolated splenic injury is most common in motor vehicle accident and others are fall down, struck by fist, blow to object, uncertain blunt trauma. 3. Delayed rupture of spleen occurred in 2 cases (8.3%). 4. Common patterns of splenic injury is simple laceration that involves both the capsule and the parenchyma and a laceration that involves the splenic pedicle. 5. Plain chest roentgenographic findings were abnormal in 4 cases (16.7%). The most common plain abdominal roentgenographic findings was the evidence of intaabdominal fluid in 21 cases (87.5%). The others are included in order of frequency; gastric dilatation, prominent mucosal folds on greater curvature of the stomach, evidence of pelvic fluid, displacement of stomach to the right or downward, mass density in the region of spleen. 6. No relationship can be shown between patterns of injury, time lapse after trauma and plain roentgenological findings. But the evidence of intraabdominal fluid is most important in the light of early diagnosis. 7. Diagnosis of splenic injury may be most helpful that in combination with clinical history, clinical symptoms and signs and plain film findings. In delayed rupture, diagnostic value of serial examination

  19. Prune belly syndrome, splenic torsion, and malrotation: a case report.

    Science.gov (United States)

    Tran, Sifrance; Grossman, Eric; Barsness, Katherine A

    2013-02-01

    An 18 year old male with a history of prune belly syndrome (PBS) presented with acute abdominal pain and palpable left upper quadrant mass. Computed tomography (CT) of the abdomen revealed a medialized spleen with a "whirl sign" in the splenic vessels, consistent with splenic torsion. Coincidentally, the small bowel was also noted to be on the right side of the abdomen, while the colon was located on the left, indicative of malrotation. Emergent diagnostic laparoscopy confirmed splenic torsion and intestinal malrotation. Successful laparoscopic reduction of the splenic torsion was achieved, however, conversion to an open procedure by a vertical midline incision was necessary owing to the patient's unique anatomy. Open splenopexy with a mesh sling and Ladd's procedure were subsequently performed. Malrotation and wandering spleen are known, rare associated anomalies in PBS; however, both have not been reported concurrently in a patient with PBS in the literature. In patients with PBS, acute abdominal pain, and an abdominal mass, high clinical suspicion for gastrointestinal malformations and prompt attention can result in spleen preservation and appropriate malrotation management. We present a case of a teenager who presented with a history of PBS, acute abdominal pain, and a palpable abdominal mass. The patient was found to have splenic torsion and intestinal malrotation. The clinical findings, diagnostic imaging, and surgical treatment options of splenic torsion are reviewed. Copyright © 2013 Elsevier Inc. All rights reserved.

  20. US and CT findings in splenic focal lesions in AIDS

    International Nuclear Information System (INIS)

    Schinina, V.; Rizzi, E.B.; Mazzuoli, G.; Bibbolilno, C.; David, V.

    2000-01-01

    To evaluate the role of US and CT in focal splenic lesions in AIDS patients in relation to etiology. Material and Methods: A total of 66 patients with AIDS and focal splenic lesions were examined with sonography. CT with administration of contrast medium was performed in 12 cases. Results: Of the focal splenic lesions, 67% were correlated with an infective pathology with prevalence of Mycobacteria tuberculosis (75%), 26% were neoplastic and 6% splenic infarcts. The lesions were hypoechoic in 60% of the cases, while 10% were hypoanechoic and 1% anechoic. At CT, all lesions appeared hypodense, even after i.v. administration of contrast medium. Conclusion: The combination of echographic reports and clinical and laboratory data allows for a diagnosis that can be confirmed, and making a decision for effective therapy of AIDS is possible. CT does not provide any additional information

  1. Syncope as the Presenting Feature of Splenic Rupture after Colonoscopy

    Directory of Open Access Journals (Sweden)

    Daniel Jamorabo

    2014-01-01

    Full Text Available Splenic rupture is a rare, catastrophic complication of colonoscopy and an exceptional cause of syncope. This injury is believed to be from direct trauma or tension on the splenocolic ligament with subsequent capsule avulsion or else from direct instrument-induced splenic injury. Diagnosis requires a high index of suspicion that may be absent because presentation can be subtle, nonspecific, and delayed anywhere from hours to days and therefore not easily attributed to a recent endoscopy. We describe a case of syncope as the initial manifestation of splenic rupture after colonoscopy. Our patient’s pain was delayed; his discomfort was mild and not localized to the left upper quadrant. Clinicians should consider syncope, lightheadedness, and drop in hemoglobin in absence of rectal bleeding following a colonoscopy as possible warning signs of imminent or emergent splenic injury.

  2. Pleural effusion following blunt splenic injury in the pediatric trauma population.

    Science.gov (United States)

    Kulaylat, Afif N; Engbrecht, Brett W; Pinzon-Guzman, Carolina; Albaugh, Vance L; Rzucidlo, Susan E; Schubart, Jane R; Cilley, Robert E

    2014-09-01

    Pleural effusion is a potential complication following blunt splenic injury. The incidence, risk factors, and clinical management are not well described in children. Ten-year retrospective review (January 2000-December 2010) of an institutional pediatric trauma registry identified 318 children with blunt splenic injury. Of 274 evaluable nonoperatively managed pediatric blunt splenic injures, 12 patients (4.4%) developed left-sided pleural effusions. Seven (58%) of 12 patients required left-sided tube thoracostomy for worsening pleural effusion and respiratory insufficiency. Median time from injury to diagnosis of pleural effusion was 1.5days. Median time from diagnosis to tube thoracostomy was 2days. Median length of stay was 4days for those without and 7.5days for those with pleural effusions (psplenic injury (IV-V) (OR 16.5, p=0.001) was associated with higher odds of developing a pleural effusion compared to low-grade splenic injury (I-III). Pleural effusion following pediatric blunt splenic injury has an incidence of 4.4% and is associated with high-grade splenic injuries and longer lengths of stay. While some symptomatic patients may be successfully managed medically, many require tube thoracostomy for progressive respiratory symptoms. Copyright © 2014 Elsevier Inc. All rights reserved.

  3. Endovascular treatment of splenic artery aneurysms

    International Nuclear Information System (INIS)

    Lagana, Domenico; Carrafiello, Gianpaolo; Mangini, Monica; Fontana, Federico; Dizonno, Massimiliano; Fugazzola, Carlo; Castelli, Patrizio

    2005-01-01

    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

  4. In vitro optical detection of simulated blood pulse in a human tooth pulp model.

    Science.gov (United States)

    Niklas, A; Hiller, K-A; Jaeger, A; Brandt, M; Putzger, J; Ermer, C; Schulz, I; Monkman, G; Giglberger, S; Hirmer, M; Danilov, S; Ganichev, S; Schmalz, G

    2014-01-01

    Noninvasive optical methods such as photoplethysmography, established for blood pulse detection in organs, have been proposed for vitality testing of human dental pulp. However, no information is available on the mechanism of action in a closed pulp chamber and on the impairing influence of other than pulpal blood flow sources. Therefore, the aim of the present in vitro study was to develop a device for the optical detection of pulpal blood pulse and to investigate the influence of different parameters (including gingival blood flow [GBF] simulation) on the derived signals. Air, Millipore water, human erythrocyte suspensions (HES), non-particulate hemoglobin suspension (NPHS), and lysed hemoglobin suspension (LHES) were pulsed through a flexible (silicone) or a rigid (glass) tube placed within an extracted human molar in a tooth-gingiva model. HES was additionally pulsed through a rigid tube around the tooth, simulating GBF alone or combined with the flow through the tooth by two separate peristaltic pumps. Light from high-power light-emitting diodes (625 nm (red) and 940 nm (infrared [IR]); Golden Dragon, Osram, Germany) was introduced to the coronal/buccal part of the tooth, and the signal amplitude [∆U, in volts] of transmitted light was detected by a sensor at the opposite side of the tooth. Signal processing was carried out by means of a newly developed blood pulse detector. Finally, experiments were repeated with the application of rubber dam (blue, purple, pink, and black), aluminum foil, and black antistatic plastic foil. Nonparametric statistical analysis was applied (n = 5; α = 0.05). Signals were obtained for HES and LHES, but not with air, Millipore water, or NPHS. Using a flexible tube, signals for HES were higher for IR compared to red light, whereas for the rigid tube, the signals were significantly higher for red light than for IR. In general, significantly less signal amplitude was recorded for HES with the rigid glass tube than with the

  5. Changing patterns in the management of splenic trauma: the impact of nonoperative management.

    Science.gov (United States)

    Pachter, H L; Guth, A A; Hofstetter, S R; Spencer, F C

    1998-01-01

    OBJECTIVE: The recognition that splenectomy renders patients susceptible to lifelong risks of septic complications has led to routine attempts at splenic conservation after trauma. In 1990, the authors reported that over an 11-year study period involving 193 patients, splenorrhaphy was the most common splenic salvage method (66% overall) noted, with nonoperative management employed in only 13% of blunt splenic injuries. This report describes changing patterns of therapy in 190 consecutive patients with splenic injuries seen during a subsequent 6-year period (1990 to 1996). An algorithmic approach for patient management and pitfalls to be avoided to ensure safe nonoperative management are detailed. METHODS: Nonoperative management criteria included hemodynamic stability and computed tomographic examination without shattered spleen or other injuries requiring celiotomy. RESULTS: Of 190 consecutive patients, 102 (54%) were managed nonoperatively: 96 (65%) of 147 patients with blunt splenic injuries, which included 15 patients with intrinsic splenic pathology, and 6 hemodynamically stable patients with isolated stab wounds (24% of all splenic stab wounds). Fifty-six patients underwent splenectomy (29%) and 32 splenorrhaphy (17%). The mean transfusion requirement was 6 units for splenectomy survivors and 0.8 units for nonoperative therapy (85% received no transfusions). Fifteen of the 16 major infectious complications that occurred followed splenectomy. Two patients failed nonoperative therapy (2%) and underwent splenectomy, and one patient required splenectomy after partial splenic resection. There no missed enteric injuries in patients managed nonoperatively. The overall mortality rate was 5.2%, with no deaths following nonoperative management. CONCLUSIONS: Nonoperative management of blunt splenic injuries has replaced splenorrhaphy as the most common method of splenic conservation. The criteria have been extended to include patients previously excluded from this form

  6. Optimization of pulping conditions of abaca. An alternative raw material for producing cellulose pulp.

    Science.gov (United States)

    Jiménez, L; Ramos, E; Rodríguez, A; De la Torre, M J; Ferrer, J L

    2005-06-01

    The influence of temperature (150-170 degrees C), pulping time (15-45 min) and soda concentration (5-10%) in the pulping of abaca on the yield, kappa, viscosity, breaking length, stretch and tear index of pulp and paper sheets, was studied. Using a factorial design to identify the optimum operating conditions, equations relating the dependent variables to the operational variables of the pulping process were derived that reproduced the former with errors lower than 25%. Using a high temperature, and a medium time and soda concentration, led to pulp that was difficult to bleach (kappa 28.34) but provided acceptable strength-related properties (breaking length 4728 m; stretch 4.76%; tear index 18.25 mN m2/g), with good yield (77.33%) and potential savings on capital equipment costs. Obtaining pulp amenable to bleaching would entail using more drastic conditions than those employed in this work.

  7. Potential of hot water extraction of birch wood to produce high-purity dissolving pulp after alkaline pulping.

    Science.gov (United States)

    Borrega, Marc; Tolonen, Lasse K; Bardot, Fanny; Testova, Lidia; Sixta, Herbert

    2013-05-01

    The potential of hot water extraction of birch wood to produce highly purified dissolving pulp in a subsequent soda-anthraquinone pulping process was evaluated. After intermediate extraction intensities, pulps with low xylan content (3-5%) and high cellulose yield were successfully produced. Increasing extraction intensity further decreased the xylan content in pulp. However, below a xylan content of 3%, the cellulose yield dramatically decreased. This is believed to be due to cleavage of glycosidic bonds in cellulose during severe hot water extractions, followed by peeling reactions during alkaline pulping. Addition of sodium borohydride as well as increased anthraquinone concentration in the pulping liquor increased the cellulose yield, but had no clear effects on pulp purity and viscosity. The low intrinsic viscosity of pulps produced after severe extraction intensities and soda-anthraquinone pulping corresponded to the viscosity at the leveling-off degree of polymerization, suggesting that nearly all amorphous cellulose had been degraded. Copyright © 2012 Elsevier Ltd. All rights reserved.

  8. Clinical study on embolization syndromes after splenic arterial embolization

    International Nuclear Information System (INIS)

    Liu Minhua; Zhou Rumin

    2004-01-01

    Objective: To analyze the reaction of splenic arterial embolization (embolization syndromes) using 3 different materials together with the therapeutic methods. Methods: Thirty nine patients of cirrhosis with hypersplenism and hypersplenotrophy, 11 of them were treated with steel coils, 15 with gelfoam, 13 with the PVA. The embolized area was approximately 60% of the whole splenic area. Results: Thirty nine cases obtained the curative effect. The blood white cell and platelet counts were normal or close to normal. The rates of splenic pain in steel coils group, gelfoam group and PVA group were 81.8%, 100% and 100% respectively. The duration of serious pain were 2-5 d, 1-7 d and 1-7 d in coil group, gelfoam group and PVA group respectively. 33 patients had moderate fever around 38.5 degree C and 8 patients had eructation after embolization. The symptoms disappeared after using antibiotics, dexamethasone and analgesic. Conclusions: The algetic grade of splenic arterial embolization was inverse proportional with the size of embolus. The correct management could effectively control the symptoms of postembolization of the spleen

  9. Enzymatic pulp upgrade for producing high-value cellulose out of a Kraft paper pulp.

    Science.gov (United States)

    Hutterer, Christian; Kliba, Gerhard; Punz, Manuel; Fackler, Karin; Potthast, Antje

    2017-07-01

    The high-yield separation of polymeric parts from wood-derived lignocellulosic material is indispensable in biorefinery concepts. For the separation of cellulose and xylan from hardwood paper pulps to obtain pulps of high cellulose contents, simple alkaline extractions were found to be the most suitable technology, although having certain limitations. These are embodied by residual alkali resistant xylan incorporated in the pulp matrix. Further purification in order to produce pure cellulose with a low uniformity could be achieved selectively degrading residual xylan and depolymerizing the cellulose macromolecules by xylanase and cellulase. The latter help to adjust cellulose chain lengths for certain dissolving pulp grades while reducing the demand for ozone in subsequent TCF bleaching. Experiments applying different commercially available enzyme preparations revealed the dependency of xylanase performance on the residual xylan content in pulps being stimulated by additional cellulase usage. The action of the latter strongly depends on the cellulose allomorphy confirming the impact of the pulp morphology. Hence, the combined application of both types of enzymes offers a high potential for upgrading pulps in order to produce a pure and high-value cellulose product. Copyright © 2017 Elsevier Inc. All rights reserved.

  10. Preliminary experimental study on splenic hemodynamics of radiofrequency ablation for the spleen.

    Science.gov (United States)

    Baba, Yasutaka; Hayashi, Sadao; Nagasato, Kohei; Higashi, Michiyo; Yoshiura, Takashi

    2017-08-01

    To test the splenic blood flow change after radiofrequency ablation (RFA) of the spleen in a porcine experimental model. Six pigs underwent RFA of the spleen via laparotomy. During the procedure of RFA, clamping of splenic artery (one) and both splenic artery/vein (one) was also performed. Measurement of blood flow of both splenic artery (SA) and splenic vein (SV) with flow-wire at pre- and post-RFA of the spleen was also performed. Ablated splenic lesions were created as estimating ∼50% area of the spleen in all pigs. Resected specimens reveal not only the coagulated necrosis but also the congestion of the spleen. On the SA hemodynamics, maximum peak velocity (MPV) changed from 37 ± 7 to 24 ± 8 cm/s (normal), 11 to 10 cm/s (clamp of the SA), and 12 to 7.5 cm/s (clamp of both SA/SV), respectively. On the SV hemodynamic, MPV changed from 15 ± 5 to 13 ± 4 cm/s (normal), 17 to 15 cm/s (clamp of the SA), and 17 to 26 cm/s (clamp of both SA/SV), respectively. RFA of the spleen could induce coagulation necrosis and reduce the splenic arterial blood flow.

  11. A Case of Ruptured Splenic Artery Aneurysm in Pregnancy

    Directory of Open Access Journals (Sweden)

    Elizabeth K. Corey

    2014-01-01

    Full Text Available Background. Rupture of a splenic artery aneurysm is rare complication of pregnancy that is associated with a significant maternal and fetal mortality. Case. A multiparous female presented in the third trimester with hypotension, tachycardia, and altered mental status. A ruptured splenic artery aneurysm was discovered at the time of laparotomy and cesarean delivery. The patient made a full recovery following resection of the aneurysm. The neonate survived but suffered severe neurologic impairment. Conclusion. The diagnosis of ruptured splenic artery aneurysm should be considered in a pregnant woman presenting with signs of intra-abdominal hemorrhage. Early intervention by a multidisciplinary surgical team is key to preserving the life of the mother and fetus.

  12. Wood-plastic composites using thermomechanical pulp made from oxalic acid-pretreated red pine chips

    Science.gov (United States)

    J.E. Winandy; N.M. Stark; E. Horn

    2008-01-01

    The characteristics and properties of wood fiber is one of many factors of critical importance to the performance of wood-plastic composites. In commercial thermo-mechanical pulping (TMP) of wood chips to produce fibers, high temperatures (>100°C) are used to separate the fibers during TMP refining. These mechanical pressures and temperatures are usually modulated...

  13. CT diagnosis of splenic infarction in blunt trauma: imaging features, clinical significance and complications

    International Nuclear Information System (INIS)

    Miller, L.A.; Mirvis, S.E.; Shanmuganathan, K.; Ohson, A.S.

    2004-01-01

    AIM: The object of this study is to describe the appearance, complications, and outcome of segmental splenic infarctions occurring after blunt trauma using computed tomography (CT). MATERIALS AND METHODS: Thirteen blunt trauma patients were identified with splenic infarction on contrast-enhanced CT. CT images were retrospectively reviewed and the percentage of infarcted splenic tissue and presence of splenic injury separate from the site of infarction were identified. Splenic angiograms were reviewed and follow-up CT images were assessed for interval change in the appearance of the infarcts. RESULTS: The mean age of patients was 32 years and the most common mechanism of injury was road traffic accident. The majority (54%) had 25-50% infarction of the spleen. Splenic angiograms were performed in nine patients and seven demonstrated wedge-shaped regions of decreased perfusion corresponding to the infarction seen on CT with no need for intervention. Eleven patients underwent a follow-up CT that demonstrated the following: no significant change in six, near-complete resolution in two, delayed appearance of infarction in one, abscess formation in one, and delayed splenic rupture in one. CONCLUSION: Segmental splenic infarction is a rare manifestation of blunt splenic trauma. The diagnosis is readily made using contrast-enhanced CT. The majority will decrease in size on follow-up CT and resolve without clinical sequelae. Resolution of infarction is also seen and these cases are best described as temporary perfusion defects. Splenic abscess or delayed rupture are uncommon complications that may necessitate angiographic or surgical intervention

  14. CT diagnosis of splenic infarction in blunt trauma: imaging features, clinical significance and complications

    Energy Technology Data Exchange (ETDEWEB)

    Miller, L.A.; Mirvis, S.E.; Shanmuganathan, K.; Ohson, A.S. E-mail: lmiller@um.edu

    2004-04-01

    AIM: The object of this study is to describe the appearance, complications, and outcome of segmental splenic infarctions occurring after blunt trauma using computed tomography (CT). MATERIALS AND METHODS: Thirteen blunt trauma patients were identified with splenic infarction on contrast-enhanced CT. CT images were retrospectively reviewed and the percentage of infarcted splenic tissue and presence of splenic injury separate from the site of infarction were identified. Splenic angiograms were reviewed and follow-up CT images were assessed for interval change in the appearance of the infarcts. RESULTS: The mean age of patients was 32 years and the most common mechanism of injury was road traffic accident. The majority (54%) had 25-50% infarction of the spleen. Splenic angiograms were performed in nine patients and seven demonstrated wedge-shaped regions of decreased perfusion corresponding to the infarction seen on CT with no need for intervention. Eleven patients underwent a follow-up CT that demonstrated the following: no significant change in six, near-complete resolution in two, delayed appearance of infarction in one, abscess formation in one, and delayed splenic rupture in one. CONCLUSION: Segmental splenic infarction is a rare manifestation of blunt splenic trauma. The diagnosis is readily made using contrast-enhanced CT. The majority will decrease in size on follow-up CT and resolve without clinical sequelae. Resolution of infarction is also seen and these cases are best described as temporary perfusion defects. Splenic abscess or delayed rupture are uncommon complications that may necessitate angiographic or surgical intervention.

  15. [Associated factors to non-operative management failure of hepatic and splenic lesions secondary to blunt abdominal trauma in children].

    Science.gov (United States)

    Echavarria Medina, Adriana; Morales Uribe, Carlos Hernando; Echavarria R, Luis Guillermo; Vélez Marín, Viviana María; Martínez Montoya, Jorge Alberto; Aguillón, David Fernando

    2017-01-01

    The non operative management (NOM) is the standard management of splenic and liver blunt trauma in pediatric patients.Hemodynamic instability and massive transfusions have been identified as management failures. Few studies evaluate whether there exist factors allowing anticipation of these events. The objective was to identify factors associated with the failure of NOM in splenic and liver injuries for blunt abdominal trauma. Retrospective analysis between 2007-2015 of patients admitted to the pediatric surgery at University Hospital Saint Vincent Foundation with liver trauma and/or closed Spleen. 70 patients were admitted with blunt abdominal trauma, 3 were excluded for immediate surgery (2 hemodynamic instability, 1 peritoneal irritation). Of 67 patients who received NOM, 58 were successful and 9 showed failure (8 hemodynamic instability, 1 hollow viscera injury). We found 3 factors associated with failure NOM: blood pressure (BP) 2 g/dl in the first 24 hours (p = 0.0009; RR = 15.3), and transfusion of 3 or more units of red blood cells (RBC) (0.00001; RR = 17.1). Mechanism and severity of trauma and Pediatric Trauma Index were not associated with failure NOM. Children with blunted hepatic or splenic trauma respond to NOM. Factors such as BP 2 g/dl in the first 24 hours and transfusion of 3 or more units of RBC were associated with the failure in NOM.

  16. 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....

  17. 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.

  18. 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.

  19. 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......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 patient was admitted to hospital. Vital signs were normal, and blood samples revealed a marginal anaemia and elevated C-reactive protein, but were otherwise normal. Computed tomography showed an 18 centimetre wide splenic hematoma. The patient was referred to another hospital for conservative treatment...

  20. Splenic dynamics of indium-111 labeled platelets in idiopathic thrombocytopenic purpura

    International Nuclear Information System (INIS)

    Syrjaelae, M.T.Sa.; Savolainen, S.; Nieminen, U.; Gripenberg, J.; Liewendahl, K.; Ikkala, E.

    1989-01-01

    Splenic dynamics of 111 In-labeled platelets and platelet-associated IgG in 33 patients with idiopathic thrombocytopenic purpura (ITP) were studied. Two half-lives were calculated for the biexponential splenic time-activity curve after i.v. injection of 111 In-labeled platelets. There was no difference in the mean half-life of the rapid component of the splenic curve (ST1) when patients with negative or slightly positive platelet suspension immunofluorescence test (PSIFT) were compared to those with strongly positive PSIFT (3.0 ± 0.7 min vs. 3.6 ± 0.4, p greater than 0.05). Mean half-life of the slow component of the splenic curve (ST2) was found to be longer in patients with a strongly positive than a negative or weakly positive PSIFT (26 ± 5 min vs. 13.2 ± 1.0 min, p less than 0.01). It seems that determination of the two components of the splenic time-activity curve provides a useful method for studying platelet kinetics in ITP

  1. Low Temperature Soda-Oxygen Pulping of Bagasse.

    Science.gov (United States)

    Yue, Fengxia; Chen, Ke-Li; Lu, Fachuang

    2016-01-13

    Wood shortages, environmental pollution and high energy consumption remain major obstacles hindering the development of today's pulp and paper industry. Energy-saving and environmental friendly pulping processes are still needed, especially for non-woody materials. In this study, soda-oxygen pulping of bagasse was investigated and a successful soda-oxygen pulping process for bagasse at 100 °C was established. The pulping parameters of choice were under active alkali charge of 23%, maximum cooking temperature 100 °C, time hold at maximum temperature 180 min, initial pressure of oxygen 0.6 MPa, MgSO4 charge 0.5%, and de-pithed bagasse consistency 12%. Properties of the resultant pulp were screened yield 60.9%, Kappa number 14, viscosity 766 dm³/kg, and brightness 63.7% ISO. Similar pulps were also obtained at 110 °C or 105 °C with a cooking time of 90 min. Compared with pulps obtained at higher temperatures (115-125 °C), this pulp had higher screened yield, brightness, and acceptable viscosity, while the delignification degree was moderate. These results indicated that soda-oxygen pulping at 100 °C, the lowest cooking temperature reported so far for soda-oxygen pulping, is a suitable process for making chemical pulp from bagasse. Pulping at lower temperature and using oxygen make it an environmental friendly and energy-saving pulping process.

  2. Low Temperature Soda-Oxygen Pulping of Bagasse

    Directory of Open Access Journals (Sweden)

    Fengxia Yue

    2016-01-01

    Full Text Available Wood shortages, environmental pollution and high energy consumption remain major obstacles hindering the development of today’s pulp and paper industry. Energy-saving and environmental friendly pulping processes are still needed, especially for non-woody materials. In this study, soda-oxygen pulping of bagasse was investigated and a successful soda-oxygen pulping process for bagasse at 100 °C was established. The pulping parameters of choice were under active alkali charge of 23%, maximum cooking temperature 100 °C, time hold at maximum temperature 180 min, initial pressure of oxygen 0.6 MPa, MgSO4 charge 0.5%, and de-pithed bagasse consistency 12%. Properties of the resultant pulp were screened yield 60.9%, Kappa number 14, viscosity 766 dm3/kg, and brightness 63.7% ISO. Similar pulps were also obtained at 110 °C or 105 °C with a cooking time of 90 min. Compared with pulps obtained at higher temperatures (115–125 °C, this pulp had higher screened yield, brightness, and acceptable viscosity, while the delignification degree was moderate. These results indicated that soda-oxygen pulping at 100 °C, the lowest cooking temperature reported so far for soda-oxygen pulping, is a suitable process for making chemical pulp from bagasse. Pulping at lower temperature and using oxygen make it an environmental friendly and energy-saving pulping process.

  3. 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.

  4. Extracellular matrix of dental pulp stem cells: Applications in pulp tissue engineering using somatic MSCs

    Directory of Open Access Journals (Sweden)

    Sriram eRavindran

    2014-01-01

    Full Text Available Dental Caries affects approximately 90% of the world’s population. At present, the clinical treatment for dental caries is root canal therapy. This treatment results in loss of tooth sensitivity and vitality. Tissue engineering can potentially solve this problem by enabling regeneration of a functional pulp tissue. Dental pulp stem cells (DPSCs have been shown to be an excellent source for pulp regeneration. However, limited availability of these cells hinders its potential for clinical translation. We have investigated the possibility of using somatic mesenchymal stem cells from other sources for dental pulp tissue regeneration using a biomimetic dental pulp extracellular matrix (ECM incorporated scaffold. Human periodontal ligament stem cells (PDLSCs and human bone marrow stromal cells (HMSCs were investigated for their ability to differentiate towards an odontogenic lineage. In vitro real-time PCR results coupled with histological and immunohistochemical examination of the explanted tissues confirmed the ability of PDLSCs and HMSCs to form a vascularized pulp-like tissue. These findings indicate that the dental pulp stem derived ECM scaffold stimulated odontogenic differentiation of PDLSCs and HMSCs without the need for exogenous addition of growth and differentiation factors. This study represents a translational perspective toward possible therapeutic application of using a combination of somatic stem cells and extracellular matrix for pulp regeneration.

  5. Arundo donax L. reed: new perspectives for pulping and bleaching. Part 4. Peroxide bleaching of organosolv pulps.

    Science.gov (United States)

    Shatalov, A A; Pereira, H

    2005-05-01

    A comparative study on TCF (totally chlorine-free) bleachability of organosolv pulps from the annual fibre crop Arundo donax L. (giant reed) was carried out using a simple three-stage peroxide bleaching sequence without oxygen pre-bleaching. ASAM (alkali-sulfite-anthraquinone-methanol), Organocell (alkali-anthraquinone-methanol) and ethanol-soda organosolv pulps were bleached and compared with kraft pulp, as a reference. The final brightness of 76-78% ISO was attained for all tested pulps. The chemical charge required to reach this level of brightness varied for different pulps (despite the equal initial content of the residual lignin) and directly related to starting brightness values. No direct correlation between brightness improvement and lignin removal during bleaching was found, indicating the influence of the specific pulp properties introduced by pulping process on bleaching chemistry. The general higher bleaching response of organosolv pulps from A. donax was noted in comparison with kraft.

  6. The Biomineralization of a Bioactive Glass-Incorporated Light-Curable Pulp Capping Material Using Human Dental Pulp Stem Cells

    Directory of Open Access Journals (Sweden)

    Soo-Kyung Jun

    2017-01-01

    Full Text Available The aim of this study was to investigate the biomineralization of a newly introduced bioactive glass-incorporated light-curable pulp capping material using human dental pulp stem cells (hDPSCs. The product (Bioactive® [BA] was compared with a conventional calcium hydroxide-incorporated (Dycal [DC] and a light-curable (Theracal® [TC] counterpart. Eluates from set specimens were used for investigating the cytotoxicity and biomineralization ability, determined by alkaline phosphatase (ALP activity and alizarin red staining (ARS. Cations and hydroxide ions in the extracts were measured. An hDPSC viability of less than 70% was observed with 50% diluted extract in all groups and with 25% diluted extract in the DC. Culturing with 12.5% diluted BA extract statistically lowered ALP activity and biomineralization compared to DC (p0.05. Ca (~110 ppm and hydroxide ions (pH 11 were only detected in DC and TC. Ionic supplement-added BA, which contained similar ion concentrations as TC, showed similar ARS mineralization compared to TC. In conclusion, the BA was similar to, yet more cytotoxic to hDPSCs than, its DC and TC. The BA was considered to stimulate biomineralization similar to DC and TC only when it released a similar amount of Ca and hydroxide ions.

  7. Splenic abscess in children: A report of three patients | Rattan ...

    African Journals Online (AJOL)

    Splenic abscess is uncommon in paediatric age group. It usually occurs in conditions of disseminated infective focus. Conventional treatment of abscess is incision and drainage, although splenectomy or splenic conservation is alternative. In this report, we are presenting case summaries of three patients suffering from ...

  8. A review of histiocytic diseases of dogs and cats.

    Science.gov (United States)

    Moore, P F

    2014-01-01

    Histiocytic proliferative disorders are commonly observed in dogs and less often cats. Histiocytic disorders occur in most of the dendritic cell (DC) lineages. Canine cutaneous histiocytoma originates from Langerhans cells (LCs) indicated by expression of CD1a, CD11c/CD18, and E-cadherin. When histiocytomas occur as multiple lesions in skin with optional metastasis to lymph nodes and internal organs, the disease resembles cutaneous Langerhans cell histiocytosis of humans. Langerhans cell disorders do not occur in feline skin. Feline pulmonary LCH has been recognized as a cause of respiratory failure due to diffuse pulmonary infiltration by histiocytes, which express CD18 and E-cadherin and contain Birbeck's granules. In dogs and cats, histiocytic sarcomas (HS) arise from interstitial DCs that occur in most tissues of the body. Histiocytic sarcomas begin as localized lesions, which rapidly disseminate to many organs. Primary sites include spleen, lung, skin, brain (meninges), lymph node, bone marrow, and synovial tissues of limbs. An indolent form of localized HS, progressive histiocytosis, originates in the skin of cats. Hemophagocytic HS originates in splenic red pulp and bone marrow macrophages in dogs and cats. In dogs, histiocytes in hemophagocytic HS express CD11d/CD18, which is a leuko-integrin highly expressed by macrophages in splenic red pulp and bone marrow. Canine reactive histiocytic diseases, systemic histiocytosis (SH) and cutaneous histiocytosis, are complex inflammatory diseases with underlying immune dysregulation. The lesions are dominated by activated interstitial DCs and lymphocytes, which invade vessel walls and extend as vasocentric infiltrates in skin, lymph nodes, and internal organs (SH).

  9. Assessment of dermal exposure and histopathologic changes of different sized nano-silver in healthy adult rabbits

    Science.gov (United States)

    kazem Koohi, Mohammad; Hejazy, Marzie; Asadi, Farzad; Asadian, Peyman

    2011-07-01

    The purpose of this study is to evaluate the dermal toxicity (Irritation/Corrosion) of three sizes of nanosilver particles (10, 20 and 30 nm) during 3 min, 1 and 4 hours according to the OECD/OCDE guideline Histopathological effects in secondary organs from liver, kidney, heart, spleen and brain 14 day post dermal administration are also reported. 10 and 20 nm Ag nanoparticles treated group showed well defined dermal erythema and oedema. Histopathological findings of 10 and 20 nm (4 hours exposure) on 14-day post dermal administration showed hyperkeratosis, acanthosis, hair-filled follicles and papillomatosis in an irregular epidermis, fibrosis, hyperemia, erythema, intracellular oedema and hyalinisation of collagen in dermis of skin. Liver revealed midzonal and periacinar necrosis, portal mononuclear infiltration, liver fatty change, liver congestion and hyperemic central vein. Splenic red pulp congestion and white pulp hyperreactivity, splenic trabeculae and sinusoidal congestion and hyaline change were found in spleen. Fatty degeneration in some cardiovascular cells and subendocardial hemorrhage without inflammation was perceived. Picnotic appearance of pyramidal neurons in the brain cortex, gliosis and mild perineuronal oedema ischemic cell change and hyperemic meninges was observed in brain. Our research concluded that dermal exposure to lesser sizes of silver nanoparticles is more disastrous than greater ones.

  10. Assessment of dermal exposure and histopathologic changes of different sized nano-silver in healthy adult rabbits

    Energy Technology Data Exchange (ETDEWEB)

    Koohi, Mohammad kazem; Hejazy, Marzie [Toxicology division, Basic science department, Faculty of Veterinary Medicine, University of Tehran, Qareeb Street, Azadi Av. PO Box: 14155-6453, Tehran (Iran, Islamic Republic of); Asadi, Farzad [Biochemistry division, Basic science department, Faculty of Veterinary Medicine, University of Tehran, Qareeb Street, Azadi Av. PO Box: 14155-6453, Tehran (Iran, Islamic Republic of); Asadian, Peyman, E-mail: mkkoohi@ut.ac.ir [Clinical pathology department, Faculty of Veterinary Medicine, University of Khorramabad (Iran, Islamic Republic of)

    2011-07-06

    The purpose of this study is to evaluate the dermal toxicity (Irritation/Corrosion) of three sizes of nanosilver particles (10, 20 and 30 nm) during 3 min, 1 and 4 hours according to the OECD/OCDE guideline Histopathological effects in secondary organs from liver, kidney, heart, spleen and brain 14 day post dermal administration are also reported. 10 and 20 nm Ag nanoparticles treated group showed well defined dermal erythema and oedema. Histopathological findings of 10 and 20 nm (4 hours exposure) on 14-day post dermal administration showed hyperkeratosis, acanthosis, hair-filled follicles and papillomatosis in an irregular epidermis, fibrosis, hyperemia, erythema, intracellular oedema and hyalinisation of collagen in dermis of skin. Liver revealed midzonal and periacinar necrosis, portal mononuclear infiltration, liver fatty change, liver congestion and hyperemic central vein. Splenic red pulp congestion and white pulp hyperreactivity, splenic trabeculae and sinusoidal congestion and hyaline change were found in spleen. Fatty degeneration in some cardiovascular cells and subendocardial hemorrhage without inflammation was perceived. Picnotic appearance of pyramidal neurons in the brain cortex, gliosis and mild perineuronal oedema ischemic cell change and hyperemic meninges was observed in brain. Our research concluded that dermal exposure to lesser sizes of silver nanoparticles is more disastrous than greater ones.

  11. Extrahepatic portal venous obstruction: The effects of early ligation of splenic artery during splenectomy.

    Science.gov (United States)

    Gazula, Suhasini; Pawar, D K; Seth, T; Bal, C S; Bhatnagar, V

    2009-10-01

    To objectively demonstrate the gain in blood volume and blood components following early ligation of splenic artery during splenectomy and splenorenal shunts in children with extra hepatic portal venous obstruction (EHPVO). Twenty-eight children (20 males and 8 females, mean age: 9.9 (+/-3.2) years) with EHPVO and hypersplenism were recruited. We followed a protocol of systematically locating and ligating the splenic artery first, followed by a 30-minute waiting period to allow the massive spleen to decongest via the splenic vein and venous collaterals and then completing the splenectomy by standard procedure. No intravenous fluid was administered during this 30-minute period. Blood samples were drawn just prior to splenic artery ligation and soon after splenectomy for the estimation of hematological and biochemical parameters. We noticed a highly significant increase in the hemoglobin, hematocrit, leukocyte, platelet, and RBC counts by early ligation of the splenic artery (p platelet count was equivalent to a platelet transfusion of atleast 4 units of platelet concentrates in an adult. There is a positive correlation between the splenic weight and the platelet gain (p= 0.0568) and the splenic volume on preoperative imaging and the platelet gain (p= 0.0251). Early ligation of the splenic artery during splenectomy results in passive splenic decongestion and thereby a significant gain in blood components. This protocol appears to be a feasible blood conservation method to avoid blood transfusions in this group of hypersplenic EHPVO patients.

  12. Recent progress in the clinical application of partial splenic embolization

    International Nuclear Information System (INIS)

    Zhou Yaojun; Liu Changjiang; Wang Yaojun

    2012-01-01

    Partial splenic embolization (PSE) is a non-surgical procedure used to treat hypersplenism in various clinical settings and thus to avoid the disadvantages of splenectomy. PSE can be employed for the treatment of a variety of diseases including hypersplenism, thrombocytopenia, portal hypertension, splenic arterial aneurysms, etc. PSE can effectively relieve the splenic artery steal syndrome which occurred after liver transplantation, and therefore significantly improve the blood perfusion of the recipient liver. Besides, PSE can also be adopted to reduce the bleeding risk in patients with esophageal and gastric varices caused by portal hypertension. PSE is beneficial to the improvement of peripheral hematologic parameters, which helps the patients successfully undergo the high-dose chemotherapy or interferon therapy. In addition, PSE possesses potential curative effect for thrombocytopenia related diseases such as chronic idiopathic thrombocytopenic purpura. This paper aims to make a comprehensive review of the recent progress in the clinical application of partial splenic embolization. (authors)

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

    International Nuclear Information System (INIS)

    Golder, W.A.

    2008-01-01

    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.) [de

  14. Growth and development of red alder compared with conifers in 30-year-old stands.

    Science.gov (United States)

    Carl M. Berntsen

    1961-01-01

    Red alder (Alnus rubra), although a widespread tree species in Pacific coast forests, has only in recent years attained commercial importance as a source of wood material for diversified products including furniture, paneling, and paper pulp. With the rapid increase in the harvest of red alder, both public agencies and private industry are making a...

  15. REPLACEMENT OF SOFTWOOD KRAFT PULP WITH ECF-BLEACHED BAMBOO KRAFT PULP IN FINE PAPER

    Directory of Open Access Journals (Sweden)

    Guanglei Zhao

    2010-06-01

    Full Text Available Non-wood fibers such as bamboo and wheat straw have been playing important roles in the pulp and paper industry in China. In this study an ECF-bleached bamboo kraft pulp was compared with a bleached softwood kraft pulp (NBSK as the reinforcement pulp in fine paper production. Areas that were examined include the refining of pure fibers, influence of bamboo on dewatering, retention, and sizing. The influence of bamboo kraft pulp as a part of a furnish replacing NBSK was compared as well. Results show that fiber shortening was more prominent with bamboo when refined. This resulted in a higher amount of fines, and addition wet-end chemicals may be required to compensate. Handsheets with bamboo as a reinforcement fiber showed similar mechanical and optical properties to handsheets containing NBSK.

  16. Nonoperative treatment of adult splenic trauma: Role of CT

    International Nuclear Information System (INIS)

    Raptopoulos, V.; Fink, M.; Resciniti, A.; Davidoff, A.; Silva, W.E.

    1987-01-01

    Of 27 adult patients with known splenic injuries admitted to a regional referral trauma center and who were initially treated nonoperatively, ten (37%) ultimately required splenectomy. A CT scoring system was developed based on the degree of splenic parenchymal injury and the presence of fluid in the perisplenic region, the upper abdomen, and the pelvis. Adult patients who were successfully treated nonoperatively had a significantly (P=.011) lower total CT score than did patients who required delayed celiotomy. No patient older than 17 years with a total CT score less than 2.5 required delayed operative intervention. CT can be used to select a subset of adults with splenic trauma who are excellent candidates for a trail of nonoperative management

  17. Splenic infarction associated with acute infectious mononucleosis due to Epstein-Barr virus infection.

    Science.gov (United States)

    Heo, Dae-Hyuk; Baek, Dae-Youb; Oh, Sang-Min; Hwang, Joo-Hee; Lee, Chang-Seop; Hwang, Jeong-Hwan

    2017-02-01

    The purpose of this study was to report a case of a previously healthy 20-year-old woman diagnosed with splenic infarction following infectious mononucleosis (IM) by Epstein-Barr virus (EBV) infection and to perform the first systematic review of the clinical characteristics of splenic infarction associated with IM. A systematic review was conducted using English, French, and Japanese literatures of splenic infarction associated with IM due to EBV infection published between 1961 and 2015 in PubMed Medline. A total of 19 cases were extracted from the collected articles. Left upper quadrant (LUQ) pain was observed in 15 (79%) patients. Splenectomy was performed in five (26%) cases, among which four patients presented with stable vital signs. Splenic rupture was accompanied in two (10%) patients. The median time from the onset of IM symptoms to the diagnosis of splenic infarction was 5 days (range, 1-25 days). Fourteen (74%) of 19 patients experienced improvement through medical treatment, and there were no deaths. Splenic infarction associated with IM due to EBV infection can show a favorable clinical outcome after medical treatment. Clinicians should consider the possibility of splenic infarction when patients with IM experience LUQ pain. J. Med. Virol. 89:332-336, 2017. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

  18. Splenic Trauma

    International Nuclear Information System (INIS)

    Cortes Diaz, Fabio F; Buitrago Mejia, Francisco; Ulloa Guerrero, Luis Heber

    2001-01-01

    The spleen is the organ that is injured during the closed trauma with more frequency and it is the cause more common of foregone death in the patients with wounded abdominal. At the present time the complications of the splenic trauma are related with their severity, associate wounds, diagnostic fail or inadequate treatments. The lesions that are diagnosed in early form are managed quick and satisfactorily, but the forgotten wounds or the diagnoses and late treatments take for themselves high rates of morbid-mortality. The paper includes their phyto pathology, diagnoses, classification and treatment

  19. Laparoscopic unroofing of splenic cysts results in a high rate of recurrences.

    Science.gov (United States)

    Schier, Felix; Waag, Karl-Ludwig; Ure, Benno

    2007-11-01

    Laparoscopic unroofing is described as an appropriate treatment modality of nonparasitic splenic cysts. However, we repeatedly encountered recurrences with this technique. Because splenic cysts are rare, we analyzed the combined experience of 3 German pediatric surgical departments. Between 1995 and 2005, primary and secondary nonparasitic splenic cysts were unroofed laparoscopically in 14 children (aged 5-12 years; median, 8.5 years). In 3 patients, the inner surface was coagulated with the argon beamer. In most children, the cavity was surfaced with omentum. In addition, in 4 patients the omentum was sutured to the splenic parenchyma. No intraoperative complications occurred, and no inadvertent splenectomy or blood transfusions were necessary. However, in 9 children (64%) the cysts recurred at intervals ranging from 6 to 12 months (median, 12 months). Also, argon laser treatment of the surface resulted in recurrence. Laparoscopic unroofing of true splenic cysts alone proved inadequate in this series. Either removal of the inner layer or partial splenectomy appears to be necessary to prevent recurrences.

  20. Variation in treatment of blunt splenic injury in Dutch academic trauma centers.

    Science.gov (United States)

    Olthof, Dominique C; Luitse, Jan S K; de Rooij, Philippe P; Leenen, Loek P H; Wendt, Klaus W; Bloemers, Frank W; Goslings, J Carel

    2015-03-01

    The incidence of splenectomy after trauma is institutionally dependent and varies from 18% to as much as 40%. This is important because variation in management influences splenic salvage. The aim of this study was to investigate whether differences exist between Dutch level 1 trauma centers with respect to the treatment of these injuries, and if variation in treatment was related to splenic salvage, spleen-related reinterventions, and mortality. Consecutive adult patients who were admitted between January 2009 and December 2012 to five academic level 1 trauma centers were identified. Multinomial logistic regression was used to measure the influence of hospital on treatment strategy, controlling for hemodynamic instability on admission, high grade (American Association for the Surgery of Trauma 3-5) splenic injury, and injury severity score. Binary logistic regression was used to quantify differences among hospitals in splenic salvage rate. A total of 253 patients were included: 149 (59%) were observed, 57 (23%) were treated with splenic artery embolization and 47 (19%) were operated. The observation rate was comparable in all hospitals. Splenic artery embolization and surgery rates varied from 9%-32% and 8%-28%, respectively. After adjustment, the odds of operative management were significantly higher in one hospital compared with the reference hospital (adjusted odds ratio 4.98 [1.02-24.44]). The odds of splenic salvage were significantly lower in another hospital compared with the reference hospital (adjusted odds ratio 0.20 [0.03-1.32]). Although observation rates were comparable among the academic trauma centers, embolization and surgery rates varied. A nearly 5-fold increase in the odds of operative management was observed in one hospital, and another hospital had significantly lower odds of splenic salvage. The development of a national guideline is recommended to minimalize splenectomy after trauma. Copyright © 2015 Elsevier Inc. All rights reserved.

  1. Mixed reality for robotic treatment of a splenic artery aneurysm.

    Science.gov (United States)

    Pietrabissa, Andrea; Morelli, Luca; Ferrari, Mauro; Peri, Andrea; Ferrari, Vincenzo; Moglia, Andrea; Pugliese, Luigi; Guarracino, Fabio; Mosca, Franco

    2010-05-01

    Techniques of mixed reality can successfully be used in preoperative planning of laparoscopic and robotic procedures and to guide surgical dissection and enhance its accuracy. A computer-generated three-dimensional (3D) model of the vascular anatomy of the spleen was obtained from the computed tomography (CT) dataset of a patient with a 3-cm splenic artery aneurysm. Using an environmental infrared localizer and a stereoscopic helmet, the surgeon can see the patient's anatomy in transparency (augmented or mixed reality). This arrangement simplifies correct positioning of trocars and locates surgical dissection directly on top of the aneurysm. In this way the surgeon limits unnecessary dissection, leaving intact the blood supply from the short gastric vessels and other collaterals. Based on preoperative planning, we were able to anticipate that the vascular exclusion of the aneurysm would result in partial splenic ischemia. To re-establish the flow to the spleen, end-to-end robotic anastomosis of the splenic artery with the Da Vinci surgical system was then performed. Finally, the aneurysm was fenestrated to exclude arterial refilling. The postoperative course was uneventful. A control CT scan 4 weeks after surgery showed a well-perfused and homogeneous splenic parenchyma. The final 3D model showed the fenestrated calcified aneurysm and patency of the re-anastomosed splenic artery. The described technique of robotic vascular exclusion of a splenic artery aneurysm, followed by re-anastomosis of the vessel, clearly demonstrates how this technology can reduce the invasiveness of the procedure, obviating an otherwise necessary splenectomy. Also, the use of intraoperative mixed-reality technology proved very useful in this case and is expected to play an increasing role in the operating room of the future.

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

    International Nuclear Information System (INIS)

    Gratwohl, A.; Hermans, J.; Biezen, A.V.

    1996-01-01

    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)

  3. Insulin radioreceptor assay on murine splenic leukocytes and peripheral erythrocytes

    International Nuclear Information System (INIS)

    Shimizu, F.; Kahn, R.

    1982-01-01

    Insulin radioreceptor assays were developed using splenic leukocytes and peripheral erythrocytes from individual mice. Splenic leukocytes were prepared using an NH 4 Cl buffer which did not alter insulin binding, but gave much higher yields than density gradient methods. Mouse erythrocytes were isolated from heparinized blood by three passages over a Boyum gradient, and a similar buffer was used to separate cells from free [ 125 I]iodoinsulin at the end of the binding incubation. Insulin binding to both splenic leukocytes and peripheral erythrocytes had typical pH, temperature, and time dependencies, and increased linearly with an increased number of cells. Optimal conditions for the splenic leukocytes (6 x 10 7 /ml) consisted of incubation with [ 125 I]iodoinsulin at 15 C for 2 h in Hepes buffer, pH 8.0. In cells from 20 individual mice, the specific [ 125 I]iodoinsulin binding was 2.6 +/- 0.1% (SEM), and nonspecific binding was 0.3 +/- 0.04% (10.6% of total binding). Erythrocytes (2.8 x 10 9 /ml) were incubated with [ 125 ]iodoinsulin at 15 C for 2 h in Hepes buffer, pH 8.2. In cells from 25 individual mice, the specific [ 125 I]iodoinsulin binding was 4.5 +/- 0.2%, and nonspecific binding was 0.7 +/- 0.03% (13.6% of total binding). In both splenic leukocytes and peripheral erythrocytes, analysis of equilibrium binding data produced curvilinear Scatchard plots with approximately 3500 binding sites/leukocyte and 20 binding sites/erythrocyte. These data demonstrate that adequate numbers of splenic leukocytes and peripheral erythrocytes can be obtained from individual mice to study insulin binding in a precise and reproducible manner

  4. Antibody response to a T-cell-independent antigen is preserved after splenic artery embolization for trauma

    NARCIS (Netherlands)

    Olthof, D. C.; Lammers, A. J. J.; van Leeuwen, E. M. M.; Hoekstra, J. B. L.; ten Berge, I. J. M.; Goslings, J. C.

    2014-01-01

    Splenic artery embolization (SAE) is increasingly being used as a nonoperative management strategy for patients with blunt splenic injury following trauma. The aim of this study was to assess the splenic function of patients who were embolized. A clinical study was performed, with splenic function

  5. Kinetics and optimization of red clover pulp drying

    Directory of Open Access Journals (Sweden)

    A. A. Shevtsov

    2013-01-01

    Full Text Available The kinetics of the drying process conducted with bagasse red clover on an experimental dry¬er superheated steam at atmospheric pressure in the active hydrodynamic regimes were study¬ing. The rational intervals of parameter changes were obtained. The problem of optimization, which allowed allocating the optimum range of variation of the input factors according to three criteria through compromise was solved.

  6. Enzymes improve ECF bleaching of pulp

    Directory of Open Access Journals (Sweden)

    Lachenal, D.

    2006-07-01

    Full Text Available The delignification efficiency of different laccase enzymes was examined on the eucalyptus Kraft pulp. The laccase enzyme from Trametes versicolor showing the highest delignification efficiency was selected and used in the elemental chlorine-free bleaching sequence for improving the pulp bleachability. An appreciable reduction in chlorine dioxide consumption was also obtained. Further reduction in chlorine dioxide consumption was obtained when the same laccase treated pulp was subjected to an acid treatment after the extraction stage followed by the DEPD sequence. Elemental-chlorine free bleaching was also performed using the xylanase-laccase treated pulp. Xylanase treatment was incorporated to the laccase mediator system in the elemental-chlorine free bleaching both sequentially and simultaneously. The bleaching sequence DEPD followed and in both the cases, the reduction in chlorine dioxide consumption was greater in comparison to the control. The chlorine dioxide consumption was reduced further when xylanase-laccase treated pulp was given an additional acid treatment. The final pulp properties of the treated pulps were comparable to the control pulp.

  7. Isolated splenic metastasis from a thymic carcinoma: A case report.

    Science.gov (United States)

    Chen, Dongmei; Meng, Xiangying; Zhao, Yaowei; Wu, Shikai

    2016-09-01

    Thymic carcinomas are rare tumors that arise in the anterior mediastinum. Most of these malignancies develop local metastases limited in the thorax. Splenic metastases from thymic carcinomas are extremely rare. Here we report a case of isolated splenic metastasis from a 38-year-old female patient with Stage IV thymic carcinoma, who was treated with chemoradiotherapy. At twenty-2 months follow-up, the patient was found to have an isolated spleen metastasis, which was treated by Cyberknife with a reduced size of the metastasis, representing a partial response. Although splenic metastasis is a rare phenomenon, physicians need to be aware of the possibility of such metastases.

  8. 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.

  9. Human dental pulp stem cells with highly angiogenic and neurogenic potential for possible use in pulp regeneration.

    Science.gov (United States)

    Nakashima, Misako; Iohara, Koichiro; Sugiyama, Masahiko

    2009-01-01

    Dental caries is a common public health problem, causing early loss of dental pulp and resultant tooth loss. Dental pulp has important functions to sustain teeth providing nutrient and oxygen supply, innervation, reactionary/reparative dentin formation and immune response. Regeneration of pulp is an unmet need in endodontic therapy, and angiogenesis/vasculogenesis and neurogenesis are critical for pulp regeneration. Permanent and deciduous pulp tissue is easily available from teeth after extraction without ethical issues and has potential for clinical use. In this review, we introduce some stem cell subfractions, CD31(-)/CD146(-) SP cells and CD105(+) cells with high angiogenic and neurogenic potential, derived from human adult dental pulp tissue. Potential utility of these cells is addressed as a source of cells for treatment of cerebral and limb ischemia and pulp inflammation complete with angiogenesis and vasculogenesis.

  10. Eucalyptus kraft pulp production: Thermogravimetry monitoring

    International Nuclear Information System (INIS)

    Barneto, Agustin G.; Vila, Carlos; Ariza, Jose

    2011-01-01

    Highlights: → Thermogravimetric analysis can be used to monitor the pulping process in a pulp mill. → ECF bleaching process affects the crystalline cellulose volatilization. → The fibre size has an influence on composition and thermal behavior of pulp. - Abstract: Under oxidative environment the thermal degradation of lignocellulosic materials like wood or pulp is sensitive to slight composition changes. For this, in order to complement the chemical and X-ray diffraction results, thermogravimetric analyses (TGA) were used to monitor pulp production in a modern pulp mill. Runs were carried out on crude, oxygen delignified and bleached pulps from three eucalyptus woods from different species and geographical origins. Moreover, with the modeling of thermogravimetric data, it was possible to obtain an approximate composition of samples which includes crystalline and amorphous cellulose. TGA results show that pulping has an intensive effect on bulk lignin and hemicellulose, but it has limited influence on the removal of these substances when they are linked to cellulose microfibril. The stages of oxygen delignification and bleaching, based in chlorine dioxide and hydrogen peroxide, increase the crystalline cellulose volatilization rate. These changes are compatible with a more crystalline microfibril. The influence of the fibre size on pulp composition, crystallinity and thermal degradation behavior was observed.

  11. Increased Risk of Hemorrhagic and Ischemic Strokes in Patients With Splenic Injury and Splenectomy

    Science.gov (United States)

    Lin, Jiun-Nong; Lin, Cheng-Li; Lin, Ming-Chia; Lai, Chung-Hsu; Lin, Hsi-Hsun; Yang, Chih-Hui; Kao, Chia-Hung

    2015-01-01

    Abstract The spleen is a crucial organ in humans. Little is known about the association between stroke and splenic injury or splenectomy. The aim of this study was to determine the risk of stroke in patients with splenic injury and splenectomy. A nationwide cohort study was conducted by analyzing the National Health Insurance Research Database in Taiwan. For comparison, control patients were selected and matched with splenic injury patients in a ratio of 4:1 according to age, sex, and the year of hospitalization. We analyzed the risks of stroke using a Cox proportional-hazards regression analysis. A total of 11,273 splenic injury patients, including 5294 splenectomized and 5979 nonsplenectomized patients, and 45,092 control patients were included in this study. The incidence rates of stroke were 8.05, 6.53, and 4.25 per 1000 person-years in splenic injury patients with splenectomy, those without splenectomy, and the control cohort, respectively. Compared with the control cohort, splenic injury patients with splenectomy exhibited a 2.05-fold increased risk of stroke (95% confidence interval [CI] 1.8–2.34), whereas those without splenectomy exhibited a 1.74-fold increased risk (95% CI 1.51–2). Splenectomy entailed an additional 1.21-fold increased risk of stroke compared with nonsplenectomy in patients with splenic injury. This study revealed that splenic injury and splenectomy were significantly associated with an increased risk of hemorrhagic and ischemic strokes. The results of this study may alert physicians and patients to the complications of splenic injury and splenectomy. PMID:26334909

  12. Coil Migration after Transarterial Coil Embolization of a Splenic Artery Pseudoaneurysm

    Directory of Open Access Journals (Sweden)

    Bezawit D. Tekola

    2013-11-01

    Full Text Available A 48-year-old man with a history of splenic artery pseudoaneurysm requiring transarterial embolization 3 months earlier presented to the emergency department with abdominal pain and fever. Computed tomography showed evidence of embolization coil fragments within the gastrointestinal tract. Upper endoscopy showed a large gastric ulcer with numerous embolization coils extruding into the gastric lumen. The patient underwent partial gastrectomy, distal pancreatectomy and resection of the splenic artery pseudoaneurysm. This case illustrates a rare delayed complication of transarterial embolization of a splenic artery pseudoaneurysm.

  13. CT grading systems as a predictor of successful nonoperative treatment of splenic trauma

    International Nuclear Information System (INIS)

    Umlas, S.L.; Cronan, J.J.

    1990-01-01

    PURPOSE: Selective nonoperative management of splenic trauma yields benefits with regard to preservation of the body's defense systems. This paper evaluates the capability of CT grading systems to predict successful non- operative management of splenic trauma in children and adults. Fifty-six patients with documented splenic injury were assessed with CT following standard trauma protocols. Each of these CT scans were graded according to the three recently proposed splenic trauma systems. The charts of these patients were then reviewed, and correlations between the CT grade and the clinical outcome were determined for each of these three grading systems

  14. Management of splenic and pancreatic trauma.

    Science.gov (United States)

    Girard, E; Abba, J; Cristiano, N; Siebert, M; Barbois, S; Létoublon, C; Arvieux, C

    2016-08-01

    The spleen and pancreas are at risk for injury during abdominal trauma. The spleen is more commonly injured because of its fragile structure and its position immediately beneath the ribs. Injury to the more deeply placed pancreas is classically characterized by discordance between the severity of pancreatic injury and its initial clinical expression. For the patient who presents with hemorrhagic shock and ultrasound evidence of major hemoperitoneum, urgent "damage control" laparotomy is essential; if splenic injury is the cause, prompt "hemostatic" splenectomy should be performed. Direct pancreatic injury is rarely the cause of major hemorrhage unless a major neighboring vessel is injured, but if there is destruction of the pancreatic head, a two-stage pancreatoduodenectomy (PD) may be indicated. At open laparotomy when the patient's hemodynamic status can be stabilized, it may be possible to control splenic bleeding without splenectomy; it is always essential to search for injury to the pancreatic duct and/or the adjacent duodenum. Pancreatic contusion without ductal rupture is usually treated by drain placement adjacent to the injury; ductal injuries of the pancreatic body or tail are treated by resection (distal pancreatectomy with or without splenectomy), with generally benign consequences. For injuries of the pancreatic head with pancreatic duct disruption, wide drainage is usually performed because emergency PD is a complex gesture prone to poor results. Postoperatively, the placement of a ductal stent by endoscopic retrograde catheterization may be decided, while management of an isolated pancreatic fistula is often straightforward. Non-operative management is the rule for the trauma victim who is hemodynamically stable. In addition to the clinical examination and conventional laboratory tests, investigations should include an abdominothoracic CT scan with contrast injection, allowing identification of all traumatized organs and assessment of the severity of

  15. 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.

  16. The pattern and management outcomes of splenic injuries in the ...

    African Journals Online (AJOL)

    Background: In the last decade or so, the management of splenic injuries has undergone a lot of debate and changes including refinement of the indications for non-operative management (NOM). The aims of this retrospective study are: to characterize the pattern of splenic injuries in the Abha region of Saudi Arabia; ...

  17. The impact of coagulopathy on traumatic splenic injuries.

    Science.gov (United States)

    Smalls, Norma; Obirieze, Augustine; Ehanire, Imudia

    2015-10-01

    Patients with pre-injury coagulopathy have worse outcomes than those without coagulopathy. This article investigated the risk-adjusted effect of pre-injury coagulopathy on outcomes after splenic injuries. Review of the National Trauma Data Bank from 2007 to 2010 comparing mortality and complications between splenic injury patients with and without a pre-injury bleeding disorder. Of 58,896 patients, 2% had a bleeding disorder. Coagulopathic patients had higher odds of mortality (odds ratio, 1.3), sepsis (odds ratio, 2.0), acute respiratory distress syndrome (odds ratio, 2.6), acute renal failure (odds ratio, 1.5), cardiac arrest (odds ratio, 1.5), and overall complications (odds ratio, 2.4). The higher odds of myocardial infarction did not achieve statistical significance (odds ratio, 1.6). Pre-injury coagulopathy in patients with splenic injury has a negative impact on cardiac arrest, sepsis, acute respiratory distress syndrome, acute renal failure, and mortality. The higher likelihood of myocardial infarction did not reach statistical significance. Copyright © 2015 Elsevier Inc. All rights reserved.

  18. Splenic irradiation in myelofibrosis. Clinical findings and ferrokinetics

    International Nuclear Information System (INIS)

    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

  19. Stimulatory effect of low dose radionuclide on DNA synthesis and UDS in splenic lymphocytes

    International Nuclear Information System (INIS)

    Zhu Shoupeng; Yang Zhanshan

    1999-12-01

    To study the stimulatory effect on DNA synthesis and unscheduled DNA synthesis (UDS) in splenic lymphocytes induced by low dose enriched uranium 235 U. By using 3 H-TdR incorporation assay technique, the DNA replicative synthesis in PHA and LPS stimulated splenic lymphocytes was observed. By using DNA synthesis inhibitor such as hydroxyurea, the UV-induced unscheduled DNA synthesis in splenic lymphocytes occurred. When the injected low dose of enriched uranium 235 u was 0.1 μg/kg body weight, the transformation capacity was elevated for splenic T lymphocytes, simultaneously the stimulative index increased. The UDS of splenic lymphocytes induced by ultra-violate revealed a statistically significant increase by low dose of enriched uranium 235 U at the range of 0.1-20 μg/kg body weight. A stimulatory action of low dose enriched uranium 235 U on DNA replicative synthesis as well as on UV-induced UDS in splenic lymphocytes was detected

  20. 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.)

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

    International Nuclear Information System (INIS)

    Phillips, Grace S.; Vo, Nghia J.; Ishak, Gisele E.; Swanson, Jonathan O.; Otto, Randolph K.

    2010-01-01

    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.)

  2. PULP DEMAND IN THE INTERNATIONAL MARKET

    Directory of Open Access Journals (Sweden)

    Edmilson Santos Cruz

    2003-01-01

    Full Text Available This study aimed at analyzing the international pulp market, taking into account themain exporting countries and importing regions, with the objective of estimating, for each market, theown-price and cross-price elasticity in relation to the demand of the pulp, differentiated for country oforigin. The model considers that imports are differentiated by origin; therefore they are not perfect substitutes. The demand from Europe, North America and the Rest of the World for the pulp from theUnited States,Canada, Sweden, Finland, Portugal and Brazil was inelastic. The Asian demand for thissome pulp was elastic. Europe and the Rest of the World showed negative cross-price elasticity, i. e.,and the imported pulp from other countries are complementary products. North America and Asiashowed positive crow-price elasticity, i. e., they consider the pulp produced in other countries assubstitute products. The net effect of the variation on the price of pulp in a country h, over the amountof pulp that goes to the region i depends on the matching of values related to the elasticity ofsubstitution and the price elasticity of the total demand.

  3. Pulp regeneration: Current approaches and future challenges

    Directory of Open Access Journals (Sweden)

    Jingwen eYANG

    2016-03-01

    Full Text Available Regenerative endodontics aims to replace inflamed/necrotic pulp tissues with regenerated pulp-like tissues to revitalize teeth and improve life quality. Pulp revascularization case reports, which showed successful clinical and radiographic outcomes, indicated the possible clinical application of pulp regeneration via cell homing strategy. From a clinical point of view, functional pulp-like tissues should be regenerated with the characterization of vascularization, re-innervation, and dentin deposition with a regulated rate similar to that of normal pulp. Efficient root canal disinfection and proper size of the apical foramen are the two requisite preconditions for pulp regeneration. Progress has been made on pulp regeneration via cell homing strategies. This review focused on the requisite preconditions and cell homing strategies for pulp regeneration. In addition to the traditionally used mechanical preparation and irrigation, antibiotics, irrigation assisted with EndoVac apical negative-pressure system, and ultrasonic and laser irradiation are now being used in root canal disinfection. In addition, pulp-like tissues could be formed with the apical foramen less than 1 mm, although more studies are needed to determine the appropriate size. Moreover, signaling molecules including stromal cell derived factor (SDF-1α, basic Fibroblast Growth Factor (bFGF, Platelet Derived Growth Factor (PDGF, stem cell factor (SCF, and Granulocyte Colony-Stimulating Factor (G-CSF were used to achieve pulp-like tissue formation via a cell homing strategy. Studies on the cell sources of pulp regeneration might give some indications on the signaling molecular selection. The active recruitment of endogenous cells into root canals to regenerate pulp-like tissues is a novel concept that may offer an unprecedented opportunity for the near-term clinical translation of current biology-based therapies for dental pulp regeneration.

  4. Splenic avulsion and bleeding shown on radiocolloid images

    International Nuclear Information System (INIS)

    Levy, H.A.; Sziklas, J.J.; Spencer, R.P.; Rosenberg, R.J.

    1983-01-01

    A case is discussed of a man who presented with trauma to the chest and abdomen. A radiocolloid image showed uptake by the liver. However, the spleen was not identified. Areas of activity outside of the spleen were noted. The patient had splenic avulsion; extra sites of activity likely represented bleeding sites in the abdomen. Failure to identify the spleen on a radiocolloid image, after trauma, should be an alerting sign to possible splenic avulsion (especially when there are also ectopic sites of accumulation of the radiocolloid)

  5. Splenic avulsion and bleeding shown on radiocolloid images

    Energy Technology Data Exchange (ETDEWEB)

    Levy, H.A.; Sziklas, J.J.; Spencer, R.P.; Rosenberg, R.J.

    1983-06-01

    A case is discussed of a man who presented with trauma to the chest and abdomen. A radiocolloid image showed uptake by the liver. However, the spleen was not identified. Areas of activity outside of the spleen were noted. The patient had splenic avulsion; extra sites of activity likely represented bleeding sites in the abdomen. Failure to identify the spleen on a radiocolloid image, after trauma, should be an alerting sign to possible splenic avulsion (especially when there are also ectopic sites of accumulation of the radiocolloid).

  6. Extrahepatic portal venous obstruction: The effects of early ligation of splenic artery during splenectomy

    Directory of Open Access Journals (Sweden)

    Gazula Suhasini

    2009-01-01

    Full Text Available Aim: To objectively demonstrate the gain in blood volume and blood components following early ligation of splenic artery during splenectomy and splenorenal shunts in children with extra hepatic portal venous obstruction (EHPVO. Methods: Twenty-eight children (20 males and 8 females, mean age: 9.9 (±3.2 years with EHPVO and hypersplenism were recruited. We followed a protocol of systematically locating and ligating the splenic artery first, followed by a 30-minute waiting period to allow the massive spleen to decongest via the splenic vein and venous collaterals and then completing the splenectomy by standard procedure. No intravenous fluid was administered during this 30-minute period. Blood samples were drawn just prior to splenic artery ligation and soon after splenectomy for the estimation of hematological and biochemical parameters. Results: We noticed a highly significant increase in the hemoglobin, hematocrit, leukocyte, platelet, and RBC counts by early ligation of the splenic artery (p < 0.0004. The gain in hemoglobin and hematocrit was equivalent to a transfusion of atleast 100-150 ml of packed RBC. The increase in platelet count was equivalent to a platelet transfusion of atleast 4 units of platelet concentrates in an adult. There is a positive correlation between the splenic weight and the platelet gain (p= 0.0568 and the splenic volume on preoperative imaging and the platelet gain (p= 0.0251. Conclusion: Early ligation of the splenic artery during splenectomy results in passive splenic decongestion and thereby a significant gain in blood components. This protocol appears to be a feasible blood conservation method to avoid blood transfusions in this group of hypersplenic EHPVO patients.

  7. Blunt splenic injuries in the adolescent trauma population: the role of angiography and embolization.

    Science.gov (United States)

    Mayglothling, Julie A; Haan, James M; Scalea, Thomas M

    2011-07-01

    Splenic artery embolization (SAE) improves non-operative splenic salvage rates in adults, but its utility and safety in the pediatric population is less well defined. Because adolescent trauma patients are often triaged to adult trauma centers, we were interested in evaluating SAE in this particular population. We hypothesize that angiography and embolization is a safe and effective adjunct to non-operative management in the adolescent population. A retrospective review of all patients aged 13-17 years admitted to our Level I Trauma Center with blunt splenic injury from 1997-2005 was performed. We reviewed patient demographics, operative reports, admission, and follow-up abdominal computed tomography (ACT) results, angiographic reports, and patient outcomes. A total of 97 patients were reviewed. Eighteen patients underwent immediate surgery, and 79 of the remaining patients had planned non-operative management. Of those participating in non-operative management, 35/79 (44%) were initially observed and 44/79 (56%) underwent initial angiography, 23/44 having embolization. Patients in the embolization group had an overall high grade of injury (American Association for the Surgery of Trauma mean grade 3.3, SD 0.6). The overall splenic salvage rate was 96% (76/79) in the non-operative management group; 100% splenic salvage was seen in the observational group; 100% salvage was also seen in patients with negative angiography, and 87% salvage (20/23) in the splenic artery embolization group. Splenic artery embolization may be a valuable adjunct in adolescent blunt splenic injury, especially in higher grade injuries or with evidence of splenic vascular injury on ACT. Copyright © 2011 Elsevier Inc. All rights reserved.

  8. 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

  9. 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.

  10. Blunt trauma induced splenic blushes are not created equal

    Directory of Open Access Journals (Sweden)

    Burlew Clay

    2012-03-01

    Full Text Available Abstract Background Currently, evidence of contrast extravasation on computed tomography (CT scan is regarded as an indication for intervention in splenic injuries. In our experience, patients transferred from other institutions for angioembolization have often resolved the blush upon repeat imaging at our hospital. We hypothesized that not all splenic blushes require intervention. Methods During a 10-year period, we reviewed all patients transferred with blunt splenic injuries and contrast extravasation on initial postinjury CT scan. Results During the study period, 241 patients were referred for splenic injuries, of whom 16 had a contrast blush on initial CT imaging (88% men, mean age 35 ± 5, mean ISS 26 ± 3. Eight (50% patients were managed without angioembolization or operation. Comparing patients with and without intervention, there was a significant difference in admission heart rate (106 ± 9 vs 83 ± 6 and decline in hematocrit following transfer (5.3 ± 2.0 vs 1.0 ± 0.3, but not in injury grade (3.9 ± 0.2 vs 3.5 ± 0.3, systolic blood pressure (125 ± 10 vs 115 ± 6, or age (38.5 ± 8.2 vs 30.9 ± 4.7. Of the 8 observed patients, 3 underwent repeat imaging immediately upon arrival with resolution of the blush. In the intervention group, 4 patients had ongoing extravasation on repeat imaging, 2 patients underwent empiric embolization, and 2 patients underwent splenectomy for physiologic indications. Conclusions For blunt splenic trauma, evidence of contrast extravasation on initial CT imaging is not an absolute indication for intervention. A period of observation with repeat imaging could avoid costly, invasive interventions and their associated sequelae.

  11. Isolated splenic metastasis of endometrial adenocarcinoma--a case report.

    Science.gov (United States)

    Andrei, S; Preda, C; Andrei, A; Becheanu, G; Herlea, V; Lupescu, I; Popescu, I

    2011-01-01

    The spleen in rarely the place for solid, non-haematological tumors, isolated splenic metastases from adenocarcinomas being extremely rare findings, regardless of the origin and the histological type of the primary tumor. We present the case of a female patient with isolated splenic metastasis diagnosed by abdominal computer tomography at only 20 months after curative surgery for endometrial adenocarcinoma, in which the final diagnosis has been established by histological and immunohistochemical examination of the splenectomy piece. The haematogenous dissemination of the endometrial cancer occurs most commonly in the lungs, liver or bones, the spleen being rarely affected. In the medical literature there are cited up to date only 12 cases of solitary splenic metastasis from endometrial adenocarcinoma. The particularity of the case presented by us is the early appearance of an isolated splenic metastasis, at less than two years after curative surgery (compared to an average of 4-5 years cited in the literature), from an endometrial cancer which was classified histologicaly in the group with low-risk for relapse (well differentiated endometrioid adenocarcinoma). In conclusion, although solitary splenic secondary determinations are very rare, the incidence of the reported cases in the medical literature is increasing, their late appearance (a few years after the primary tumor's resection) and the lack of symptoms until the tumor reaches appreciable size or it complicates with necrosis, justifies the periodic abdominal imaging examination, on long-term, for postoperative monitorisation after the initial curative surgery. Their treatment of choice is open, classical splenectomy that must be followed by chemotherapy in order to prevent the development of other possible micrometastases.

  12. SOLITARY SPLENIC METASTASIS OF COLON CANCER: A CASE REPORT

    Directory of Open Access Journals (Sweden)

    Sh. Hashemzadeh M. Safari

    2004-11-01

    Full Text Available Although splenic metastasis is fairly common in disseminated cancer, solitary splenic metastasis in the absence of diffuse dissemination is rare. We report a case of 44 year-old man who developed isolated splenic metastasis of colon cancer. The patient had undergone right sided hemicolectomy for colon cancer in 1988. In 2001, he underwent reoperation because of local recurrence of tumor in the anastomotic site. The patient was admitted to our hospital on Sep 2003 with abdominal pain. Chest X-ray was normal. Abdominal CT scan showed a large cystic lesion in the spleen. Splenectomy was performed for the patient. The spleen was enlarged, firm and irregular. Histological examination showed metastatic mucinous adenocarcinoma. Based on this case, we recommend that clinicians consider possibility of metastasis in cystic lesions of spleen, especially in patients with a history of a malignant disease.

  13. 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.

  14. 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.

  15. Splenic marginal zone lymphoma: comprehensive analysis of gene expression and miRNA profiling.

    Science.gov (United States)

    Arribas, Alberto J; Gómez-Abad, Cristina; Sánchez-Beato, Margarita; Martinez, Nerea; Dilisio, Lorena; Casado, Felipe; Cruz, Miguel A; Algara, Patrocinio; Piris, Miguel A; Mollejo, Manuela

    2013-07-01

    Splenic marginal zone lymphoma is a small B-cell neoplasm whose molecular pathogenesis is still essentially unknown and whose differentiation from other small B-cell lymphomas is hampered by the lack of specific markers. We have analyzed the gene expression and miRNA profiles of 31 splenic marginal zone lymphoma cases. For comparison, 7 spleens with reactive lymphoid hyperplasia, 10 spleens infiltrated by chronic lymphocytic leukemia, 12 spleens with follicular lymphoma, 6 spleens infiltrated by mantle cell lymphoma and 15 lymph nodes infiltrated by nodal marginal zone lymphoma were included. The results were validated by qRT-PCR in an independent series including 77 paraffin-embedded splenic marginal zone lymphomas. The splenic marginal zone lymphoma miRNA signature had deregulated expression of 51 miRNAs. The most highly overexpressed miRNAs were miR-155, miR-21, miR-34a, miR-193b and miR-100, while the most repressed miRNAs were miR-377, miR-27b, miR-145, miR-376a and miR-424. MiRNAs located in 14q32-31 were underexpressed in splenic marginal zone lymphoma compared with reactive lymphoid tissues and other B-cell lymphomas. Finally, the gene expression data were integrated with the miRNA profile to identify functional relationships between genes and deregulated miRNAs. Our study reveals miRNAs that are deregulated in splenic marginal zone lymphoma and identifies new candidate diagnostic molecules for splenic marginal zone lymphoma.

  16. Observation Versus Embolization in Patients with Blunt Splenic Injury After Trauma : A Propensity Score Analysis

    NARCIS (Netherlands)

    Olthof, Dominique C.; Joosse, Pieter; Bossuyt, Patrick M. M.; de Rooij, Philippe P.; Leenen, Loek P. H.; Wendt, Klaus W.; Bloemers, Frank W.; Goslings, J. Carel

    Non-operative management (NOM) is the standard of care in hemodynamically stable patients with blunt splenic injury after trauma. Splenic artery embolization (SAE) is reported to increase observation success rate. Studies demonstrating improved splenic salvage rates with SAE primarily compared SAE

  17. Observation Versus Embolization in Patients with Blunt Splenic Injury After Trauma: A Propensity Score Analysis

    NARCIS (Netherlands)

    Olthof, Dominique C.; Joosse, Pieter; Bossuyt, Patrick M. M.; de Rooij, Philippe P.; Leenen, Loek P. H.; Wendt, Klaus W.; Bloemers, Frank W.; Goslings, J. Carel

    2016-01-01

    Non-operative management (NOM) is the standard of care in hemodynamically stable patients with blunt splenic injury after trauma. Splenic artery embolization (SAE) is reported to increase observation success rate. Studies demonstrating improved splenic salvage rates with SAE primarily compared SAE

  18. Observation Versus Embolization in Patients with Blunt Splenic Injury after Trauma: A Propensity Score Analysis

    NARCIS (Netherlands)

    D.C. Olthof; P. Joosse (Pieter); P.M.M. Bossuyt (Patrick); P.P. de Rooij (Philippe); L.P.H. Leenen (Luke); K.W. Wendt (Klaus); F.W. Bloemers (Frank); J.C. Goslings (Carel)

    2016-01-01

    textabstractBackground: Non-operative management (NOM) is the standard of care in hemodynamically stable patients with blunt splenic injury after trauma. Splenic artery embolization (SAE) is reported to increase observation success rate. Studies demonstrating improved splenic salvage rates with SAE

  19. Splenic Pregnancy: A New Minimally Invasive Approach to Treatment

    Energy Technology Data Exchange (ETDEWEB)

    Klang, Eyal, E-mail: eyalkla@hotmail.com; Keddel, Nicholas; Inbar, Yael; Rimon, Uri; Amitai, Michal [Tel Hashomer Hospital, The Chaim Sheba Medical Center, Department of Radiology (Israel)

    2016-09-15

    The spleen is a rare site of abdominal ectopic pregnancy. In a review of the literature, we found 16 published cases of primary splenic pregnancies. Of the cases identified, all received surgical intervention, with one case successfully treated with laparoscopic methotrexate injection, and the rest underwent splenectomy. We would like to present a case of primary splenic pregnancy in a 35-year-old woman successfully treated with percutaneous image-guided injection of methotrexate and KCl.

  20. Splenic Pregnancy: A New Minimally Invasive Approach to Treatment

    International Nuclear Information System (INIS)

    Klang, Eyal; Keddel, Nicholas; Inbar, Yael; Rimon, Uri; Amitai, Michal

    2016-01-01

    The spleen is a rare site of abdominal ectopic pregnancy. In a review of the literature, we found 16 published cases of primary splenic pregnancies. Of the cases identified, all received surgical intervention, with one case successfully treated with laparoscopic methotrexate injection, and the rest underwent splenectomy. We would like to present a case of primary splenic pregnancy in a 35-year-old woman successfully treated with percutaneous image-guided injection of methotrexate and KCl.

  1. Decellularized Swine Dental Pulp as a Bioscaffold for Pulp Regeneration

    OpenAIRE

    Hu, Lei; Gao, Zhenhua; Xu, Junji; Zhu, Zhao; Fan, Zhipeng; Zhang, Chunmei; Wang, Jinsong; Wang, Songlin

    2017-01-01

    Endodontic regeneration shows promise in treating dental pulp diseases; however, no suitable scaffolds exist for pulp regeneration. Acellular natural extracellular matrix (ECM) is a favorable scaffold for tissue regeneration since the anatomical structure and ECM of the natural tissues or organs are well-preserved. Xenogeneic ECM is superior to autologous or allogeneic ECM in tissue engineering for its unlimited resources. This study investigated the characteristics of decellularized dental p...

  2. Fcγ receptor expression on splenic macrophages in adult immune thrombocytopenia

    NARCIS (Netherlands)

    Audia, S; Santegoets, K; Laarhoven, A G; Vidarsson, G; Facy, O; Ortega-Deballon, P; Samson, M; Janikashvili, N; Saas, P; Bonnotte, B; Radstake, T R

    2017-01-01

    Splenic macrophages play a key role in immune thrombocytopenia (ITP) pathogenesis by clearing opsonized platelets. Fcγ receptors (FcγR) participate in this phenomenon, but their expression on splenic macrophages and their modulation by treatment have scarcely been studied in human ITP. We aimed to

  3. 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

  4. Results of non-operative management of splenic trauma and its complications in children

    Directory of Open Access Journals (Sweden)

    Ndour Oumar

    2014-01-01

    Full Text Available Introduction: Non-operative management (NOM of splenic trauma in children is currently the treatment of choice. Purpose: We report a series of 83 cases in order to compare our results with literature data. Patients and Methods: For this, we conducted a retrospective study of 13 years and collected 83 cases of children with splenic trauma contusion, managed at Lapeyronie Montpellier Hospital in Visceral Pediatric Surgery Department. The studied parameters were age, sex, circumstances, the blood pressure (BP, hematology, imaging, associated injuries, transfusion requirements, treatment, duration of hospital stay, physical activity restriction and evolution. Results: NOM was successful in 98.7% of cases. We noted 4 complications including 3 pseudo aneurysms (PSA of splenic artery and 1 pseudocyst spleen with a good prognosis. There was no mortality in our series. Conclusion: NOM is the treatment of choice for splenic trauma in children with a success rate of over 90%. Complications are rare and are dominated by the PSA of splenic artery.

  5. Low Temperature Soda-Oxygen Pulping of Bagasse

    OpenAIRE

    Fengxia Yue; Ke-Li Chen; Fachuang Lu

    2016-01-01

    Wood shortages, environmental pollution and high energy consumption remain major obstacles hindering the development of today’s pulp and paper industry. Energy-saving and environmental friendly pulping processes are still needed, especially for non-woody materials. In this study, soda-oxygen pulping of bagasse was investigated and a successful soda-oxygen pulping process for bagasse at 100 °C was established. The pulping parameters of choice were under active alkali charge of 23%, maximum coo...

  6. Massive splenic infarction in Saudi patients with sickle cell anemia: a unique manifestation.

    Science.gov (United States)

    Jama, Ali Hassan Al; Salem, Ahmed Hassan Al; Dabbous, Ibrahim Abdalla Al

    2002-03-01

    Splenic infarcts are common in patients with sickle cell anemia (SCA), but these are usually small and repetitive, leading ultimately to autosplenectomy. Massive splenic infarcts on the other hand are extremely rare. This is a report of our experience with 8 (4 males and 4 females) cases of massive splenic infarction in patients with SCA. Their ages ranged from 16 to 36 years (mean 22 years). Three presented with left upper quadrant abdominal pain and massive splenic infarction on admission, while the other 5 developed massive splenic infarction while in hospital. In 5 the precipitating factors were high altitude, postoperative, postpartum, salmonella septicemia, and strenuous exercise in one each, while the remaining 3 had severe generalized vasoocclusive crises. Although both ultrasound and CT scan of the abdomen were of diagnostic value, we found CT scan more accurate in delineating the size of infarction. All our patients were managed conservatively with I.V. fluids, analgesia, and blood transfusion when necessary. Diagnostic aspiration under ultrasound guidance was necessary in two patients to differentiate between massive splenic infarction and splenic abscess. Two patients required splenectomy during the same admission because of suspicion of secondary infection and abscess formation, while a third patient had splenectomy 2 months after the attack because of persistent left upper quadrant abdominal pain. In all the 3 histology of the spleen showed congestive splenomegaly with massive infarction. All of our patients survived. Two patients subsequently developed autosplenectomy while the remaining 3 continue to have persistent but asymptomatic splenomegaly. Massive splenic infarction is a rare and unique complication of SCA in the Eastern Province of Saudi Arabia, and for early diagnosis and treatment, physicians caring for these patients should be aware of such a complication.

  7. Partial splenectomy and autotransplantation of splenic fragments in pigs: a model for prevention of septicemia

    International Nuclear Information System (INIS)

    Pabst, R.; Binns, R.M.

    1986-01-01

    Normal young piglets and miniature piglets of the Gottingen breed were used as animal models for autotransplantation of splenic fragments. In pigs, regeneration kinetics seem to be comparable to man. Even after six mo, only small splenic nodules with a reduced blood flow were found. No effective stimulator of splenic regeneration has been found for pigs. Pig spleen size and blood supply enable partial splenectomies and ligation of the splenic artery which are models for spleen surgery in man

  8. 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

  9. Mineralization Effect of Hyaluronan on Dental Pulp Cells via CD44.

    Science.gov (United States)

    Chen, Kuan-Liang; Yeh, Ying-Yi; Lung, Jrhau; Yang, Yu-Chi; Yuan, Kuo

    2016-05-01

    CD44 is a cell-surface glycoprotein involved in various cellular functions. Recent studies have suggested that CD44 is involved in early mineralization of odontoblasts. Hyaluronic acid (HA) is the principal ligand for receptor CD44. Whether and how HA regulated the mineralization process of dental pulp cells were investigated. The effects of high-molecular-weight HA on differentiation and mineral deposition of dental pulp cells were tested by using alkaline phosphatase (ALP) activity assay and alizarin red S staining. Osteogenesis real-time polymerase chain reaction array, quantitative polymerase chain reaction, and Western blotting were performed to identify downstream molecules involved in the mineralization induction of HA. CD44 was knocked down and examined to confirm whether the mineralization effect of HA was mediated by receptor CD44. Immunohistochemistry was used to understand the localization patterns of CD44 and the identified downstream proteins in vivo. Pulse treatment of HA enhanced ALP activity and mineral deposition in dental pulp cells. Tissue-nonspecific ALP, bone morphogenetic protein 7 (BMP7), and type XV collagen (Col15A1) were upregulated via the HA-CD44 pathway in vitro. Immunohistochemistry of tooth sections showed that the staining pattern of BMP7 was very similar to that of CD44. Results of this study indicated that high-molecular-weight HA enhanced early mineralization of dental pulp cells mediated via CD44. The process involved important mineralization-associated molecules including tissue-nonspecific ALP, BMP7, and Col15A1. The findings may help develop new strategies in regenerative endodontics. Copyright © 2016 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

  10. [Primary infection with cytomegalovirus: An infectious cause of splenic infarction].

    Science.gov (United States)

    Kassem, H; Khamadi, K; Farrugia, C; Ho Hio Hen, N; El Gharbi, T; Turner, L

    2017-08-01

    Cytomegalovirus-associated thrombosis has been extensively reported in the medical literature, mainly in immune-compromised patients. However, the association with splenic infarcts has rarely been reported. We report a 32-year-old Caucasian and immunocompetent woman who presented with a splenic infarction during a primary infection with CMV. The differential diagnostic ruled out embolic, hematologic, gastrointestinal and coagulation disorders. The outcome was favorable with symptomatic treatment. A primary infection with CMV must be added to the diagnostic work-up in the presence of a febrile splenic infarction, especially when it is associated with a biological mononucleosis reaction. Copyright © 2016 Société Nationale Française de Médecine Interne (SNFMI). Published by Elsevier SAS. All rights reserved.

  11. Splenic rupture in a neonate – a rare complication | Lloyd | South ...

    African Journals Online (AJOL)

    Birth trauma is well described in the neonatal literature, but intra-abdominal injuries occur infrequently and are often forgotten in the differential diagnosis of a hypovolaemic shocked infant with an abdominal mass. The symptoms of splenic rupture are nonspecific, creating a diagnostic dilemma for the clinician. As splenic ...

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

    International Nuclear Information System (INIS)

    Kuni, C.C.; Crass, J.R.; Du Cret, R.P.; Boudreau, R.J.; Loken, M.K.

    1987-01-01

    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

  13. Pulp regeneration by transplantation of dental pulp stem cells in pulpitis: a pilot clinical study.

    Science.gov (United States)

    Nakashima, Misako; Iohara, Koichiro; Murakami, Masashi; Nakamura, Hiroshi; Sato, Yayoi; Ariji, Yoshiko; Matsushita, Kenji

    2017-03-09

    Experiments have previously demonstrated the therapeutic potential of mobilized dental pulp stem cells (MDPSCs) for complete pulp regeneration. The aim of the present pilot clinical study is to assess the safety, potential efficacy, and feasibility of autologous transplantation of MDPSCs in pulpectomized teeth. Five patients with irreversible pulpitis were enrolled and monitored for up to 24 weeks following MDPSC transplantation. The MDPSCs were isolated from discarded teeth and expanded based on good manufacturing practice (GMP). The quality of the MDPSCs at passages 9 or 10 was ascertained by karyotype analyses. The MDPSCs were transplanted with granulocyte colony-stimulating factor (G-CSF) in atelocollagen into pulpectomized teeth. The clinical and laboratory evaluations demonstrated no adverse events or toxicity. The electric pulp test (EPT) of the pulp at 4 weeks demonstrated a robust positive response. The signal intensity of magnetic resonance imaging (MRI) of the regenerated tissue in the root canal after 24 weeks was similar to that of normal dental pulp in the untreated control. Finally, cone beam computed tomography demonstrated functional dentin formation in three of the five patients. Human MDPSCs are safe and efficacious for complete pulp regeneration in humans in this pilot clinical study.

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

    International Nuclear Information System (INIS)

    Luo, Xuefeng; Nie, Ling; Wang, Zhu; Tsauo, Jiaywei; Tang, Chengwei; Li, Xiao

    2014-01-01

    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

  15. 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.

  16. Splenic injuries at Bugando Medical Centre in northwestern Tanzania: a tertiary hospital experience

    Science.gov (United States)

    2012-01-01

    Background Splenic injuries constitute a continuing diagnostic and therapeutic challenge to the trauma or general surgeons practicing in developing countries where sophisticated imaging facilities are either not available or exorbitantly expensive. The purpose of this review was to describe our own experience in the management of the splenic injuries outlining the aetiological spectrum, injury characteristics and treatment outcome of splenic injuries in our local environment and to identify predictors of outcome among these patients. Methods A prospective descriptive study of splenic injury patients was carried out at Bugando Medical Centre in Northwestern Tanzania between March 2009 and February 2011. Statistical data analysis was done using SPSS software version 17.0. Results A total of 118 patients were studied. The male to female ratio was 6.4:1. Their ages ranged from 8 to 74 years with a median age of 22 years. The modal age group was 21-30 years. The majority of patients (89.8%) had blunt trauma and road traffic accidents (63.6%) were the most frequent cause of injuries. Most patients sustained grade III (39.0%) and IV (38.1%) splenic injuries. Majority of patients (86.4%) were treated operatively with splenectomy (97.1%) being the most frequently performed procedure. Postoperative complications were recorded in 30.5% of cases. The overall length of hospital stay (LOS) ranged from 1 day to 120 days with a median of 18 days. Mortality rate was 19.5%. Patients who had severe trauma (Kampala Trauma Score II ≤ 6) and those with associated injuries stayed longer in the hospital (P trauma scores (KTS II), grade of splenic injuries, admission systolic blood pressure ≤ 90 mmHg, estimated blood loss > 2000 mls, HIV infection with CD4 ≤ 200 cells/μl and presence of postoperative complications were significantly associated with mortality (P Trauma resulting from road traffic accidents (RTAs) remains the most common cause of splenic injuries in our setting. Most

  17. Splenic congestion associated with acepromazine administration in dogs

    Directory of Open Access Journals (Sweden)

    Denise Cláudia Tavares

    2015-02-01

    Full Text Available The aim of this study was evaluate splenic dilatation induced by acepromazine in a prospective, randomized study. Thirty-three adult mongrel dog were divided into two groups designated as AG (acepromazine 0.05 mg/kg, i.v., n = 23 and CG (0.9% sodium chloride administered at a similar volume, n = 10. In both groups underwent sonographic examinations before (T0 and fifteen minutes (T15 after drug injection. The thickness spleen and splenic vein width were measured. Higher thickness was found in the AG group at T15 (2.47 cm when compared to that at T0 (2.06 cm, p = 0.016, while the T0 (2.33 cm and T15 (2.39 cm measures did not differ within the CG group. Moreover, the splenic vein width was higher (p = 0.013 at T15 than at T0 in the AG group. Based on results of this study, we concluded that acepromazine, in doses of 0.05 mg/kg, promotes splenomegaly in dogs after fifteen minutes of the injection.

  18. Predictors of splenic function preservation in children with sickle cell anemia treated with hydroxyurea.

    Science.gov (United States)

    Nottage, Kerri A; Ware, Russell E; Winter, Bryan; Smeltzer, Matthew; Wang, Winfred C; Hankins, Jane S; Dertinger, Stephen D; Shulkin, Barry; Aygun, Banu

    2014-11-01

    More than 90% of children with sickle cell anemia (SCA) lose splenic function by the age of 2 yrs. Splenic function may improve with hydroxyurea, but previous studies are conflicting. We prospectively evaluated the effect of hydroxyurea on splenic filtrative function. Children with SCA enrolled in the Hydroxyurea Study of Long-Term Effects (HUSTLE-NCT00305175) underwent clinical evaluations including Tc(99) m liver-spleen (LS) scans before hydroxyurea initiation and after 3 yrs of treatment to maximum tolerated dose (MTD). LS scans were classified as follows: no uptake, Hydroxyurea at MTD is associated with preserved or improved splenic filtrative function, with 33% demonstrating LS scan uptake after 3 yrs. Younger age, higher %HbF, and baseline splenic function are associated with a favorable outcome. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  19. Reliability of injury grading systems for patients with blunt splenic trauma.

    Science.gov (United States)

    Olthof, D C; van der Vlies, C H; Scheerder, M J; de Haan, R J; Beenen, L F M; Goslings, J C; van Delden, O M

    2014-01-01

    The most widely used grading system for blunt splenic injury is the American Association for the Surgery of Trauma (AAST) organ injury scale. In 2007 a new grading system was developed. This 'Baltimore CT grading system' is superior to the AAST classification system in predicting the need for angiography and embolization or surgery. The objective of this study was to assess inter- and intraobserver reliability between radiologists in classifying splenic injury according to both grading systems. CT scans of 83 patients with blunt splenic injury admitted between 1998 and 2008 to an academic Level 1 trauma centre were retrospectively reviewed. Inter and intrarater reliability were expressed in Cohen's or weighted Kappa values. Overall weighted interobserver Kappa coefficients for the AAST and 'Baltimore CT grading system' were respectively substantial (kappa=0.80) and almost perfect (kappa=0.85). Average weighted intraobserver Kappa's values were in the 'almost perfect' range (AAST: kappa=0.91, 'Baltimore CT grading system': kappa=0.81). The present study shows that overall the inter- and intraobserver reliability for grading splenic injury according to the AAST grading system and 'Baltimore CT grading system' are equally high. Because of the integration of vascular injury, the 'Baltimore CT grading system' supports clinical decision making. We therefore recommend use of this system in the classification of splenic injury. Copyright © 2012 Elsevier Ltd. All rights reserved.

  20. CT grading scales for splenic injury: why can't we agree?

    International Nuclear Information System (INIS)

    Clark, Rhys; Hird, Kathryn

    2011-01-01

    Full text: Computed tomography (CT) has been proven to be able to accurately diagnose splenic injury, Many have published CT splenic injury grading scales to quantify the extent of injury, However, these scales have failed at predicting clinical outcomes and therefore cannot be used to accu rately predict the need for intervention. We hypothesi sed that low interrater reliability is the reason why these scales have failed at predicting clinical outcomes. This is a retrospective study of patients who were admitted to the Royal Perth Hospital with blunt splenic injury as coded in the trauma registry, The abdominal CT images of these patients were reviewed by three consultant radiologists and were graded using the six different splenic injury grading scales. We assessed interrater reliability between each of the scales using generalised kappa and proportion of agreement calculations. Results: The images of 64 patients were reviewed. The interrater reliability yielded a generalised kappa score of 0.32-0,60 and proportion of agreement ranging from 34,4% to 65,5%, The six studied CT splenic injury grading scales did not have a high enough interrater reliability to be adequate for clinical use, The poor interrater reliability is likely to contribute to the failure of the scales at predicting clinical outcomes. Further research to improve the interrater reliability is recommended.

  1. Dynamic alteration in splenic function during acute falciparum malaria

    International Nuclear Information System (INIS)

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

    1987-01-01

    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 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

  2. Laparoscopic Splenectomy for Traumatic Splenic Injury after Screening Colonoscopy

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    Salim Abunnaja

    2012-09-01

    Full Text Available Colonoscopy is a widespread diagnostic and therapeutic procedure. The most common complications include bleeding and perforation. Splenic rupture following colonoscopy is rarely encountered and is most likely secondary to traction on the splenocolic ligament. Exploratory laparotomy and splenectomy is the most commonly employed therapeutic intervention for this injury reported in the literature. We present the case of a patient with this potentially fatal complication who was treated successfully at our institution. To our knowledge it is the first report in the literature of laparoscopic splenectomy as a successful minimally invasive treatment of splenic rupture following colonoscopy. The patient was a 62-year-old female who underwent screening colonoscopy with polypectomies at the cecum, descending colon and rectum. Immediately following the procedure she developed abdominal pain and had a syncopal episode. Clinical, laboratory and imaging findings were suggestive of hemoperitoneum and a ruptured spleen. A diagnostic laparoscopy was emergently performed and revealed a grade IV splenic laceration and hemoperitoneum. Laparoscopic splenectomy was completed safely and effectively. The patient’s postoperative recovery was uneventful. We conclude that splenic rupture after colonoscopy is a rare but dangerous complication. A high index of suspicion is required to recognize it early. Awareness of this potential complication can lead to optimal patient outcome. Laparoscopic splenectomy may be a feasible treatment option.

  3. Viscoelastic Properties of Dental Pulp Tissue and Ramifications on Biomaterial Development for Pulp Regeneration.

    Science.gov (United States)

    Erisken, Cevat; Kalyon, Dilhan M; Zhou, Jian; Kim, Sahng G; Mao, Jeremy J

    2015-10-01

    A critical step in biomaterial selection effort is the determination of material as well as the biological properties of the target tissue. Previously, the selection of biomaterials and carriers for dental pulp regeneration has been solely based on empirical experience. In this study, first, the linear viscoelastic material functions and compressive properties of miniature pig dental pulp were characterized using small-amplitude oscillatory shear and uniaxial compression at a constant rate. They were then compared with the properties of hydrogels (ie, agarose, alginate, and collagen) that are widely used in tissue regeneration. The comparisons of the linear viscoelastic material functions of the native pulp tissue with those of the 3 hydrogels revealed the gel-like behavior of the pulp tissue over a relatively large range of time scales (ie, over the frequency range of 0.1-100 rps). At the constant gelation agent concentration of 2%, the dynamic properties (ie, storage and loss moduli and the tanδ) of the collagen-based gel approached those of the native tissue. Under uniaxial compression, the peak normal stresses and compressive moduli of the agarose gel were similar to those of the native tissue, whereas alginate and collagen exhibited significantly lower compressive properties. The linear viscoelastic and uniaxial compressive properties of the dental pulp tissue reported here should enable the more appropriate selection of biogels for dental pulp regeneration via the better tailoring of gelation agents and their concentrations to better mimic the dynamic and compressive properties of native pulp tissue. Copyright © 2015 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

  4. Splenic Abscesses: Review of 29 Cases

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    I-Shun Chiang

    2003-10-01

    Full Text Available Splenic abscess is an unusual and potentially life-threatening disease. Due to the nonspecific clinical picture, it remains a diagnostic challenge. Splenic abscess should be suspected in febrile patients with left upper quadrant tenderness and leukocytosis, and diagnosis confirmed based mostly on imaging studies, microbiologic and/or pathologic evidence, or by response to antibiotic or antifungal treatment. We present 29 cases of splenic abscess treated in our hospital from 1990 to 2001. There were 18 male patients (62% and 11 female patients (38%. Ages ranged from 4 to 85 years, with a median of 44 years. There were five pediatric patients (17% and 24 adults (83%. The most common associated condition was leukemia. Most patients were immunocompromised (72%. The more common signs and symptoms were fever (90%, chills (41%, abdominal pain (31%, and leukocytosis (38%. Ultrasonography of the abdominal cavity was positive in 27 cases (93%; computerized tomography or magnetic resonance imaging was used in 26 patients (90% and was positive in all patients. The abscess was solitary in 21 cases (72% and multiple in eight cases (28%. Positive blood cultures were found in only seven patients (24%. According to the literature, the treatment of choice is still splenectomy, but in our study, the success rate of 75% with antibiotics alone indicates that antibiotic therapy should be considered an important alternative treatment modality in patients not suitable for percutaneous drainage and splenectomy.

  5. 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.)

  6. Pediatric blunt splenic trauma: a comprehensive review

    International Nuclear Information System (INIS)

    Lynn, Karen N.; Werder, Gabriel M.; Callaghan, Rachel M.; Jafri, Zafar H.; Sullivan, Ashley N.; Bloom, David A.

    2009-01-01

    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.)

  7. Evaluation of splenic autotransplants by radionuclide methods

    International Nuclear Information System (INIS)

    Nawaz, K.; Nema, T.A.; Al-Mohannadi, S.; Abdel-Dayem, H.M.

    1986-01-01

    The viability of omental autotransplantation of splenic tissue after splenectomy has been disputed. The authors followed up splenic implants by imaging with either Tc-99m tin colloid or heat-damaged RBCs to determine how early implants can be visualized and whether a difference exists between patients who underwent emergency splenectomy for trauma (nine patients) and those who underwent elective splenectomy (seven patients). In the latter group, splenectomy was performed for portal hypertension in six patients and for hematologic disorder (Wiscott Aldrich syndrome) in one. All patients were imaged 2-4 weeks and 6 months after surgery. In the first group, seven implants were seen at 2-4 weeks and all nine were seen by 6 months. In the second group, only two implants were seen at 2-4 weeks and four were seen at 6 months; two implants were not visualized even at 6 months. The implant of the patient with hematologic disorder was not seen before 6 months. The authors conclude that splenic implants can be visualized bu scintigraphic methods as early as 2-4 weeks after surgery, and that by 6 months all implants from normal spleen are viable. By contrast, spleen implants placed for portal hypertension or hematologic disorders may fail

  8. Risk of venous thromboembolism in patients with splenic injury and splenectomy. A nationwide cohort study.

    Science.gov (United States)

    Lin, Jiun-Nong; Chen, Hsuan-Ju; Lin, Ming-Chia; Lai, Chung-Hsu; Lin, Hsi-Hsun; Yang, Chih-Hui; Kao, Chia-Hung

    2016-01-01

    The spleen is a crucial organ in humans. However, little is known about the association of venous thromboembolism (VTE) with splenic injury and splenectomy in trauma patients. The aim of this study was to determine the subsequent risk of VTE following splenic injury and splenectomy. A nationwide retrospective cohort study was conducted by analysing data from the National Health Insurance Research Database in Taiwan. We included 6,162 splenic injury patients (3,033 splenectomised and 3,129 nonsplenectomised patients) and 24,648 comparison patients who were selected by frequency match based on sex, age, and the index year during 2000-2006. All patients were followed until the occurrence of VTE, 31 December, 2011, death, or withdrawal from the insurance program. The age of patients with splenic injury was 41.93 ± 16.44 years. The incidence rates of VTE were 11.81, 8.46, and 5.21 per 10,000 person-years in the splenic injury patients with splenectomy, splenic injury patients without splenectomy, and comparison patients, respectively. Compared with the comparison cohort, splenic injury patients with splenectomy exhibited a 2.21-fold risk of VTE (95% confidence interval [CI], 1.43-3.43), whereas those without splenectomy exhibited a 1.71-fold risk of VTE (95% CI, 1.05-2.80). The overall incidence rate of VTE was 1.97-fold higher in the splenic injury cohort than the comparison cohort (95% CI, 1.38-2.81). Although splenectomy increased the risk of VTE 1.35-fold compared with no splenectomy, the difference was not statistically significant (95% CI, 0.74-2.45). These results may alert physicians and patients to the complications of splenic injury and splenectomy.

  9. Splenic injuries at Bugando Medical Centre in northwestern Tanzania: a tertiary hospital experience

    Directory of Open Access Journals (Sweden)

    Chalya Phillipo L

    2012-01-01

    Full Text Available Abstract Background Splenic injuries constitute a continuing diagnostic and therapeutic challenge to the trauma or general surgeons practicing in developing countries where sophisticated imaging facilities are either not available or exorbitantly expensive. The purpose of this review was to describe our own experience in the management of the splenic injuries outlining the aetiological spectrum, injury characteristics and treatment outcome of splenic injuries in our local environment and to identify predictors of outcome among these patients. Methods A prospective descriptive study of splenic injury patients was carried out at Bugando Medical Centre in Northwestern Tanzania between March 2009 and February 2011. Statistical data analysis was done using SPSS software version 17.0. Results A total of 118 patients were studied. The male to female ratio was 6.4:1. Their ages ranged from 8 to 74 years with a median age of 22 years. The modal age group was 21-30 years. The majority of patients (89.8% had blunt trauma and road traffic accidents (63.6% were the most frequent cause of injuries. Most patients sustained grade III (39.0% and IV (38.1% splenic injuries. Majority of patients (86.4% were treated operatively with splenectomy (97.1% being the most frequently performed procedure. Postoperative complications were recorded in 30.5% of cases. The overall length of hospital stay (LOS ranged from 1 day to 120 days with a median of 18 days. Mortality rate was 19.5%. Patients who had severe trauma (Kampala Trauma Score II ≤ 6 and those with associated injuries stayed longer in the hospital (P 2000 mls, HIV infection with CD4 ≤ 200 cells/μl and presence of postoperative complications were significantly associated with mortality (P Conclusion Trauma resulting from road traffic accidents (RTAs remains the most common cause of splenic injuries in our setting. Most of the splenic injuries were Grade III & IV and splenectomy was performed in majority of

  10. PRODUCTION OF DISSOLVING GRADE PULP FROM ALFA

    Directory of Open Access Journals (Sweden)

    Baya Bouiri

    2010-02-01

    Full Text Available Alfa, also known as Stipa tenacissimaI or “halfa”, is grown in North Africa and south Spain. Due to its short fiber length, paper made from alfa pulp retains bulk and takes block letters well. In this study alfa was evaluated for bleached pulp production. Two cellulose pulps with different chemical compositions were pulped by a conventional kraft process. One sample was taken from the original alfa material and another from alfa that had been pretreated by diluted acid. The pulp produced from the pretreated alfa was bleached by the elemental-chlorine-free sequences DEPD and DEDP. The yield, Kappa number, brightness, and α- cellulose content of bleached and unbleached pulps were evaluated. The results showed that during the chemical pulping process, treated alfa cooked more easily than the original alfa. The treated alfa pulp also showed very good bleaching, reaching a brightness level of 94.8% ISO with a yield of 93.6% at an α-cellulose content 96.8(% with a DEDP bleaching sequence, compared to 83.2% ISO brightness level, 92.8% yield, and 95.1% α-cellulose content for bleached pulp with a DEPD bleaching sequence. Therefore, this alfa material could be considered as a worthwhile choice for cellulosic fiber supply.

  11. Splenic embolization in cirrhotic patients with portal hypertension

    International Nuclear Information System (INIS)

    Falappa, P.G.; Cotroneo, A.R.; De Cinque, M.; Maresca, G.; Patane', D.

    1988-01-01

    Over the last four years the authors performed transcatheter embolization of the splenic artery by Gianturco coils in 32 consecutive cirrhotic patients with portal hypertension, splenomegaly, cytopenia and gastro-esophageal varices endoscopically proved. This procedure was especially useful for treatement of splenomegaly and cytopenia because a constant reduction of spleen dimensions and increase in platelet count were registered. The effectiveness of transcatheter embolization and follow-up are based on clinic, hematologic and sonographic findings. Sonographic monitoring is believed to be very useful both to evaluate splenomegaly and signs of portal hypertension and to reveal splenic complications (abscesses). Severe complications have been never registered

  12. Splenic Abscess: A Rare Complication of the UVC in Newborn

    Directory of Open Access Journals (Sweden)

    Ameer Aslam

    2014-01-01

    Full Text Available Splenic abscess is one of the rarest complications of the UVC in a newborn and it is hypothesized that it could be due to an infection or trauma caused by a catheter. The case that is being reported presented with abdominal distension and recurrent desaturation with suspicion of neonatal sepsis versus necrotizing enterocolitis. However, the final diagnosis was splenic abscess as a complication of an inappropriate UVC insertion which was discovered by abdominal ultrasound. The patient was given broad spectrum antibiotics empirically and the symptoms were resolved without any surgical intervention. Such cases and controlled studies need to be reported in order to identify further causes and risk factors associated with splenic abscess in a patient with UVC which can eventually help us adopt preventive strategies to avoid such complications.

  13. Alkaline pulping of some eucalypts from Sudan.

    Science.gov (United States)

    Khristova, P; Kordsachia, O; Patt, R; Dafaalla, S

    2006-03-01

    Four eucalypts (Eucalyptus camaldulensis, Eucalyptus microtheca, Eucalyptus tereticornis and Eucalyptus citriodora) grown in Sudan were examined for their suitability for pulping and papermaking with different alkaline methods. Their physical, morphological and chemical characteristics are reported. The pulping trials with E. citriodora and E. tereticornis were carried out using the kraft-AQ, soda-AQ, modified AS/AQ (ASA), ASAM and kraft methods. For the other two species, only the ASAM and the kraft process were applied. ASAM pulping gave the best results in terms of yield, degree of delignification, mechanical and optical pulp properties. The best pulps, obtained in kraft and ASAM cooking of E. citriodora, were bleached to 88% ISO brightness in a totally chlorine free bleaching sequence (OQ1O/PQ2P). The bleached pulps, especially the ASAM pulp, showed good papermaking properties and would be suitable for manufacture of writing and printing grades of paper.

  14. Management of isolated splenic injuries after blunt trauma: an institution's experience over 6 years.

    Science.gov (United States)

    Tan, K K; Chiu, M T; Vijayan, A

    2010-12-01

    Forty-two patients with traumatic blunt splenic injuries were admitted over a six year period. Vehicular-related collisions and fall from height accounted for the injuries in 38 (90.5%) of them. Eleven (26.2%) underwent immediate surgery (7 splenectomy and 4 splenorrhaphy), while the remaining 31 patients were treated nonoperatively of which 3 underwent angio-embolisation. Twenty seven patients had either grade III or IV splenic injuries. Operative management was more likely in patients with lower haemoglobin or with more severe splenic injury. Nonoperative management can be adopted in patients with blunt isolated splenic injuries but operative management is still indispensable in certain instances.

  15. Fatal disseminated toxoplasmosis in an immunocompetent cat

    Directory of Open Access Journals (Sweden)

    Susanna S. Nagel

    2013-02-01

    Full Text Available A 10-year-old domestic short hair cat was referred for investigation of anorexia and polydipsia of 3 days’ duration. Clinically the cat was obese, pyrexic (39.8 °C, had acute abdominal pain and severe bilirubinuria. Haematology and serum biochemistry revealed severe panleukopenia, thrombocytopenia, markedly elevated alanine aminotransferase (ALT and five-fold increased pre-prandial bile acids. Ultrasonographic evaluation of the abdomen did not identify any abnormalities. Serum tests for feline immunodeficiency virus (FIV and feline leukaemia virus (FeLV were negative. Broad-spectrum antibiotic treatment for infectious hepatitis was to no avail; the cat deteriorated and died 72 h after admission. Necropsy revealed mild icterus and anaemia, severe multifocal hepatic necrosis, serofibrinous hydrothorax, pulmonary oedema and interstitial pneumonia. Histopathology confirmed the macroscopic findings and revealed multifocal microgranulomata in the brain and myocardium, as well as areas of necrosis in lymph nodes and multifocally in splenic red pulp. Long bone shaft marrow was hyperplastic with a predominance of leukocyte precursors and megakaryocytes and splenic red pulp showed mild extramedullary haemopoiesis. Immunohistochemical staining for Toxoplasma gondii was strongly positive, with scattered cysts and tachyzoites in the liver, lymph nodes, spleen, lungs, brain, salivary glands and intracellularly in round cells in occasional blood vessels. Immunohistochemical staining for corona virus on the same tissues was negative, ruling out feline infectious peritonitis (FIP. Polymerase chain reaction (PCR on formalin-fixed paraffin-wax embedded tissues was positive for Toxoplasma sp., but attempts at sequencing were unsuccessful. This was the first case report of fulminant disseminated toxoplasmosis in South Africa, in which detailed histopathology in an apparently immunocompetent cat was described.

  16. Fatal disseminated toxoplasmosis in an immunocompetent cat.

    Science.gov (United States)

    Nagel, Susanna S; Williams, June H; Schoeman, Johannes P

    2013-02-14

    A 10-year-old domestic short hair cat was referred for investigation of anorexia and polydipsia of 3 days' duration. Clinically the cat was obese, pyrexic (39.8 °C), had acute abdominal pain and severe bilirubinuria. Haematology and serum biochemistry revealed severe panleukopenia, thrombocytopenia, markedly elevated alanine aminotransferase (ALT) and five-fold increased pre-prandial bile acids. Ultrasonographic evaluation of the abdomen did not identify any abnormalities. Serum tests for feline immunodeficiency virus (FIV) and feline leukaemia virus (FeLV) were negative. Broad-spectrum antibiotic treatment for infectious hepatitis was to no avail; the cat deteriorated and died 72 h after admission. Necropsy revealed mild icterus and anaemia, severe multifocal hepatic necrosis, serofibrinous hydrothorax, pulmonary oedema and interstitial pneumonia. Histopathology confirmed the macroscopic findings and revealed multifocal microgranulomata in the brain and myocardium, as well as areas of necrosis in lymph nodes and multifocally in splenic red pulp. Long bone shaft marrow was hyperplastic with a predominance of leukocyte precursors and megakaryocytes and splenic red pulp showed mild extramedullary haemopoiesis. Immunohistochemical staining for Toxoplasma gondii was strongly positive, with scattered cysts and tachyzoites in the liver, lymph nodes, spleen, lungs, brain, salivary glands and intracellularly in round cells in occasional blood vessels. Immunohistochemical staining for corona virus on the same tissues was negative, ruling out feline infectious peritonitis (FIP). Polymerase chain reaction (PCR) on formalin-fixed paraffin-wax embedded tissues was positive for Toxoplasma sp., but attempts at sequencing were unsuccessful. This was the first case report of fulminant disseminated toxoplasmosis in South Africa, in which detailed histopathology in an apparently immunocompetent cat was described.

  17. Kinetic modeling of formic acid pulping of bagasse.

    Science.gov (United States)

    Tu, Qiliang; Fu, Shiyu; Zhan, Huaiyu; Chai, Xinsheng; Lucia, Lucian A

    2008-05-14

    Organic solvent or organosolv pulping processes are alternatives to soda or kraft pulping to delignify lignocellulosic materials for the production of paper pulp. Formic acid, a typical organosolv system, has been presently examined under atmospheric pressure to pulp bagasse fibers. It was shown that efficient bagasse pulping was achieved when the formic acid concentration was limited to 90% (v/v). A statistical kinetic model based on the experimental results for the delignification of bagasse during formic acid pulping was developed that can be described as follows: D (delignification) = 0.747 x C(formicacid) (1.688) x (1 - e(-0.05171t)), an equation that can be used to predict the lignin content in formic acid during the pulping process. The delignification of bagasse by 90% formic acid was almost completed after approximately 80 min, while extended pulping did not improve the delignification but tended to degrade the carbohydrates in bagasse, especially the hemicelluloses, which were rapidly hydrolyzed at the onset of pulping.

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

    NARCIS (Netherlands)

    van der Vlies, C. H.; Hoekstra, J.; Ponsen, K. J.; Reekers, J. A.; van Delden, O. M.; Goslings, J. C.

    2012-01-01

    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

  19. 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

    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. 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. 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. Splenic infarcts can be an atypical presentation of B19 infection. Parvovirus B19 may induce thromboembolic events, even in the absence of antiphospholipid antibodies.

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

    International Nuclear Information System (INIS)

    Ding, Ning; Kunugita, Naoki; Ichinose, Takamichi; Song, Yuan; Yokoyama, Mitsuru; Arashidani, Keiichi; Yoshida, Yasuhiro

    2011-01-01

    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.

  1. Chapter 6: Prehydrolysis Pulping with Fermentation Coproducts

    Science.gov (United States)

    T.H. Wegner; C.J. Houtman; A.W. Rudie; B.L. Illman; P.J. Ince; E.M. Bilek; T.W. Jeffries

    2013-01-01

    Although the term “integrateed biorefinery” is new, the concept has long been familiar to the pulp and paper industry, where processes include biomass boilers providing combined heat and power, and byproducts of pulping include turpentine, fatty acids and resin acids. In the dominant kraft (or sulfate) pulping process, dissolved lignin and chemicals from the pulp...

  2. 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

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

    International Nuclear Information System (INIS)

    Kim, Keunyoung; Kim, Seongjang; Kim, Injoo; Kim, Dong Uk; Kim, Heeyoung; Kim, Sojung; Ahn, Sang Hyun

    2014-01-01

    Although diffuse splenic 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

  4. Thrombocytosis in splenic trauma: In-hospital course and association with venous thromboembolism.

    Science.gov (United States)

    Chia, Tze L; Chesney, Tyler R; Isa, David; Mnatzakanian, Gevork; Colak, Errol; Belmont, Caio; Hirpara, Dhruvin; Veigas, Precilla V; Acuna, Sergio A; Rizoli, Sandro; Rezende-Neto, Joao

    2017-01-01

    Thrombocytosis is common following elective splenectomy and major trauma. However, little is known about the in-hospital course of platelet count (PC) and incidence of thrombocytosis after splenic trauma. Extreme thrombocytosis (PC>1000×10 9 ) is associated with increased risk of venous thromboembolism (VTE) in primary thrombocytosis leading to the use of acetylsalicylic acid (ASA) for risk reduction, but the need for this agent in splenic trauma is undefined. Retrospective cohort study of all patients with splenic trauma between April 1, 2010 and March 31, 2014. The in-hospital course of PC was assessed based on splenic injury management type. The association of management type with thrombocytosis was evaluated using a multivariable logistic regression model adjusting for potential confounders. The association of thrombocytosis, extreme thrombocytosis, and ASA use for the outcome of VTE was explored. 156 patients were eligible, PC initially increased in all patients with the highest peak after total splenectomy. The incidence of thrombocytosis was 41.0% (64/156). Thrombocytosis was more likely following splenectomy compared with spleen preserving strategies independent of length of stay, injury grade, ISS, age and transfusion (OR 7.58, 95% CI: 2.26-25.45). Splenectomy was associated with extreme thrombocytosis (OR 10.39, 95% CI: 3.59-30.07). Thrombocytosis in splenic trauma is more likely after splenectomy than with spleen preserving strategies. Splenectomy is associated with extreme thrombocytosis. There was insufficient data in our study to determine the use of ASA as primary prevention of VTE after splenic trauma. Copyright © 2016 Elsevier Ltd. All rights reserved.

  5. Acute appendiceal abscess and atraumatic splenic rupture: A case of dual pathology.

    Science.gov (United States)

    Ananthavarathan, Piriyankan; Patel, Kamlesh; Doran, Catherine; Suggett, Nigel

    2016-01-01

    Atraumatic splenic rupture is a rare surgical emergency that is often attributed to neoplastic or infectious causes. Rarely, it has been identified to also occur in the setting of an acute severe sepsis and in cases of pelvic or splenic abscess formation post-appendicectomy. However, to our knowledge, the co-presentation of acute appendiceal abscess and splenic rupture has not been previously described. We present the case of a 67-year old male with decompensating haemorrhagic shock secondary to atraumatic splenic rupture on a background of an inadequately treated complicated appendicitis originally managed as diverticulitis with antibiotics in the community. Intra-operatively, in addition to a de-gloved, ruptured spleen; an acutely inflamed appendiceal abscess was also identified. A concomitant splenectomy, washout and appendicectomy and was therefore performed. Histopathological examination revealed a normal spleen with a stripped capsular layer. Mucosal ulceration, transmural inflammation and serositis of the appendix appeared to be consistent with acute appendicitis. Our case demonstrates how inadequately treated sepsis may predispose to an acute presentation of splenic rupture with associated haemorrhagic shock; which may initially be interpreted as septic shock. However, we demonstrate how insults such as sepsis and haemorrhagic shock may co-exist warranting careful consideration of possible dual pathologies in complex presentations which may be life-threatening. While the causal relationship between acute appendicitis and atraumatic spontaneous splenic rupture remains unclear, our case considers and highlights the importance of considering dual pathology in patients presenting in the acute setting. Copyright © 2016. Published by Elsevier Ltd.

  6. Expression of high mobility group box 1 in inflamed dental pulp and its chemotactic effect on dental pulp cells

    International Nuclear Information System (INIS)

    Zhang, Xufang; Jiang, Hongwei; Gong, Qimei; Fan, Chen; Huang, Yihua; Ling, Junqi

    2014-01-01

    Highlights: • HMGB1 translocated from nucleus to cytoplasm during dental pulp inflammation. • HMGB1and its receptor RAGE were up-regulated in hDPCs under LPS stimulation. • HMGB1 enhanced hDPCs migration and induces cytoskeleton reorganization. • HMGB1 may play a critical role in dental pulp repair during inflamed state. - Abstract: High mobility group box 1 protein (HMGB1) is a chromatin protein which can be released extracellularly, eliciting a pro-inflammatory response and promoting tissue repair process. This study aimed to examine the expression and distribution of HMGB1 and its receptor RAGE in inflamed dental pulp tissues, and to assess its effects on proliferation, migration and cytoskeleton of cultured human dental pulp cells (DPCs). Our data demonstrated that cytoplasmic expression of HMGB1 was observed in inflamed pulp tissues, while HMGB1 expression was confined in the nuclei in healthy dental pulp. The mRNA expression of HMGB1 and RAGE were significantly increased in inflamed pulps. In in vitro cultured DPCs, expression of HMGB1 in both protein and mRNA level was up-regulated after treated with lipopolysaccharide (LPS). Exogenous HMGB1 enhanced DPCs migration in a dose-dependent manner and induced the reorganization of f-actin in DPCs. Our results suggests that HMGB1 are not only involved in the process of dental pulp inflammation, but also play an important role in the recruitment of dental pulp stem cells, promoting pulp repair and regeneration

  7. Expression of high mobility group box 1 in inflamed dental pulp and its chemotactic effect on dental pulp cells

    Energy Technology Data Exchange (ETDEWEB)

    Zhang, Xufang, E-mail: xufang.zhang@student.qut.edu.au [Department of Operative Dentistry and Endodontics, Guanghua School of Stomatology, Guangdong Province Key Laboratory of Stomatology, Sun Yat-sen University, Guangzhou 510055 (China); Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, QLD 4059 (Australia); Jiang, Hongwei, E-mail: jianghw@163.com [Department of Operative Dentistry and Endodontics, Guanghua School of Stomatology, Guangdong Province Key Laboratory of Stomatology, Sun Yat-sen University, Guangzhou 510055 (China); Gong, Qimei, E-mail: gongqmei@gmail.com [Department of Operative Dentistry and Endodontics, Guanghua School of Stomatology, Guangdong Province Key Laboratory of Stomatology, Sun Yat-sen University, Guangzhou 510055 (China); Fan, Chen, E-mail: c3.fan@student.qut.edu.au [Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, QLD 4059 (Australia); Huang, Yihua, E-mail: enu0701@163.com [Department of Operative Dentistry and Endodontics, Guanghua School of Stomatology, Guangdong Province Key Laboratory of Stomatology, Sun Yat-sen University, Guangzhou 510055 (China); Ling, Junqi, E-mail: lingjq@mail.sysu.edu.cn [Department of Operative Dentistry and Endodontics, Guanghua School of Stomatology, Guangdong Province Key Laboratory of Stomatology, Sun Yat-sen University, Guangzhou 510055 (China)

    2014-08-08

    Highlights: • HMGB1 translocated from nucleus to cytoplasm during dental pulp inflammation. • HMGB1and its receptor RAGE were up-regulated in hDPCs under LPS stimulation. • HMGB1 enhanced hDPCs migration and induces cytoskeleton reorganization. • HMGB1 may play a critical role in dental pulp repair during inflamed state. - Abstract: High mobility group box 1 protein (HMGB1) is a chromatin protein which can be released extracellularly, eliciting a pro-inflammatory response and promoting tissue repair process. This study aimed to examine the expression and distribution of HMGB1 and its receptor RAGE in inflamed dental pulp tissues, and to assess its effects on proliferation, migration and cytoskeleton of cultured human dental pulp cells (DPCs). Our data demonstrated that cytoplasmic expression of HMGB1 was observed in inflamed pulp tissues, while HMGB1 expression was confined in the nuclei in healthy dental pulp. The mRNA expression of HMGB1 and RAGE were significantly increased in inflamed pulps. In in vitro cultured DPCs, expression of HMGB1 in both protein and mRNA level was up-regulated after treated with lipopolysaccharide (LPS). Exogenous HMGB1 enhanced DPCs migration in a dose-dependent manner and induced the reorganization of f-actin in DPCs. Our results suggests that HMGB1 are not only involved in the process of dental pulp inflammation, but also play an important role in the recruitment of dental pulp stem cells, promoting pulp repair and regeneration.

  8. Pulp mill as an energy producer

    International Nuclear Information System (INIS)

    Kaulamo, O.

    1998-01-01

    The recovery boilers of pulp mills are today the most significant producers of wood energy. The power-to-heat ratio of the power plant process, i.e., power yield, is poor in existing applications. In the study, an alternative of improving the power yield of conventional pulp mills significantly was studied by applying solutions used in power plants to a pulp mill. Extensive conversion of wood energy into electricity is possible only in the recovery boiler of the pulp mill and in a large combustion boiler of bark, wood waste and wood chips integrated to this boiler. Hence, the harvest and transports of wood raw materials, i.e. pulp wood and energy wood, are integrated, and the fraction going to cook and the energy wood fraction are separated at the pulp mill. The method guarantees competitive supply of energy wood. As a result a SELLUPOWER mill was designed, where the recovery boiler combusting black liquor and the large power plant boiler combusting energy wood are integrated to one unit and constructed to a power plant process with a high power-to-heat ratio. Necessary technical solutions, project costs and economical feasibility compared to a conventional pulp mill were determined, and the effect of different production-economical parameters was also studied. (orig.)

  9. Immunolocalization of bone-resorptive cytokines in rat pulp and periapical lesions following surgical pulp exposure.

    Science.gov (United States)

    Tani-Ishii, N; Wang, C Y; Stashenko, P

    1995-08-01

    The bone-resorptive cytokines interleukin 1 (IL-1) and tumor necrosis factor (TNF) have been implicated in the pathogenesis of many chronic inflammatory diseases, including pulpitis and apical periodontitis.To further elucidate their role in these disorders, we have identified cells that express IL-1 alpha and TNF alpha in infected pulps and in developing rat periapical lesions after surgical pulp exposure. As detected by immunohistochemistry, IL-1 alpha- and TNF alpha-positive cells were present as early as 2 days after pulp exposure in both the pulp and periapical region. The numbers of cytokine-expressing cells increased up to day 4 in the pulp and up to day 30 in the periapex. In contrast, cells expressing IL-1 beta and TNF beta, the homologous forms of these mediators, were not found in pulp or periapical lesions during this period. Cells expressing IL-1 alpha and TNF alpha were identified primarily as macrophages and fibroblasts, with occasional staining of polymorphonuclear leukocytes. Osteoblasts and osteoclasts were also positive, whereas lymphocytes were negative. In general, cytokine-expressing cells were located proximal to abscesses and the root apex. These findings demonstrate that cells that express bone-resorptive cytokines IL-1 alpha and TNF alpha are present immediately after pulp exposure in this model, which supports the hypothesis that these mediators play a key role in pulpal and periapical pathogenesis, including the concomitant bone destruction. They also indicate that both resident connective tissue cells as well as infiltrating cells express bone-resorptive cytokines in response to infection in these lesions.

  10. Common and uncommon features of focal splenic lesions on contrast-enhanced ultrasound: a pictorial review

    Energy Technology Data Exchange (ETDEWEB)

    Zavariz, Julia D., E-mail: julia.zavariz@hc.fm.usp.br [Universidade de São Paulo (HC/FMUSP), São Paulo, SP (Brazil). Faculdade de Medicina. Hospital das Clínicas; Konstantatou, Eleni; Deganello Annamaria; Bosanac, Diana; Huang, Dean Y.; Sellars, Maria E.; Sidhu, Paul S. [Department of Radiology, King’s College Hospital, Denmark Hill, London (United Kingdom)

    2017-11-15

    The characterization of focal splenic lesions by ultrasound can be quite challenging. The recent introduction of contrast-enhanced ultrasound (CEUS) has come to play a valuable role in the field of imaging splenic pathologies, offering the possibility of an ionizing radiation-free investigation. Because CEUS has been incorporated into everyday clinical practice, malignant diseases such as focal lymphomatous infiltration, metastatic deposits, benign cysts, traumatic fractures, and hemangiomas can now be accurately depicted and characterized without the need for further imaging. More specifically, splenic traumatic fractures do not require additional imaging by computed tomography (with ionizing radiation exposure) for follow-up, because splenic fractures and their complications are safely imaged with CEUS. In the new era of CEUS, more patients benefit from radiation-free investigation of splenic pathologies with high diagnostic accuracy. (author)

  11. Evaluating pulp stiffness from fibre bundles by ultrasound

    Science.gov (United States)

    Karppinen, Timo; Montonen, Risto; Määttänen, Marjo; Ekman, Axel; Myllys, Markko; Timonen, Jussi; Hæggström, Edward

    2012-06-01

    A non-destructive ultrasonic tester was developed to measure the stiffness of pulp bundles. The mechanical properties of pulp are important when estimating the behaviour of paper under stress. Currently available pulp tests are tedious and alter the fibres structurally and mechanically. The developed tester employs (933 ± 15) kHz tweezer-like ultrasonic transducers and time-of-flight measurement through (9.0 ± 2.5) mm long and (0.8 ± 0.1) mm thick fibre bundles kept at (19.1 ± 0.4) °C and (62 ± 1)% RH. We determined the stiffness of soft wood pulps produced by three kraft pulping modifications: standard kraft pulp, (5.2 ± 0.4) GPa, prehydrolysis kraft pulp, (4.3 ± 0.4) GPa, and alkali extracted prehydrolysis kraft pulp, (3.3 ± 0.4) GPa. Prehydrolysis and alkali extraction processes mainly lowered the hemicellulose content of the pulps, which essentially decreased the fibre-wall stiffness hence impairing the stiffness of the fibre networks. Our results indicate that the method allows ranking of pulps according to their stiffness determined from bundle-like samples taken at an early phase of the papermaking process.

  12. Quantitative assessment of hepatic and splenic blood flow detected by Tc-99m-Sn colloid liver scintigraphy

    International Nuclear Information System (INIS)

    Narabayashi, Isamu; Nishiyama, Shoji; Sugimura, Kazuro

    1983-01-01

    Quantitative assessment of hepatic and splenic blood flow detected by injecting Tc-99m-Sn colloid as a bolus was performed on 75 patients who were suspected of having liver disease. Using a computer, the hepatic and splenic time-activity curves were analyzed. Hepatic index was calculated as the ratio of arterial to portal blood flow. The peak time of the right kidney was corresponded to the junction of the arterial and portal phases of the hepatic curve. Splenic index was calculated as the ratio of splenic arterial to liver arterial blood flow. Hepatic and splenic indices had elevated in cases of liver cirrhosis and hepatoma than those of normal controls. There was no significant difference in the hepatic and splenic indices among chronic hepatitis, liver metastasis and normal subject. These noninvasive tests for the hepatic and splenic blood flow may be useful in writing a report of liver scintigram because of the added information of the liver. (author)

  13. Diabetes induces metabolic alterations in dental pulp.

    Science.gov (United States)

    Leite, Mariana Ferreira; Ganzerla, Emily; Marques, Márcia Martins; Nicolau, José

    2008-10-01

    Diabetes can interfere in tissue nutrition and can impair dental pulp metabolism. This disease causes oxidative stress in cells and tissues. However, little is known about the antioxidant system in the dental pulp of diabetics. Thus, it would be of importance to study this system in this tissue in order to verify possible alterations indicative of oxidative stress. The aim of this study was to evaluate some parameters of antioxidant system of the dental pulp of healthy (n = 8) and diabetic rats (n = 8). Diabetes was induced by streptozotocin in rats. Six weeks after diabetes induction, a pool of the dental pulp of the 4 incisors of each rat (healthy and diabetic) was used for the determination of total protein and sialic acid concentrations and catalase and peroxidase activities. Data were compared by a Student t test (p pulps from both groups presented similar total protein concentrations and peroxidase activity. Dental pulps of diabetic rats exhibited significantly lower free, conjugated, and total sialic acid concentrations than those of control tissues. Catalase activity in diabetic dental pulps was significantly enhanced in comparison with that of control pulps. The result of the present study is indicative of oxidative stress in the dental pulp caused by diabetes. The increase of catalase activity and the reduction of sialic acid could be resultant of reactive oxygen species production.

  14. Atraumatic splenic rupture and ileal volvulus following cocaine abuse.

    Science.gov (United States)

    Ballard, David H; Smith, J Patrick; Samra, Navdeep S

    2015-01-01

    We present the case of a 38-year-old male with an atraumatic splenic rupture, hemoperitoneum, and ileal volvulus following acute cocaine intoxication. Computed tomography showed a "whirl sign", a subcapsular splenic hematoma with suspected peripheral laceration, and diffuse hemoperitoneum. At laparotomy, the spleen was confirmed to be the source of bleeding and was removed. A nonreducible volvulus was found at the distal ileum, and this segment of small bowel was removed. The patient had an uneventful postoperative recovery. Copyright © 2015 Elsevier Inc. All rights reserved.

  15. Biogas generation apple pulp.

    Science.gov (United States)

    Llaneza Coalla, H; Blanco Fernández, J M; Morís Morán, M A; López Bobo, M R

    2009-09-01

    In view of the pressing problem that appears in our region (Asturias, north of Spain) with the residues from the cider production, it was decided to test this kind of material as a co-substrate joint with slaughterhouse waste in a laboratory unit. The anaerobic digestion of apple pulp was investigated for biogas production. This paper presents the results where apple pulp was co-digested with slaughterhouse waste (pig intestine and bovine stomach content) in a biogas laboratory unit (10 l CSTR reactor). The production of biogas has reached very satisfactory values during the whole test (0.8m(3)kg(-1)OTS), verifying that the process is kept in stable conditions of pH (near 8.0), and the volatile fatty acids was always underneath 3000 mg/l, when the pulp amount was lower than 100g in mesophilic conditions. The fat concentration into the digester remained always below the value that causes inhibition of the methanogenic bacteria, 500 mg/l. Finally, methane concentration (77-80%) and H(2)S concentration (400 ppm) in the biogas, they were similar to those obtained when the test was run out in the absence of apple pulp. The process efficiency with respect to COD removal was high, near 80% of the total COD. Finally, inhibitory effects of methanogenic bacteria were observed when pulp concentration was around 10% in the input material.

  16. [Treatment practice in patients with isolated blunt splenic injuries. A survey of Swiss traumatologists].

    Science.gov (United States)

    Schnüriger, B; Martens, F; Eberle, B M; Renzulli, P; Seiler, C A; Candinas, D

    2013-01-01

    The non-operative management (NOM) of blunt splenic injuries has gained widespread acceptance. However, there are still many controversies regarding follow-up of these patients. The purpose of this study was to survey active members of the Swiss Society of General and Trauma Surgery (SGAUC) to determine their practices regarding the NOM of isolated splenic injuries. A survey of active SGAUC members with a written questionnaire was carried out. The questionnaire was designed to elicit information about personal and facility demographics, diagnostic practices, in-hospital management, preferred follow-up imaging and return to activity. Out of 165 SGAUC members 52 (31.5%) completed the survey and 62.8% of all main trauma facilities in Switzerland were covered by the sample. Of the respondents 14 (26.9%) have a protocol in place for treating patients with splenic injuries. For initial imaging in hemodynamically stable patients 82.7% of respondents preferred ultrasonography (US). In cases of suspected splenic injury 19.2% of respondents would abstain from further imaging. In cases of contrast extravasation from the spleen half of the respondents would take no specific action. For low-grade injuries 86.5% chose to admit patients for an average of 1.6 days (range 0-4 days) with a continuously monitored bed. No differences in post-discharge activity restrictions between moderate and high-grade splenic injuries were found. The present survey showed considerable practice variation in several important aspects of the NOM of splenic injuries. Not performing further CT scans in patients with suspected splenic injuries and not intervening in cases of a contrast extravasation were the most important discrepancies to the current literature. Standardization of the NOM of splenic injuries may be of great benefit for both surgeons and patients.

  17. 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.

  18. Kraft pulping of industrial wood waste

    Science.gov (United States)

    Aziz. Ahmed; Masood. Akhtar; Gary C. Myers; Gary M. Scott

    1998-01-01

    Most of the approximately 25 to 30 million tons of industrial wood waste generated in the United States per year is burned for energy and/or landfilled. In this study, kraft pulp from industrial wood waste was evaluated and compared with softwood (loblolly pine, Douglas-fir) and hardwood (aspen) pulp. Pulp bleachability was also evaluated. Compared to loblolly pine...

  19. CT and MR imaging of splenic leiomyoma in a child with ataxia telangiectasia

    Energy Technology Data Exchange (ETDEWEB)

    Coskun, M. [Dept. of Radiology, Hacettepe University Hospital, Ankara (Turkey); Aydingoez, Ue. [Dept. of Radiology, Hacettepe University Hospital, Ankara (Turkey); Tacal, T. [Dept. of Radiology, Hacettepe University Hospital, Ankara (Turkey); Ariyuerek, M. [Dept. of Radiology, Hacettepe University Hospital, Ankara (Turkey); Demirkazik, F. [Dept. of Radiology, Hacettepe University Hospital, Ankara (Turkey); Oguzkurt, L. [Dept. of Radiology, Hacettepe University Hospital, Ankara (Turkey)

    1995-02-01

    Computed tomographic and magnetic resonance imaging findings of a splenic leiomyoma in an 8-year-old boy with ataxia telangiectasia are presented. This is the first reported case of a splenic leiomyoma in the literature. (orig.)

  20. CT and MR imaging of splenic leiomyoma in a child with ataxia telangiectasia

    International Nuclear Information System (INIS)

    Coskun, M.; Aydingoez, Ue.; Tacal, T.; Ariyuerek, M.; Demirkazik, F.; Oguzkurt, L.

    1995-01-01

    Computed tomographic and magnetic resonance imaging findings of a splenic leiomyoma in an 8-year-old boy with ataxia telangiectasia are presented. This is the first reported case of a splenic leiomyoma in the literature. (orig.)

  1. Splenic flexure volvulus presenting with gangrene

    International Nuclear Information System (INIS)

    Machado, Norman O; Chopra, Pradeep J; Subramanian, Sureshkannan K

    2009-01-01

    Volvulus of the splenic flexure is very rare cause of colonic obstruction constituting 2% of cases of colonic segmental volvulus. Primary splenic flexure volvulus (SFV) is due to congenital absence or laxity of the phrenocolic, gastro colic, and splenocolic ligaments while secondary volvulus is due to other causes including some prior surgery releasing these ligaments. A preoperative diagnosis can be established based on the characteristic radiological findings on plain x-ray abdomen and CT scan. We present a case of SFV in a young man who presented with acute abdominal pain, and distension, and illustrate the usefulness of CT scan, and plain x-ray of the abdomen in making a preoperative diagnosis. Laparotomy revealed a gangrenous SFV, which was resected and primary anastomosis was carried out. Literature is reviewed with regards to predisposing factors, presentation, investigation, and management among the more than 32 cases reported so far. (author)

  2. Asymptomatic appearance of splenic infarction in Wegeners granulomatosis

    International Nuclear Information System (INIS)

    Martusewicz-Boros, M.; Roszkowski-Sliz, K.; Wiatr, E.; Baranska, I.; Bestry, I.

    2011-01-01

    Splenic involvements in Wegeners granulomatosis (WG) are rarely diagnosed ante-mortem, while an autopsy is able to reveal a high rate of spleen lesions (78 - 100%). To date, there have been a few reported cases of splenic abnormalities in WG, including: splenomegaly, capsular adhesion, dysfunction and infarction. We reported a case of biopsy-verified WG with radiological evidence of diffuse spleen infarction despite the lack of any clinical symptoms. We concluded that due to a potential risk of severe hemorrhagic complications when anticoagulant therapy is necessary, radiological assessment of spleen should be performed regularly in this group of patients, particularly because spleen involvement can be asymptomatic. (authors)

  3. Successful Treatment of Bleeding Gastric Varices with Splenectomy in a Patient with Splenic, Portal, and Mesenteric Thromboses

    Directory of Open Access Journals (Sweden)

    Lior Menasherian-Yaccobe

    2013-01-01

    Full Text Available A 59-year-old female with a history of multiple splanchnic and portal thromboses treated with warfarin underwent an esophagogastroduodenoscopy for cancer screening, and a polypoid mass was biopsied. One week later, she was admitted with upper gastrointestinal hemorrhage. Her therapeutic coagulopathy was reversed with fresh frozen plasma, and she was transfused with packed red blood cells. An esophagogastroduodenoscopy demonstrated an erosion of a gastric varix without evidence of recent bleeding. Conservative measures failed, and she continued to bleed during her stay. She was not considered a candidate for a shunt procedure; therefore, a splenectomy was performed. Postoperative esophagogastroduodenoscopy demonstrated near complete resolution of gastric varices. One year after discharge on warfarin, there has been no recurrence of hemorrhage. Gastric varices often arise from either portal hypertension or splenic vein thrombosis. Treatment of gastric variceal hemorrhage can be challenging. Transjugular intrahepatic portosystemic shunt is often effective for emergency control in varices secondary to portal hypertension. Splenectomy is the treatment for varices that arise from splenic vein thrombosis. However, treatment of gastric variceal hemorrhage in the context of multiple splanchnic and portal vein thromboses is more complicated. We report splenectomy as a successful treatment of gastric varices in a patient with multiple extrahepatic thromboses.

  4. The role of splenic angioembolization as an adjunct to nonoperative management of blunt splenic injuries: A systematic review and meta-analysis.

    Science.gov (United States)

    Crichton, James Charles Ian; Naidoo, Kamil; Yet, Barbaros; Brundage, Susan I; Perkins, Zane

    2017-11-01

    Nonoperative management (NOM) of hemodynamically normal patients with blunt splenic injury (BSI) is the standard of care. Guidelines recommend additional splenic angioembolization (SAE) in patients with American Association for the Surgery of Trauma (AAST) Grade IV and Grade V BSI, but the role of SAE in Grade III injuries is unclear and controversial. The aim of this systematic review was to compare the safety and effectiveness of SAE as an adjunct to NOM versus NOM alone in adults with BSI. A systematic literature search (Medline, Embase, and CINAHL) was performed to identify original studies that compared outcomes in adult BSI patients treated with SAE or NOM alone. Primary outcome was failure of NOM. Secondary outcomes included morbidity, mortality, hospital length of stay, and transfusion requirements. Bayesian meta-analyses were used to calculate an absolute (risk difference) and relative (risk ratio [RR]) measure of treatment effect for each outcome. Twenty-three studies (6,684 patients) were included. For Grades I to V combined, there was no difference in NOM failure rate (SAE, 8.6% vs NOM, 7.7%; RR, 1.09 [0.80-1.51]; p = 0.28), mortality (SAE, 4.8% vs NOM, 5.8%; RR, 0.82 [0.45-1.31]; p = 0.81), hospital length of stay (11.3 vs 9.5 days; p = 0.06), or blood transfusion requirements (1.8 vs 1.7 units; p = 0.47) between patients treated with SAE and those treated with NOM alone. However, morbidity was significantly higher in patients treated with SAE (SAE, 38.1% vs NOM, 18.6%; RR, 1.83 [1.20-2.66]; p splenic injury, SAE significantly reduced the failure rate of NOM in patients with Grade IV and Grade V splenic injuries but had minimal effect in those with Grade I to Grade III injuries. Splenic angioembolization should be strongly considered as an adjunct to NOM in patients with AAST Grade IV and Grade V BSI but should not be routinely recommended in patients with AAST Grade I to Grade III injuries. Systematic review and meta-analysis, level III.

  5. Physical and Flavor Profiles of Arabica Coffee as Affected by Cherry Storage Before Pulping

    Directory of Open Access Journals (Sweden)

    Yusianto .

    2014-08-01

    Full Text Available Harvesting and pulping process of coffee cherry in the same day is inaccesible. Storage of coffee cherry before pulping was carried out incorrectly. Some storage treatments before pulping of Arabica coffee cherry had been examined at Indonesian Coffee and Cocoa Research Institute using Arabica coffee cherries from Andungsari Experimental Garden, Bondowoso, East Java. Treatments of the experiment were method and period of cherry storage. Methods of coffee cherry storage were put in plastic sacks; immerse in water, without water replacement; and immerse in water with daily water replacement. Period of coffee cherry storage were 0, 1, 2, 3, 4, 5, 6, and 7 days. After storage treatments, the coffee cherries were pulped, fermented, washed, sundried, and dehulled. The experiment were carried out using randomized block design with three replications. Observation of coffee cherry during storage periods was done on the physical and temperature. Observation of the green coffee were done on the color dan bulk density. The green coffee were roasted at medium roast level for sensory analysis. Observation of roasting profile were out-turn, bulk density and pH of roasted coffee. Sensory analysis used Specialty Coffee Association of America method. Methods and period of cherry storage before pulping significanly influence on the cherry color, parchment color, green coffee color, and the flavor profile of Arabica coffee. Color of dry parchment changed to be red-brown becouse of cherry immersed in water for two days or more. In plastic sacks, Arabica coffee cherry may be stored only for two days, but underwater with or without water replacement, should be not more than five days. Green and sensory quality of Arabica coffee will be deteriorated after five days storage underwater. Coffee cherry storage immerse in water with daily replacing water may improve sensory quality of Arabica coffee.Key word: Arabica coffe, storage, pulping, flavor, physical

  6. Potassium hydroxide pulping of rice straw in biorefinery initiatives.

    Science.gov (United States)

    Jahan, M Sarwar; Haris, Fahmida; Rahman, M Mostafizur; Samaddar, Purabi Rani; Sutradhar, Shrikanta

    2016-11-01

    Rice straw is supposed to be one of the most important lignocellulosic raw materials for pulp mill in Asian countries. The major problem in rice straw pulping is silica. The present research is focused on the separation of silica from the black liquor of rice straw pulping by potassium hydroxide (KOH) and pulp evaluation. Optimum KOH pulping conditions of rice straw were alkali charge 12% as NaOH, cooking temperature 150°C for 2h and material to liquor ratio, 1:6. At this condition pulp yield was 42.4% with kappa number 10.3. KOH pulp bleached to 85% brightness by D0EpD1 bleaching sequences with ClO2 consumption of 25kg/ton of pulp. Silica and lignin were separated from the black liquor of KOH pulping. The amount of recovered silica, lignin and hemicelluloses were 10.4%, 8.4% and 13.0%. The papermaking properties of KOH pulp from rice straw were slightly better than those of corresponding NaOH pulp. Copyright © 2016 Elsevier Ltd. All rights reserved.

  7. Radiological characteristics of splenic lesions: how to distinguish them?

    International Nuclear Information System (INIS)

    Leao, Alberto Ribeiro de Souza; Freire Filho, Edison de Oliveira; Szejnfeld, Jacob; D'Ippolito, Giuseppe

    2005-01-01

    The spleen is often overlooked in studies of the upper abdomen probably due to the low frequency in which it occurs when compared to other abdominal solid organs. In this study we describe the main forms of splenic involvement by malignant or benign neoplasms, vascular, inflammatory and traumatic lesions, as well as congenital anomalies and variants of normality. We aimed to evaluate some characteristics and radiological aspects that permit the definition of the nature of splenic changes with considerable precision in order to allow an accurate diagnosis and increase radiologist's confidence on different situations. (author)

  8. High-yield pulping effluent treatment technologies

    International Nuclear Information System (INIS)

    Su, W.X.; Hsieh, J.S.

    1993-03-01

    The objective of this report is to examine the high-yield (mechanical) pulp processes with respect to environmental issues affected by the discharge of their waste streams. Various statistics are given that support the view that high-yield pulping processes will have major growth in the US regions where pulp mills are located, and sites for projects in the development phase are indicated. Conventional and innovative effluent-treatment technologies applicable to these processes are reviewed. The different types of mechanical pulping or high-yield processes are explained, and the chemical additives are discussed. The important relationship between pulp yield and measure of BOD in the effluent is graphically presented. Effluent contaminants are identified, along with other important characteristics of the streams. Current and proposed environmental limitations specifically related to mechanical pulp production are reviewed. Conventional and innovative effluent-treatment technologies are discussed, along with their principle applications, uses, advantages, and disadvantages. Sludge management and disposal techniques become an intimate part of the treatment of waste streams. The conclusion is made that conventional technologies can successfully treat effluent streams under current waste-water discharge limitations, but these systems may not be adequate when stricter standards are imposed. At present, the most important issue in the treatment of pulp-mill waste is the management and disposal of the resultant sludge

  9. Infection and Pulp Regeneration

    Directory of Open Access Journals (Sweden)

    Sahng G. Kim

    2016-03-01

    Full Text Available The regeneration of the pulp-dentin complex has been a great challenge to both scientists and clinicians. Previous work has shown that the presence of prior infection may influence the characteristics of tissues formed in the root canal space after regenerative endodontic treatment. The formation of ectopic tissues such as periodontal ligament, bone, and cementum has been observed in the root canal space of immature necrotic teeth with apical periodontitis, while the regeneration of dentin and pulp has been identified in previously non-infected teeth. The current regenerative endodontic therapy utilizes disinfection protocols, which heavily rely on chemical irrigation using conventional disinfectants. From a microbiological point of view, the current protocols may not allow a sufficiently clean root canal microenvironment, which is critical for dentin and pulp regeneration. In this article, the significance of root canal disinfection in regenerating the pulp-dentin complex, the limitations of the current regenerative endodontic disinfection protocols, and advanced disinfection techniques designed to reduce the microorganisms and biofilms in chronic infection are discussed.

  10. Laparoscopic resection of transverse colon cancer at splenic flexure: technical aspects and results.

    Science.gov (United States)

    Okuda, Junji; Yamamoto, Masashi; Tanaka, Keitaro; Masubuchi, Shinsuke; Uchiyama, Kazuhisa

    2016-03-01

    Laparoscopic resection of transverse colon cancer at splenic flexure is technical demanding and its efficacy remains controversial. The aim of this study was to investigate its technical aspects such as pitfalls and overcoming them, and to demonstrate the short-term and oncologic long-term outcomes. To overcome the difficulty in laparoscopic resection of transverse colon cancer at splenic flexure, we recognized the following technical tips as essential. First of all, we have to precisely identify major vessels variations feeding tumor. Secondary, anatomical dissection of mesocolon through medial approach is indispensible. Third, safe takedown of splenic flexure to fully mobilization of left hemicolon is mandatory. This cohort study analyzed 95 patients with stage II (43) and III (52) underwent resection of transverse colon cancer at splenic flexure. 61 laparoscopic surgeries (LAC) and 34 conventional open surgeries (OC) from December 1996 to December 2009 were evaluated. Short-term and oncologic long-term outcomes were recorded. Operative time was longer in LAC. However, blood loss was less, recovery of bowel function and hospital stay were shorter in LAC. There was no conversion in LAC and no significant difference in the postoperative complications. Regarding oncologic long-term outcomes, there were no significant differences between OC and LAC. Laparoscopic resection of transverse colon cancer at splenic flexure resulted in acceptable short-term and oncologic long-term outcomes. Once technical tips acquired, laparoscopic resection of transverse colon cancer at splenic flexure could be feasible as minimally invasive surgery.

  11. US and CT Findings of Splenic Hydatid Cyst: A Case Report

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Il Young; Kim, Sang Won; Shin, Hyeong Cheol; Han, Jong Kyu [Soonchunhyang University Cheonan Hospital, Cheonan (Korea, Republic of)

    2009-03-15

    Hydatid disease is a parasitic infection caused by the larvae of the cestode worms Echinococcus. In humans, the most commonly affected organ is the liver, the next second common organ is the lung. The third common affected organ is the spleen. In the case of splenic hydatid cyst, most cysts remain clinically silent and are diagnosed incidentally or when complications occur. We experienced a case of splenic hydatid cyst in a 28-year-old man. The patient complained of abdominal pain for 1 month. Abdominal ultrasound revealed a cystic lesion with daughter cysts in the spleen. The CT imaging also showed a cystic lesion with daughter cysts. We diagnosed it as a splenic hydatid cyst which was confirmed by pathology after surgery

  12. US and CT Findings of Splenic Hydatid Cyst: A Case Report

    International Nuclear Information System (INIS)

    Kim, Il Young; Kim, Sang Won; Shin, Hyeong Cheol; Han, Jong Kyu

    2009-01-01

    Hydatid disease is a parasitic infection caused by the larvae of the cestode worms Echinococcus. In humans, the most commonly affected organ is the liver, the next second common organ is the lung. The third common affected organ is the spleen. In the case of splenic hydatid cyst, most cysts remain clinically silent and are diagnosed incidentally or when complications occur. We experienced a case of splenic hydatid cyst in a 28-year-old man. The patient complained of abdominal pain for 1 month. Abdominal ultrasound revealed a cystic lesion with daughter cysts in the spleen. The CT imaging also showed a cystic lesion with daughter cysts. We diagnosed it as a splenic hydatid cyst which was confirmed by pathology after surgery

  13. Hydrothermal carbonization of autoclaved municipal solid waste pulp and anaerobically treated pulp digestate

    Science.gov (United States)

    In this study, the autoclaved organic fraction of municipal solid waste pulp (OFMSW) and the digestate from OFMSW pulp after anaerobic digestion (AD) were processed by hydrothermal carbonization (HTC) at 200, 250, and 300 °C for 30 min and 2 h. The focus of this work was to evaluate the potential fo...

  14. Pulp stem cells: implication in reparative dentin formation.

    Science.gov (United States)

    Dimitrova-Nakov, Sasha; Baudry, Anne; Harichane, Yassine; Kellermann, Odile; Goldberg, Michel

    2014-04-01

    Many dental pulp stem cells are neural crest derivatives essential for lifelong maintenance of tooth functions and homeostasis as well as tooth repair. These cells may be directly implicated in the healing process or indirectly involved in cell-to-cell diffusion of paracrine messages to resident (pulpoblasts) or nonresident cells (migrating mesenchymal cells). The identity of the pulp progenitors and the mechanisms sustaining their regenerative capacity remain largely unknown. Taking advantage of the A4 cell line, a multipotent stem cell derived from the molar pulp of mouse embryo, we investigated the capacity of these pulp-derived precursors to induce in vivo the formation of a reparative dentin-like structure upon implantation within the pulp of a rodent incisor or a first maxillary molar after surgical exposure. One month after the pulp injury alone, a nonmineralized fibrous matrix filled the mesial part of the coronal pulp chamber. Upon A4 cell implantation, a mineralized osteodentin was formed in the implantation site without affecting the structure and vitality of the residual pulp in the central and distal parts of the pulp chamber. These results show that dental pulp stem cells can induce the formation of reparative dentin and therefore constitute a useful tool for pulp therapies. Finally, reparative dentin was also built up when A4 progenitors were performed by alginate beads, suggesting that alginate is a suitable carrier for cell implantation in teeth. Copyright © 2014 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

  15. The involvement of splenic artery in the blood supply of hepatomas: its DSA findings and interventional treatment

    International Nuclear Information System (INIS)

    Duan Xuhua; Liang Huiming; Feng Gansheng; Zheng Chuangsheng; Ren Jianzhuang

    2009-01-01

    Objective: To investigate the DSA manifestations of the involvement of splenic artery in supplying blood to hepatomas and to assess the therapeutic value of super-selective interventional embolization. Methods: During the period of March 2005-June 2008, 897 patients with hepatoma underwent angiography and the involvement of splenic artery in the blood supply of hepatoma was confirmed in 7 cases. Splenic arteriography was performed by means of super-selective catheterization with 5 F Yashiro catheter together with 3 F SP catheter. The splenic arteries which supplied blood to hepatomas were embolized with hyper-liquid iodized-oil emulsion mixed with chemotherapy drug, which was followed by the injection of sufficient gelatin sponge or ethanol. The clinical results were analyzed. Results: Splenic arteriography revealed that the splenic artery was the main supplying vessel of the hepatoma in two cases, and was not the main supplying vessel of the hepatoma in five cases. The splenic supplying vessels were completely embolized in all 7 cases. After the procedure, AFP level was decreased over 50%, and in two patients it dropped to normal. CT checkup 4-6 weeks after the surgery revealed that the diameter of tumor decreased to 2.5 - 4.6 cm. Conclusion: The involvement of splenic artery in supplying blood to hepatomas is not common. Super-selective catheterization and sufficient embolization of the splenic supplying vessels are very important for improving the interventional effectiveness. (authors)

  16. Laparoscopic splenic biopsy in dogs and cats: 15 cases (2006-2008).

    Science.gov (United States)

    Radhakrishnan, Anant; Mayhew, Philipp D

    2013-01-01

    This retrospective study describes a technique and evaluates outcome associated with laparoscopic splenic biopsy in dogs and cats. Medical records of dogs (n = 10) and cats (n = 5) that had a laparoscopic splenic biopsy performed as part of their diagnostic evaluation for systemic disease were evaluated. Splenic biopsies were performed with the patient in dorsal recumbency using a two-portal approach. In some cases, concurrent organ biopsy was also performed. A pair of 5 mm cup biopsy forceps was used for biopsy collection, and an absorbable gelatin hemostatic sponge was placed at the biopsy site to aid in hemostasis. All patients recovered without major complications. Conversion to an open surgical approach was not required. Median survival time was 180 days, and nine patients were alive at the time of manuscript preparation. Four patients were diagnosed with neoplasia; however, only one had neoplasia involving the spleen. Median survival time for the nonneoplasia group (n = 11) was 300 days. Eight of those patients were alive at time of manuscript preparation. Minimal morbidity was observed in this cohort of clinical patients. Histopathology may be preferred over cytology in some clinical situations, and laparoscopic splenic biopsy provides a minimally invasive diagnostic option.

  17. [Spleen-preserving surgery after blunt abdominal trauma with splenic hilum involvement].

    Science.gov (United States)

    Navas-Cuéllar, José Aurelio; Cañete-Gómez, Jesús; López-Bernal, Francisco; García-Rivera, Carla; Pareja-Ciuró, Felipe; Padillo-Ruiz, Javier

    2015-01-01

    Splenic involvement secondary to blunt abdominal trauma is often treated by performing a splenectomy. The severity of the post-splenectomy syndrome is currently well known (blood loss, sepsis), so there is an increasing tendency to preserve the spleen. The case is presented of splenic preservation after blunt abdominal trauma with hilum involvement, emphasising the role of Floseal as a haemostatic agent, as well as the use of resorbable meshes to preserve the spleen. A 22-year-old woman presenting with a grade IV splenic lesion secondary to a blunt abdominal trauma after a traffic accident. Partial splenic resection was performed and bleeding was controlled with Floseal and use of a reinforcing polyglycolic acid mesh. No postoperative complications occurred, being discharged on day 5. The long-term follow-up has been uneventful. The use of haemostatic agents such as thrombin and the gelatine gel (FloSeal) and the use of polyglycolic acid meshes enable spleen-preserving surgery, making it a feasible and reproducible procedure and an alternative to classical splenectomy. Copyright © 2015 Academia Mexicana de Cirugía A.C. Published by Masson Doyma México S.A. All rights reserved.

  18. Observation Versus Embolization in Patients with Blunt Splenic Injury After Trauma: A Propensity Score Analysis.

    Science.gov (United States)

    Olthof, Dominique C; Joosse, Pieter; Bossuyt, Patrick M M; de Rooij, Philippe P; Leenen, Loek P H; Wendt, Klaus W; Bloemers, Frank W; Goslings, J Carel

    2016-05-01

    Non-operative management (NOM) is the standard of care in hemodynamically stable patients with blunt splenic injury after trauma. Splenic artery embolization (SAE) is reported to increase observation success rate. Studies demonstrating improved splenic salvage rates with SAE primarily compared SAE with historical controls. The aim of this study was to investigate whether SAE improves success rate compared to observation alone in contemporaneous patients with blunt splenic injury. We included adult patients with blunt splenic injury admitted to five Level 1 Trauma Centers between January 2009 and December 2012 and selected for NOM. Successful treatment was defined as splenic salvage and no splenic re-intervention. We calculated propensity scores, expressing the probability of undergoing SAE, using multivariable logistic regression and created five strata based on the quintiles of the propensity score distribution. A weighted relative risk (RR) was calculated across strata to express the chances of success with SAE. Two hundred and six patients were included in the study. Treatment was successful in 180 patients: 134/146 (92 %) patients treated with observation and 48/57 (84 %) patients treated with SAE. The weighted RR for success with SAE was 1.17 (0.94-1.45); for complications, the weighted RR was 0.71 (0.41-1.22). The mean number of transfused blood products was 4.4 (SD 9.9) in the observation group versus 9.1 (SD 17.2) in the SAE group. After correction for confounders with propensity score stratification technique, there was no significant difference between embolization and observation alone with regard to successful treatment in patients with blunt splenic injury after trauma.

  19. Pulping Variables, Storage Time and Pitch Deposit | Ogunwusi ...

    African Journals Online (AJOL)

    Pulp resin is also influenced by effective alkali concentration of the pulping medium. With increase in effective alkali concentration from 13% to 15%, pulp pitch is reduced. The interaction effect of storage and effective alkali concentration was not significant indicating that reduction in pulp pitch caused by effective alkali ...

  20. 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.

  1. [Splenic infarction at high altitude, Huaraz-Peru (3,100 masl)].

    Science.gov (United States)

    López de Guimaraes, Douglas; Menacho López, Julio; Villanueva Palacios, Jovita; Mosquera Vásquez, Vitaliano

    2009-01-01

    We report three cases of splenic infarction in healthy men for the first time that amounted to high altitudes, observed in the hospital "Victor Ramos Guardia" Huaraz (3100 m). Case 1 (1995) of 55 years, born in Cuba, from Lima, caucasian suddenly presented acute abdominal pain in epigastrium, distension, nausea and vomiting, was laparotomized for acute abdomen and surgical pathology revealed thrombosis with splenic infarction splenic artery and vein. During follow-up in Lima, hemoglobin electrophoresis showed that it was heterozygous carrier of the sickle trait (Hb A: 57% Hb S: 38.5%). Case 2 (1998) of 23 years, born in Cuba, from Lima, Black said acute abdominal pain in left hypochondrium, shortness of breath and chest pain, clinical examination and radiography of the abdomen showed the spleen volume increased. Case 3 (2006) of 17 years, natural and from Lima, mestizo, who came on tour promotion, acute abdominal pain referred onset in the epigastrium and left hypochondrium, headache, increase heat, nausea and vomiting, pharyngitis was found acute and painful, and spleen increased in size by clinical and x-ray of abdomen simple stand. None had no history of hemoglobinopathy and anemia. In general, medical management was supportive and cases 2 and 3 are recommended hemoglobin electrophoresis. We conclude that we must think of splenic infarction associated with height in any healthy person who is first at high altitude (> 3000m) and having a sudden acute abdominal pain in epigastrium and / or left hypochondrium, pain and palpable spleen and radiological study compatible with image. In this case is indicated by hemoglobin electrophoresis to determine whether there is an individual heterozygous carrier of the sickle trait. splenic infarction, high altitude, sickle trait, Huaraz.

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

    International Nuclear Information System (INIS)

    Resende, Vivian; Tavares Junior, Wilson Campos; Vieira, Jose Nelson Mendes; Drumond, Domingos Andre Fernandes

    2005-01-01

    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)

  3. CT imaging of splenic sequestration in sickle cell disease

    International Nuclear Information System (INIS)

    Sheth, S.; Piomelli, S.; Ruzal-Shapiro, C.; Berdon, W.E.

    2000-01-01

    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.)

  4. Is non-operative management safe and effective for all splenic blunt trauma? A systematic review.

    Science.gov (United States)

    Cirocchi, Roberto; Boselli, Carlo; Corsi, Alessia; Farinella, Eriberto; Listorti, Chiara; Trastulli, Stefano; Renzi, Claudio; Desiderio, Jacopo; Santoro, Alberto; Cagini, Lucio; Parisi, Amilcare; Redler, Adriano; Noya, Giuseppe; Fingerhut, Abe

    2013-09-03

    The goal of non-operative management (NOM) for blunt splenic trauma (BST) is to preserve the spleen. The advantages of NOM for minor splenic trauma have been extensively reported, whereas its value for the more severe splenic injuries is still debated. The aim of this systematic review was to evaluate the available published evidence on NOM in patients with splenic trauma and to compare it with the operative management (OM) in terms of mortality, morbidity and duration of hospital stay. For this systematic review we followed the "Preferred Reporting Items for Systematic Reviews and Meta-analyses" statement. A systematic search was performed on PubMed for studies published from January 2000 to December 2011, without language restrictions, which compared NOM vs. OM for splenic trauma injuries and which at least 10 patients with BST. We identified 21 non randomized studies: 1 Clinical Controlled Trial and 20 retrospective cohort studies analyzing a total of 16,940 patients with BST. NOM represents the gold standard treatment for minor splenic trauma and is associated with decreased mortality in severe splenic trauma (4.78% vs. 13.5% in NOM and OM, respectively), according to the literature. Of note, in BST treated operatively, concurrent injuries accounted for the higher mortality. In addition, it was not possible to determine post-treatment morbidity in major splenic trauma. The definition of hemodynamic stability varied greatly in the literature depending on the surgeon and the trauma team, representing a further bias. Moreover, data on the remaining analyzed outcomes (hospital stay, number of blood transfusions, abdominal abscesses, overwhelming post-splenectomy infection) were not reported in all included studies or were not comparable, precluding the possibility to perform a meaningful cumulative analysis and comparison. NOM of BST, preserving the spleen, is the treatment of choice for the American Association for the Surgery of Trauma grades I and II

  5. Splenic masses in dogs. Part 1: Epidemiologic, clinical characteristics as well as histopathologic diagnosis in 249 cases (2000-2011).

    Science.gov (United States)

    Eberle, N; von Babo, V; Nolte, I; Baumgärtner, W; Betz, D

    2012-01-01

    Splenic masses have a high prevalence and are more common than diffuse splenic enlargement in dogs. It was the aim of the present study to retrospectively describe clinical aspects and histopathologic characteristics of dogs with splenic masses. Records of patients with a histologically diagnosed splenic mass between January 2000 and March 2011 were reviewed. 249 dogs met the inclusion criteria and could be included in the study. Splenic masses were diagnosed histologically as non-malignant disease (n=117; 47%) and malignant splenic disease (n=132; 53%). Hemangiosarcoma was the most common histological diagnosis (n=97; 73.5%). Other malignant tumors included sarcoma (n=14), fibrohistiocytic nodules (n=9) as well as lymphoma, blastoma and adenocarcinoma. The non-malignant masses consisted of nodular hyperplasia (n=60), splenic hematoma (n=41), and splenitis (n=6). Dogs with hemoperitoneum had a higher frequency of splenic neoplasia. The results corroborate previous findings that hemangiosarcoma is the most frequent neoplasm of the canine spleen. However, in approximately half of the cases benign lesions were histologically diagnosed. It is essential that a frank discussion is held with owners regarding the prognosis associated with the treatment of dogs with a splenic mass associated with hemoperitoneum.

  6. Dental pulp stem cells

    DEFF Research Database (Denmark)

    Ashri, N. Y.; Ajlan, S. A.; Aldahmash, Abdullah M.

    2015-01-01

    scaffold, and guided through signaling molecules. Dental pulp stem cells have been used in an increasing number of studies in dental tissue engineering. Those cells show mesenchymal (stromal) stem cell-like properties including self-renewal and multilineage differentiation potentials, aside from...... an updated review on dental pulp stem cells and their applications in periodontal regeneration, in combination with different scaffolds and growth factors....

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

    International Nuclear Information System (INIS)

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

    1980-01-01

    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

  8. [Myelophthisis and kasabach merrit syndrome as initial manifestation of splenic angiosarcoma].

    Science.gov (United States)

    Serra, Jeremias Tomas; Orozco, Maira J; Prato, Franco J; Sánchez, Victoria; Basqueira, Ana J; Brocca, Carlos A

    2016-01-01

    Primary splenic angiosarcoma is an extremely agressive and rare neoplasm. Manifestations as bone marrow invasion and coagulation disorders have been reported isolatedly. A 26 years-old woman presented with abdominal pain; several anemia and thrombocytopenia associated to leukoerythroblastic reaction were found in the laboratory. Consumpion coagulopathy signs and microangiopathy as schistocytes, prolonged prothrombine time, decreased fibrinogen and increased D dimer were also present. Imaging findings included a lobulated, enlarged spleen, with spontanously hyperdense areas, and heterogeneous nodules with intense, irregular enhancement after contrast administration. There were hepatic and pulmonary metastases, as well as bone lesions with conspicuous vessels. Clinical features of Kasabach-Merrit syndrome and imaging vascular neoplasm characteristics suggest a primary splenic angiosarcoma. Splenectomy and bone marrow biopsy confirmed the diagnosis of primary splenic angiosarcoma in metastatic stage.

  9. Campylobacter jejuni, an uncommon cause of splenic abscess diagnosed by 16S rRNA gene sequencing

    Directory of Open Access Journals (Sweden)

    Piseth Seng

    2014-12-01

    Full Text Available Splenic abscess is a rare disease that primarily occurs in patients with splenic trauma, endocarditis, sickle cell anemia, or other diseases that compromise the immune system. This report describes a culture-negative splenic abscess in an immunocompetent patient caused by Campylobacter jejuni, as determined by 16S rRNA gene sequencing.

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

    International Nuclear Information System (INIS)

    Maurer, M. H.; Mogl, M. T.; Podrabsky, P.; Denecke, T.; Grieser, C.; Fröling, V.; Scheurig-Münkler, C.; Guckelberger, O.; Kroencke, T. J.

    2011-01-01

    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.

  11. Spleen and splenic vessel preserving distal pancreatectomy for bifocal PNET in a young patient with MEN1.

    Science.gov (United States)

    Conrad, Claudius; Schwarz, Lilian; Perrier, Nancy; Fleming, Jason B; Katz, Matthew H G; Aloia, Thomas A; Vauthey, Jean-Nicolas; Lee, Jeffrey E

    2016-10-01

    MEN1 patients requiring resection of neuroendocrine tumors (pNET) are frequently young, active patients in whom a minimal access approach minimizes perioperative morbidity and splenic preservation decreases the risk of post-splenectomy sepsis. Laparoscopic spleen preserving distal pancreatectomy can be performed with removal (Warshaw's technique) or preservation of the splenic vessels, the later having a higher rate of successful splenic preservation. This is an active, 16-year-old Jehovah's Witness with trifocal nonfunctioning neuroendocrine tumor in the proximal body and tail of the pancreas as part of MEN1 syndrome. A spleen preserving distal pancreatectomy was performed with the final pathology showing three pNET with low mitotic count and three lymph nodes free of cancer (final stage pT2pN0). This video demonstrates patient and trocar positioning as well as operative tactics for a laparoscopic distal pancreatectomy with preservation of splenic vessels. Intraoperative ultrasound is crucial in assessing pNETs' relation to critical vessels, pancreatic duct, and to exclude synchronous lesions. The video focuses on safe laparoscopic creation of the retropancreatic tunnel and dissecting the pancreas off the splenic vessels using novel energy devises to control direct splenic venous branches into the pancreas. Improvements in laparoscopic techniques and technology have enabled surgeons to preserve the major splenic vessels to avoid splenic infarcts, abscesses and re-operations, and minimize the risk of left-sided portal hypertension. Splenic preservation is particularly important in young MEN1 patients undergoing laparoscopic pancreatectomy for pNET due to the increased risk of overwhelming post-splenectomy sepsis.

  12. Nanofibrillated cellulose as paper additive in Eucalyptus pulps

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    Israel González

    2012-11-01

    Full Text Available In this work, the physical and mechanical properties of bleached Eucalyptus pulp reinforced with nanofibrillated cellulose (NFC are compared with those of traditional beaten pulp used in the making of writing/printing and offset printing papers. For this purpose, three different types of hardwood slurries were prepared: beaten pulps, unbeaten pulps reinforced with NFC, and slightly beaten pulps also reinforced with NFC. Physical and mechanical tests were performed on handsheets from these different slurries. The results showed that adding NFC to unbeaten pulps results in physical and mechanical properties similar to those in pulps used for printing/writing papers. Nevertheless, the best results were obtained in slurries previously beaten at slight conditions and subsequently reinforced with NFC. These results demonstrate that the addition of NFC allows a reduction in beating intensity without decreasing the desired mechanical properties for this specific purpose.

  13. A novel role for Twist-1 in pulp homeostasis.

    Science.gov (United States)

    Galler, K M; Yasue, A; Cavender, A C; Bialek, P; Karsenty, G; D'Souza, R N

    2007-10-01

    The molecular mechanisms that maintain the equilibrium of odontoblast progenitor cells in dental pulp are unknown. Here we tested whether homeostasis in dental pulp is modulated by Twist-1, a nuclear protein that partners with Runx2 during osteoblast differentiation. Our analysis of Twist-1(+/-) mice revealed phenotypic changes that involved an earlier onset of dentin matrix formation, increased alkaline phosphatase activity, and pulp stones within the pulp. RT-PCR analyses revealed Twist-1 expression in several adult organs, including pulp. Decreased levels of Twist-1 led to higher levels of type I collagen and Dspp gene expression in perivascular cells associated with the pulp stones. In mice heterozygous for both Twist-1 and Runx2 inactivation, the phenotype of pulp stones appeared completely rescued. These findings suggest that Twist-1 plays a key role in restraining odontoblast differentiation, thus maintaining homeostasis in dental pulp. Furthermore, Twist-1 functions in dental pulp are dependent on its interaction with Runx2.

  14. Disagreement between splenic switch-off and myocardial T1-mapping after caffeine intake

    NARCIS (Netherlands)

    Kuijpers, Dirkjan; van Dijk, Randy; van Assen, Marly; Kaandorp, Theodorus A M; van Dijkman, Paul R M; Vliegenthart, Rozemarijn; van der Harst, Pim; Oudkerk, Matthijs

    Caffeine is an adenosine receptor antagonist and a possible cause of inadequate stress perfusion. Splenic switch-off (SSO) and splenic rest-stress T1-mapping have been proposed as indicators of stress adequacy during perfusion cardiac magnetic resonance (CMR). We compared myocardial rest-stress

  15. Splenic artery embolisation for portal hypertention in children

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    Meisheri Ila

    2010-01-01

    Full Text Available Background: Bleeding from esophageal varices is one of the most common causes of serious gastrointestinal haemorrhage in children. We analysed our experience with the use of splenic artery embolisation and variceal sclerotherapy for bleeding oesophageal varices. Patients and Methods: Records of all patients treated for bleeding oesophageal varices caused by portal hypertension from 1998 to 2004 were retrospectively analysed. Patients were followed up for five years. Results: Out of 25 patients treated, ten belonged to sclerotherapy (group A, eight to combined sclerotherapy and embolisation (group B, and seven to only embolisation (group C. The patients were selected randomly, only two patients who had active bleed recently were directly sclerosed. The splenic artery was embolised at the hilum using steel coils in 15 patients with portal hypertension and hypersplenism. Follow-up findings showed decrease in splenic mass, varices, and hyperdynamic flow. Conclusion: In spite of few patients and a short period of follow-up, our results pointed out that a serious consideration should be given to this procedure, as it slowed the sequel of portal hypertension and the complications associated with it. Patients who were embolised and followed up for five years had lesser rebleeds and complications than sclerotherapy patients.

  16. Splenic vasculitis, thrombosis, and infarction in a febrile dog infected with Bartonella henselae.

    Science.gov (United States)

    Friedenberg, Steven G; Balakrishnan, Nandhakumar; Guillaumin, Julien; Cooper, Edward S; Lewis, Kristin; Russell, Duncan S; Breitschwerdt, Edward B

    2015-01-01

    To describe the clinical course and successful management of a febrile dog with polyarthritis, splenic vasculitis, thrombosis, and infarction that was infected with Bartonella henselae. An 8-year-old female spayed Labrador Retriever was referred to The Ohio State University Veterinary Medical Center Emergency Service for evaluation of limping, fever, vomiting, and malaise of 4 days' duration. Physical examination abnormalities included generalized weakness, diminished conscious proprioception, bilateral temporalis muscle atrophy, and diarrhea. Peripheral lymph nodes were normal, and there were no signs of abdominal organomegaly, joint effusion, or spinal pain. Abdominal ultrasound identified a nonocclusive splenic vein thrombus. Fine-needle aspirates of the spleen revealed pyogranulomatous inflammation, mild reactive lymphoid hyperplasia, and mild extramedullary hematopoiesis. Splenic histopathology found marked, multifocal to coalescing acute coagulation necrosis (splenic infarctions) and fibrinoid necrotizing vasculitis. Bartonella henselae DNA was amplified by polymerase chain reaction and sequenced from the splenic tissue. The dog responded favorably to antimicrobials and was healthy at the time of follow-up evaluation. Bartonella henselae is an incompletely characterized emerging canine pathogen. This case report establishes a potential role for this bacterium as a cause of vasculitis and thromboembolism, which have not been previously reported in association with B. henselae infection in dogs. © Veterinary Emergency and Critical Care Society 2015.

  17. Pancreatitis-Associated Splenic Artery Pseudoaneurysm: Endovascular Treatment with Self-Expandable Stent-Grafts

    International Nuclear Information System (INIS)

    Brountzos, Elias N.; Vagenas, Kostantinos; Apostolopoulou, Sotiria C.; Panagiotou, Irene; Lymberopoulou, Dimitra; Kelekis, Dimitrios A.

    2003-01-01

    We present a patient with a splenic arterypseudoaneurysm (SAPA) treated with placement of self-expandable stent-grafts. The procedure was complicated by stent-graft migration,but successful management resulted in lasting exclusion of the SAPA,while the patency of the splenic artery was preserved. This is the first report of self-expandable stent-graft treatment of SAPA

  18. Evaluation of bleachability on pine and eucalyptus kraft pulps

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    Marcela Freitas Andrade

    2013-09-01

    Full Text Available In recent decades, the pulp industry has been changing and improving its manufacturing processes in order to enhance production capacity, product quality and environmental performance. The aim of this study was to evaluate the bleachability effect on the efficient washing and alkaline leaching in eucalyptus and pine Kraft pulps using three different bleaching sequences: AD(EPD, A/D(EPDP and DHT(EPDP. This study was carried out in two stages. In the first part, the optimum conditions for pulp bleaching in order to achieve a brightness of 90% ISO were established. The second step was a comparative study between the pulps that received alkaline leaching and efficient washing with reference pulp (without treatment. The brightness, viscosity, kappa number and HexA in pulp were analyzed. The three sequences studied reached the desired brightness, but the sequence AD(EPD produced a lower reagent consumption for the same brightness. In the three sequences studied, the efficient washing of the pulp after oxygen delignification has contributed significantly to the removal of dissolved organic and inorganic materials in the pulp and the alkaline leaching decreased significantly the pulp kappa number due to a higher pulp delignification and bleachability.

  19. Antioxidant activity of dietary fruits, vegetables, and commercial frozen fruit pulps.

    Science.gov (United States)

    Hassimotto, Neuza Mariko Aymoto; Genovese, Maria Inés; Lajolo, Franco Maria

    2005-04-20

    Fruits, vegetables, and commercial frozen pulps (FP) consumed in the Brazilian diet were analyzed for antioxidant activities using two different methods, one that determines the inhibition of copper-induced peroxidation of liposome and another based on the inhibition of the co-oxidation of linoleic acid and beta-carotene. The anthocyanin-rich samples showed the highest, concentration-dependent, antioxidant activities in both systems. In the liposome system, at both 10 and 50 microM gallic acid equivalent (GAE) addition levels, the neutral and acidic flavonoids of red cabbage, red lettuce, black bean, mulberry, Gala apple peel, jambolao, acai FP, mulberry FP, and the acidic flavonoids of acerola FP showed the highest antioxidant activities (>85% inhibition). In the beta-carotene bleaching system, the samples cited above plus red guava gave inhibition values >70%. On the other hand, some samples showed pro-oxidant activity in the liposome system coincident with a low antioxidant activity in the beta-carotene system. There was no relationship between total phenolics content, vitamin C, and antioxidant activity, suggesting that the antioxidant activity is a result of a combination of different compounds having synergic and antagonistic effects.

  20. Impact of concomitant trauma in the management of blunt splenic injuries.

    Science.gov (United States)

    Lo, Albert; Matheson, Anne-Marie; Adams, Dave

    2004-09-10

    Conservative management of isolated blunt splenic injuries has become widely accepted for haemodynamically stable patients, but may be untenable in those with multiple injuries. A retrospective review was performed to evaluate of our cumulative experience with non-operative management of splenic injuries, and to identify the risk factors for operative management. Eighty patients were identified. Demographics, mechanism of injury, injury severity score (ISS), clinical signs at presentation, utility of computed tomography scans and methods of treatment (operative management vs conservative management) were documented and statistically analysed to identify predictors for operative management. Initially, 45 patients (56%) were managed without operation, while 35 patients underwent urgent laparotomy - with 26 (74% in operative group) of these having splenectomy performed. Two patients (out of 45) failed conservative management and required delayed splenectomy, a 96% success rate for intended conservative management. Thus, overall rates of 54% non-operative management and 65% splenic conservation were achieved. The mean ISS of the operative management group (ISS=30) was higher than that of the non-operative treatment group (ISS=13, ptrauma. Risk factors for patients with blunt splenic injuries requiring operative management include ISS > or =16, hypotension, GCS trauma, there is an increasing trend towards operative management.

  1. The role of splenic irradiation in treating HIV-associated immune thrombocytopenia

    International Nuclear Information System (INIS)

    Blauth, Jeanette; Fisher, Scot; Henry, David; Nichini, Franco

    1999-01-01

    Purpose: To evaluate our experience in treating patients with HIV-associated thrombocytopenia using splenic irradiation. Methods and Materials: From 1993 to 1998, 10 patients with HIV-related immune thrombocytopenia (ITP) were treated in our department with low-dose splenic irradiation. All patients had either failed more conventional treatment modalities or possessed some contraindication to them. Results: Nine of 10 patients had at least a small, transient rise in their platelet counts, but only two received a substantial therapeutic benefit. Of these two, one died shortly after completing his course of radiation therapy while the other maintained near normal platelet counts up to approximately 3((1)/(2)) years following treatment. There were no treatment-related morbidities and one patient was treated twice. Conclusion: While most patients with HIV-associated ITP may initially respond favorably to splenic irradiation with small rises in platelet count, few responses are likely to be sustained or provide clinically significant outcomes. Our results support those previously reported by others treating this same condition. What remains to be investigated is whether there are any prognostic indicators to help identify those patients most likely to respond to this treatment, thus enabling us to reserve splenic irradiation for those who might derive a substantial benefit from it

  2. Association between dental pulp stones and calcifying nanoparticles.

    Science.gov (United States)

    Zeng, Jinfeng; Yang, Fang; Zhang, Wei; Gong, Qimei; Du, Yu; Ling, Junqi

    2011-01-07

    The etiology of dental pulp stones, one type of extraskeletal calcification disease, remains elusive to date. Calcifying nanoparticles (CNPs), formerly referred to as nanobacteria, were reported to be one etiological factor in a number of extraskeletal calcification diseases. We hypothesized that CNPs are involved in the calcification of the dental pulp tissue, and therefore investigated the link between CNPs and dental pulp stones. Sixty-five freshly collected dental pulp stones, each from a different patient, were analyzed. Thirteen of the pulp stones were examined for the existence of CNPs in situ by immunohistochemical staining (IHS), indirect immunofluorescence staining (IIFS), and transmission electron microscope (TEM). The remaining 52 pulp stones were used for isolation and cultivation of CNPs; the cultured CNPs were identified and confirmed via their shape and growth characteristics. Among the dental pulp stones examined in situ, 84.6% of the tissue samples staines positive for CNPs antigen by IHS; the corresponding rate by IIFS was 92.3 %. In 88.2% of the cultured samples, CNPs were isolated and cultivated successfully. The CNPs were visible under TEM as 200-400 nm diameter spherical particles surrounded by a compact crust. CNPs could be detected and isolated from a high percentage of dental pulp stones, suggesting that CNPs might play an important role in the calcification of dental pulp.

  3. Analysis of the value of imaging as part of the follow-up of splenic injury in children

    Energy Technology Data Exchange (ETDEWEB)

    Huebner, S. [Dept. of Radiology, Helath Sciences Centre, Winnipeg, MB (Canada); Reed, M.H. [Pediatric Radiology, Children' s Hospital, Winnipeg, Man. (Canada)

    2001-12-01

    Objective: A recent article suggested that routine follow-up imaging is still frequently used in the conservative management of splenic trauma in children. The purpose of this study was to use decision analysis to assess the value of routine imaging as part of the long-term follow-up of splenic injury in children managed nonoperatively. Methods: A literature review (1970-1999) on the management of blunt splenic trauma in children was performed. Data, including the use of follow-up imaging and the occurrence of delayed splenic rupture and death, on those patients managed nonoperatively were collected. The data were used to construct a decision tree. A Poisson distribution was used to determine the risk of delayed splenic rupture. Results: Information was extracted from 26 cohort studies. Nineteen of these studies were retrospective and six were prospective. One study had both retrospective and prospective arms. The study population consisted of 1,083 children. Of these patients, 920 (85 %) underwent routine follow-up imaging (US, CT, or scintigraphy). Follow-up imaging was either not performed or selectively performed in 163 patients (15 %). No cases of post-discharge splenic rupture or death were encountered in any of these groups. The maximum risk of delayed splenic rupture in the entire group was 0.3 % (0-3.7 cases). Conclusion:. The risk of delayed splenic rupture following blunt injury in children is very low, and is apparently unaffected by imaging protocols. No deaths, even in cases of delayed presentation, were identified in our study. These findings do not support the use of routine follow-up imaging of children with blunt splenic trauma. (orig.)

  4. Analysis of the value of imaging as part of the follow-up of splenic injury in children

    International Nuclear Information System (INIS)

    Huebner, S.; Reed, M.H.

    2001-01-01

    Objective: A recent article suggested that routine follow-up imaging is still frequently used in the conservative management of splenic trauma in children. The purpose of this study was to use decision analysis to assess the value of routine imaging as part of the long-term follow-up of splenic injury in children managed nonoperatively. Methods: A literature review (1970-1999) on the management of blunt splenic trauma in children was performed. Data, including the use of follow-up imaging and the occurrence of delayed splenic rupture and death, on those patients managed nonoperatively were collected. The data were used to construct a decision tree. A Poisson distribution was used to determine the risk of delayed splenic rupture. Results: Information was extracted from 26 cohort studies. Nineteen of these studies were retrospective and six were prospective. One study had both retrospective and prospective arms. The study population consisted of 1,083 children. Of these patients, 920 (85 %) underwent routine follow-up imaging (US, CT, or scintigraphy). Follow-up imaging was either not performed or selectively performed in 163 patients (15 %). No cases of post-discharge splenic rupture or death were encountered in any of these groups. The maximum risk of delayed splenic rupture in the entire group was 0.3 % (0-3.7 cases). Conclusion:. The risk of delayed splenic rupture following blunt injury in children is very low, and is apparently unaffected by imaging protocols. No deaths, even in cases of delayed presentation, were identified in our study. These findings do not support the use of routine follow-up imaging of children with blunt splenic trauma. (orig.)

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

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    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

  6. Computed tomography characteristics of hepatic and splenic abscesses associated with melioidosis: a 7- year study

    International Nuclear Information System (INIS)

    Apisarnthanarak, Piyaporn; Thairatananon, Atita; Muangsomboon, Kobkum

    2011-01-01

    Full text: This study aimed to characterise the CT findings associated with hepatic and splenic melioid abscesses. Patients with CT evidence of hepatic and/or splenic abscesses were retrospectively evaluated for clinical evidence of melioidosis over a 7-year period. After blinded review of the CT characteristics of intra-abdominal abscesses (IAA), we conducted a stratified analysis of patients with and without melioid IAA. Among 49 patients with CT evidence of hepatic and/or splenic IAA, the mean age was 50.2 years, 22 (44.9%) were women and eight (16.3%) had laboratory confirmation of melioidosis. For the 113 IAA, 33 were melioid abscesses (15 liver and 18 spleen) and 80 were non-melioid abscesses (69 liver and 11 spleen). Splenic IAA were more common in the melioid group (P = 0.001) and smaller in diameter than the hepatic IAA (P < 0.001). Melioid IAA were smaller than non-melioid IAA (P < 0.001) and the CT necklace sign was the strongest predictor for melioid IAA (odds ratio = 24.6, P = 0.006) with 100% specificity. Other significant predictors for melioidosis were concurrent hepatic and splenic involvement (P = 0.009), multiple abscesses (P = 0.015) and residence in an endemic area (P = 0.047). By multivariate analysis, concurrent hepatic and splenic involvement was the sole predictor of melioi dosis (adjusted odds ratio = 11.3, 95% confidence interval = 1.6-77.5, P = 0.014). The CT necklace sign, along with concurrent hepatic and splenic IAA, were highly suggestive of melioidosis in persons from Central Thailand.

  7. The clinical significance of T-cells, sIL-2R and TNF in evaluating patients with splenic autotransplantation

    International Nuclear Information System (INIS)

    Wang Haowei; Wu Haorong; Li Juncheng; Wu Jingchang

    2002-01-01

    To study the immunological effects of splenic autotransplantation, forty patients with splenic trauma were divided into two groups equally. One group underwent splenic autotransplantation and another underwent splenectomy. Control group included ten cases. Splenic autotransplantation and splenectomy group were compared with the control group. In the group of splenic autotransplantation, CD3 + , CD4 + , CD8 + , CD4 + /CD8 + dropped and sIL-2R, TNF rose after a week of operation. Then CD3 + , CD4 + , CD8 + , CD4 + /CD8 + rose and sIL-2R, TNF dropped three months later. In the group of splenectomy, CD 3+ , CD4 + , CD8 + and CD4 + /CD8 + dropped persistently, while sIL-2R and TNF rose postoperatively. Result showed splenic autotransplantation can help body to maintain T-cells level and improve the anti-infective ability

  8. Free toe pulp flap for finger pulp and volar defect reconstruction

    Directory of Open Access Journals (Sweden)

    Jyoshid R Balan

    2016-01-01

    Full Text Available Background: Fingertip injury requiring flap cover is very common in the modern era. The ideal cover should fulfill both functional and aesthetic improvement. Materials and Methods: From June 2015 to April 2016, we performed seven free toe pulp flaps for finger defect reconstruction. All patients were males. Five flaps were done in emergency post-traumatic cases, and two were done in elective set up. The cases included reconstruction of three thumbs, one index and one ring finger in an emergency set up and two ring fingers in the elective. Thumb reconstruction was done with great toe lateral pulp and the other digits reconstructed with second toe pulp flap. Follow-up evaluation included both functional and aesthetic assessment. Results: Five flaps survived completely, one suffered partial loss, and one flap failed completely. The median follow-up period was 9 months. The median duration of surgery was 255 min (range 210 to 300 min. The median two-point discrimination was 6.5 mm (range 4–8 mm. There was the return of temperature sensation in all patients; two had cold intolerance. The Semmes-Weinstein monofilament score varied from 3.61 to 5.07 (median filament index value 4.31/pressure value of 2 g/mm2. Three patients had delayed donor site wound healing. Conclusions: The free toe pulp flap is an efficient choice for fingertip and volar finger defects reconstruction with an excellent tissue match.

  9. Pulping and paper properties of Palmyra palm fruit fibers

    Directory of Open Access Journals (Sweden)

    Waranyou Sridach

    2010-05-01

    Full Text Available Palmyra palm fruit fibers have the properties to be used as an alternative raw material of cellulosic pulps for papermaking.Acid and alkali pulping were investigated by using nitric acid and caustic soda on a laboratory scale, with the purpose of producing printing or writing grade pulp. The chemical composition of fiber strands from palmyra palm fruits were examined, such as holocellulose, cellulose, pentosan, lignin and extractives. The yields of acid and soda pulps were below 40%. The main physical and mechanical properties of hand sheets produced from acid and soda processes were evaluated on 80 g/m2 test sheets as functions of the following parameters: tensile index, tear index, and brightness. The mechanical properties of soda pulps were developed by twin-roll press while it was not necessary to fibrillate acidic pulps through the beating step. The soda pulp sheets presented a lower brightness than that of acidic pulp sheets. The mechanicaland physical properties of the acidic and alkaline pulps verified that they were of an acceptable quality for papermaking.

  10. Pemanfaatan Limbah Pulp Buah Semangka (Citrullus vulgaris, Schard) Untuk Pembuatan Nata De Watermelon Pulp Dengan Menggunakan Bakteri Acetobacter xylinum

    OpenAIRE

    Mawaddah

    2011-01-01

    This research done to know can or not the waste of watermelon pulp use to produce nata and how the effect of mass variation using to nata’s quality. This research was done with mass variation of watermelon pulp that is 10 g, 20 g, 30 g, 40 g, 50 g, 60 g, and watermelon pulp without adding sugar as control. Statistical analysis count the thickness, water content, ash content, fiber content and organoleptic test of texture, color, aroma, and taste of nata de watermelon pulp. The result show...

  11. Epigenetic regulation in dental pulp inflammation

    Science.gov (United States)

    Hui, T; Wang, C; Chen, D; Zheng, L; Huang, D; Ye, L

    2016-01-01

    Dental caries, trauma, and other possible factors could lead to injury of the dental pulp. Dental infection could result in immune and inflammatory responses mediated by molecular and cellular events and tissue breakdown. The inflammatory response of dental pulp could be regulated by genetic and epigenetic events. Epigenetic modifications play a fundamental role in gene expression. The epigenetic events might play critical roles in the inflammatory process of dental pulp injury. Major epigenetic events include methylation and acetylation of histones and regulatory factors, DNA methylation, and small non-coding RNAs. Infections and other environmental factors have profound effects on epigenetic modifications and trigger diseases. Despite growing evidences of literatures addressing the role of epigenetics in the field of medicine and biology, very little is known about the epigenetic pathways involved in dental pulp inflammation. This review summarized the current knowledge about epigenetic mechanisms during dental pulp inflammation. Progress in studies of epigenetic alterations during inflammatory response would provide opportunities for the development of efficient medications of epigenetic therapy for pulpitis. PMID:26901577

  12. PEMUTIHAN PULP DENGAN HIDROGEN PEROKSIDA

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    Ahmad M. Fuadi

    2012-01-01

    Full Text Available The use of bleaching agent has increased as the result of increasing of paper consumption. The conventional bleaching agent that commonly used is material containing of chlorine. This material is not environmentally friendly and should be replaced by environmentally benign chemical, such as H2O2. About 40 gram of dry Akasia pulp was mixed with 600 ml of distilled water was put into plastic bag heated in a water bath. When the temperature reached 630C, a solution of 4 % of H2O2 and distilled water was added to obtain 5 % consistency. This mixture was put into water bath and was heated for 2 hours. The same procedure was conducted with various concentration of H2O2, time and pH. At the end of the process, the pulp was dewatered and washed. The filtrate obtained from the initial dewatering was used to determine the residual of H2O2. The pulp was analyzed to determine brightness, fiber strength and kappa number. The maximum achievement of brightness was 62,1 % ISO, 6.86 of kappa number and 1.02 kg/15 mm of fiber strength, which are reached at16 % of the use of H2O2, pH 11 and 5 hours of bleaching time. This achievement is similar to bleaching result by the additional of 4% H2O2. Inefficient usage of H2O2 was caused by some metal ions in the pulp which facilitate the decomposition of H2O2 to produce oxygen and water which has not effect on increasing the brightness. To improve the bleach ability of H2O2, initial treatment to remove metal ions from pulp should be done. Seiring dengan meningkatnya kebutuhan kertas, kebutuhan bahan pemutih juga mengalami kenaikan. Saat ini bahan pemutih yang banyak digunakan adalah senyawa yang mengandung khlor. Senyawa ini sangat tidak ramah lingkungan, oleh karena itu, perlu dicari bahan yang ramah lingkungan untuk menggantikannya. Salah satunya adalah hidrogen peroksida. Pulp dari pohon akasia sebanyak 40 gram kering dicampur dengan 600 ml aquadest dimasukkan dalam kantung plastik dipanaskan dalam water bath

  13. Massive Hematemesis from a Splenic Artery Pseudoaneurysm Presenting Two Years after Penetrating Trauma

    Directory of Open Access Journals (Sweden)

    Geraldine Abbey-Mensah

    2018-01-01

    Full Text Available Splenic artery pseudoaneurysms (PSA are rare entities and far less common than true aneurysms of the splenic artery. The most common etiology is pancreatitis, recurrent either in the setting of chronic pancreatitis or as an episode of acute pancreatitis. Less common causes include trauma, peptic ulcer disease, or iatrogenic causes. Almost all of the trauma-related case reports have been due to blunt trauma. We believe this to be the first reported case of a splenic artery PSA presenting with massive hematemesis at a significant time frame after penetrating trauma. Successful transcatheter treatment was performed and alternative techniques are also discussed.

  14. 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.

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

    International Nuclear Information System (INIS)

    Ryu, Chang Woo; Kim, Hee Jin

    2000-01-01

    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

  16. Basic effects of pulp refining on fiber properties--a review.

    Science.gov (United States)

    Gharehkhani, Samira; Sadeghinezhad, Emad; Kazi, Salim Newaz; Yarmand, Hooman; Badarudin, Ahmad; Safaei, Mohammad Reza; Zubir, Mohd Nashrul Mohd

    2015-01-22

    The requirement for high quality pulps which are widely used in paper industries has increased the demand for pulp refining (beating) process. Pulp refining is a promising approach to improve the pulp quality by changing the fiber characteristics. The diversity of research on the effect of refining on fiber properties which is due to the different pulp sources, pulp consistency and refining equipment has interested us to provide a review on the studies over the last decade. In this article, the influence of pulp refining on structural properties i.e., fibrillations, fine formation, fiber length, fiber curl, crystallinity and distribution of surface chemical compositions is reviewed. The effect of pulp refining on electrokinetic properties of fiber e.g., surface and total charges of pulps is discussed. In addition, an overview of different refining theories, refiners as well as some tests for assessing the pulp refining is presented. Copyright © 2014 Elsevier Ltd. All rights reserved.

  17. Dental pulp stone formation during orthodontic treatment: A ...

    African Journals Online (AJOL)

    2015-06-21

    Jun 21, 2015 ... the presence of dental pulp stone, gender, age, tooth type and arches. Results: Dental pulp ... primary and permanent dentition.[1] Dental pulp stones .... interpretation provided training to familiarize the other observer with the ...

  18. CT-guided percutaneous treatment of solitary pyogenic splenic abscesses

    Energy Technology Data Exchange (ETDEWEB)

    Pombo, F. [Dept. of Radiology, Hospital Juan Canalejo, La Coruna (Spain); Suarez, I. [Dept. of Radiology, Hospital Juan Canalejo, La Coruna (Spain); Marini, M. [Dept. of Radiology, Hospital Juan Canalejo, La Coruna (Spain); Arrojo, L. [Dept. of Radiology, Hospital Juan Canalejo, La Coruna (Spain); Echaniz, A. [Dept. of Internal Medicine, Hospital Juan Canalejo, La Coruna (Spain)

    1991-08-01

    Six patients with solitary pyogenic splenic abscesses treated by CT-guided percutaneous drainage (by catheter or needle), are presented. There were 3 unilocular, purely intrasplenic abscesses and 3 complex lesions with loculations and perisplenic involvement. Percutaneous drainage and intravenous antibiotics were curative in 4 patients. In the other 2, who had multiloculated abscesses, despite initially successful drainage, splenectomy was performed because of intractable left upper quadrant pain in one case and persistent fever and drainage of pus after 30 days in the other. These patients also developed large, sterile left pleural effusions. Solitary pyogenic splenic abscesses - particularly if uniloculated - can be effectively treated by CT-guided percutaneous drainage. (orig.)

  19. Organo mercurials in pulp and paper industry

    Energy Technology Data Exchange (ETDEWEB)

    Bouveng, H O

    1967-01-01

    Today phenyl mercury acetate (PMA) is used in the paper and pulp industry for two purposes: slime control in paper machine systems and impregnation of wet mechanical pulp. PMA is a commonly used slimicide. It is used for slime control in such a way that a minor part (5-20% depending on mill operation) will reach the watercourse with the waste water and contaminate aquatic life. PMA used for impregnation concerns wet mechanical pulp produced for export as raw material, mostly for newsprint. Treatment of this pulp with PMA is necessary to avoid changes caused by molds and rot fungi.

  20. Ruptured Splenic Abscess following Percutaneous Transluminal Angioplasty in a 40-Year-Old Man

    Directory of Open Access Journals (Sweden)

    C. Rajasekharan

    2012-05-01

    Full Text Available The incidence of splenic abscesses is currently 0.14–0.7% with a reported mortality of 0–47%. The diagnosis of splenic abscess which has ruptured into the abdomen is often overlooked because of its rarity and its misleading clinical presentations. Percutaneous coronary interventions (PCIs and coronary stenting procedures increased from 184,000 to 885,000 (from 335 to 1,550 and from 3,000 to 770,000 (from 5 to 1,350 per one million inhabitants, respectively. A 40-year-old Asian male presented to our emergency department with upper abdominal pain 5 days after a percutaneous transluminal coronary angioplasty. Clinical examination raised the possibilities of acute pancreatitis and intraabdominal sepsis. An initial ultrasound of the abdomen and blood tests were negative. A computed tomography scan of the abdomen revealed a splenic abscess that had ruptured into the abdomen. Pus culture revealed a multidrug-resistant strain of Klebsiella pneumoniae that was sensitive to meropenem. The patient recovered quickly after open surgical drainage and antibiotic therapy. As this is the second case of splenic abscess and the first case report of a ruptured splenic abscess following a PCI, it will be rational to administer a short course of antibiotic prophylaxis for high-risk immunocompromised patients who are undergoing percutaneous transluminal coronary intervention.

  1. Ten-year experience of splenic trauma in New Zealand: the rise of non-operative management.

    Science.gov (United States)

    Alamri, Yassar; Moon, Dana; Yen, Damien Ah; Wakeman, Chris; Eglinton, Tim; Frizelle, Frank

    2017-10-06

    The aim of this study was to describe the demographics, mechanisms of injury, management and outcomes in patients who suffered splenic trauma in Christchurch, New Zealand. A retrospective study included all splenic injury patients admitted to Christchurch Public Hospital between January 2005 and August 2015. A total of 238 patients were included, with a median age of 26 years (4-88.7). Of these, 235 patients had blunt injuries. Eighty-nine had high-grade injuries. Yearly admissions of splenic trauma patients have gradually increased. A total of 173 (72.7%) patients were managed with observation; 28 patients (11.8%) had radiological intervention and 37 patients (15.5%) had splenectomy. Patients who died were significantly more likely to be older (median, 46.5 vs 25.2 years, p=0.04) and to have been admitted to ICU (100% vs 32%, p=Splenic injuries have shown a steady increase in the last decade. Splenectomy rates have decreased in favour of non-operative techniques. Radiological intervention with splenic artery embolisation was successful in all selected patients with high-grade injuries.

  2. 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.

  3. Increased Risk of Hemorrhagic and Ischemic Strokes in Patients With Splenic Injury and Splenectomy: A Nationwide Cohort Study.

    Science.gov (United States)

    Lin, Jiun-Nong; Lin, Cheng-Li; Lin, Ming-Chia; Lai, Chung-Hsu; Lin, Hsi-Hsun; Yang, Chih-Hui; Kao, Chia-Hung

    2015-09-01

    The spleen is a crucial organ in humans. Little is known about the association between stroke and splenic injury or splenectomy. The aim of this study was to determine the risk of stroke in patients with splenic injury and splenectomy.A nationwide cohort study was conducted by analyzing the National Health Insurance Research Database in Taiwan. For comparison, control patients were selected and matched with splenic injury patients in a ratio of 4:1 according to age, sex, and the year of hospitalization. We analyzed the risks of stroke using a Cox proportional-hazards regression analysis.A total of 11,273 splenic injury patients, including 5294 splenectomized and 5979 nonsplenectomized patients, and 45,092 control patients were included in this study. The incidence rates of stroke were 8.05, 6.53, and 4.25 per 1000 person-years in splenic injury patients with splenectomy, those without splenectomy, and the control cohort, respectively. Compared with the control cohort, splenic injury patients with splenectomy exhibited a 2.05-fold increased risk of stroke (95% confidence interval [CI] 1.8-2.34), whereas those without splenectomy exhibited a 1.74-fold increased risk (95% CI 1.51-2). Splenectomy entailed an additional 1.21-fold increased risk of stroke compared with nonsplenectomy in patients with splenic injury.This study revealed that splenic injury and splenectomy were significantly associated with an increased risk of hemorrhagic and ischemic strokes. The results of this study may alert physicians and patients to the complications of splenic injury and splenectomy.

  4. Coeliac disease, splenic function, and malignancy

    OpenAIRE

    Robertson, D A F; Swinson, C M; Hall, R; Losowsky, M S

    1982-01-01

    Blood films from 41 cases of coeliac disease complicated by malignancy were examined and evidence of hyposplenism found in 12 cases (29%). This is similar to the proportion of adult coeliacs without malignancy who have hypoplenism and it is concluded that impaired splenic function is not associated with the development of malignancy in coeliac disease.

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

    International Nuclear Information System (INIS)

    Yan Youxia; Zhang Jin'e; Chen Xiaocong; Cai Shufang

    2007-01-01

    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)

  6. Acute Splenic Sequestration Crisis in Adult Sickle Cell Disease: A Report of 16 Cases.

    Science.gov (United States)

    Naymagon, Leonard; Pendurti, Gopichand; Billett, Henny H

    2015-01-01

    Acute splenic sequestration crisis (ASSC), characterized by rapidly progressive anemia and circulatory compromise in the setting of sudden splenic enlargement, is an uncommon entity among adult sickle cell patients. We reviewed cases of adult ASSC encountered at our institution to generate insight into the recognition, diagnosis, and treatment of the condition. Cases of adult ASSC during a 10-year period were identified retrospectively. Patient charts were reviewed for laboratory and imaging results; demographic data and clinical course were collected and reviewed. Sixteen cases of adult ASSC were identified. Most patients presented with pain crisis; only four of 16 patients presented with abdominal pain. The maximum decreases in hemoglobin (Hb) (42.0%) and platelets (62.1%) occurred at day 2.9, delaying identification and treatment. Hemodynamic instability played a large role in dictating risk stratification. Therapy consisted of transfusion (14/16) and splenectomy (5/16). No recurrences were noted in a mean follow-up time of 5.3 years but review of patients' charts demonstrated that at least one of the patients had two prior episodes. Adult ASSC may present with non specific findings and patients may not deteriorate until several days into a previously uneventful hospital course. Changes in platelet counts may be more reliable markers than changes in Hb level since red cell transfusions may interfere with assessments of the sequestration process. This case series of adult ASSC, the largest reported in the literature to date, highlights common clinical, laboratory, radiological, and pathological features of this uncommon entity and helps to guide recognition, diagnosis, and treatment.

  7. The relationship between pulp calcifications and salivary gland calcifications

    OpenAIRE

    Kaswan, Sumita; Patil, Santosh; Maheshwari, Sneha; Rahman, Farzan; Khandelwal, Suneet

    2014-01-01

    Aim: Pulp stones are discrete calcified bodies found in the dental pulp. Sialolithasis is the most common salivary gland disease. The aim of the present study was to determine the relationship between the pulp stones and salivary gland stones. Material and Methods: 196 patients were randomly selected from the out patient department for the study. The periapical radiographs for all patients were evaluated for the presence or absence of the narrowing of dental pulp chambers and pulp canals. The...

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

    International Nuclear Information System (INIS)

    Punwani, Shonit; Taylor, Stuart A.; Halligan, Steve; Cheung, King Kenneth; Skipper, Nicholas; Bell, Nichola; Humphries, Paul D.; Bainbridge, Alan; Groves, Ashley M.; Hain, Sharon F.; Ben-Haim, Simona; Shankar, Ananth; Daw, Stephen

    2013-01-01

    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. 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.)

  10. Systemic lupus erythematosus and splenic abscess

    International Nuclear Information System (INIS)

    Guarnizo Z, Pilar; Ramirez R, Francisco Alejandro; Ramirez G, Luis Alberto

    2006-01-01

    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

  11. Splenic function in chronic myelogenous leukemia

    Energy Technology Data Exchange (ETDEWEB)

    Covas, D.T.; Zago, M.A.

    1987-01-01

    Spleen function was evaluated by measurement of the clearance of autologous heat-damaged /sup 99m/Tc-labelled erythrocytes from the circulation and into the spleen and the enumeration of pitted erythrocytes by interference contrast microscopy, and the spleen area was determined by scintillation scanning. All measurements were performed on 12 patients with chronic myelogenous leukemia and compared with 10 controls with apparently normal spleens, 6 splenectomized subjects and 9 patients with a reactive splenomegaly. Patients with CML had spleen function test results similar to normal controls in spite of having enlarged spleens whose projection area did not differ from that of the patients with reactive splenomegaly. Thus, patients with CML have a decreased spleen function per unit volume and signs of splenic hypofunction in the peripheral blood. The reduction of spleen function per unit volume in CML is the result of a severe decrease of the splenic blood perfusion which could result from the combined effects of the myeloid metaplasia and the increased whole-blood viscosity due to high white-cell counts.

  12. Splenic function in chronic myelogenous leukemia

    International Nuclear Information System (INIS)

    Covas, D.T.; Zago, M.A.

    1987-01-01

    Spleen function was evaluated by measurement of the clearance of autologous heat-damaged 99m Tc-labelled erythrocytes from the circulation and into the spleen and the enumeration of pitted erythrocytes by interference contrast microscopy, and the spleen area was determined by scintillation scanning. All measurements were performed on 12 patients with chronic myelogenous leukemia and compared with 10 controls with apparently normal spleens, 6 splenectomized subjects and 9 patients with a reactive splenomegaly. Patients with CML had spleen function test results similar to normal controls in spite of having enlarged spleens whose projection area did not differ from that of the patients with reactive splenomegaly. Thus, patients with CML have a decreased spleen function per unit volume and signs of splenic hypofunction in the peripheral blood. The reduction of spleen function per unit volume in CML is the result of a severe decrease of the splenic blood perfusion which could result from the combined effects of the myeloid metaplasia and the increased whole-blood viscosity due to high white-cell counts. (author)

  13. Isolated Splenic Metastasis from Renal Cell Carcinoma: Case Report and Review

    Directory of Open Access Journals (Sweden)

    J.A.G. Moir

    2011-04-01

    Full Text Available This report presents the case of a 70-year-old woman with a previous history of a left nephrectomy for renal cell carcinoma (RCC, who developed general malaise and fatigue. Abdominal computed tomography demonstrated an enhancing 6 × 7 cm necrotic lesion in the lower pole of the spleen suggestive of a metastasis. Given the highly suspicious nature of the lesion we proceeded to splenectomy. The tumour did not breach the splenic capsule, and there was no local diaphragmatic involvement. The mass was concluded to be a true metastasis of the original RCC rather than local recurrence of the disease. The causes of isolated solid splenic lesions are wide and varied, however a past or present history of malignancy should lead to a high index of suspicion for a splenic metastasis. We report an extremely unusual case of spread from a RCC.

  14. Partial splenic embolization in a child with Gaucher disease, massive splenomegaly and severe thrombocytopenia

    International Nuclear Information System (INIS)

    Pena, Andres H.; Clevac, Egor; Marie Cahill, Anne; Kaplan, Paige; Ganesh, Jaya

    2009-01-01

    A 13-month-old boy with Gaucher disease presented with severe thrombocytopenia, anemia and massive splenomegaly. In addition he had significant respiratory compromise caused by abdominal compartment syndrome, requiring mechanical ventilation. Because of the degree of respiratory compromise and his existing bone marrow suppression, splenic artery embolization was chosen as an alternative to splenectomy. Splenic artery embolization was performed using 355-500-μm polyvinyl alcohol particles, with 70% ablation achieved. Within 24 h of the procedure the platelet count had risen to greater than 70,000/mm 3 and to more than 170,000/mm 3 on postoperative day 4. At the 8-month follow-up the splenic size had decreased from 18 cm to 8 cm, with a platelet count of 578,000/mm 3 . Partial splenic embolization provides a minimally invasive alternative to splenectomy in patients with Gaucher disease with massive splenomegaly and bone marrow suppression. (orig.)

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

    International Nuclear Information System (INIS)

    Cokca, F.; Yilmaz-Bozkurt, G.; Azap, A.; Memikoglu, O.; Takeli, E.

    2006-01-01

    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)

  16. Non operative management of blunt splenic trauma: a prospective evaluation of a standardized treatment protocol.

    Science.gov (United States)

    Brillantino, A; Iacobellis, F; Robustelli, U; Villamaina, E; Maglione, F; Colletti, O; De Palma, M; Paladino, F; Noschese, G

    2016-10-01

    The advantages of the conservative approach for major spleen injuries are still debated. This study was designed to evaluate the safety and effectiveness of NOM in the treatment of minor (grade I-II according with the American Association for the Surgery of Trauma; AAST) and severe (AAST grade III-V) blunt splenic trauma, following a standardized treatment protocol. All the hemodynamically stable patients with computer tomography (CT) diagnosis of blunt splenic trauma underwent NOM, which included strict clinical and laboratory observation, 48-72 h contrast-enhanced ultrasonography (CEUS) follow-up and splenic angioembolization, performed both in patients with admission CT evidence of vascular injuries and in patients with falling hematocrit during observation. 87 patients [32 (36.7 %) women and 55 (63.2 %) men, median age 34 (range 14-68)] were included. Of these, 28 patients (32.1 %) had grade I, 22 patients (25.2 %) grade II, 20 patients (22.9 %) grade III, 11 patients (12.6 %) grade IV and 6 patients (6.8 %) grade V injuries. The overall success rate of NOM was 95.4 % (82/87). There was no significant difference in the success rate between the patients with different splenic injuries grade. Of 24 patients that had undergone angioembolization, 22 (91.6 %) showed high splenic injury grade. The success rate of embolization was 91.6 % (22/24). No major complications were observed. The minor complications (2 pleural effusions, 1 pancreatic fistula and 2 splenic abscesses) were successfully treated by EAUS or CT guided drainage. The non operative management of blunt splenic trauma, according to our protocol, represents a safe and effective treatment for both minor and severe injuries, achieving an overall success rate of 95 %. The angiographic study could be indicated both in patients with CT evidence of vascular injuries and in patients with high-grade splenic injuries, regardless of CT findings.

  17. Concomitant hollow viscus injuries in patients with blunt hepatic and splenic injuries: an analysis of a National Trauma Registry database.

    Science.gov (United States)

    Swaid, Forat; Peleg, Kobi; Alfici, Ricardo; Matter, Ibrahim; Olsha, Oded; Ashkenazi, Itamar; Givon, Adi; Kessel, Boris

    2014-09-01

    Non-operative management has become the standard approach for treating stable patients sustaining blunt hepatic or splenic injuries in the absence of other indications for laparotomy. The liberal use of computed tomography (CT) has reduced the rate of unnecessary immediate laparotomies; however, due to its limited sensitivity in the diagnosis of hollow viscus injuries (HVI), this may be at the expense of a rise in the incidence of missed HVI. The aim of this study was to assess the incidence of concomitant HVI in blunt trauma patients diagnosed with hepatic and/or splenic injuries, and to evaluate whether a correlation exists between this incidence and the severity of hepatic or splenic injuries. A retrospective cohort study involving blunt trauma patients with splenic and/or liver injuries, between the years 1998 and 2012 registered in the Israel National Trauma Registry. The association between the presence and severity of splenic and/or liver injuries and the incidence of HVI was examined. Of the 57,130 trauma victims identified as suffering from blunt torso injuries, 2335 (4%) sustained hepatic injuries without splenic injuries (H group), 3127 (5.4%) had splenic injuries without hepatic injuries (S group), and 564 (1%) suffered from both hepatic and splenic injuries (H+S group). Overall, 957 patients sustained 1063 HVI. The incidence of HVI among blunt torso trauma victims who sustained neither splenic nor hepatic injuries was 1.5% which is significantly lower than in the S (3.1%), H (3.1%), and H+S (6.7%) groups. In the S group, there was a clear correlation between the severity of the splenic injury and the incidence of HVI. This correlation was not found in the H group. The presence of blunt splenic and/or hepatic injuries predicts a higher incidence of HVI, especially if combined. While in blunt splenic injury patients there is a clear correlation between the incidence of HVI and the severity of splenic injury, such a correlation does not exist in patients

  18. Pulp and paper from blue agave waste from tequila production.

    Science.gov (United States)

    Idarraga, G; Ramos, J; Zuñiga, V; Sahin, T; Young, R A

    1999-10-01

    Pulping of blue agave waste, from the production of tequila, was evaluated by both chemical and biomechanical pulping processes. Two conventional and two organosolv systems were used to pulp the agave waste under a standard set of conditions. The soda-ethanol process was superior in terms of delignification and pulp properties in comparison to the soda and ethanol organosolv processes for pulping of agave waste; however, the kraft process gave the best strength properties. In general, the strength of the agave waste pulps was rather poor in comparison to wood and other agro-based pulps; however, the tear strength was relatively high. This result is typical of poorly bonded sheets and may be due to the coarseness of the agave fibers and/or loss of hemicelluloses in the steaming process for the tequila production. Fungal treatment of the agave waste with Ceriporiopsis subvermispora reduced the energy consumption for mechanical refining but gave biomechanical pulps with inferior strength properties. The blue agave chemical pulps should be suitable for blending with softwood kraft pulps for publication grade paper.

  19. Segmental resection with primary anastomosis is not always safe in splenic flexure perforation.

    Science.gov (United States)

    Weledji, Elroy P; Mokake, Martin D; Sinju, Motaze

    2016-01-16

    Familial adenomatous polyposis (FAP) is caused by a rare mutation of the adenomatous polyposis coli gene on Chromosome 5q. The risk of colorectal cancer in patients with FAP is nearly 100% and intensive endoscopic surveillance or prophylactic colectomy are mandatory. If extensive endoscopic surveillance is chosen, there is a cumulative risk of perforation and bleeding especially after polypectomy. We discussed the problems and options in the management of the late diagnosis of an iatrogenic perforation of the splenic flexure complicating endoscopic surveillance in FAP. We present a 35-year-old black African man with FAP who sustained a splenic flexure perforation following a colonoscopic polypectomy of a suspicious lesion. He underwent a splenic flexure resection and primary anastomosis that dehisced and the patient benefited from an emergency definitive colectomy and ileorectal anastomosis. Resection with primary anastomosis following iatrogenic perforation of the splenic flexure is not safe because of a high chance of anastomotic dehiscence. Following a late diagnosis in an unstable patient exteriorization of the perforation as a stoma is a better option prior to a definitive prophylactic colectomy.

  20. CT of hepatic and splenic injury in children: Role in the decision for laparotomy

    International Nuclear Information System (INIS)

    Brick, S.H.; Taylor, G.A.; Potter, B.M.; Eichelberger, M.R.

    1987-01-01

    Two hundred seventy-four children were examined with CT after incurring blunt trauma to the abdomen. Hepatic and/or splenic injuries were detected in 36 patients. Of 12 children with moderate to severe hepatic injuries, only one required operative intervention. Of 13 children with moderate to sever splenic injuries, only one required splenorrhaphy. Only two of 16 patients with a moderate to large hemoperitoneum required surgery for hepatic or splenic injury. The authors conclude that the decision for laparotomy should not be based on the extent of injury as seen on CT, but on the physiologic condition of the child

  1. A comparison of microRNA expression profiles from splenic hemangiosarcoma, splenic nodular hyperplasia, and normal spleens of dogs.

    Science.gov (United States)

    Grimes, Janet A; Prasad, Nripesh; Levy, Shawn; Cattley, Russell; Lindley, Stephanie; Boothe, Harry W; Henderson, Ralph A; Smith, Bruce F

    2016-12-03

    Splenic masses are common in older dogs; yet diagnosis preceding splenectomy and histopathology remains elusive. MicroRNAs (miRNAs) are short, non-coding RNAs that play a role in post-transcriptional regulation, and differential expression of miRNAs between normal and tumor tissue has been used to diagnose neoplastic diseases. The objective of this study was to determine differential expression of miRNAs by use of RNA-sequencing in canine spleens that were histologically confirmed as hemangiosarcoma, nodular hyperplasia, or normal. Twenty-two miRNAs were found to be differentially expressed in hemangiosarcoma samples (4 between hemangiosarcoma and both nodular hyperplasia and normal spleen and 18 between hemangiosarcoma and normal spleen only). In particular, mir-26a, mir-126, mir-139, mir-140, mir-150, mir-203, mir-424, mir-503, mir-505, mir-542, mir-30e, mir-33b, mir-365, mir-758, mir-22, and mir-452 are of interest in the pathogenesis of hemangiosarcoma. Findings of this study confirm the hypothesis that miRNA expression profiles are different between canine splenic hemangiosarcoma, nodular hyperplasia, and normal spleens. A large portion of the differentially expressed miRNAs have roles in angiogenesis, with an additional group of miRNAs being dysregulated in vascular disease processes. Two other miRNAs have been implicated in cancer pathways such as PTEN and cell cycle checkpoints. The finding of multiple miRNAs with roles in angiogenesis and vascular disease is important, as hemangiosarcoma is a tumor of endothelial cells, which are driven by angiogenic stimuli. This study shows that miRNA dysregulation is a potential player in the pathogenesis of canine splenic hemangiosarcoma.

  2. Effects of transportation time after extraction on the magnetic cryopreservation of pulp cells of rat dental pulp

    Directory of Open Access Journals (Sweden)

    Mao-Suan Huang

    2011-03-01

    Conclusions: The freezing technique used in this animal study provided positive effects on pulp cell storage. In addition, the storage time before the freezing procedure is an important issue for cryopreserving pulp cells in intact teeth.

  3. Acquired A amyloidosis from injection drug use presenting with atraumatic splenic rupture in a hospitalized patient: a case report

    Directory of Open Access Journals (Sweden)

    Hanks Douglas K

    2011-01-01

    Full Text Available Abstract Introduction Little is known about splenic rupture in patients who develop systemic acquired A amyloidosis. This is the first report of a case of atraumatic splenic rupture in a patient with acquired A amyloidosis from chronic injection drug use. Case presentation A 58-year-old Caucasian man with a long history of injection drug use, hospitalized for infective endocarditis, experienced atraumatic splenic rupture and underwent splenectomy. Histopathological and microbiological analyses of the splenic tissue were consistent with systemic acquired A amyloidosis, most likely from injection drug use, that led to splenic rupture without any recognized trauma or evidence of bacterial embolization to the spleen. Conclusion In patients with chronic inflammatory conditions, including the use of injection drugs, who experience acute onset of left upper quadrant pain, the diagnosis of atraumatic splenic rupture must be considered.

  4. Final Technical Report Steam Cycle Washer for Unbleached Pulp

    Energy Technology Data Exchange (ETDEWEB)

    Starkey, Yvonne; Salminen, Reijo; Karlsnes, Andy

    2008-09-22

    Project Abstract for “Steam Cycle Washer for Unbleached Pulp” When completed, the patented SC Washer will provide an innovative, energy efficient demonstration project to wash unbleached pulp using a pressure vessel charged with steam. The Port Townsend Paper Corporation’s pulp mill in Port Townsend, WA was initially selected as the host site for conducting the demonstration of the SCW. Due to 2006 and 2007 delays in the project caused by issues with 21st Century Pulp & Paper, the developer of the SCW, and the 2007 bankruptcy proceedings and subsequent restructuring at Port Townsend Paper, the mill can no longer serve as a host site. An alternate host site is now being sought to complete the commercial demonstration of the Steam Cycle Washer for Unbleached Pulp. Additionally, estimated costs to complete the project have more than doubled since the initial estimates for the project were completed in 2002. Additional grant funding from DOE was sought and in July, 2008 the additional DOE funds were procured under a new DOE award, DE-PS36-08GO98014 issued to INL. Once the new host site is secured the completion of the project will begin under the management of INL. Future progress reports and milestone tracking will be completed under requirements of new DOE Award Number DE-PS36-08GO98014. The following are excerpts from the project Peer Review completed in 2006. They describe the project in some detail. Additional information can be found by reviewing DOE Award Number: DE-PS36-08GO98014. 5. Statement of Problem and Technical Barriers: The chemical pulping industry is one of the major users of fresh water in the United States. On average the industry uses over 80 tons of water to produce one ton of pulp, some states use up to 50% more (Washington 120 and Wisconsin 140). In order to process one ton of pulp using 80 tons of process water, a large amount of: • energy is used in process heat and • power is required for pumping the large volume of pulp slurries

  5. [Sonographically detectable splenic disorders in dogs with malignant lymphoma].

    Science.gov (United States)

    Eberhardt, F; Köhler, C; Krastel, D; Winter, K; Alef, M; Kiefer, I

    2015-01-01

    To evaluate the frequency of different sonographic splenic disorders in dogs with different anatomic forms of malignant lymphoma. Additionally, the occurrence of the moth-eaten pattern in the parenchyma of the spleen in patients with diseases other than lymphoma should be investigated. Retrospective analysis of patient data collected from dogs histologically or cytologically diagnosed with malignant lymphoma and for which ultrasonographic images were available before the initiation of therapy. Patient data from dogs with a moth-eaten pattern within the splenic parenchyma were evaluated separately. Exclusion criterion was the administration of cytostatic agents prior to diagnosis. In 84% of 164 dogs with malignant lymphoma, an altered pattern of the spleen was diagnosed ultrasonographically. Ninety-four of these 137 patients had a moth-eaten pattern of the splenic parenchyma and 43 dogs displayed abnormalities in the form of splenomegaly, coarse echotexture or other changes of the parenchyma. When a moth-eaten pattern was diagnosed, the affected dogs suffered significantly more often from a multicentric lymphoma (95%) than from any other anatomical lymphoma form. Only one dog displayed a moth-eaten pattern of the splenic parenchyma without diagnosis of a malignant lymphoma. The positive predictive value of the moth-eaten pattern for malignant lymphoma was 99% and, in particular, for the multicentric lymphoma this was 95%. In total, 84% of the 164 dogs displayed a multicentric lymphoma, 5% a mediastinal or a cutaneous lymphoma, respectively, 4% a gastrointestinal lymphoma, and one animal had an ocular or renal lymphoma, respectively. Sonographic changes of the spleen are often diagnosed in dogs with malignant lymphoma, independent of the anatomical lymphoma form. When the moth-eaten pattern is observed, it is very likely that the affected dog suffers from a malignant lymphoma, most probably a multicentric lymphoma.

  6. 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 ...

  7. Influence of Soda Pulping Variables on Properties of Pineapple (Ananas comosus Merr. Leaf Pulp and Paper Studied by Face-Centered Composite Experimental Design

    Directory of Open Access Journals (Sweden)

    Jantharat Wutisatwongkul

    2016-01-01

    Full Text Available Face-centered composite design (FCC was used to study the effect of pulping variables: soda concentration (4-5 wt%, temperature (90–130°C, and pulping time (20–60 min on the properties of pineapple leaf pulp and paper employing soda pulping. Studied pulp responses were screened yield and lignin content (kappa number. Paper properties, which include tensile index, burst index, and tear index, were also investigated. Effects of the pulping variables on the properties were statistically analyzed using Minitab 16. The optimum conditions to obtain the maximum tensile index were soda concentration of 4 wt%, pulping temperature of 105°C, and pulping time of 20 min. The predicted optimum conditions provided tensile index, burst index, tear index, screened yield, and kappa number of 44.13 kN·m/kg, 1.76 kPa·m2, 1.68 N·m2/kg, 21.29 wt%, and 28.12, respectively, and were experimentally confirmed.

  8. Partial splenic embolization in a child with Gaucher disease, massive splenomegaly and severe thrombocytopenia

    Energy Technology Data Exchange (ETDEWEB)

    Pena, Andres H.; Clevac, Egor; Marie Cahill, Anne [Children' s Hospital of Philadelphia, Department of Radiology, Philadelphia, PA (United States); Kaplan, Paige; Ganesh, Jaya [Children' s Hospital of Philadelphia, Division of Metabolic Diseases, Philadelphia, PA (United States)

    2009-09-15

    A 13-month-old boy with Gaucher disease presented with severe thrombocytopenia, anemia and massive splenomegaly. In addition he had significant respiratory compromise caused by abdominal compartment syndrome, requiring mechanical ventilation. Because of the degree of respiratory compromise and his existing bone marrow suppression, splenic artery embolization was chosen as an alternative to splenectomy. Splenic artery embolization was performed using 355-500-{mu}m polyvinyl alcohol particles, with 70% ablation achieved. Within 24 h of the procedure the platelet count had risen to greater than 70,000/mm{sup 3} and to more than 170,000/mm{sup 3} on postoperative day 4. At the 8-month follow-up the splenic size had decreased from 18 cm to 8 cm, with a platelet count of 578,000/mm{sup 3}. Partial splenic embolization provides a minimally invasive alternative to splenectomy in patients with Gaucher disease with massive splenomegaly and bone marrow suppression. (orig.)

  9. Scanning in the diagnosis of hepatic and splenic trauma

    International Nuclear Information System (INIS)

    Fitzer, P.M.

    1976-01-01

    The diagnosis of hepatic and splenic injuries in the trauma patient with classic physical and plain film findings usually presents little problem. If bleeding is severe there is no time for extensive roentgenographic or laboratory studies. Often, however, the trauma is mild, and the physical findings quite minimal at best. Other injuries may divert attention. The patient may be unconscious. In such circumstances, clinical evaluation of possible hepatic or splenic injuries is difficult. Scanning of the liver and spleen is a safe, accurate, noninvasive, readily available technique for the detection of traumatic rupture, laceration, or hematoma. This report describes two cases in which scanning proved helpful in the management of blunt abdominal trauma

  10. Water requirements of the pulp and paper industry

    Science.gov (United States)

    Mussey, Orville D.

    1955-01-01

    Water, of varied qualities, is used for several purposes in the manufacture of pulp and paper, as a vehicle for transporting the constituents of paper in the paper machines; as process water for cooking wood chips to make pulp; as a medium for heat transfer; and for washing the pulpwood, the woodpulp, and the machines that handle the pulp. About 3,200 million gallons of water was withdrawn from surface- and ground-water sources each day during 1950 for the use of the pulp and paper industry. This is about 4 percent of the total estimated industrial withdrawal of water in the Nation The paper industry in the United States has been growing at a rapid rate. It has increased about tenfold in the last 50 years and has doubled every 15 years. The 1950 production of paper was about 24 million tons, which amounts to about 85 percent of the domestic consumption. In 1950, the pulp mills of the country produced more than 14 million tons of woodpulp, which supplied about 85 percent of the demand by the paper mills and other industries. The remainder of the fiber for paper manufacture was obtained from imported woodpulp, from reclaimed wastepaper, and from other fibers including rags and straw. The nationwide paper consumption for 1955 has been estimated at 31,700,000 tons. Woodpulp is classified according to the process by which it is made. Every woodpulp has characteristics that are carried over into the many and diverse grades of paper. Groundwood pulp is manufactured by simply grinding up wood and refining the resulting product. Soda, sulfite, and sulfate pulps are manufactured by chemically breaking down the lignin that cements the cellulose of the wood together and removing, cleaning, and sometimes bleaching the resulting fibers. Some woodpulp is produced by other methods. Sulfate-pulp mills are increasing in number and in rated daily capacity and are manufacturing more than half of the present domestic production of woodpulp. Most of the newer and larger woodpulp mills

  11. Incidental splenic nodules found on MR imaging done for assessment of iron overload in children

    International Nuclear Information System (INIS)

    Ahyad, Rayan A.; Lam, Christopher Z.; Navarro, Oscar M.; Shearkhani, Omid

    2017-01-01

    MR imaging is used to assess iron overload in patients with hemoglobinopathies and in those who have undergone multiple blood transfusions. Sometimes splenic nodules are found incidentally on these examinations and this may cause diagnostic uncertainty. To determine the prevalence, imaging characteristics and evolution of splenic nodules found on MR imaging for iron overload evaluation. Retrospective review of all MR imaging examinations performed for iron overload assessment from 2005 to 2015 in a tertiary pediatric hospital. The presence of focal splenic nodules including number, size, signal characteristics and changes on follow-up MR imaging were recorded. Relevant patient clinical information including underlying hematological disease was also documented. A total of 318 patients had MR imaging for iron overload assessment. Of these, 25 (8%) had at least one incidental splenic nodule. Sickle cell disease was present in 22 patients (88%) and thalassemia in 3 (12%). On intermediate-weighted spin-echo images, the nodules had high signal intensity compared to the remainder of the spleen in 23 patients (92%) and low signal intensity in the remaining 2 (8%). In all patients (100%) the nodules showed progressive loss of signal intensity with increasing echo time values. Follow-up MR imaging was performed in 20 (80%) patients, which showed an increase in the size of the splenic nodules in 7 patients (35%) stability in 11 (55%) and a decrease in size in 2 (10%). It is not uncommon to find splenic nodules during MR evaluation of iron overload. In patients with sickle cell disease, most of these nodules are thought to represent preserved splenic tissue and appear hyperintense compared to the remainder of the spleen. They frequently remain stable on follow-up imaging, although about a third of them may show growth. Awareness of these nodules is important to avoid concern for potential malignancy and unnecessary investigations. (orig.)

  12. Incidental splenic nodules found on MR imaging done for assessment of iron overload in children

    Energy Technology Data Exchange (ETDEWEB)

    Ahyad, Rayan A.; Lam, Christopher Z.; Navarro, Oscar M. [University of Toronto, Department of Medical Imaging, Toronto, ON (Canada); The Hospital for Sick Children, Department of Diagnostic Imaging, Toronto, ON (Canada); Shearkhani, Omid [The Hospital for Sick Children, Department of Diagnostic Imaging, Toronto, ON (Canada)

    2017-06-15

    MR imaging is used to assess iron overload in patients with hemoglobinopathies and in those who have undergone multiple blood transfusions. Sometimes splenic nodules are found incidentally on these examinations and this may cause diagnostic uncertainty. To determine the prevalence, imaging characteristics and evolution of splenic nodules found on MR imaging for iron overload evaluation. Retrospective review of all MR imaging examinations performed for iron overload assessment from 2005 to 2015 in a tertiary pediatric hospital. The presence of focal splenic nodules including number, size, signal characteristics and changes on follow-up MR imaging were recorded. Relevant patient clinical information including underlying hematological disease was also documented. A total of 318 patients had MR imaging for iron overload assessment. Of these, 25 (8%) had at least one incidental splenic nodule. Sickle cell disease was present in 22 patients (88%) and thalassemia in 3 (12%). On intermediate-weighted spin-echo images, the nodules had high signal intensity compared to the remainder of the spleen in 23 patients (92%) and low signal intensity in the remaining 2 (8%). In all patients (100%) the nodules showed progressive loss of signal intensity with increasing echo time values. Follow-up MR imaging was performed in 20 (80%) patients, which showed an increase in the size of the splenic nodules in 7 patients (35%) stability in 11 (55%) and a decrease in size in 2 (10%). It is not uncommon to find splenic nodules during MR evaluation of iron overload. In patients with sickle cell disease, most of these nodules are thought to represent preserved splenic tissue and appear hyperintense compared to the remainder of the spleen. They frequently remain stable on follow-up imaging, although about a third of them may show growth. Awareness of these nodules is important to avoid concern for potential malignancy and unnecessary investigations. (orig.)

  13. Performance of Schizolobium amazonicum Wood in Bleached Kraft Pulp Production

    Directory of Open Access Journals (Sweden)

    Camila Sarto

    2015-05-01

    Full Text Available This study aimed to evaluate the characteristics of Schizolobium amazonicum wood, specifically its performance in bleached kraft pulp production and the characteristics of its pulp. Chips of Schizolobium amazonicum and Eucalyptus grandis x Eucalyptus urophylla (reference were used. The following parameters were evaluated in the wood: basic density, total extractives, total lignin, holocellulose, and fiber morphology. The pulping simulations were carried out in a laboratory digester, with parameters set to obtain pulp with kappa number 19 ± 0.5. Both pulps were bleached in a PFI mill and submitted to physical-mechanical tests. The results showed that S. amazonicum wood has low basic density and higher content of extractives when compared to E. grandis x E. urophylla wood. For pulping, S. amazonicum required higher alkali charge and H factor to achieve the same delignification level of E. grandis x E. urophylla, resulting in a lower yield, pulp with lower viscosity, and higher wood specific consumption. During bleaching, the brightness gain and final viscosity of S. amazonicum pulp were lower than E. grandis x E. urophylla pulp. Moreover, S. amazonicum pulp had worse physical-mechanical characteristics than E. grandis x E. urophylla.

  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. 78 FR 31315 - Kraft Pulp Mills NSPS Review

    Science.gov (United States)

    2013-05-23

    ... Kraft Pulp Mills NSPS Review; Proposed Rule #0;#0;Federal Register / Vol. 78 , No. 100 / Thursday, May...-OAR-2012-0640; FRL-9815-9] RIN 2060-AR64 Kraft Pulp Mills NSPS Review AGENCY: Environmental Protection... performance standards for kraft pulp mills. These revised standards include particulate matter emission limits...

  16. Idiopathic Splenic Artery Pseudoaneurysm Rupture as an Uncommon Cause of Hemorrhagic Shock

    Directory of Open Access Journals (Sweden)

    Richard A. Schatz MD

    2015-04-01

    Full Text Available Splenic artery pseudoaneurysms are infrequently encountered but critical to recognize. Limited literature to date describes associations with pancreatitis, trauma, and rarely peptic ulcer disease. Hemorrhage and abdominal pain are the most common manifestations. There is typically overt gastrointestinal blood loss but bleeding can also extend into the peritoneum, retroperitoneum, adjacent organs, or even a pseudocyst. Most patients with ruptured splenic artery pseudoaneurysms present with hemodynamic instability. Here, we describe a patient recovering from acute illness in the intensive care unit but with otherwise no obvious risk factors or precipitants for visceral pseudoaneurysm. He presented with acute onset altered mental status, nausea, and worsening back and abdominal pain and was found to be in hypovolemic shock. The patient was urgently stabilized until more detailed imaging could be performed, which ultimately revealed the source of blood loss and explained his rapid decompensation. He was successfully treated with arterial coiling and embolization. Thus, we herein emphasize the importance of prompt recognition of hemorrhagic shock and of aggressive hemodynamic stabilization, as well as a focused diagnostic approach to this problem with specific treatment for splenic artery pseudoaneurysm. Finally, we recommend that multidisciplinary management should be the standard approach in all patients with splenic artery pseudoaneurysm.

  17. Sisal organosolv pulp as reinforcement for cement based composites

    Directory of Open Access Journals (Sweden)

    Ana Paula Joaquim

    2009-09-01

    Full Text Available The present work describes non-conventional sisal (Agave sisalana chemical (organosolv pulp from residues of cordage as reinforcement to cement based materials. Sisal organosolv pulp was produced in a 1:1 ethanol/water mixture and post chemically and physically characterized in order to compare its properties with sisal kraft pulp. Cement based composites reinforced with organosolv or kraft pulps and combined with polypropylene (PP fibres were produced by the slurry de-watering and pressing method as a crude simulation of the Hatschek process. Composites were evaluated at 28 days of age, after exposition to accelerated carbonation and after 100 soak/dry cycles. Composites containing organosolv pulp presented lower mechanical strength, water absorption and apparent porosity than composites reinforced with kraft pulp. The best mechanical performance after ageing was also achieved by samples reinforced with kraft pulp. The addition of PP fibres favoured the maintenance of toughness after ageing. Accelerated carbonation promoted the densification of the composites reinforced with sisal organosolv + PP fibres.

  18. Characterization and Degradation of Pectic Polysaccharides in Cocoa Pulp.

    Science.gov (United States)

    Meersman, Esther; Struyf, Nore; Kyomugasho, Clare; Jamsazzadeh Kermani, Zahra; Santiago, Jihan Santanina; Baert, Eline; Hemdane, Sami; Vrancken, Gino; Verstrepen, Kevin J; Courtin, Christophe M; Hendrickx, Marc; Steensels, Jan

    2017-11-08

    Microbial fermentation of the viscous pulp surrounding cocoa beans is a crucial step in chocolate production. During this process, the pulp is degraded, after which the beans are dried and shipped to factories for further processing. Despite its central role in chocolate production, pulp degradation, which is assumed to be a result of pectin breakdown, has not been thoroughly investigated. Therefore, this study provides a comprehensive physicochemical analysis of cocoa pulp, focusing on pectic polysaccharides, and the factors influencing its degradation. Detailed analysis reveals that pectin in cocoa pulp largely consists of weakly bound substances, and that both temperature and enzyme activity play a role in its degradation. Furthermore, this study shows that pulp degradation by an indigenous yeast fully relies on the presence of a single gene (PGU1), encoding for an endopolygalacturonase. Apart from their basic scientific value, these new insights could propel the selection of microbial starter cultures for more efficient pulp degradation.

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

    Directory of Open Access Journals (Sweden)

    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.

  20. Ranking mechanical pulps for their potential to photoyellow

    Science.gov (United States)

    Umesh P. Agarwal

    2000-01-01

    Recently found experimental evidence has provided strong support for an alternative photoyellowing mechanism that suggests that pulp- photoyellowing occurs due to direct photooxidation of hydroquinones (present in mechanical pulps) top-quinones. Because hydroquinones were found to be present in pulps, it may be possible to quantify them. Quantification of mechanical-...

  1. Splenic injury after blunt abdominal trauma during a soccer (football) game.

    Science.gov (United States)

    Padlipsky, Patricia S; Brindis, Seth; Young, Kelly D

    2014-10-01

    The spleen is the most commonly injured abdominal organ in children who sustain blunt abdominal trauma, and pediatric splenic injury may result from minor mechanisms of injury, including sports participation. We present 2 cases of splenic injury in soccer goalies because of blunt abdominal trauma sustained during game play. Although abdominal organ injuries are uncommon in soccer, emergency medicine and primary care physicians must be aware of the possibility. A high index of suspicion and careful physical examination are key in making the diagnosis.

  2. Cell-derived micro-environment helps dental pulp stem cells promote dental pulp regeneration.

    Science.gov (United States)

    Zhang, Xuexin; Li, Hui; Sun, Jingjing; Luo, Xiangyou; Yang, Hefeng; Xie, Li; Yang, Bo; Guo, Weihua; Tian, Weidong

    2017-10-01

    The function of the dental pulp is closely connected to the extracellular matrix (ECM) structure, and ECM has received significant attention due to its biological functions for regulating cells. As such, the interaction between the ECM niche and cells is worth exploring for potential clinical uses. In this study, dental pulp stem cell (DPSC)-derived ECM (DPM) was prepared through cell culture and decellularization to function as the cell niche, and changes in DPSC behaviour and histological analysis of dental pulp tissue regeneration were evaluated following the DPM culture. DPM promoted the replication of DPSCs and exhibited retention of their mineralization. Then, the DPM-based culture strategy under odontogenic culture medium was further investigated, and the mineralization-related markers showed that DPSCs were regulated towards odontogenic differentiation. Dental pulp-like tissue with well-arranged ECM was harvested after a 2-month subcutaneous implantation in nude mice with DPM application. Additionally, DPSCs cultured on the plastic culture surface showed the up-regulation of mineralization makers in vitro, but there was a disorder in matrix formation and mineralization when the cells were cultured in vivo. DPM-based cultivation could serve as a cell niche and modulate DPSC behaviour, and this method also provided an alternative to harvest tissue-specific ECM and provided a strategy for ECM-cell interaction. © 2017 John Wiley & Sons Ltd.

  3. Splenic trauma in a patient with portal hypertension and splenomegaly: A case report

    Directory of Open Access Journals (Sweden)

    Ahmet Topçu

    2017-08-01

    Full Text Available The spleen is the most commonly injured organ in cases of blunt abdominal trauma. Currently, 50-80% of adults with blunt splenic injuries are treated nonoperatively. In this report, we present a blunt abdominal trauma patient having a history of portal hypertension and splenomegaly. In grade 3 and even grade 4 splenic injuries non-operative treatment is recommended in current literature. Management of splenic trauma with a patient with history of splenomegaly and portal hypertension is insufficiently discussed in literature. In presented case, hypersplenism and portal hypertension were burden on hemostasis. Even with massive resuscitation, thrombocyte level decreased to 40.000/mm³ after five hours. But, insistence on non-operative treatment in this situation could be fatal.

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

    International Nuclear Information System (INIS)

    Matsumoto, Keiji; Ushijima, Yasuhiro; Tajima, Tsuyoshi; Nishie, Akihiro; Hirakawa, Masakazu; Ishigami, Kousei; Yamaji, Yukiko; Honda, Hiroshi

    2010-01-01

    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.

  5. SPLENIC INFARCTION: an intriguing and important cause of pain abdomen in high altitude

    Directory of Open Access Journals (Sweden)

    P. K. Hota

    2015-01-01

    Full Text Available Background: Patients with Sickle cell trait (SCT are usually asymptomatic. They are usually unaware of their condition unless they have a family history. There are specific situations, where these people suffer from the effects of sickle cell trait. Splenic syndrome at high altitude is one of the specific problems. It is usually seen after a patient with SCT has been inducted to high altitude like in case of mountaineers and military personnel deployed in high altitude warfare. Pain abdomen due to splenic infarction in individuals with SCT is one of the manifestations. These patients, if diagnosed in time, they can be spared from unnecessary surgical interventions. We present herewith our experience of splenic infarction due to SCT in high altitude and their management.

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

    International Nuclear Information System (INIS)

    Kwak, Hyo Sung; Han, Young Min; Jin, Gong Yong

    2004-01-01

    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

  7. The efficacy and benefits of transcatheter arterial embolization (TAE) in patients with blunt splenic injury

    International Nuclear Information System (INIS)

    Kwack, Kyu Sung; Kim, Young Ju; Lee, Myung Sub; Kim, Dong Jin; Hong, In Soo

    2000-01-01

    To evaluate the efficacy and benefits of transcatheter arterial embolization (TAE) in patients with blunt splenic injury after blunt abdominal trauma. We retrospectively analyzed the results of transcatheter arterial embolization in 23 patients who suffered splenic injury after blunt abdominal trauma. Fourteen of the patients were male, and 9 were female; 13 were adults, and 10 were children. Transcatheter arterial embolization was performed in patients with hypotension, tachycardia, evidence of hemodynamic instability due, for example, to low levels of Hgb and Hct, or those who needed fluid therapy or blood transfusion. After embolization the patients' progress was monitored by CT scanning, abdominal sonography, or 99m Tc-sulfur colloid scintigraphy. The degree of splenic injury was classified according to the system devised by Mirvis et al.; nine cases were CT grade III, and 14 were grade IV. After demonstrating angiographically the site of contrast leakage, embolization was performed; for this, a coil only was used in 16 cases, gelfoam only in four, and both coil and gelfoam in three. There were three sites of vascular embolization: 16 procedures were performed in the proximal part of the main trunk of the splenic artery, four in a superselected branch of this same artery, and three in both the splenic artery and one of its superselected branches. Of the 23 cases, 18 recovered without splenectomy after embolization, three adult patients died from coexisting conditions (spinal or cerebral injuries, liver cirrhosis, or pelvic bone fracture) or complications (acute renal failure or disseminated intravascular coagulation). Due to co-existing pancreatic and mesenteric vessel injury, two of the adult patients who underwent TAE also underwent delayed surgery; intraoperatively, there was no evidence of splenic rebleeding. In all patients who did not undergo surgery, follow-up observation revealed a decreased volume of hemoperitoneum, increased uptake of radionuclide in

  8. The efficacy and benefits of transcatheter arterial embolization (TAE) in patients with blunt splenic injury

    Energy Technology Data Exchange (ETDEWEB)

    Kwack, Kyu Sung; Kim, Young Ju; Lee, Myung Sub; Kim, Dong Jin; Hong, In Soo [Wonju Christian Hospital, College of Medicine, Yonsei University, Wonju (Korea, Republic of)

    2000-07-01

    To evaluate the efficacy and benefits of transcatheter arterial embolization (TAE) in patients with blunt splenic injury after blunt abdominal trauma. We retrospectively analyzed the results of transcatheter arterial embolization in 23 patients who suffered splenic injury after blunt abdominal trauma. Fourteen of the patients were male, and 9 were female; 13 were adults, and 10 were children. Transcatheter arterial embolization was performed in patients with hypotension, tachycardia, evidence of hemodynamic instability due, for example, to low levels of Hgb and Hct, or those who needed fluid therapy or blood transfusion. After embolization the patients' progress was monitored by CT scanning, abdominal sonography, or {sup 99m}Tc-sulfur colloid scintigraphy. The degree of splenic injury was classified according to the system devised by Mirvis et al.; nine cases were CT grade III, and 14 were grade IV. After demonstrating angiographically the site of contrast leakage, embolization was performed; for this, a coil only was used in 16 cases, gelfoam only in four, and both coil and gelfoam in three. There were three sites of vascular embolization: 16 procedures were performed in the proximal part of the main trunk of the splenic artery, four in a superselected branch of this same artery, and three in both the splenic artery and one of its superselected branches. Of the 23 cases, 18 recovered without splenectomy after embolization, three adult patients died from coexisting conditions (spinal or cerebral injuries, liver cirrhosis, or pelvic bone fracture) or complications (acute renal failure or disseminated intravascular coagulation). Due to co-existing pancreatic and mesenteric vessel injury, two of the adult patients who underwent TAE also underwent delayed surgery; intraoperatively, there was no evidence of splenic rebleeding. In all patients who did not undergo surgery, follow-up observation revealed a decreased volume of hemoperitoneum, increased uptake of

  9. Laparoscopy of a splenic flexure volvulus

    Directory of Open Access Journals (Sweden)

    Yuichi Sesumi

    2017-09-01

    Full Text Available Splenic flexure volvulus (SFV is a very rare condition that is unlikely to be suspected even when a patient has repeated episodes of abdominal pain and dyschezia. We describe the case of SFV diagnosed and treated laparoscopically in the non-volvulus condition. A 14-year-old boy with no medical history had severe left upper abdominal pain and dyschezia for approximately 1 year. Although contrast enema examination revealed no characteristic findings of volvulus, such as a bird-beak sign, a redundant part of the colon was found to be the site of abdominal pain. We suspected that this part of the colon was the cause of the left upper abdominal pain and performed laparoscopic exploration. The colon at the splenic flexure formed a long loop and was predisposed to twisting; therefore, we performed resection and functional anastomosis of this redundant colon. The postoperative course was uneventful, and the left upper abdominal pain and dyschezia did not recur. Laparoscopic exploration can play a role in patients who are suspected to have recurrent colonic volvulus with radiographic evidence of a redundant portion of the colon, as indicated in our case.

  10. Nutrient contents of the fresh pulps and dried pulp cakes of vitellaria paradoxa of Gulu District, Uganda

    DEFF Research Database (Denmark)

    Oryema, Christine; Oryem-Origa, Hannington; Roos, Nanna

    2016-01-01

    Vitellaria paradoxa Gaertn locally known as ‘Yaa’ in Acholi is a valuable edible indigenous wild fruit in Gulu District, northern Uganda. It is a multipurpose fruit tree and highly favoured by the inhabitants of this district. Its fruit pulps are eaten when fresh and/or made into cakes and dried....... This study determined the nutrient compositions of the fresh pulps and dried pulp cakes of V. paradoxa. Laboratory analyses were undertaken to determine the micro and macro nutrients in the samples on fresh (FM) and dry matter (DM) basis following standard procedures and protocols. The potassium, sodium...

  11. 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.

  12. Splenic rupture in infectious mononucleosis: A systematic review of published case reports.

    Science.gov (United States)

    Bartlett, A; Williams, R; Hilton, M

    2016-03-01

    Infectious mononucleosis (IM) is a common viral illness that predominantly causes sore throat, fever and cervical lymphadenopathy in adolescents and young adults. Although usually a benign, self-limiting disease, it is associated with a small risk of splenic rupture, which can be life-threatening. It is common practice therefore to advise avoiding vigorous physical activity for at least 4-6 weeks, however this is not based on controlled trials or national guidelines. We reviewed published case reports of splenic rupture occurring in the context of IM in an attempt to ascertain common factors that may predict who is at risk. A search of MEDLINE and EMBASE databases was performed for case reports or series published between 1984 and 2014. In total, 52 articles or abstracts reported 85 cases. Data was extracted and compiled into a Microsoft Excel(®) spreadsheet. The average patient age was 22 years, the majority (70%) being male. The average time between onset of IM symptoms and splenic rupture was 14 days, with a range up to 8 weeks. There was a preceding history of trauma reported in only 14%. Abdominal pain was the commonest presenting complaint of splenic rupture, being present in 88%. 32% were successfully managed non-operatively, whereas 67% underwent splenectomy. Overall mortality was 9%. From our data, it appears that men under 30 within 4 weeks of symptom onset are at highest risk of splenic rupture, therefore particular vigilance in this group is required. As cases have occurred up to 8 weeks after the onset of illness, we would recommend avoidance of sports, heavy lifting and vigorous activity for 8 weeks. Should the patient wish to return to high risk activities prior to this, an USS should be performed to ensure resolution of splenomegaly. The majority of cases reviewed had no preceding trauma, although previous studies have suggested this may be so minor as to go unnoticed by the patient. It is therefore prudent to warn patients about the symptoms of

  13. Effect of Bagasse Chemical Pulping and Coupling Agent on the Physical - Mechanical Properties of Composites Based on Bagasse pulp/Low density polyethylene

    Directory of Open Access Journals (Sweden)

    maryam allahdadi

    2016-12-01

    Full Text Available In this research, effect of reinforcing bagasse pulp and raw bagasse fibers and applying coupling agent MAPE (Maleic Anhydride Polyethylene on physical-mechanical properties of low density polyethylene (LDPE composites were studided. Fresh bagasse were collected from an experimental field in Khuzestan and after investigating anatomy and chemical properties of Different pulp fibers including monoethanolamine (MEA bagasse pulp, alkaline sulfite-anthraquinone (AS bagasse pulp, bleached soda (BS bagasse pulp, unbleached soda (UNS bagasse pulp and raw bagasse fibers (B were prepared. Then, composites with 30wt.% fiber content were manufactured by twin-screw extrusion followed by compression molding processing. The mechanical and physical properties of these composites were analyzed and compared. Results revealed that the chemical pulping dissolved a fraction of lignin and hemicelluloses so that the linkage potential and aspect ratio of bagasse fibers was improved and consequently, as compared with the raw bagasse fibers, bagasse pulp fibers have better reinforcing capability. The best overall properties were achieved with MEA and AS/AQ fibers. Addition of 5% (wt/wt of coupling agent MAPE resulted in a significant enhancement in the tensile strength, tensile modulus and impact strength in line with the improvement of the fiber-matrix interfacial adhesion making more effective the transfer of stress from the matrix to the rigid reinforcement.

  14. PULP OBTAINING METHOD FOR PACKAGE PRODUCTION

    Directory of Open Access Journals (Sweden)

    V. V. Kuzmich

    2015-01-01

    Full Text Available The paper presents a new method for obtaining pulp which is used for production of cardboard, paper and package while using carbon dioxide and hydrazine hydrate and neutral-sulfite  shive cooking. Output increase of  the desired product can be explained by reduction in destruction of plant raw material carbohydrates during its cooking process. Quality improvement of the desired product (improvement in bleaching and output is attributed to the fact that usage of carbon dioxide and hydrazine contributes to provision of polysaccharide chain resistance to destruction due to the presence of  end links having structure of metasaccharinic and aldonic acids.The author has developed a new method for pulp obtaining on the basis of the executed investigations  and literature data.  СО2 and hydrazine hydrate have been used for obtaining pulp. Method invention concerns pulp obtaining and it can be used for paper and cardboard package manufacturing in pulp and paper industry.The method is to be carried in the following way: pulp-containing plant raw material is loaded into an autoclave and then aqua solution of sodium monosulfite containing hydrazine hydrate that constitutes 4–5 % of absolute dry pulp-containing raw material mass with liquid module 1:6–1:8 is supplied into the autoclave. The autoclave is closed for operation under pressure and the solution is carbonated under pressure which constitutes 5–8 % of absolute dry plant raw material (shover. Temperature is subsequently raised up to 180 °С in the space of 2 hours and cooking is carried out in the course of 4 hours. Usage of  the proposed method for shover cooking makes it possible to reduce monosulfite cooking process and improve qualitative characteristics and output of the desired product.  In addition to above mentioned fact there is a possibility to improve bleaching and final product output. 

  15. Functionalized scaffolds to control dental pulp stem cell fate

    Science.gov (United States)

    Piva, Evandro; Silva, Adriana F.; Nör, Jacques E.

    2014-01-01

    Emerging understanding about interactions between stem cells, scaffolds and morphogenic factors has accelerated translational research in the field of dental pulp tissue engineering. Dental pulp stem cells constitute a sub-population of cells endowed with self-renewal and multipotency. Dental pulp stem cells seeded in biodegradable scaffolds and exposed to dentin-derived morphogenic signals give rise to a pulp-like tissue capable of generating new dentin. Notably, dentin-derived proteins are sufficient to induce dental pulp stem cell differentiation into odontoblasts. Ongoing work is focused on developing ways of mobilizing dentin-derived proteins and disinfecting the root canal of necrotic teeth without compromising the morphogenic potential of these signaling molecules. On the other hand, dentin by itself does not appear to be capable of inducing endothelial differentiation of dental pulp stem cells, despite the well known presence of angiogenic factors in dentin. This is particularly relevant in the context of dental pulp tissue engineering in full root canals, where access to blood supply is limited to the apical foramina. To address this challenge, scientists are looking at ways to use the scaffold as a controlled release device for angiogenic factors. The aim of this manuscript is to present and discuss current strategies to functionalize injectable scaffolds and customize them for dental pulp tissue engineering. The long-term goal of this work is to develop stem cell-based therapies that enable the engineering of functional dental pulps capable of generating new tubular dentin in humans. PMID:24698691

  16. Odontoblast-Like Cells Differentiated from Dental Pulp Stem Cells Retain Their Phenotype after Subcultivation

    Directory of Open Access Journals (Sweden)

    Paula A. Baldión

    2018-01-01

    Full Text Available Odontoblasts, the main cell type in teeth pulp tissue, are not cultivable and they are responsible for the first line of response after dental restauration. Studies on dental materials cytotoxicity and odontoblast cells physiology require large quantity of homogenous cells retaining most of the phenotype characteristics. Odontoblast-like cells (OLC were differentiated from human dental pulp stem cells using differentiation medium (containing TGF-β1, and OLC expanded after trypsinization (EXP-21 were evaluated and compared. Despite a slower cell growth curve, EXP-21 cells express similarly the odontoblast markers dentinal sialophosphoprotein and dentin matrix protein-1 concomitantly with RUNX2 transcripts and low alkaline phosphatase activity as expected. Both OLC and EXP-21 cells showed similar mineral deposition activity evidenced by alizarin red and von Kossa staining. These results pointed out minor changes in phenotype of subcultured EXP-21 regarding the primarily differentiated OLC, making the subcultivation of these cells a useful strategy to obtain odontoblasts for biocompatibility or cell physiology studies in dentistry.

  17. Potential for biohydrogen and methane production from olive pulp

    DEFF Research Database (Denmark)

    Gavala, Hariklia N.; Skiadas, Ioannis V.; Ahring, Birgitte Kiær

    2005-01-01

    The present study investigates the potential for thermophilic biohydrogen and methane production from olive pulp, which is the semi-solid residue coming from the two-phase processing of olives. It focussed on: a) production of methane from the raw olive pulp, b) anaerobic bio-production of hydrogen...... from the olive pulp, and c) subsequent anaerobic treatment of the hydrogen-effluent with the simultaneous production of methane. Both continuous and batch experiments were performed. The hydrogen potential of the olive pulp amounted to 1.6 mmole H-2 per g TS. The methane potential of the raw olive pulp...... and hydrogen-effluent was as high as 19 mmole CH4 per g TS. This suggests that olive pulp is an ideal substrate for methane production and it shows that biohydrogen production can be very efficiently coupled with a subsequent step for methane production....

  18. Splenic embolization in cirrhotic patients with portal hypertension. US findings

    Energy Technology Data Exchange (ETDEWEB)

    Falappa, P G; Cotroneo, A R; De Cinque, M; Maresca, G; Patane' , D

    1988-01-01

    Over the last four years the authors performed transcatheter embolization of the splenic artery by Gianturco coils in 32 consecutive cirrhotic patients with portal hypertension, splenomegaly, cytopenia and gastro-esophageal varices endoscopically proved. This procedure was especially useful for treatement of splenomegaly and cytopenia because a constant reduction of spleen dimensions and increase in platelet count were registered. The effectiveness of transcatheter embolization and follow-up are based on clinic, hematologic and sonographic findings. Sonographic monitoring is believed to be very useful both to evaluate splenomegaly and signs of portal hypertension and to reveal splenic complications (abscesses). Severe complications have been never registered. 21 refs.

  19. Disagreement between splenic switch-off and myocardial T1-mapping after caffeine intake.

    Science.gov (United States)

    Kuijpers, Dirkjan; van Dijk, Randy; van Assen, Marly; Kaandorp, Theodorus A M; van Dijkman, Paul R M; Vliegenthart, Rozemarijn; van der Harst, Pim; Oudkerk, Matthijs

    2018-04-01

    Caffeine is an adenosine receptor antagonist and a possible cause of inadequate stress perfusion. Splenic switch-off (SSO) and splenic rest-stress T1-mapping have been proposed as indicators of stress adequacy during perfusion cardiac magnetic resonance (CMR). We compared myocardial rest-stress T1-mapping with SSO and splenic rest-stress T1-mapping in patients with and without recent coffee intake. We analyzed 344 consecutive patients suspected of myocardial ischemia with adenosine perfusion CMR. All 146 normal CMR studies with a normal T1-rest of the myocardium, used as standard of reference, were included and divided in two groups. 22 patients accidentally ingested coffee < 4 h before CMR, compared to control group of 124 patients without self-reported coffee intake. Two independent readers graded SSO visually. T1-reactivity (ΔT1) was defined as percentual difference in T1-rest and T1-stress. Follow-up data were extracted from electronic patients records. In patients with recent coffee intake SSO was identified in 96%, which showed no significant difference with SSO in controls (94%, p = 0.835), however event rates were significantly different (13.6 and 0.8%, respectively (p < 0.001), median FU 17 months). Myocardial ΔT1 in the coffee group (- 5.2%) was significantly lower compared to control (+ 4.0%, p < 0.001), in contrast to the splenic ΔT1 (- 3.7 and - 4.0%, p = 0.789). The splenic T1-mapping results failed to predict false negative results. SSO and splenic rest-stress T1-mapping are not reliable indicators of stress adequacy in patients with recent coffee intake. Therefore, the dark spleen sign does not indicate adequate myocardial stress in patients with recent caffeine intake. Myocardial rest-stress T1-mapping is an excellent indicator of stress adequacy during adenosine perfusion CMR.

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

    International Nuclear Information System (INIS)

    Saba, Luca; Mallarini, Giorgio; Anzidei, Michele; Lucatelli, Pierleone

    2011-01-01

    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