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At least 955 records · Page 53Linked to original sources
PubMed1990

Reasons for incomplete surgical staging in early ovarian carcinoma.

The completeness and associated morbidity of surgical staging in 86 patients with early ovarian carcinoma were analyzed. According to strict criteria for completeness of the procedure established before the onset of the study, surgical staging after one or two laparotomies was complete in only 53% of cases. Initial staging in a peripheral hospital was complete in only 15% of patients. Intraoperative complications occurred in between 8 and 15% of patients and included injury of the vena cava (5), small bowel injury (2), myocardial infarction (1), transection of the ureter (1), and splenic rupture (1). The most frequently omitted staging steps were biopsy of the paracolic gutter, biopsy of the pelvic peritoneum, and sampling of retroperitoneal lymph nodes. Reasons for incomplete surgical staging were divided into factors associated with increased risk of difficulty of the procedure and lack of knowledge of the sites at risk for ovarian cancer metastases. It was found that both phenomena should be held responsible to the same extent for the large number of incomplete surgical staging procedures. The conclusion was made that either gynecologists should be better educated in the staging of ovarian cancer or a more efficient patient referral policy should be considered.

Adult↗
PubMed1985

Acute renal failure with polyarteritis nodosa and multiple myeloma.

A patient who presented with acute renal failure due to renal cortical necrosis is described. Renal biopsy showed cortical infarction and angiography demonstrated aneurysms in the renal, splenic and hepatic circulations. Concurrently he was found to have an IgA kappa paraprotein with bone marrow changes diagnostic of multiple myeloma. He was treated with haemodialysis, immunosuppressive drugs and plasma exchange but died 3 months after presentation.

Acute Kidney Injury↗
PubMed1989

[Blunt upper abdominal trauma as a complication of cardiac resuscitation].

The case of a combined manifold rupture of the liver and spleen give rise to the discussion of the blunt abdominal trauma after extern cardiopulmonary resuscitation. A survey concerning the recent status of the diagnostic possibilities will be given according to the literature and our own experiences. The values of the different diagnostic procedures, advantages and disadvantages will be discussed.

Female↗
PubMed1980

[Anatomo-pathological study of the development of a focus of cryonecrosis in the rat spleen].

A focus of cryonecrosis in the rat spleen, induced with liquid nitrogen (4 mm diameter probe, application time 2') does not cause haemorrhage either during or after treatment. The frozen area, which is of infarctual type with disappearance of spleen cells and preservation of the elastic structures of the follicular arteries, sees its surface reduced considerably and is replaced by connective tissue within 30 days.

Animals↗
PubMed1979

[Spenic abscesses].

Abscess of the spleen is an uncommon entity that seems even less common as it still represents a diagnostic problem. The most common cause of splenic abscess is metastatic hematogenous seeding of the diseased spleen especially of the infarcted areas or traumatic hematomas. It can result also from the direct spread of infection from surrounding structures. Many patients with splenic abscess have a rapidly progressive generalized sepsis and even the combination of well-timed surgery and antibiotic therapy is not always curative. Local symptoms may be mild and overlooked and there may be only general symptoms of suppuration present. X-rays investigations often yield valuable information about the location of the abscess. By far the most promising technique is splenic scanning with the use of radioisotopes. Our case of splenic abscess following appendicitis has been described. The course and the diagnosis has been established using liver-spleen scanning. The patient was treated with Obracin and Dalacin and the diseased spleen has been removed. After drainage of the left subphrenic abscess the recovery was uneventful.

Abscess↗
PubMed1988

A case of thromboangiitis obliterans affecting coronary, pulmonary, and splenic vessels. Is thromboangiitis obliterans a generalized vascular disease?

We describe a 53 year old man who died following his 3rd myocardial infarction. Before death there were scintigraphic signs of infarctions in the lung and spleen. Postmortem examination revealed an occlussive vascular disease in coronary, pulmonary, and splenic vessels. The histological findings were consistent with thromboangiitis obliterans. We suggest that thromboangiitis obliterans probably is a generalized vascular disease.

Coronary Vessels↗
PubMed1995

Effects of enalapril on T and B cell function in rats after myocardial infarction.

The cellular mechanisms following myocardial infarction remain poorly characterized. It is believed that an inflammatory and immunologic process may be involved and that the beneficial effects of enalapril on remodeling may, in part, work through an immune mechanism. To characterize the effect of enalapril on immune alterations in the late phase of ventricular remodeling after myocardial infarction, rats underwent left coronary artery ligation followed by 6 weeks of either enalapril or placebo treatment. Infarct sizes, heart weights, and volumes were compared. Peripheral and splenic leukocyte and lymphocyte subsets, along with T cell blastogenesis, were quantified in enalapril treated rats 6 weeks after coronary ligation and compared to untreated control rats. Additionally, antibody production to a de novo antigen, keyhole limpet hemocyanin, was assessed with and without treatment. Average infarct size was equivalent among enalapril-treated myocardial infarction rats and untreated infarct rats. There was, however, less left and right ventricular hypertrophy in the enalapril treated group. Enalapril completely prevented the 42% increase in white blood count, the 88% increase in neutrophils, and the 28% increase in lymphocyte count seen in untreated infarct rats. Both untreated and enalapril treated rats tended toward a decrease in T helper:suppressor ratio. All rats treated with enalapril, however, had a significant increase in the T helper:suppressor ratio versus untreated control rats (F = 3.6, P = .018). Blastogenesis was markedly increased in T cells from infarcted animals. This was mitigated by treatment with enalapril. Additionally, immunoglobulin G antibody production was significantly lessened in rats treated with enalapril. The results of this study suggest that alterations in immunoregulatory cell type and function occurs following myocardial infarction. The beneficial effects of the angiotensin-converting enzyme inhibitor enalapril may be, in part, due to its mitigating effects on immune cell release and activation following myocardial infarction.

Angiotensin-Converting Enzyme Inhibitors↗
PubMed2003

[The feasibility and safety of radiofrequency ablation for secondary splenomegaly and hypersplenism in dogs].

OBJECTIVE: To assess the feasibility and safety of radiofrequency ablation (RFA) in spleen to treat secondary splenomegaly and hypersplenism in dogs. METHODS: Fourteen healthy mongrel dogs were randomly divided into two groups: group A (n = 4) and group B (n = 10) Both groups underwent ligation of the splenic vein and its collateral branches to induce congestive splenomegaly. At the end of the 3rd week, radiofrequency thermal ablation of the spleen was performed in the group B via laparotomy. After splenic RFA, the procedure-related complications were observed, CT scan was performed and the spleens were obtained according to schedule. The radiofrequency (RF) thermal lesions and its histo- pathological changes of the spleen were examined regularly. RESULTS: There were no morbidity and mortality in the experimental dogs. CT findings revealed that splenomegaly could sustained over 2 months after ligation of the splenic vein. The segmental RF lesions included hyperintense zone of coagulative necrosis and more extensively peripheral hypo-intense infarcted zone. The latter was called as "bystander effect". The infarcted zone would be absorbed and subsequently disappeared between 4 and 6 weeks after RFA, and the size of the remnant spleen shrunk, but the lesion of coagulative necrosis hardly altered. The fundamental histopathological changes of splenic lesions caused by RF thermal energy included local coagulative necrosis and the peripheral thrombotic infarction zone. Subsequently, tissue absorption and fibrosis occurred in the zone of thrombotic infarction. Simultaneously occluded vessels, fibrin deposition, and disappearance of normal splenic sinuses resulted in the condensed structure of the viable remnant spleen, which were the pathological basis responsible for the shrunk spleen. CONCLUSIONS: It is feasible and safe to perform RFA in the spleen to treat experimental splenomegaly and hypersplenism. The RFA technique could be safely performed clinically via laparotomy or laparoscopic procedure to strictly isolate the spleen from the surrounding organs.

Animals↗
PubMedDate not supplied

Splenic abscess caused by Propionibacterium acnes.

A 59-year-old male diabetic was admitted with an acute myocardial infarction and had recurrent. Propionibacterium acnes bacteremia. Fifteen months after the initial admission a splenectomy was required for removal of a large splenic abscess caused by P. acnes. Although this organism represents part of the normal skin flora, its presence of blood cultures requires serious evaluation since it may signify clinical disease, not merely contamination of blood cultures by skin flora.

Abscess↗
PubMed1985

Microfilarial granulomas in the spleens of wild-caught cynomolgus monkeys (Macaca fascicularis).

Splenic nodules from 38 cynomolgus monkeys (Macaca fascicularis) which were captured in Malaysia and Indonesia were studied histologically. The lesions were characterized by well-circumscribed focal fibrosis, accumulation of eosinophils and histiocytes, hemorrhage or hemosiderosis, and loss of normal splenic architecture. Small arteries in the lesion frequently had intimal thickening and narrowing of the lumen in addition to the presence of microfilariae. Microfilariae were also seen in the extravascular area of the lesion, and were occasionally engulfed by multinucleated giant cells. The splenic lesion was thought to have been initiated by incomplete infarction caused by intimal thickening and microfilarial occupation of the small arteries.

Animals↗
PubMedDate not supplied

Splenic imaging with ultrasmall superparamagnetic iron oxide ferumoxtran-10 (AMI-7227): preliminary observations.

PURPOSE: Ferumoxtran-10 (ultrasmall superparamagnetic iron oxide; Combidex, AMI-7227) is a long-circulating MR contrast agent with reticuloendothelial uptake known to enhance tissue T1 and T2 relaxation rates. The purpose of this study was to assess the effect of ferumoxtran-10-enhanced MRI in evaluating focal splenic lesions. METHOD: Eighteen patients underwent MR evaluation of the spleen. Two of these patients with exophytic normal splenic tissue (splenules) and 13 of these patients with 24 focal splenic lesions (7 cysts, 2 hemangiomas, 7 metastases, 1 infarct, 7 lymphoma) were assessed by T1-weighted gradient echo and T2-weighted fast SE MRI following intravenous administration of ferumoxtran-10 (1.1 mg of Fe/kg). Qualitative analysis involving improved lesion detection and/or characterization, additional information from postcontrast images affecting staging, and patient management was performed. Quantitative measurements of lesion-to-spleen contrast-to-noise ratio were also performed. RESULTS: Additional information was provided by ferumoxtran-10-enhanced images in 15 of 18 patients. In 8 of 15 (53%) patients, improved lesion detection (i.e., number of lesions) was obtained on contrast-enhanced images. Improved lesion visualization (i.e., conspicuity) was noted in 11 of 15 (73%) of patients. In 10 of 15 (67%) patients, postcontrast imaging provided additional information leading to lesion characterization. Staging of disease and patient management were affected in 5 of 15 (33%) and 6 of 15 (40%) patients, respectively. CONCLUSION: Ferumoxtran-10 is a promising contrast agent for the evaluation of focal splenic lesions.

Adult↗
PubMed1993

Primary angiosarcoma of the spleen. A clinicopathologic study of 40 cases.

Forty primary splenic angiosarcomas occurring in 21 men and 19 women, 19-84 years old (median 59 years) are reported. Patients presented with splenomegaly (35 of 38, 92%), abdominal pain (33 of 40, 83%), and systemic symptoms such as fatigue (2 of 40, 5%), fever (4 of 40, 10%), and/or weight loss (16 of 40, 40%). Five (13%) experienced splenic rupture associated with hemoperitoneum. Abnormal laboratory findings included cytopenia (31 of 34, 91%), leukocytosis (8 of 21, 38%), and thrombocytosis (1/39, 3%). Most spleens weighed 500-1,000 g (mean, 1,180 g). The cut splenic surfaces showed multiple hemorrhagic nodules that were frequently associated with infarction, although some had a diffuse pattern of involvement. Microscopically, there were a variety of histologic patterns displayed by the vasoformative component. A honeycomb or sponge-like pattern was common in some, whereas others simulated a cavernous hemangioma or normal splenic sinuses (pseudosinusoidal pattern). Papillary endothelial tufts and solid proliferations of spindled to round to epithelioid cells were also seen. Factor VIII-related antigen was detected in 19 of 23 cases, BMA-120 in 18 of 23, UEA-1 receptor in 18 of 23, and vimentin in 23 of 23 as well as CD68 antigen in 1 of 23 cases. S-100 protein and cytokeratin were not found in any of the 23 cases studied. Metastases in 22 of 32 patients (69%) were to the liver (13 patients), bone or bone marrow (7 patients), lymph nodes (1 patient), and brain (1 patient). Three patients had concomitant malignancies and one had a prior history of a mixed B-cell lymphoma 5 years previously that had been treated with chemotherapy. Follow-up in 38 patients revealed that 30 (79%) are dead at a median interval of 6 months (range 0-48 months) and 8 are alive 5-21 months after diagnosis. These findings indicate that splenic angiosarcoma is an aggressive neoplasm with a high metastatic rate and an abysmal prognosis. Recognition of the wide range of histologic patterns is of diagnostic value but no apparent prognostic significance.

Adult↗
PubMed1982

[Splenic abscess. 3 cases (author's transl)].

The authors report three cases of splenic abscess. The condition developed twice during a salmonella infection associated in one case with sickle cell disease. In two patients, the spleen was the site of a suppurated infarction. One patient died shortly after operation. Study of the 79 cases of splenic abscess treated surgically published since 1960 reveals a mortality of 16%. This rare condition is seen essentially during typhoid and septicaemias (endocarditis). Such pathology in also now seen in drug addicts. The diagnosis and, hence, the prognosis should be improved by the use of echography which seems to be the most reliable investigation before peritonitis by rupture which remains a complication associated with a heavy mortality.

Abscess↗
PubMed1990

Jejunal pouch reconstruction after total gastrectomy for cancer: experience in 29 patients.

The experience with interposed jejunal pouch after total gastrectomy for cancer in 29 patients is reviewed. There were two postoperative deaths (7 per cent) due, respectively, to myocardial infarction on day 5 and massive haemorrhage from the splenic vein on day 14. Anastomotic leaks, all from the proximal anastomosis, were encountered in three patients (11 per cent). These consisted of one minor clinical leak in a stapled anastomosis and two radiological leaks from hand-sutured anastomoses. Obstruction of the pouch or its conduit by recurrent tumour was not observed in any patient, including those who died from metastatic disease. There was one instance of benign stenosis of the distal anastomosis to the duodenum which required revisional surgery. The symptomatic assessment in the long-term surviving patients was good except for mild oesophagitis due to bile reflux in five patients. Body-weight was maintained and adverse nutritional consequences were not observed.

Aged↗
PubMedDate not supplied

Chemically optimized antimyosin Fab conjugates with chelating polymers: importance of the nature of the protein-polymer single site covalent bond for biodistribution and infarction localization.

Murine antimyosin Fab fragment was conjugated with 111In-labeled N-terminal-modified DTPA-polylysine using three bifunctional reagents: N-hydroxysuccinimide esters of 3-(2-pyridyldithio)propionic acid (SPDP conjugate), 4-(maleimidomethyl)cyclohexanecarboxylic acid (SMCC conjugate) and bromoacetic acid (BrAc conjugate) for potential localization of experimental myocardial infarction. Using various antibody preparations and a rabbit acute myocardial infarction model the following parameters were observed: (1) an in vitro antigen binding activity of SPDP conjugate = SMCC conjugate > BrAc conjugate, (2) a blood clearance rate of SPDP conjugate > BrAc conjugate > SMCC conjugate, (3) a liver and splenic accumulation of SPDP conjugate > BrAc conjugate > SMCC conjugate, and (4) the infarcted tissue activity showed an accumulation of SMCC conjugate > SPDP conjugate > BrAc conjugate. This study exemplifies the importance of rational chemical design of antimyosin Fab-chelating polymer conjugate for improved target tissue localization in vivo.

Animals↗