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Elrahim, E. Abd. "Estimation of normal spleen dimensions Using Ultra Sound." Scholars Journal of Applied Medical Sciences 9, no. 1 (2021): 132–36. http://dx.doi.org/10.36347/sjams.2021.v09i01.026.
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Thapa, N. B., S. Shah, A. Pradhan, K. Rijal, A. Pradhan, and S. Basnet. "Sonographic Assessment of the Normal Dimensions of Liver, Spleen, and Kidney in Healthy Children at Tertiary Care Hospital." Kathmandu University Medical Journal 13, no. 4 (2017): 286–91. http://dx.doi.org/10.3126/kumj.v13i4.16825.
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Background Ultrasonography is one of the most common imaging modality to measure dimensions of visceral organs in children. However, the normal limit of size of visceral organs according to age and body habitus has not been specified in the standard textbooks. This might result in under detection of organomegaly in pediatrics population.Objective The objective of this study was to determine the normal range of dimensions for the liver, spleen, and kidney in healthy children.Method This is prospective cross-sectional, hospital-based study done at Tertiary-care teaching hospital. Participants included 272 pediatric subjects (152 male and 120 female) with normal physical or sonographic findings who were examined because of problems unrelated to the measured organs. The subjects were one month to 15 year (180 months) old. All measured organs were sonographically normal. Relationships of the dimensions of these organs with sex, age, body weight and height were investigated. Limits of normal dimensions of these organs were defined.Result Normal length of liver, kidneys and spleen were obtained sonographically for 272 children (152 male [55.9%] and 120 female [44.1%]) in the age group from 1 months to 15 (180 months) years. The mean age was 45.78 months (SD, 44.73). The measured dimensions of all these organs showed highest correlation with height and age so the descriptive analysis of the organ dimensions (mean, minimum, and maximum values, SD and 5th and 95th percentiles) were expressed in 10 age groups along with height range of the included children. The mean length of right kidney was shorter than the left kidney length, and the difference was statistically significant (p = 0.001).Conclusion This study provides practical and comprehensive guide to the normal visceral organ dimension in pediatric population. The normal range limit of the liver, spleen, and kidney determined in this study could be used as a reference in daily practice in local radiology clinics.
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Musleh, Anas Hamed, Atyaf Mohammed Ali, and Mahdi Salih Shalal. "Anatomical and Histological Study of Neonatal Human Spleen." NeuroQuantology 20, no. 4 (2022): 52–57. http://dx.doi.org/10.14704/nq.2022.20.4.nq22094.
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The spleen is the human body's largest lymphoid organ. The appearance of the spleen is inflated by a variety of conditions, such as cell abnormalities that lodge within the spleen or storage function disorders. As a result, the spleen's size can be used as a predictor of illness severity. Place and period of study: From July 2019 to May 2020, all of these samples were taken from autopsied bodies in the mortuary room of Kirkuk forensic medicine and the institute of forensic medicine in Baghdad, with legal authority. Study design: Cross-sectional descriptive study. Materials: The current study used 20 autopsy neonate human spleens ranging in age from 1 to 28 days that were collected from available dead undergoing post-mortem examination, were studied macroscopic and microscopic after staining with Hematoxylin and Eosin. Results: The number of notches in this study ranged from zero to five, however the top score of the specimens had one or two notches. The accessory spleen, on the other hand, was not found in the area the spleen's hilum. From the first day forward, the characteristic lymphoid follicle or white pulp could be recognized. During this time, nucleated red blood cells were observed. Purpose of study: Because no data on the standard dimensions of the normal spleen exists in the Iraqi population, the findings of this study may reveal differences in spleen morphology and provide valuable data for parameter standardization, It will be useful for correct clinical diagnosis and treatment of disease by physicians, surgeons, radiologists, and anatomists.
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Huang, Ying, Yumei Zheng, Cuncheng Zhang, and Shigen Zhong. "Ultrasound Assessment of the Relevance of Liver, Spleen, and Kidney Dimensions with Body Parameters in Adolescents." Computational and Mathematical Methods in Medicine 2022 (July 4, 2022): 1–7. http://dx.doi.org/10.1155/2022/9150803.
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Objective. Ultrasound is a practical imaging modality for screening and identification of anomalies in the organs. This study used ultrasonography to examine the association between body parameters and dimensions of the normal liver, spleen, and kidney in adolescents based on ultrasound examination results. Methods. A total of 300 junior and senior high school teenagers receiving routine health check-ups in our hospital from January 2020 to January 2021 were included. Their height and weight were measured, and their body surface area (BSA) and body mass index (BMI) were calculated. Ultrasound imaging was employed to obtain information such as the length and volume of the liver, gallbladder, spleen, and kidney. Besides, the correlation of body parameters such as gender, age, height, weight, BSA, and BMI with visceral dimension was investigated using the Pearson test and multiple regression analysis, respectively. Results. We observed that the abdominal organs of adolescents were enlarged with age. The span and volume of the liver and the length and volume of the right kidney were significantly larger in boys than in girls. The age, BSA, and BMI were positively correlated with the liver span and spleen length, as well as the left and right kidney lengths. Additionally, age, BSA, and BMI were identified as important predictors for dimensions of the spleen, liver, and kidney. Conclusions. Body parameters are notably associated with the dimensions of the liver, spleen, and kidney and could be utilized as predicting factors for the liver, spleen, and kidney dimensions.
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Stiff, P. J., K. S. Hansen, L. Dreiling, M. Guo, and A. S. Artz. "Exploratory analysis describing ultrasonic (US) evaluation of spleen size during peripheral blood progenitor cell (PBPC) mobilization by filgrastim in normal donors." Journal of Clinical Oncology 27, no. 15_suppl (2009): 7102. http://dx.doi.org/10.1200/jco.2009.27.15_suppl.7102.
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7102 Background: Filgrastim is used to mobilize CD34+ cells into the peripheral blood that are collected by apheresis for allogeneic transplantation. We prospectively evaluated spleen size during PBPC mobilization Methods: Donors ≥18 yrs eligible to be PBPC donors per institutional guidelines enrolled. Splenic assessments were done before, during, and after PBPC mobilization. Filgrastim dose and schedule and leukapheresis (LK) procedures were per local practice. Spleen size by US was measured in 3 dimensions: longitudinal (craniocaudal), transverse, and diagonal (perpendicular to transverse). Splenic volume was estimated by taking the cross-product of 3 dimensions and multiplying by 0.52, approximating an ellipse volume. Stiff (ASH 2007) reported the primary endpoint, fold change from baseline in splenic volume during mobilization. Exploratory analyses, including a linear regression evaluating the effect of age and baseline spleen size on fold-change, were performed. Results: 309 enrolled, median age 44yrs, 56% male. Median fold volume change from baseline to first LK was 1.47, resolving to near baseline 1 week after last LK. No significant clinical sequelae, including splenic rupture, were reported. Older donors appeared to have the smallest baseline spleen volume and the largest fold change (table). Linear regression analyses indicated age was a significant predictor for both baseline spleen volume (p=0.0031) and spleen volume fold change from baseline at first LK (p=0.0499). Conclusions: During mobilization, spleen volume transiently increased from baseline to day of 1st LK and returned to near baseline 1 week after last LK. Older donors tended to have smaller baseline splenic volume and greater fold changes in spleen size. Preclinical models suggest decreasing hematopoietic stem cell homing after mobilization with aging (Morrison 1996; Wagers 2002), which could result in splenic accumulation of progenitor and stem cells. [Table: see text] [Table: see text]
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Мekić, Nina, Nermin Salkić, Amela Selimović, et al. "Ultrasonographic parameters of the liver, spleen and kidney in a healthy paediatric population in Bosnia and Herzegovina: a prospective study." Medicinski Glasnik 21, no. 2 (2024): 321–27. http://dx.doi.org/10.17392/1765-21-02.
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<p><strong>Aim </strong>To determine the normative range of ultrasound dimensions for the liver, spleen and kidneys in healthy children according to gender, age, body measurements, body surface area (BSA), and the influence of ethnicity on organ size.<br /><strong>Methods </strong>The prospective study included children, ranging from full-term neonates to children aged 15, with normal ultrasonographic (US) findings of the liver, spleen and kidney and no clinical evidence of a disease. Gender, age, as well as body measurements and BSA, were determined for each child along with US measurements, and normative ranges were established. <br /><strong>Results </strong>US images of the liver and spleen from 372 children and 366 US images of kidneys of 366 children were included. US measurements of the liver, spleen and kidney correlated well with gender, age, body weight and height, and often differed to a greater or lesser extent from the normal range of measurements (5th to 95th percentile) reported in other studies.<br /><strong>Conclusion </strong>Our results differed slightly from other reports conducted in Europe, but larger differences compared to measurements performed on children on other continents were found. Thus, our study confirmed that ethnically appropriate and modern tables of normal ultra-sound dimensions for the liver, spleen and kidneys should be used, and that the national nomogram is justified.</p>
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Qumrul Ahasan, Md, Tanvir Kabir Chowdhury, Durdana Sadab, Tasmiah Tahera Aziz, and Tahmina Banu. "Nomograms of Liver, Spleen and Kidney Dimensions Based on Ultrasonographic Measurements." Chattagram Maa-O-Shishu Hospital Medical College Journal 22, no. 2 (2024): 36–41. http://dx.doi.org/10.3329/cmoshmcj.v22i2.77677.
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Background: For Liver, spleen and kidney measurement, available data are not always representative for all population. This study was aimed to find out the normal measurement of kidney, liver, spleen using ultrasonography at Chattogram, Bangladesh. Materials and methods: Among a total of 3699 subjects (Male: Female 1.4:1; median age 35 years) without any liver, splenic or renal diseases ultrasonographic images of these organs were from 2780, 1596, and 2780 individuals respectively. Measurements were taken for liver length, splenic length and breadth and renal length, breadth and cortical thickness. Results: The average liver length in neonates and infants were 5.2 and 6.5 cm in females and 5.7 and 6.6 cm in males. After 20 years of age, average liver sizes ranged from 11.1 to 11.6 cm. The average spleen length in neonates and infants were 3.5 and 5.6 cm in females and 5.7 and 6.4 cm in males. After 20 years of age, it ranged from 8.2 to 9.0 cm. The average renal length in neonates and infants were 4.2 and 5.3 cm for right kidney and 4.3 and 5.5 cm for left kidney in females. In male neonates and infants were 4.9 and 5.3 cm for right kidney and 4.8 and 5.6 cm for left kidney. After 20 years of age, it ranged from 9.0 to 9.7 cm for right kidney and from 9.6 to 10.2 cm for left kidney. Conclusion: These values may be used as reference for normal liver, spleen and kidney dimensions for populations of Chattogram, Bangladesh. Chatt Maa Shi Hosp Med Coll J; Vol.22 (2); July 2023; Page 36-41
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Stiff, Patrick J., William Bensinger, Muneer H. Abidi, et al. "Clinical and Radiographic Evaluation of Spleen Size during Peripheral Blood Progenitor Cell (PBPC) Mobilization by Filgrastim: Results of an Open-Label Trial in Normal Donors." Blood 110, no. 11 (2007): 477. http://dx.doi.org/10.1182/blood.v110.11.477.477.
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Abstract Introduction: Filgrastim is widely used for mobilizing CD34+ cells into the peripheral blood that are easily collected by apheresis for allogeneic transplantation. With case reports documenting splenomegaly with life-threatening complications in normal donors, we prospectively evaluated spleen size using ultrasonography and clinical examination during PBPC mobilization and collection in a single-arm trial. Methods: Subjects ≥18 yrs eligible to be PBPC donors per institutional guidelines enrolled. Splenic assessments were done before, during, and after PBPC mobilization. Filgrastim dose and schedule and leukapheresis (LK) procedures were per institutional practice. The primary endpoint was fold change from baseline in splenic volume in post-baseline measurements during mobilization (measured by ultrasound [US]). Spleen size by US was measured in 3 dimensions similarly by all centers: longitudinal (craniocaudal), transverse, and diagonal (perpendicular to transverse in transverse image) diameters. Splenic volume was estimated by taking the cross-product of 3 dimensions and multiplying by 0.52, approximating the volume of an ellipse. Physical examination was performed on US days, assessing spleen palpability. US and palpation results were blinded from each other at assessment times. Timepoints included baseline (before first filgrastim dose), first LK (done before LK, typically day 4 or 5 of filgrastim), 2 and 4 days after first LK, and 7 days after last LK. Timepoints in the post-amendment cohort (n=219) were reduced to facilitate enrollment and were baseline and day of first LK (before LK). Results: 309 donors enrolled, median age 44yrs (range 18 to 74), 56% male. Mean daily filgrastim dose was 11.4mcg/kg (SD=3.0). Median number of LK was 1.5 (range 1 to 4). In all donors, the median increase in each measured dimension on first LK day was 1.4cm, 1.4cm, and 0.6cm (12.8%, 12.6%, and 15.0%), and the median fold volume increase from baseline to first LK was 1.47, resolving to near baseline 1 week after last LK. There was no apparent relationship between volume fold change and filgrastim dose, ANC, or CD34+ yield. Of 861 splenic palpation assessments reported in all donors, 98% were reported as nonpalpable (842 assessments), and 2% were palpable (19 assessments, 2 at baseline). Reporting of palpable spleens did not correlate with increased spleen size. Tenderness or guarding upon splenic palpation was reported in 2 donors with a spleen considered palpable and in 6 donors with nonpalpable spleens. No donor experienced a splenic rupture. Adverse events related to filgrastim were generally mild to moderate. Conclusion: During PBPC mobilization with filgrastim in normal donors, the spleen increased a median of approximately 50% from baseline to day of first LK and returned to near baseline 1 week after last LK. Size change was not associated with significant clinical sequelae. Timepoint Median fold change from baseline in splenic volume (Q1, Q3) *statistically significant (p<0.05); Q1=1st quartile, Q3=3rd quartile First LK (n=304) 1.47* (1.27, 1.68) Day 2 after first LK (n=88) 1.41* (1.21, 1.61) Day 4 after first LK (n=86) 1.19* (1.10, 1.38) Day 7 after last LK (n=89) 1.08* (0.96, 1.21)
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Konuş, O. L., A. Ozdemir, A. Akkaya, G. Erbaş, H. Celik, and S. Işik. "Normal liver, spleen, and kidney dimensions in neonates, infants, and children: evaluation with sonography." American Journal of Roentgenology 171, no. 6 (1998): 1693–98. http://dx.doi.org/10.2214/ajr.171.6.9843315.
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Parijat, Mukherjee, Das Sayantan, Khalkho Anupam, and Kumar Avinash. "A Study of Anatomical Dimensions of Spleen in Population of Eastern Bihar: A Sonological Study." International Journal of Pharmaceutical and Clinical Research 15, no. 7 (2023): 1126–34. https://doi.org/10.5281/zenodo.11682021.
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<strong>Background</strong><strong>:</strong> Accurate knowledge of normal splenic dimensions is important for diagnosing clinical conditions associated with altered spleen size. A descriptive cross sectional study was conducted with the aim to determine normal splenic measurements in the Eastern Bihar population and to compare them with body parameters such as height, weight, age and sex. <strong>Methods:</strong> 78 females and 32 male adult participants underwent abdominal ultrasound in Kishanganj, Bihar, India. Participants were taken after they met with inclusion criteria and gave informed consent for the study. The splenic length, breadth and thickness were measured, and their height, weight and age were also recorded. The analysis was done using SPSS version 26. <strong>Results</strong><strong>:</strong> The study included 110 subjects (78 females, 32 males). Average splenic dimensions were: length 97.05 mm, breadth 60.50 mm, thickness 34.82 mm, volume 111.53 cm<sup>3</sup>. No significant differences were found between males and females. A negative correlation with age with splenic parameters except thickness was also found. No significant correlation was found between splenic parameters with other body parameters such as height or weight. <strong>Conclusion:</strong> The study indicated no significant correlation of splenic parameters with height and weight, and indicated difference between male and female splenic parameters to be insignificant. This might reflect the population variations found in other studies. The findings emphasize the need for population-specific reference ranges and suggest a potential age-associated shrinkage effect on splenic dimensions. Further research with larger sample sizes is recommended.
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Vozgoment, O. V., M. I. Pykov, N. V. Zaytseva, A. A. Akatova, Y. A. Ivashova, and V. M. Chigvintsev. "A NEW ULTRASONIC CRITERION OF EVALUATING SPLEEN DIMENSIONS IN CHILDREN AND DETERMINATION OF THE RANGE OF NORMAL ORGAN’S DIMENSIONS." Pediatric pharmacology 11, no. 3 (2014): 89. http://dx.doi.org/10.15690/pf.v11i3.1016.
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Mohammadi, Shabnam, Arya Hedjazi, Maryam Sajjadian, et al. "Morphometric Study of Spleen in Iranian Cadavers from Razavi-Khorasan Province." Bangladesh Medical Research Council Bulletin 42, no. 2 (2017): 61–66. http://dx.doi.org/10.3329/bmrcb.v42i2.32000.
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Anthropologic parameters of the spleen are important because many diseases present with reduction or enlargement of the spleen. No data exists about the standard dimensions of the normal spleen in Iranian population. Therefore, the objective of the study was to investigate anthropologic parameters of the spleen in Iranian cadavers. In 2014-2015, this cross sectional study was undertaken from the Razavi Khorasan Province of Iran. Iranian cadavers (n=693, 152 female/541 male) with no history of poisoning, drug or alcohol addiction, no gross abnormality and injury of the spleen were included in the study. The length, width and thickness of spleen were measured using a Vernier caliper. The mean values of the demographic data were age= 40.28 ± 20.97 years; weight = 63.68 ± 17.40 kg; height = 160.03 ± 28.45 cm and BMI = 25.03 ± 20.46 kg/m2. The mean values of the spleen length, width, thickness, notch, weight and index in the cadavers were 11.32 ± 3.10 cm, 8.05 ± 2.35 cm, 20.12 ± 9.21 mm, 0.84 ± 1.35, 123.87 ± 82.46 g, and 2.01 ± 1.40, respectively. Accessory spleen was found in five cadavers. The anthropologic parameters of the spleen showed significant difference between males and females except for index of the spleen. Having standard data on the spleen is useful for radiologists, surgeons, anatomists and anthropologists. The results of the study may provide valuable data in the standardization of the anthropologic parameters of the spleen in the Iranian population.
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Asghar, Adil, Dushyant Agrawal, S. M. Yunus, P. K. Sharma, S. H. H. Zaidi, and Aruna Sinha. "Standard Splenic Volume Estimation in North Indian Adult Population: Using 3D Reconstruction of Abdominal CT Scan Images." Anatomy Research International 2011 (March 8, 2011): 1–5. http://dx.doi.org/10.1155/2011/707325.
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A prospective study was carried out to establish normative data for splenic dimensions in North Indian population and their correlation with physical standard on abdominal CT of 21 patients aged between 20 and 70 years having no splenic disorders. Splenic volume was measured by two methods—volume and surface rendering technique of Able 3D doctor software and prolate ellipsoid formula. Volumes measured by both the techniques were correlated with their physical standards. Mean splenic volume was 161.57±90.2 cm3 and range 45.7–271.46 cm3. The volume of spleen had linear correlation with body height (r=0.512, P<.05). Splenic volume (cm3) = 7 × height (cm) − 961 can be used to generate normal standard volume of spleen as a function of body height in North Indian population (with 95% confidence interval). This formula can be used to objectively measure the size of the spleen in adults who have clinically suspected splenomegaly.
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Mohtasib, Rafat S., Kamal Alshamiri, Aman Jobeir, et al. "Sonographic measurements for spleen size in healthy Saudi children and correlation with body parameters." Annals of Saudi Medicine 41, no. 1 (2021): 14–23. http://dx.doi.org/10.5144/0256-4947.2021.14.
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BACKGROUND: Ultrasound is commonly the first-line imaging modality for assessing the visceral organ dimensions without any risk of radiation. An abnormal size of the spleen may indicate disease, but the evaluation is challenging because of the normal size changes with age. In addition, published normal value charts for children may vary by population and methods. OBJECTIVES: Determine normal growth curves for splenic length in relationship to sex, age, body weight, height, body mass index, and body surface area of healthy children in Saudi Arabia. DESIGN: A retrospective review of ultrasonography images SETTING: Tertiary referral hospital SUBJECTS AND METHODS: We included all normal ultrasonography exams of splenic length (from full-term neonates to 16 years of age) performed between 2003 and 2018. The greatest longitudinal distance of the spleen from the dome to the tip (splenic length) measured at the hilum in the coronal plane was obtained by ultrasonography. MAIN OUTCOME MEASURES: The relationship between the longitudinal length of the spleen and sex, age, height, weight, body mass index, and body surface area. SAMPLE SIZE: 1028 healthy children RESULTS: Height had the most significant correlation with the length of the spleen ( P <.001). There was a consistent difference in splenic length according to sex. The spleen was longer in males than in females in children older than 2 years. In terms of splenic growth according to age, our data showed a statistically significant correlation between the ages of 0-24 months and 2-16 years. There was a significant difference between cases from Saudi Arabia, the United States ( P =.023) and India ( P =.045). CONCLUSION: We developed scatter plots between splenic lengths and body parameters among Saudi children for children from 0 day to 24 months and children from 2 years to 16 years for reference. LIMITATION: Retrospective study. Ultrasound techniques in patient positioning, and cursor placement differed from other studies, which can affect measurements of splenic length. CONFLICTS OF INTEREST: None.
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Alyami, Ali, Meaad Elbashir, Sarra Ali, et al. "Normal sonographic spleen dimensions in a healthy population in Saudi Arabia: A cross-sectional prospective study." Journal of Radiation Research and Applied Sciences 16, no. 4 (2023): 100711. http://dx.doi.org/10.1016/j.jrras.2023.100711.
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Tanzifi, Mahdis, Mohammad Yousofpour, Amirsaeed Hosseini, Jamshid Yazdani Chrati, and Tahereh Amirian. "Comparison of spleen characterization and plasma levels of interleukin 6 and 10 in obese and healthy individuals." Journal of Shahrekord University of Medical Sciences 26, no. 4 (2024): 166–71. https://doi.org/10.34172/jsums.948.
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Background and aims: Spleen is one of the organs that has great importance in Iranian traditional medicine due to its relationship with obesity. Therefore, in this study, we aim to investigate spleen characterization and plasma levels of interleukin 6 (IL-6) and IL-10 in patients referred to medical centers affiliated with Golestan University of Medical Sciences during 2021-2022. Methods: This cross-sectional study included 24 subjects with obesity and 24 subjects with normal body mass index (BMI). The length, thickness, and width of the spleen were determined for each subject. Spleen volume was calculated for each subject using the standard prolate ellipsoid formula (length x thickness x width x 0.523). Fasting blood samples were taken from the subjects to check IL- 6 and 10 using the ELISA assay. P<0.05 was considered statistically significant. Results: Our results showed that the two groups had a statistically significant difference in length, width, thickness, and volume of the spleen (P<0.001, P<0.017, P<0.002, and P<0.001, respectively). However, there was no significant difference in the elasticity of the spleen (P=0.58). Plasma levels of IL-6 were significantly higher in subjects with obesity compared to the control group (P<0.001). However, the two groups had no significant difference in IL-10 levels (P=0.92). Conclusion: The increase in spleen dimensions and high plasma levels of IL-6 may reflect the development of obesity.
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Müller, Thiago R., Raquel S. Marcelino, Livia P. de Souza, Carlos R. Teixeira, and Maria J. Mamprim. "Ultrasonographic anatomy of the healthy southern tigrina (Leopardus guttulus) abdomen: comparison with domestic cat references." Journal of Feline Medicine and Surgery 19, no. 2 (2016): 132–40. http://dx.doi.org/10.1177/1098612x15617498.
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Objectives The aim of the study was to describe the normal abdominal echoanatomy of the tigrina and to compare it with the abdominal echoanatomy of the domestic cat. Reference intervals for the normal abdominal ultrasonographic anatomy of individual species are important for accurate diagnoses and interpretation of routine health examinations. The hypothesis was that the echoanatomy of the tigrina was similar to that of the domestic cat. Methods Eighteen clinically healthy tigrina were selected for abdominal ultrasound examination, in order to obtain normal parameters of the bladder, spleen, adrenal gland, kidney, gastrointestinal tract, liver and gall bladder, and Doppler parameters of liver and kidney vessels. Results The splenic parenchyma was consistently hyperechoic to the kidneys and liver. The liver, kidneys and spleen had similar echotexture, shape and dimensions when compared with the domestic cat. The gall bladder was lobulated and surrounded by a clearly visualized thin, smooth, regular echogenic wall. The adrenal glands had a bilobulated shape. The urinary bladder had a thin echogenic wall. The Doppler parameters of the portal vein and renal artery were similar to the domestic cat. Conclusions and relevance The results support the hypothesis that the ultrasonographic parameters of the abdominal viscera of the southern tigrina are similar to those of the domestic cat.
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Siddiqui, M., A. Ali, and O. Serhan. "Estimation of standard splenic volume in Saudi Arabian adult population: using 3D reconstruction of abdominal CT scan images." Journal of Morphological Sciences 32, no. 04 (2015): 227–30. http://dx.doi.org/10.4322/jms.064713.
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Abstract Purpose: Spleen is enlarged in a variety of clinical conditions including infectious, infiltrative, immunologic and malignant states. Evaluation of splenic size is important in every physical examination of the abdomen by a physician. Determination of its size by palpation can be extremely inaccurate because spleen is never palpable till it is enlarged 2 to 3 times its own size. The accurate diagnosis of splenic enlargement is a matter of considerable importance as it is a useful guide for arriving at a diagnosis of the disease. It is therefore of utmost importance to resort to a mechanism that will give us an accurate estimation of the size of spleen. Aim of this work was to determine the normal range of spleen dimensions in average adult Saudi Arabian population and compare it from the published data. Methods: CT scans of 34 adult patients (male and female) aged between 20-70 years, having no splenic disorders, were collected from department of radio-diagnosis King Khalid Hospital Al-Kharj, KSA. Splenic volume was measured by two methods— by volumetric software and the prolate ellipsoid formula. Results: The average splenic volume of all subjects was 161.42 ±54.91 cm3 with a range of 106-319 cm3. The average splenic volume of males was 196.95 ±48.70 cm3 and that of female was 196.95 ±26.97 cm3. Conclusion: These results provide normative data for evaluating patients with splenic enlargement.
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Cho, Young Seo, Sanghyeok Lim, Yongsoo Kim, Joo Hyun Sohn, and Jae Yoon Jeong. "Spleen Stiffness Measurement Using 2-Dimensional Shear Wave Elastography: The Predictors of Measurability and the Normal Spleen Stiffness Value." Journal of Ultrasound in Medicine 38, no. 2 (2018): 423–31. http://dx.doi.org/10.1002/jum.14708.
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Santos, Beatriz Tamargo, Simona Bungau, Catherine Fleitas Perez, et al. "Immuno-toxicological Evaluation of the Adjuvant Formulations for Experimental Anti-meningococcal Vaccines without Aluminium Hydroxide." Revista de Chimie 70, no. 4 (2019): 1251–57. http://dx.doi.org/10.37358/rc.19.4.7103.
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The proteoliposomes and cochleates are used as adjuvants for vaccines since they are potent immune stimulators. However, the hyper stimulation of the immune system provoked by adjuvants can cause immune-toxicological side effects. The present study was carried out to evaluate the toxic and immuno-toxicological effects of new adjuvants for anti-meningococci vaccines based on neo-proteoliposomes (nPL) and neo-cochleates (nCh), in Balb/c mice that were administered doses of 15 �g each, over periods of 14 days through intramuscular route and three inoculations with the same doses through intranasal route, every 7 days. The Scanning and Transmission Electron Microscopy showed that the nPL and nCh had nanometric dimensions and their normal peculiar forms. The experimental formulations did not provoke general toxic effects in the tested animals, which tended to the progressive normal growing of this species, that did not statistically differ from the control ones. The studies of pathologic anatomy in inoculation organs and sites did not reveal modifications that can indicate toxicity and there was no sign of hepatic damage. The structural observations found in the spleen and lymphatic nodes showed the physiological development of the immune response, which was normal in all cases showing the restitution of the stimulation signs. The relative weight values of the spleen were within the standard range. These results showed that the nPL and nCh elaborated as adjuvants for vaccines did not show any evident induction of general toxic or particular immune-toxicologicl effects.
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Safak, Alp Alper, Enver Simsek, and Talat Bahcebasi. "Sonographic Assessment of the Normal Limits and Percentile Curves of Liver, Spleen, and Kidney Dimensions in Healthy School-Aged Children." Journal of Ultrasound in Medicine 24, no. 10 (2005): 1359–64. http://dx.doi.org/10.7863/jum.2005.24.10.1359.
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Erohubie, OA, AA Adeyekun, FO Ehigiamusoe, NO Enaruna, PO Erohubie, and FE Ogbetere. "Sonographic Difference in Splenic Dimensions Between Healthy Pregnant and Non-Pregnant Women." Nigerian Journal of Clinical Practice 27, no. 12 (2024): 1351–57. https://doi.org/10.4103/njcp.njcp_116_24.
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Background: The spleen undergoes variations in its dimensions during pregnancy. Splenic morbidities can also affect pregnancy. Aim: This study was aimed at investigating by means of ultrasound, the normal splenic dimensions throughout gestation in healthy pregnant women and to ascertain any relationship between it and other parameters such as age, weight, height and parity. Materials and Methods: The study comprised 100 pregnant subjects and 100 controls. The splenic dimensions and foetal biometry, where appropriate, were measured for assessment of gestational age (GA). Comparison of splenic dimensions between study groups and controls was made. Data analysis was done using Statistical Package for Social Sciences 22 (SPSS). Results were displayed using appropriate statistical methods. For all statistical tests, P < 0.05 was significant. Results: The mean age of the pregnant subjects was 31.3 ± 3.9 years, while that of the non-pregnant controls was 30.1 ± 5.7 years. The mean splenic length, width, thickness and volume for pregnant subjects were 10.3 ± 1.17 cm, 5.1 ± 0.74 cm, 5.2 ± 0.69 cm and 147.3 ± 45.03 cm3 , respectively. The mean splenic length, width, thickness and volume for controls were 9.6 ± 1.00 cm, 4.3 ± 0.35 cm, 4.7 ± 0.33 cm and 104.0 ± 21.65 cm3, respectively. Pregnant subjects were observed to have higher mean splenic length, width, thickness and volume (P = 0.001). There was increase in splenic dimensions with increasing GA. Conclusion: Pregnant subjects had significantly higher splenic dimensions compared to non-pregnant subjects. A statistically significant increase in length, throughout pregnancy, was also observed.
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Ehimwenma, Ogbeide, and MarchieTobechukwu Tagbo. "Determination of normal dimension of the spleen by ultrasound in an endemic tropical environment." Nigerian Medical Journal 52, no. 3 (2011): 198. http://dx.doi.org/10.4103/0300-1652.86141.
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Miolski, Jelena, Jasminka Marjanović, Sanja Stanojević, Nevena Didić, and Vera Zdravković. "Ectopic pelvic kidney in a child: A case report." Medicinski casopis 56, no. 4 (2022): 123–26. http://dx.doi.org/10.5937/mckg56-39508.
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Ntroduction. An ectopic pelvic kidney is an anatomical anomaly in the position of the kidney. In the stage of metanephros, its movement, rotation, and lifting from the pelvis to the lumbar area are absent. Due to vascular or other abnormalities, the kidney does not reach its usual anatomical position and therefore remains ectopic. The position in which it can be placed is retroperitoneal, abdominal, or thoracic, with numerous variations. Case report: A three-month-old male infant underwent kidney screening during an ultrasound examination of the hips. There had been a positive family history in the mother and maternal aunt of the existence of an ectopic, left pelvic kidney, without complications and accompanying symptoms. The clinical findings of the infant's systems were normal, he was developing in terms of body mass. The analyzes of urine, biochemistry, and urine culture did not show any pathological findings. Ultrasound examination showed that the left renal lobe was completely filled with spleen, without visualization of the left kidney. In the right lumbar box, there was the right kidney, with regular dimensions, clear edges and normal thickness of the parenchyma. Inferior to the right kidney, in the area of the right lumbar region, facing inwards, there was the left kidney with regular ultrasonographic characteristics. Urinary bladder was properly positioned, with normal dimensions and wall thickness. The infant was advised to see a pediatric nephrologist. Conclusion: This is another case of an ectopic kidney recorded during an echosonographic examination of the hips, thus demonstrating the importance of routine ultrasound examinations of the abdomen, in order to increase the possibility of early detection of anomalies of the abdominal organs.
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Sharma, Keshab, PS Lamichhane, B. Sharma, and BK Sharma. "Sonographic Measurement of Spleen in Relation to Age: A Prospective Study among Adult Nepalese People in Western Nepal." Journal of Gandaki Medical College-Nepal 10, no. 1 (2017): 11–16. http://dx.doi.org/10.3126/jgmcn.v10i1.17904.
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Introduction: Splenomegaly is an enlargement of the spleen which is a quite common problem in any part of the world. Spleen is enlarged in various clinical disorders e.g. infections, metabolism or storage disorders and hematological abnormalities. Splenomegaly is an indicator of pathologic process that may be of primary splenic origin but also may be a reflection of disease in virtually any other organ system. Thus, it is important to estimate the splenic size in vivo in the diagnosis, treatment and prognosis of a variety of disorders.Objective: The objective of this study was to determine the normal dimension of the spleen in the adult Nepalese people.Methods: This is a prospective study in which 320 adults subjects were scanned by using 3.5 MHz curvilinear probe. We used ultrasonography to examine 160 males and 160 females, not to have any condition likely to be associated with splenic enlargement. The measurement for the length and thickness of spleen were obtained in right lateral position.Results: This study revealed the splenic dimensions for males were greater than in females. The men spleen length were (10.07 ±0.7 cm, 10.1 ±0.54 cm, 9.5 ±0.7 cm and 9.0 ±0.43 cm for age group of 16 - 30, 31 - 45, 46 - 60 and 61 - 75 years respectively). The females spleen length were (9.83 ±0.53 cm, 9.58 ±0.58cm, 9.2 ±0.64 cm and 8.8 ±0.36 cm for age group of 16 - 30, 31 - 45, 46 - 60 and 61 - 75 years respectively). The men spleen thickness were more (4.1 ±0.5 cm, 4.05 ±0.58 cm, 3.43 ±0.38 cm and 3.0 ±0.36 cm for age group of 16 - 30, 31 - 45, 46 - 60 and 61 - 75 years respectively). The females splenic thickness were 4.06 ±0.47 cm, 3.78 ±0.48 cm, 3.38 ±0.35 cm and 2.29 ±0.23 cm for age group of 16 - 30, 31 - 45, 46 - 60 and 61 - 75 years respectively. Thus significant differences between male and female splenic dimensions were found for each age group chosen (P <0.05).Conclusions: The results show that the splenic length and thickness decreased with increase in age in both males and females and all the dimensions were greater in males than in females. This study established normogram that can be more reliably used as both a complementary modality to clinical evaluation and as a more sensitive means of evaluating and screening patients for splenic disorders for any pathological enlargement or reduction of size in clinical practice in a Nepalese populations.Journal of Gandaki Medical College Vol. 10, No. 1, 2017, page: 11-16
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Marques, R. G., Y. Petroianu, and J. M. C. de O. Coelho. "Bacterial phagocytosis by macrophage of autogenous splenic implant." Brazilian Journal of Biology 63, no. 3 (2003): 491–95. http://dx.doi.org/10.1590/s1519-69842003000300015.
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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.
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Kumar, Govind, Vinod Kumar, Manisha Kumari, Himanshu Mishra, and Suruthi T.I. "Abdominal CT Scan Based Estimation of Splenic Index and Splenic Volume in North Indian Adults." Journal of Evolution of Medical and Dental Sciences 10, no. 33 (2021): 2749–53. http://dx.doi.org/10.14260/jemds/2021/561.
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BACKGROUND Exposure of various tropical infections and infestations like tuberculosis, filariasis, malaria, anemia, kala-azar and poor sanitation are major health concerns in Bihar and it’s neighboring state. Spleen size increases in several other diseases e.g., metabolism or storage disorder, malignancies and hematological disorders. Determining the normal parameters of spleen is essential for assessment of splenomegaly in routine ultrasonography (USG) or in the computed tomography (CT) scan. In this study, we wanted to estimate the CT based measurement of splenic dimensions in various planes, splenic index (linear dimension) and splenic volume and also to estimate the relationship of splenic index and splenic volume with age, gender and other splenic dimensions. METHODS It was a retrospective study and data was collected from January 2019 to December 2019. A total of 154 cases (including both genders) of age range 18 - 60 years were collected from the vitrea system (Vitrea software used for the 3-D assessment of splenic volume) and clinical data was collected from the medical record section. CT scan data of only those patients were included who had the clinical history of pain in abdomen, abdominal trauma or other diseases not affecting the spleen. Various measurements including splenic length and thickness at hilum and maximum thickness in axial view and height (maximum interpolar and true vertical height) in coronal views were recorded. RESULTS 154 cases including both gender and age range of 18 - 60 years were included in our study. There were 60 males and 94 females. The average age of the male and female patients was 45.93 +/- 15.19 years and 45.87 +/- 15.12 years respectively. The mean splenic dimensions were 9.03 +/- 1.49 cm in length (axial view), 3.69 +/- 0.05 cm thickness at hilum (axial view) and 9.05 +/- 2.23 cm maximum craniocaudal length and 7.9 +/- 2.96 cm true vertical length (coronal view). Mean splenic index and mean splenic volume were 340.30 +/- 107.39 cm3 and 227.02 +/- 62.22 cm3 respectively. There was statistically significant correlation between splenic volume and maximum craniocaudal length (r2 = 0.4848, P = 0.001), maximum axial length (r2 = 0.4765, P < 0.001) and true vertical length (r2 = 0.3142, P = 0.001) with 95 % confidence interval. For all splenic measurements, there was stronger correlation with maximum craniocaudal length followed by maximum axial length. However, there was no statistically significant correlation either of splenic volume with age in either gender (r2 = 0.019, P = 0.043) or splenic index with age in either gender present (r2 = 0.016, P = 0.059). CONCLUSIONS Maximum splenic length both in coronal (craniocaudal) and axial sections are positively and strongly correlated with splenic volume and splenic index but age of the individuals doesn’t show any correlation either with the splenic volume or with splenic index. Hence, a regional reference of splenic parameters was established with a slightly different range of values reported previously. KEY WORDS Splenic Volume, Splenic Index, Computed Tomography
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KC, Crystal, Bikash Bikram Adhikari, and Rakshya Parajuli. "Computed Tomography Assessment of Linear Splenic Dimensions and their Correlation with Anthropometric Measurements in Nepalese Population." Journal of Nobel Medical College 12, no. 2 (2023): 98–102. http://dx.doi.org/10.3126/jonmc.v12i2.61472.
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Background: Geographical locations and ethnicity may influence variations in normal spleen dimensions, potentially leading to errors in assessment. This study aimed to correlate splenic dimensions with anthropometry and predict their variation with age and body surface area.
 Materials and Methods: Subjects (n=384) undergoing abdominal computed tomography were selected by random sampling. Splenic volume was calculated using the standard prolate ellipsoid equation. Correlation of splenic volume with body surface area and body mass index was done with Pearson’s correlation analysis. A multiple regression was run to predict splenic volume from age, height, and body surface area.
 Results: The mean age was 45±18 (range, 18-90 years). The mean splenic length, width, thickness, and volume were 7.6 ± 1.7 cm, 8.8 ± 1.5cm, 3.8 ± 0.9 cm, and 139 ± 58.2 cm3, respectively. The splenic width and splenic volume were significantly lower at extremes of age. A significant (P<0.05) correlation was seen between splenic volume, body surface area(r=0.393) and body mass index (r=0.126); a negative correlation was observed between splenic volume and age (r=-0.180). Splenic dimensions were significantly larger in males. Multiple regression revealed that an increase in body surface area (by 10 cm2), predicted increased splenic volume was 4.3 cm3. An increase in age (by 1-year), predicted decrease in splenic volume was 8.3 cm3. For 10 cm increase in height, predicted increase in splenic volume was 1.7cm3.
 Conclusion: The study showed a positive correlation between splenic volume and body surface area, as well as body mass index and provides a crucial normative data for assessing splenic enlargement in Nepalese population.
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Suthar, Dr Bhumika, Dr Payal Damor, and Dr Sandeep Rathva. "Sonographical evaluation of normal liver, spleen, and kidney dimensions in neonates, infants, and children upto 5 years of age at tertiary care teaching hospital in Gujarat." International Journal of Radiology and Diagnostic Imaging 4, no. 2 (2021): 38–41. http://dx.doi.org/10.33545/26644436.2021.v4.i2a.197.
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Orel, Yuriy H., Hlib Y. Orel, Yuriy Z. Khorkavyi, and Oleg M. Slabyy. "Features of Surgical Treatment of Patients with Splenic Artery Aneurysms (Case Report and Literature Review)." Ukrainian Journal of Cardiovascular Surgery 30, no. 4 (2022): 88–93. http://dx.doi.org/10.30702/ujcvs/22.30(04)/oo055-8893.
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Despite the insigniϐicant prevalence, aneurysms of the splenicartery take a dominant share among all visceral aneurysms with a predominance of morbidity in women of childbearing age. Taking into account the mostly asymptomatic course and the high risk of mortality due to its rupture, timely diagnosis and correct treatment strategy remain extremely important. Questions regarding the choice of surgical treatment tactics for patients with this pathology remain debatable.
 The aim. Demonstration of a clinical case, improvement of diagnosis andsurgical treatment of patients with splenic artery aneurysms.
 Clinical case. Female patient G., 32 years old, with complaints of periodic pain in the left hypochondrium, signs of portal hypertension against the background of cavernous transformationof the portal vein, history of recurrent bleeding from the esophageal veins, hypersplenism admitted with a pre-diagnosed aneurysm of the splenic artery of giant dimensions (diameter 8x5 cm). The patient was qualified for open surgery and aneurysm resection with splenectomy and spleen autotransplantation by N. Roth. The postoperative period was complicated by the occurrence of reactive pancreatitis on day 7, which was successfully treated conservatively. In the future, the course was unremarkable. The remote follow-up lasted two years, and no recurrence of the aneurysm was detected. The performed immunogram showed normal results.
 Conclusion. The timely diagnosis makes it possible to establish the correct diagnosis, justify the treatment tactics and prevent fatal complications. Open surgical intervention in somecases remains the method of choice in the treatment of this pathology. Autotransplantation of the spleen has shown good long-term results and can be performed in patients of this category for the prevention of immunodeficiency states.
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Park, Terrence, Anique Mustafa, Biswaraj Tharu, and Munir Shah. "1550. Beyond Skin Deep: Cellulitis Induced Splenic Abscess." Open Forum Infectious Diseases 7, Supplement_1 (2020): S775—S777. http://dx.doi.org/10.1093/ofid/ofaa439.1730.
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Abstract Background A 51 year old male presented with splenic abscess from chronic eczema with cellulitis. Coronal plane view of the CT abdomen showing the splenic abscess. CT abdomen without contrast in the transverse plane showed a splenic mass measuring 7.8 x 8.8 x 6.9 cm, similar in size to the results found on ultrasound examination. Methods The patient had poor medical compliance, diabetes, hypertension, hyperlipidemia, COPD, and chronic eczema with cellulitis presented with fever, malaise, abdominal pain and distension. The patient denied any previous intravenous drug use. CT abdomen showed a splenic mass measuring 7.8 x 8.8 x 6.9 cm. A TTE showed normal ejection fraction and normal mitral valve structure and function. The patient underwent a CT guided drainage with tube placement in the spleen. MRI of the spine showed some osteomyelitis of the L4 vertebrae, which likely developed from the splenic abscess. Subsequent cultures of the splenic abscess showed MRSA. Abdominal ultrasound with 2-D grayscale sector imaging shows a cystic mass in the spleen measuring roughly 8 x 8 x 6.5 cm in dimensions. No vascular flow was identified within the mass. CT chest showed a prominent left sided pleural effusion, lower lobe lung consolidation air bronchograms. An air-filled and regular cystic area in the posterior dependent portion of the left lower lobe was noted (possibly a small pneumatocele). Patchy infiltrates in right lung were noted as well. Results Endocarditis is the most common primary source of splenic abscess, with urinary tract infections, appendicitis, pneumonia, and wound infections as other primary etiologies. Organisms that can be involved are Streptococci, Staphylococci, and Escherichia coli, Enterococcus and Klebsiella pneumoniae. Splenic abscess follows a bimodal distribution, occuring in those younger than 40 and older than 70 years of age. Leukocytosis can be as high as the 18,000 cells/mL range or within the upper range of normal limits. The sensitivity of abdominal ultrasonography in the diagnosis of splenic abscesses is roughly 75-93%. The abdominal CT diagnostic sensitivity for splenic abscess ranges from 92-96%. In tandem with the ultrasound examination, the diagnostic sensitivity is estimated at 94.7%. Treatment options entail intravenous antibiotics with CT-guided percutaneous aspiration or splenectomy. Previous studies noted a 70.8-100% mortality rate in patients with splenic abscess who were treated only with intravenous antibiotics. MRI of the spine with contrast showing some probable small osteomyelitis of L4 vertebrae at the anterior/inferior corner. Conclusion Characteristics of the patient population, geographic location, recent travel, possible vector exposures, predisposing medical conditions, and individual behaviors may be contributing factors in regards to the underlying etiologic organism(s) involved in each individual case of splenic abscess. This case study is especially rare in that the etiology of the splenic abscess was chronic eczematous cellulitis. Disclosures All Authors: No reported disclosures
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Hoppe, Chantal C., Roger G. Evans, John F. Bertram, and Karen M. Moritz. "Effects of dietary protein restriction on nephron number in the mouse." American Journal of Physiology-Regulatory, Integrative and Comparative Physiology 292, no. 5 (2007): R1768—R1774. http://dx.doi.org/10.1152/ajpregu.00442.2006.
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In rats, maternal protein restriction reduces nephron endowment and often leads to adult hypertension. Sex differences in these responses have been identified. The molecular and genetic bases of these phenomena can best be identified in a mouse model, but effects of maternal protein restriction on kidney development have not been examined in mice. Therefore, we determined how combined prenatal and postnatal protein restriction in mice affects organ weight, glomerular number and dimensions, and renal expression of angiotensin receptor mRNA, in both male and female offspring. C57/BL6/129sv mice received either a normal (20% wt/wt; NP) or low (9% wt/wt; LP) protein diet during gestation and postnatal life. Offspring were examined at postnatal day 30. Protein restriction retarded growth of the kidney, liver, spleen, heart, and brain. All organs except the brain weighed less in female than male offspring. Protein restriction increased normalized (to body weight) brain weight, with females having relatively heavier brains than males. The effects of protein restriction were not sex dependent, except that normalized liver weight was reduced in males but increased in females. Glomerular volume, but not number, was greater in female than in male mice. Maternal protein restriction reduced nephron endowment similarly in male and female mice. Renal expression of AT1A receptor mRNA was approximately sixfold greater in female than male NP mice, but similar in male LP and female LP mice. We conclude that maternal protein restriction reduces nephron endowment in mice. This effect provides a basis for future studies of developmental programming in the mouse.
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Jiao, Yiqun, Ping Zhang, Divino DeOliveira, Nicholas Drago, Nelson J. Chao, and Benny J. Chen. "An Ear-Tissue Model for High-Resolution In Vivo Imaging." Blood 116, no. 21 (2010): 1456. http://dx.doi.org/10.1182/blood.v116.21.1456.1456.
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Abstract Abstract 1456 The use of microscopy in medicine has revolutionized medical research, diagnosis, and treatment. Unfortunately, current use of microscopy is mostly limited to 2 dimensional structures. The introduction of next generation microscopy, such as confocal and multiphoton, has enabled study of 3 dimensional structures deep in living tissues. Because there is a limit as to how deep these microscopic techniques can detect signal in tissue, many tissues/organs can not be studied due to inaccessibility (e.g., thymus). We have been using an ear-heart murine model to study immune tolerance. In this model, a heart from a newborn mouse is transplanted subcutaneously into the ear pinna. If the heart is not rejected (e.g., syngeneic setting), it can survive and beat indefinitely. In this study, we tested a hypothesis that other tissues can also be transplanted into the mouse ear pinna and function. Skin on the mouse ear pinna is extremely thin (<15 μm), thus allowing for visualization of cellular and subcellular changes in transplanted tissues in 4 dimensions (3D plus time) in real time using existing technologies such as multiphoton microscopy. We transplanted a variety of C57BL/6 adult (lung, trachea, aorta, kidney, bone marrow, thymus, spleen, lymph node, skeletal muscle, thyroid gland, adrenal gland) and fetal (colon, ileum, stomach, heart, lung, kidney, bone marrow, thymus, spleen, skeletal muscle) tissues subcutaneously into syngeneic mouse ear pinna. All of these tissues were able to survive at least 4–8 weeks after transplantation. Many of these tissues maintained normal or close to normal structures for at least 4–8 weeks. We chose an ear-thymus model to test whether the engrafted tissues can function. Thymic tissue from C57BL/6 newborn mice (<48 hrs) was transplanted into BALB/c nude mice (lacking thymic tissue). The numbers of CD4+ and CD8+ T cells were followed by flow cytometric analysis in peripheral blood over time. CD4+ T cell counts were significantly higher in thymic tissue recipients compared with sham transplanted control group (Figure, P<0.05). As an internal control, B220+ B cells, which are normal in nude mice and are not produced in thymus, remained similar between transplanted and sham transplanted groups at all time points. To test whether this model is useful for high-resolution imaging in live animals, we transplanted GFP+ C57BL/6 T cell depleted bone marrow into thymic tissue recipients. After bone marrow transplantation, almost all hematopoietic cells were replaced by GFP+ cells. Using two photon microscopy technology, we were able to obtain 4 dimension images of the transplanted thymic tissue at the cellular level in living animals. Because surgical exposure is not required, we were able to perform imaging of living tissues repeatedly in these animals indefinitely. We conclude that multiple tissues are able to survive and function for a long period of time when transplanted into ear pinna. Our innovative ear-tissue transplant model has the potential to allow many living tissues to be visualized at the cellular and subcelluar level in real time and in live animals. Disclosures: Chao: Genzyme: Research Funding.
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Kapralov, Sergey V., Dmitry Yu Potapov, Denis V. Nikitin, and Dmitry V. Safronov. "APPLICATION OF ULTRASONOGRAPHY FOR QUANTITATIVE ASSESSMENT OF RETROPERITONEAL FIBERS." Bulletin of Medical Science 35, no. 3 (2024): 77–83. http://dx.doi.org/10.31684/25418475-2024-3-77.
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The aim of the study was to explore the possibility of using ultrasound to quantify the fiber of the retroperitoneal space under normal conditions. Materials and methods. 3 linear dimensions between anatomical landmarks are proposed, which are well visualized with standard transabdominal ultrasound of the abdominal cavity and retroperitoneal space. These include: 1) the distance between the lower edge of the rectus abdominis and the aorta; 2) the distance between the upper pole of the right kidney and the lower border of the liver; and 3) the distance between the upper pole of the left kidney and the lower pole of the spleen. 145 practically healthy people were included in the study. All subjects were segregate into 3 groups according to body mass index (BMI). The first group consisted of persons with a BMI of 17.5 to 24.9 kg/m2, the second included persons with a BMI from 25 to 29.9 kg / m2, and the third consisted of people with a BMI ≥30 kg/m2. The median, minimum, maximum, upper and lower quartile values, as well as the 10th and 90th percentiles were used to describe the data obtained. Results. 80% of the distance values between the upper pole of the right kidney and the lower edge of the liver fit into the range of 10 mm to 25 mm in persons with a BMI of 17.5 to 24.9 kg/m2, in the range from 15 mm to 30 mm in persons with a BMI of 25 to 29.9 kg/m2, and in the range of 13.5 mm to 42.5 mm in obese individuals. The distance between the lower margin of the rectus abdominis and the aorta at a distance of 5 cm above the umbilicus along the midline is from 15 mm to 35 mm in people with a BMI of 17.5 to 24.9 kg/m2, from 25 mm to 60 mm in persons with a BMI of 25 to 29.9 kg/m2 and from 35 mm to 75 mm In obese individuals, it includes values between the 10th and 90th percentiles for this measurement point. Finally, 80% of the distance measurement values between the upper pole of the left kidney and the lower pole of the spleen fit in sizes from 10 mm to 30 mm for people with a BMI of 17.5 to 24.9 kg/m2, from 18 mm to 40 mm for people with a BMI from 25 to 29.9 kg/m2 and from 25 mm to 52.5 mm for subjects with obesity. Conclusion. The results obtained allow us to recommend ultrasound of retroperitoneal tissue for the evaluation of its condition.
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Ibacache-Pulgar, Germán, Pablo Pacheco, Orietta Nicolis, and Miguel Angel Uribe-Opazo. "Local Influence for the Thin-Plate Spline Generalized Linear Model." Axioms 13, no. 6 (2024): 346. http://dx.doi.org/10.3390/axioms13060346.
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Thin-Plate Spline Generalized Linear Models (TPS-GLMs) are an extension of Semiparametric Generalized Linear Models (SGLMs), because they allow a smoothing spline to be extended to two or more dimensions. This class of models allows modeling a set of data in which it is desired to incorporate the non-linear joint effects of some covariates to explain the variability of a certain variable of interest. In the spatial context, these models are quite useful, since they allow the effects of locations to be included, both in trend and dispersion, using a smooth surface. In this work, we extend the local influence technique for the TPS-GLM model in order to evaluate the sensitivity of the maximum penalized likelihood estimators against small perturbations in the model and data. We fit our model through a joint iterative process based on Fisher Scoring and weighted backfitting algorithms. In addition, we obtained the normal curvature for the case-weight perturbation and response variable additive perturbation schemes, in order to detect influential observations on the model fit. Finally, two data sets from different areas (agronomy and environment) were used to illustrate the methodology proposed here.
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Singh, Ajita V., G. Kenneth Lloyd, Michael A. Palladino, Dharminder Chauhan, and Kenneth C. Anderson. "Pharmacodynamic and Efficacy Studies of a Novel Proteasome Inhibitor NPI-0052 in Human Plasmacytoma Xenograft Mouse Model." Blood 112, no. 11 (2008): 3665. http://dx.doi.org/10.1182/blood.v112.11.3665.3665.
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Abstract Background: We recently characterized a novel proteasome inhibitor NPI-0052, a small molecule derived from the fermentation of a marine gram-positive actinomycete Salinispora tropica. NPI-0052 induces apoptosis in multiple myeloma (MM) cells resistant to conventional and bortezomib therapies. Importantly, NPI-0052 is distinct from bortezomib in its chemical structure, proteasome inhibition profiles, and mechanisms of action. In the present study, we utilized a human plasmacytoma xenograft mouse model to examine the effect of NPI-0052 on proteasome activity profiles in selected organs and tumors. Our results demonstrate that NPI-0052 rapidly leaves the vascular compartment in an active form after intravenous (IV) administration and inhibits the proteasome in extra-vascular tumors and other organs, excluding brain. NPI-0052 triggers a more sustained proteasome inhibition in tumors than in other organs examined. Importantly, we also confirmed the anti-tumor efficacy of NPI-0052. Methods and Model: Animal studies were approved by the DFCI Institutional Animal Care and Use Committee. Sixty CB-17 SCID-male mice were inoculated with 5.0 × 106 MM.1S cells in 100ul of serum free RPMI-1640 medium. The mice were divided into three different groups: Groups 1 and 2 (25 mice EA group) for pharmacodynamic studies (time course) and Group 3 (10 mice) for drug efficacy study. Tumor size was measured every third day in two dimensions using calipers, and tumor volume was calculated using the formula V = 0.5 a × b2, where a and b are the long and short diameter of the tumor respectively. When tumors were ~250 mm3 (~three-four weeks after injection), mice were treated with 0.15 mg/kg of NPI-0052 (IV) or vehicle control. Proteasome inhibition was assessed after either single NPI-0052 treatment (given at Day1) or three treatments (given at Day1, Day4 and Day8). Mice were euthanized at 10 mins, 1h, 4h, and 24h; and packed whole blood (PWB), liver, spleen, lung, kidney, brain and tumors were analyzed for chymotrypsin-like (CT-L), Caspase-like (C-L), and Trypsin-like (T-L) proteasome activities. For efficacy studies mice were treated with NPI-0052 twice a week for three weeks. Mice were sacrificed when their tumors reached ~1.5 cm3. NPI-0052 was dissolved in 100% DMSO to generate a 10 mg/ml stock solution, aliquoted, and stored frozen at − 80°C. The stock solution was serially diluted with 100% DMSO and for injection with 5% Solutol (Solutol HS, polyethylene glycol 660, 12 hydroxystearate; BASF, Shreveport, LA) yielding a final concentration of 2% DMSO and 98% (5% Solutol). The vehicle control was 2% DMSO and 98% (5% Solutol). The pH of the dosing solutions is between 6–7. Results: Inhibition of all three proteasome activities after a single treatment of NPI-0052 was detectable as early as 10 mins in the liver, lung, spleen, kidney and PWB; Within 24h after either a single or three IV treatments of NPI-0052, proteasome activity recovered in liver, lung, spleen and kidney, but not in tumor or PWB; No significant proteasome inhibition was noted in brain up to 24h after either a single or three IV treatments with NPI-0052; CT-L activity was inhibited within 1h post first dose, and 24h exposure triggered marked inhibition of CT-L, C-L and T-L activities in vivo in the xenografted MM.1S tumors. For example, in 1h CT-L activity was inhibited 34%, T-L activity 6% and C-L activity 16%. After 24h hours, CT-L activity was inhibited 60%, T-L activity 24% and C-L activity 49%; and finally, 6) Inhibition of CT-L, C-L and T-L activities increased in the tumor after the third NPI-0052 treatment compared to the first treatment. For example, at 1h post third dose all three activities were inhibited approximately 70–80%. Additionally, the anti-MM activity of NPI-0052 was associated with significant proteasome inhibition in tumors (P < 0.005). Conclusions: Our findings show that NPI-0052 induces a prolonged inhibition (>24h) of all three-20S proteasome activities in established MM.1S tumor xenografts which correlated with marked anti-tumor activity. In contrast, proteasome inhibition in normal tissues including liver, spleen, kidney and lung markedly recovered within 24h of administration after a single or three treatments with NPI-0052. In addition, no significant inhibition of proteasome activities was detectable in the brain after either treatment schedule.
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Kannan, Sneha, Boon‐Keng Kevin Teo, Timothy Solberg, and Christine Hill‐Kayser. "Organ motion in pediatric high‐risk neuroblastoma patients using four‐dimensional computed tomography." Journal of Applied Clinical Medical Physics 18, no. 1 (2016): 107–14. http://dx.doi.org/10.1002/acm2.12012.
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AbstractPurpose/objective(s)High‐risk neuroblastoma (HR‐NBL) requires multimodality treatment, including external beam radiation of the primary tumor site following resection. Radiotherapy planning must take into account motion of the target and adjacent normal anatomy, both of which are poorly understood in the pediatric population, and which may differ significantly from those in adults.Methods/materialsWe examined 4DCT scans of 15 consecutive pediatric patients treated for HR‐NBL, most with tumors in the abdominal cavity. The diaphragm and organs at risk were contoured at full inhale, full exhale, and on free‐breathing scans. Maximum displacement of organs between full inhale and full exhale was measured in the anterior, posterior, superior, inferior, left, and right directions, as was displacement of centroids in the A/P, S/I, and L/R axes. Contours on free‐breathing scans were compared to those on 4D scans.ResultsMaximum displacement was along the S/I axis, with the superior aspects of organs moving more than the inferior, implying organ compression with respiration. Liver and spleen exhibited the largest motion, which correlated strongly with the S/I motion of the diaphragm. The maximum organ motion observed in the abdomen and thorax were 4.5 mm and 7.4 mm, respectively, while maximum diaphragm displacement was 5.7 mm. Overall findings mirrored observations in adults, but with smaller magnitudes, as expected. No consistent margins could be added to the free‐breathing scans to encompass the motion determined using 4DCT.ConclusionsOrgan motion within the pediatric abdomen and pelvis is similar to that observed in adults, but with smaller magnitude. Precise margins to accommodate motion are patient‐specific, underscoring the need for 4DCT scanning when possible.
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Perepelitsa, S. A., G. E. Bakhalova, Yu A. Sharapova, and G. M. Sharapova. "Ultrasound evaluation of fetal spleen dimensions." Voprosy ginekologii, akušerstva i perinatologii 21, no. 4 (2022): 15–20. http://dx.doi.org/10.20953/1726-1678-2022-4-15-20.
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Objective. To examine the ultrasonic morphometric parameters of fetal spleen at 23–40 weeks’ gestation. Patients and methods. This study included 75 patients with complicated pregnancy. Morphometric measurements of spleen dimensions (length, width, and thickness) were additionally performed during a standard fetal ultrasound. The data obtained were used to calculate spleen weight and spleen mass coefficient (SMC). Results. SMC ranging from 1.5 to 4 indicates the absence of spleen enlargement, SMC greater than 4 indicates splenomegaly and less than 1.5 – microsplenia. Splenomegaly was detected in 48% of the fetuses. Conclusion. The aim of prenatal ultrasound is the earliest possible diagnosis of splenomegaly as a marker of fetal immune response to a probable inflammatory or infectious process. Key words: spleen mass coefficient, newborns, spleen, splenomegaly, ultrasound
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Sidhu, Shabnam, Sanjeev Kumar Uppal, and Swaran Singh Randhawa. "Diagnostic utility of echocardiography and ultrasonography in buffaloes suffering from pericarditis." Buffalo Bulletin 43, no. 2 (2024): 155–71. http://dx.doi.org/10.56825/bufbu.2024.4324779.
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Pericarditis remains a serious problem faced by bovine producers in the developing countries. This study was designed to evaluate the echocardiographic and ultrasonographic changes in dairy buffaloes affected with pericarditis presented to Large Animal Clinic, Teaching Veterinary Hospital of Guru Angad Dev Veterinary and Animal Sciences University (GADVASU), Ludhiana, India. 49 buffaloes were included and selected on the basis one or more of the clinical signs viz., brisket edema, dyspnoea, muffled heart sounds and distended jugular veins. Animals were subjected to clinical examination, thoracic and abdominal ultrasonography and M- mode echocardiography. The CVS examination revealed normal intensity of heart sounds in 17 and muffled in 32 cases with splashing/pericardial rub in 9 cases. Ultrasonography revealed spleenic congestion, liver was congested in majority of the cases with visible dilatation of the caudal vena cava. Heart was normal in 7 and visibly compressed in 42 cases due to the pericardial fluid. Massive pleural fluid was seen in 28 cases. Buffaloes in our study had pericardial effusions (n=49), pleural and pericardial effusions (n=45) and pleural, pericardial and peritoneal effusions (n=19). The predominant echocardiographic findings were significantly decreased dimensions of the heart chambers in both systole and diastole. The left ventricular contractility indices (FS% and EF%) were significantly high. The clinical findings alone do not allow a definitive diagnosis of pericarditis as characteristic signs were not present in all the cases. The combined use of ultrasonography and echocardiography provides a comprehensive idea about such cases and aids in early diagnosis of pericarditis.
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Gopal, Ajay K., Oliver W. Press, Jonathan R. Fromm, Shani Wilbur, and John M. Pagel. "I-131-Anti-CD45 Radioimmunotherapy Effectively Targets and Treats T-Cell Non-Hodgkin’s Lymphoma." Blood 112, no. 11 (2008): 880. http://dx.doi.org/10.1182/blood.v112.11.880.880.
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Abstract T-cell non-Hodgkin lymphoma (T-NHL) exhibits inferior remission durations and survival rates compared to B-cell NHL. This may be at least partially due to the paucity of targeted therapies and the absence of approved radioimmunoconjugates available for T-NHL. The CD45 antigen is expressed on ~90% of T-NHL and is not readily internalized or shed, making it an appealing target for radioimmunotherapy (RIT). In order to test this hypothesis, we first demonstrated that CD45 was expressed in high copy numbers on the surface of human T-NHL samples and T-NHL cell lines with a median of 3.4×105 CD45 molecules/cell on T-NHL lines (CCRF-CEM, Karpas 299) and 2.25×105 CD45 molecules/cell on patient derived T-NHL specimens (T-LBL, CTCL, NK/T-NHL). We employed an athymic murine xenograft model with the above human T-NHL lines to show that targeting human CD45 could deliver more radioactivity to tumor nodules than to normal tissues. Mice with palpable human T-NHL xenografts were injected with 131I-labeled BC8 (a murine anti-human CD45 antibody [Ab]) and an 125I-labeled murine isotype matched nonbonding control Ab (BHV1). CCRF-CEM xenografts targeted with 131I-BC8 demonstrated 86% (p=.003) and 106% (p=.001) more radioiodine retention at 24h and 48h, respectively, compared to xenografts targeted with the control BHV1 Ab. More importantly, tumor sites exhibited 1.6 (p=.045), 2.4 (p=.008), and 2.7 (p=.007)-fold 131I retention compared to the lungs, liver, and kidneys, respectively (CCRF-CEM, 24h). Similar results were observed at later time points and with other T-NHL lines. We next hypothesized that this preferential tumor targeting would translate into improved tumor control and survival using therapeutic doses of 131I-BC8. Mice with palpable T-NHL xenografts (CCRF-CEM) were randomly assigned to receive 200μg of BC8 labeled with either 300 or 400μCi of 131I, 200μg of BHV-1 (control) labeled with 300μCi 131I, or no treatment. Tumor dimensions and survival were tracked. By day 9, complete remissions (CR) were attained in 90% of mice treated with 400 μCi of 131I-BC8 and 67% of mice that received 300 μCi of 131I-BC8 (Figure). In contrast, none of the untreated control mice or mice that received 300 μCi of 131I-BHV-1 achieved CR (p<0.0001). All 20 mice in the 2 control groups required euthanasia due to tumor growth, whereas only 4 of 20 of the mice in experimental arms needed to be sacrificed due to disease progression and unmaintained remissions persisted for over 72 days following therapy. Since CD45 is also expressed on most normal hematopoietic tissues, we evaluated the ability of anti-CD45 RIT to preferentially localize to tumor and hematolymphoid sites in a syngeneic model targeting murine CD45. Mice with palpable EL-4 (murine T-NHL) xenografts were treated with 200 μg of 131I-30F11 (anti-murine CD45) followed by harvest of tumor sites and normal organs. In this syngeneic model, the ratios of retained radioactivity in tumor sites to critical non-target sites were: lung 5.3 (p<.001), liver 5.4 (p<.001), and kidney 8.7 (p<.001). Comparable ratios were seen when other target sites (marrow, spleen) were compared to normal non-target organs. These data indicate that CD45 is highly expressed on T-NHL, allows reliable antibody targeting of tumor sites in both xenogeneic and syngeneic models, and translates into significantly improved control of T-NHL xenografts. These results support the hypothesis that CD45-targed RIT transplant conditioning regimens may improve outcomes for patients with relapsed/refractory T-NHL. Figure: Tumor volumes of T-NHL xenografts after treatment with 131I-BC8 (anti-CD45), 131I-BHV1 (control), or no-treatment. Figure:. Tumor volumes of T-NHL xenografts after treatment with 131I-BC8 (anti-CD45), 131I-BHV1 (control), or no-treatment.
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D. Srivani, P. Sofia, and J. Jayachandra Pillai. "A Study on Morphometric Dimensions of Human Fetal Spleen at Different Gestational Ages." Academia Anatomica International 6, no. 1 (2020): 10–14. http://dx.doi.org/10.21276/aanat.2020.6.1.3.
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Introduction:The spleen is the largest hemolymphatic organ of the human body that plays a significant role in Hematopoiesis and immune phagocytosis. Recent studies have emphasized the importance of spleen as hematopoietic organ in fetal period, role in synthesis of immunoglobulins & defense of human body against infections. A thorough knowledge of splenic morphometry and dimensions is vital in comprehending the development of spleen in fetal period.Aim:The aim of the study is to study detailed morphometric analysis human fetal splenic specimens of various gestational ages and compare the findings with earlier studiesSubjects and Methods:The present study included 40 fetal cadaveric spleen and morphometric features i.e.,length, breadth, width and weight of spleen were measured.Results:The average weight of the fetal spleen was 1.98 gm and varied from 0.1 to 5.1 gm. The average length, breadth and width of spleen in prenatal group were 2.21 cm, 1.39 cm and 0.645 cm respectively. In the present study the average weight of the fetal spleen was 1.98 gm and varied from 0.1 to 5.1 gm. There was statistically significant increase in splenic weight till 33 weeks.Conclusion:Knowledge of spleen size at different gestational ages will help in early detection and diagnosis of splenic anomalies, identifying congenital malformations, early diagnosis and prompt treatment of intrauterine infections.
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van Krieken, J. H. J. M., and J. te Velde. "Normal Histology of the Human Spleen." American Journal of Surgical Pathology 12, no. 10 (1988): 777–85. http://dx.doi.org/10.1097/00000478-198810000-00007.
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Maymon, Ron, Ariel L. Zimerman, Simon Strauss, and Gabriela Gayer. "Maternal Spleen Size Throughout Normal Pregnancy." Seminars in Ultrasound, CT and MRI 28, no. 1 (2007): 64–66. http://dx.doi.org/10.1053/j.sult.2006.10.005.
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Sprogøe-Jakobsen, Susan, and Ulrik Sprogøe-Jakobsen. "The weight of the normal spleen." Forensic Science International 88, no. 3 (1997): 215–23. http://dx.doi.org/10.1016/s0379-0738(97)00103-5.
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Choudhury, A. K. "Spontaneous rupture of a normal spleen." Injury 35, no. 3 (2004): 325–26. http://dx.doi.org/10.1016/s0020-1383(03)00238-9.
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Rodrigues, Aldo Junqueira, Consuelo Junqueira Rodrigues, Marco Antonio Germano, Irineu Rasera, and Giovanni Guido Cerri. "Sonographic assessment of normal spleen volume." Clinical Anatomy 8, no. 4 (1995): 252–55. http://dx.doi.org/10.1002/ca.980080403.
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Paulvannan, S., and JK Pye. "SPONTANEOUS RUPTURE OF A NORMAL SPLEEN." International Journal of Clinical Practice 57, no. 3 (2003): 245–46. http://dx.doi.org/10.1111/j.1742-1241.2003.tb10474.x.
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Li, Youjian, Xuefeng Qiu, Weijian Li, Hongqian Guo, and Xiaogong Li. "Diagnostic challenge for giant left retroperitoneal accessory spleen: a case report." Journal of International Medical Research 48, no. 2 (2019): 030006051987589. http://dx.doi.org/10.1177/0300060519875898.
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An accessory spleen refers to single or multiple splenic tissues that appear outside the normal spleen position and have structures and functions similar to those of a normal spleen. We herein present a rare case of a 31-year-old woman who was hospitalized because of a 14-year history of sudden left upper abdominal pain after running. Abdominal computed tomography suggested a large soft tissue mass at the left renal hilum surrounded by several enlarged lymph nodes, which was totally different from computed tomography scanning of normal accessory spleen. The mass was resected by robot-assisted laparoscopic surgery. Histopathological examination confirmed the diagnosis of accessory spleen. The incidence of retroperitoneal accessory spleen is very rare, which should be differentiated with retroperitoneal tumors.
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Aladwan, Khaled M., Mohammad A. Abualoush, Hudaib N. Sawalha, Ahmad Y. Mheidat, and Anas M. Wardat. "Torted Wondering Spleen." Scholars Journal of Medical Case Reports 11, no. 03 (2023): 344–47. http://dx.doi.org/10.36347/sjmcr.2023.v11i03.024.
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Background: Wandering spleen was first mentioned by Van Horne in 1667. Wandering spleen (floating, ectopic, ptotic, hypermobile or splenoptosis) may float anchored only by its vascular pedicle with no hooking to the nearby structuresand it is induced by the lengthening of the spleen’s holding ligaments. Although it is rare (less than 0.2%) but it affects mostly children and female adults of active reproductive age. It features as a mass in the abdomen without clinical signs or with intermittent abdominal discomfort due to torsion and spontaneous detorsion of the spleen. Case Report: A 34-year-old male presented to the emergency department with complaints of abdominal pain, distension of the abdomen and vomiting with constipation for two days. There was no past history of any surgery. On general examination, patient was afebrile (temperature of 37°c), pulse rate of 80 bpm and blood pressure of 110/70 mmHg. An abdominal examination revealed mild abdominal distension with mild diffuse abdominal tenderness and guarding. A tender lump sizing 10 × 9 cm with smooth surface, well defined margins and firm consistency was found. Digital rectal examination was normal. Laboratory parameters showed hemoglobin 14.5 gm/dl and white blood cells 12000/mm3. The platelet count was normal. Ultrasonography (USG) showed a solid mass and the absence of the spleen from its normal location. A computed tomography (CT) scan of the abdomen showed large torted spleen at mid abdomen with partial or no enhancement of splenic shape mass on contrast-enhanced CT scan and the patient was scheduled for an exploratory laparotomy for surgical acute abdomen. During laparotomy, a mass measuring 11 × 9 × 3 cm and weighing approximately 280 g was found. The mass was identified as the spleen by visualizing its notch and the absence of the spleen from its normal position. All splenic ligamentous attachments were completely absent. The spleen was found to be partly infarcted due to twisting of the spleen .....
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Karen, Ntanisian, Olga Soboleva, Olga Sorkina, Suren Karagyulyan, and Valeri G. Savchenko. "Place of Splenectomy (SE) in the Treatment of Immune Thrombocytopenic Purpura (ITP)." Blood 124, no. 21 (2014): 5010. http://dx.doi.org/10.1182/blood.v124.21.5010.5010.
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Abstract Introduction Proposed in 1916 by Shlofferom Katznelson, splenectomy has been widely used since then in the treatment of immune thrombocytopenic purpura. ITP seems to be the most common indication for SE. According to the available literature up to 50-80% of laparoscopic SEs are being performed in patients with ITP, in our Centre - up to 20%. Laparoscopic SE should be considered as the treatment of choice for recurrent thrombocytopenic purpura after the initial response to steroid therapy. Indications for SE include all forms of immune thrombocytopenic purpura, requiring repeated courses of hormone therapy, as well as the cases of developed life-threatening complications, as for example intracranial hemorrhage. Earlier indications for splenectomy included lack of the hormone replacement therapy effect for 6 months. The dimensions of the spleen in patients with ITP are usually within normal or slightly increased limits. Thus these patients may get all the benefits of minimally invasive surgery. Goal: 1. to assess the results of the SE in the treatment of ITP 2. to clarify its place in the treatment of ITP. 3. to investigate the influence of the multiple lines drug therapy on the efficiency of SE in patients with ITP. Materials and Methods 87 SE have been performed in patients with ITP in 2008 – 2013, among them 63 female, 24 male. Median age 28 years old. Duration of the disease before surgery was from one month to 51 years, in 69 patients - over 6 months. 62 patients (71.3%) before SE received only corticosteroids. 25 (28.7%) received besides corticosteroids: 14 - GCS + immunoglobulin 5 - GCS + rituximab 7 - GCS + romiplostim 3 - GCS + cyclosporine 1 - GCS + eltrombopag 1 - GCS + azathioprine Results and Discussion Average duration of the laparoscopic SE was 109 min (from 50 to 250 min), on the average 100 min with the mean blood loss of 300 ml (median 200 ml). In 20 patients intraoperative blood loss was negligible, in 14 – over 500 ml. In patients treated with only corticosteroids blood loss over 500 ml was in 16%, in pretreated- in 20%. Intraoperative complications (5.7%): • pneumothorax-1 • intraoperative bleeding led to conversion-2 • acute respiratory failure-1 • bleeding from the bed of the spleen, stopped by conservative measures-1 Postoperative complications occurred in 13,8% (n = 12): •patients treated with corticosteroids 11.3% •patients receiving multiple lines of therapy - 24%. •thrombotic complications (3.4%) •portal vein thrombosis 1 •tibial vein thrombosis 1 •ischemic stroke 1 •pneumonia 8 (9%) •intestinal bleeding-1 (1.1%) In 13 (14.9%) patients, operated on with thrombocytopenia < 20x109/l, average blood loss was 320 ml (100-1200 ml). The operation was complicated in 2 patients by intraoperative bleeding required conversion. One patient in the postoperative period developed acute adrenal failure, pneumonia, septic shock. In 49 (56.3%) patients, operated on with thrombocytopenia 20-100x109/l, mean blood loss was 240 ml (0-1100 ml). Postoperative complications developed in 7 (14%) of them (1 portal vein thrombosis, acute respiratory failure 1, pneumonia 5). In 26 (29.8%) patients, operated on with the platelet count of more than 100x10, average blood loss was 370 ml (0-2000 ml). One intraoperative complication - injury to the diaphragm. Postoperative complications (1 bleeding, pneumothorax, 1, 1 pneumonia, thrombosis of the saphenous veins of the lower extremities 1) developed in 4 (15%) pts. In 69 patients with the duration of the disease over 6 months the efficiency of SE was 84%. In 17 patients with the duration of the disease less than 6 months - 70.6%. In patients treated with corticosteroids, efficiency of SE was estimated as 85.5% In pretreated - 60%. Nonefficient SEs were observed in 10 pts. In 10 patients the platelets count after SE remained <20x109/l Administration of romiplostim (n = 7) led to an increase of the platelets count up to 60-80 x 109/l in 7 patients (100%) in the first week after surgery Conclusion • SE results in a full or partial response in 79.6% of patients with ITP • Optimal time for SE is 6 - 12 months after the onset of the disease • Risk of complications of the procedure increases with the delay of SE • A history of multiple lines of drug therapy reduces the efficiency of SE in ITP from 79.6% to 60.0%. Disclosures No relevant conflicts of interest to declare.