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Ivashkevich D, Ponomarenko A, Manzhulo I, Sultanov R, Dyuizen I. Effect of Oleoylethanolamide-Based Dietary Supplement on Systemic Inflammation in the Development of Alimentary-Induced Obesity in Mice. Nutrients 2023; 15:4345. [PMID: 37892420 PMCID: PMC10609781 DOI: 10.3390/nu15204345] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Revised: 10/06/2023] [Accepted: 10/10/2023] [Indexed: 10/29/2023] Open
Abstract
The complex effect of oleoylethanolamide-based dietary supplement (OEA-DS) was studied in a model of diet-induced obesity in mice. Physiological, biochemical, and immunohistochemical methods were used to reveal differences in the changes in the weight of experimental animals, morphological changes in the spleen tissues, and changes in the cytokine expression profile in the spleen, blood plasma, and macrophage cell culture. First, it is shown that a hypercaloric diet high in carbohydrates and cholesterol led to the development of systemic inflammation, accompanied by organ morphological changes and increased production of proinflammatory cytokines. In parallel, the use of OEA-DS reduced the intensity of cellular inflammatory reactions, accompanied by a decrease in markers of cellular inflammation and proliferation, such as CD68, Iba-1, and Ki67 in the spleen tissue, and stabilized the level of proinflammatory cytokines (IL-1β, IL-6, TNFα) both in animals and in cell culture. In addition, in the macrophage cell culture (RAW264.7), it was shown that OEA-DS also suppressed the production of reactive oxygen species and nitrites in LPS-induced inflammation. The results of this study indicate the complex action of OEA-DS in obesity, which includes a reduction of systemic inflammation.
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Affiliation(s)
| | - Arina Ponomarenko
- A.V. Zhirmunsky National Scientific Center of Marine Biology, Far Eastern Branch, Russian Academy of Sciences, 690041 Vladivostok, Russia; (D.I.); (I.M.); (R.S.); (I.D.)
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2
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Choi G, Kim KA, Lee J, Park YS, Lee J, Choi JW, Lee CH. Ultrasonographic atlas of splenic lesions. Ultrasonography 2022; 41:416-429. [PMID: 35045593 PMCID: PMC8942726 DOI: 10.14366/usg.21189] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Accepted: 12/02/2021] [Indexed: 11/03/2022] Open
Abstract
Ultrasonography (US) is widely used for abdominal imaging. Its noninvasiveness, extensive range of application, and low cost make US a useful and valuable tool for the detection, diagnosis, and follow-up of splenic abnormalities. Concomitantly with the increasing frequency of imaging, more splenic lesions are being discovered and the requirements for the differential diagnosis are rising. In this pictorial essay, we introduce the representative US findings of many different splenic lesions, including normal sonographic findings, normal variants and congenital anomalies, infectious conditions, benign and malignant neoplasms, and non-neoplastic lesions. Knowledge of the US features of various splenic lesions will help narrow the differential diagnosis and guide clinical decision-making.
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Affiliation(s)
- Gayoung Choi
- Department of Radiology, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea.,Department of Radiology, Korea University Ansan Hospital, Korea University College of Medicine, Ansan, Korea
| | - Kyeong Ah Kim
- Department of Radiology, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea
| | - Jinhwan Lee
- Department of Pathology, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea
| | - Yang Shin Park
- Department of Radiology, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea
| | - Jongmee Lee
- Department of Radiology, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea
| | - Jae Woong Choi
- Department of Radiology, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea
| | - Chang-Hee Lee
- Department of Radiology, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea
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Demissie S, Mergu P, Hailu T, Abebe G, Warsa M, Fikadu T. Morphometric assessment of spleen dimensions and its determinants among individuals living in Arba Minch town, southern Ethiopia. BMC Med Imaging 2021; 21:186. [PMID: 34863114 PMCID: PMC8642847 DOI: 10.1186/s12880-021-00719-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2021] [Accepted: 11/19/2021] [Indexed: 12/01/2022] Open
Abstract
Introduction The spleen is a vital lymphoid soft organ that demands constant attention from the clinical point of view. It is a multi-dimensional organ that enlarges in its all dimensions during some disease condition. The detection of the spleen by palpation is not an indicator of an enlarged spleen because normal spleen may be palpable. Therefore, this study aimed to assess the morphometry of spleen dimensions and its determinants among individuals living in Arba Minch town by sonographic examinations. Methods and materials Community-based cross-sectional study was conducted in Arba Minch town from February 1 to March 30, 2020. Seven hundred and eight study participants were selected using a multi-stage systematic random sampling technique. Data were checked for completeness, edited, coded and entered into Epi-Data version 3.1 and exported to STATA software version 16 for analysis. Result The mean splenic length, width, thickness and volume were 10.24 cm, 4.79 cm, 3.93 cm, and 109.34 cm3, respectively. The mean spleen length, width, thickness and volumes among males were 10.64 cm, 4.92 cm, 4.05 cm and 119.81 cm3 and among females were 9.75 cm, 4.63 cm, 3.78 cm and 96.50 cm3 respectively. As age increased by one year the mean spleen length, width, thickness and volume was decreased by 0.032 cm, 0.018 cm 0.004 cm and 0.012 cm respectively. As height increased by 1 cm the mean spleen width and volume were increased by 0.096 cm and 0.052 cm respectively. As we go from male to female the mean spleen length decreased by 0.294 cm. Conclusion The spleen dimensions were higher in males than females. Splenic length was determined by age & sex, the spleen width was determined by age & height, the spleen volume was determined by age & height and the spleen thickness was determined by age.
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Affiliation(s)
- Solomon Demissie
- Department of Clinical Anatomy, College of Medicine and Health Science, Arba Minch University, Arba Minch, Ethiopia.
| | - Prasad Mergu
- Department of Anatomy, MNR Medical College and Hospital, Sagerddy, Telangana, India
| | - Tadiwos Hailu
- Department of Internal Medicine, College of Medicine and Health Science, Arba Minch University, Arba Minch, Ethiopia
| | - Getachew Abebe
- Department of Clinical Anatomy, College of Medicine and Health Science, Arba Minch University, Arba Minch, Ethiopia
| | - Mengistu Warsa
- Department of Medicine, Arba Minch General Hospital, Arba Minch, Ethiopia
| | - Teshale Fikadu
- Department of Public Health and Epidemiology, College of Medicine and Health Science, Arba Minch University, Arba Minch, Ethiopia
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Saad AM, Abdel-Megied AES, Elbaz RA, Hassab El-Nabi SE, Elshazli RM. Genetic variants of APEX1 p.Asp148Glu and XRCC1 p.Gln399Arg with the susceptibility of hepatocellular carcinoma. J Med Virol 2021; 93:6278-6291. [PMID: 34289138 DOI: 10.1002/jmv.27217] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2021] [Accepted: 07/17/2021] [Indexed: 12/30/2022]
Abstract
The DNA repair genes have a crucial function in the base excision repair (BER) mechanism among different cancerous disorders, particularly hepatocellular carcinoma (HCC). The foremost objective of this study is to explore the association of genetic variants of the APEX1 p.Asp148Glu and the XRCC1 p.Gln399Arg with the susceptibility of HCC and to identify the computational bioinformatics frameworks of these missense variants. A total of 250 participants were enrolled in this study, including 150 HCC patients and 100 cancer-free controls. The genomic DNA was characterized and genotyped by applying the PCR-CTPP method. The frequency of the APEX1 (rs1130409*Glu) allele was statistically significant with increased risk of HCC (OR = 1.66, 95% CI = 1.12-2.45), while the XRCC1 (rs25487*Gln) allele conferred a protection against the progression of HCC (OR = 0.64, 95% CI = 0.42-0.96). Furthermore, HCC patients carrying the APEX1 p.Asp148Glu and the XRCC1 p.Gln399Arg variants indicated no significant difference with the clinical, and laboratory parameters (p > .05). Our findings confirmed that the APEX1 p.Asp148Glu variant was associated with increased risk of HCC, while the XRCC1 p.Gln399Arg variant revealed protection against the development of HCC.
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Affiliation(s)
- Ahmad M Saad
- Biochemistry Section, Department of Chemistry, Faculty of Science, Menoufia University, Menoufia, Egypt
| | | | - Rizk A Elbaz
- Genetic Unit, Children Hospital, Mansoura University, Mansoura, Egypt
| | | | - Rami M Elshazli
- Biochemistry and Molecular Genetics Unit, Department of Basic Sciences, Faculty of Physical Therapy, Horus University-Egypt, New Damietta, Egypt
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Safai Zadeh E, Dietrich CF, Görg C, Bleyl T, Alhyari A, Ignee A, Jenssen C, Trenker C. [Spleen biopsy: "pros and cons" or better "when and when not?"]. ZEITSCHRIFT FUR GASTROENTEROLOGIE 2021; 59:879-885. [PMID: 33752245 DOI: 10.1055/a-1404-3926] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Due to the relatively high complication rate, the necessity of a spleen biopsy is controversially discussed. In establishing its indication, the clinical background and performed diagnostics must be considered. Based on the medical history, imaging procedures and sonographic course, different clinical scenarios are conceivable. The aim of this review is to describe the indications of splenic biopsy considering various clinical scenarios.
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Affiliation(s)
- Ehsan Safai Zadeh
- Interdisziplinäres Ultraschallzentrum, UKGM Marburg und Philipps-Universität Marburg
| | - Christoph F Dietrich
- Department Allgemeine Innere Medizin (DAIM), Kliniken Hirslanden Bern, Beau Site, Salem und Permanence, Bern, Schweiz
| | - Christian Görg
- Interdisziplinäres Ultraschallzentrum, UKGM Marburg und Philipps-Universität Marburg
| | - Tobias Bleyl
- Klinik für Gastroenterologie, Endokrinologie, Stoffwechsel und klinische Infektiologie, UKGM Marburg und Philipps-Universität Marburg
| | - Amjad Alhyari
- Klinik für Gastroenterologie, Endokrinologie, Stoffwechsel und klinische Infektiologie, UKGM Marburg und Philipps-Universität Marburg
| | - Andre Ignee
- Department für Innere Medizin, Caritas Hospital, Bad Mergentheim, Germany
| | - Christian Jenssen
- Department für Innere Medizin, Krankenhaus Märkisch Oderland, Strausberg/Wriezen, Brandenburg Institute for Clinical Ultrasound at Medical Universitäy Brandenburg, Neuruppin, Germany
| | - Corinna Trenker
- Klinik für Hämatologie, Onkologie und Immunologie, UKGM Marburg und Philipps-Universität Marburg
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Yalçın K, Demir BÇ. Spleen stiffness measurement by shear wave elastography using acoustic radiation force impulse in predicting the etiology of splenomegaly. Abdom Radiol (NY) 2021; 46:609-615. [PMID: 32770399 DOI: 10.1007/s00261-020-02649-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2020] [Revised: 07/01/2020] [Accepted: 07/09/2020] [Indexed: 12/28/2022]
Abstract
PURPOSE To measure spleen stiffness by shear wave elastography (SWE) using acoustic radiation force impulse (ARFI) in patients with splenomegaly and to evaluate utility of elastography technique in identifying etiology of splenomegaly. METHODS Sixty-one treatment-naïve patients with splenomegaly were enrolled. The control group consisted of 20 healthy subjects without history of any disease including diabetes and hypertension, alcohol consumption, or biochemical or ultrasonographic findings indicating hepatic and renal diseases. B-mode ultrasonography and elastographic examinations were performed by a radiologist blinded to the participants. Spleen stiffness was measured by SWE using ARFI. Shear wave velocity (SWV) values were given in m/s. RESULTS Splenomegaly patients were assigned into three groups according to their etiologies as hepatoportal (n = 21), myeloproliferative (n = 23), and infectious (n = 17). Splenomegaly groups and control group were comparable regarding age and sex. Spleen size was higher in the splenomegaly groups than in the controls. Median SWV was significantly higher in the hepatoportal (3.85 m/s) and myeloproliferative (3.42 m/s) groups than in the infectious (2.66 m/s) and control (2.22 m/s) groups. The correlation between SWV and spleen size was not significant in any of the groups. The cut-off value was 3.42 (sensitivity 80.9%, specificity 56.5%) in distinguishing hepatoportal from myeloproliferative etiology; 3.02 (sensitivity 100%, specificity 100%) in distinguishing hepatoportal from infectious etiology; and 2.84 (sensitivity 91.3%, specificity 88.2%) in distinguishing myeloproliferative from infectious etiology. CONCLUSION Spleen stiffness measured by elastographic techniques in splenomegaly patients was higher than that in healthy subjects. SWV appeared to be beneficial in predicting the etiology of splenomegaly.
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Affiliation(s)
- Kadihan Yalçın
- Radiology Department, Başkent University İstanbul Altunizade Training and Research Hospital, Başkent Üniversitesi, Altunizade, Üsküdar, Istanbul, Turkey.
| | - Bilge Çakar Demir
- Radiology Department, Başkent University İstanbul Altunizade Training and Research Hospital, Başkent Üniversitesi, Altunizade, Üsküdar, Istanbul, Turkey
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Mohtasib RS, Alshamiri K, Jobeir A, Ambu-Saidi FM, Masawi A, Alabdulaziz L, Hussain FB. Sonographic measurements for spleen size in healthy Saudi children and correlation with body parameters. Ann Saudi Med 2021; 41:14-23. [PMID: 33550908 PMCID: PMC7868621 DOI: 10.5144/0256-4947.2021.14] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
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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Affiliation(s)
- Rafat S Mohtasib
- From the Biomedical Physics, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
| | - Kamal Alshamiri
- From the Department of Radiology, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
| | - Aman Jobeir
- From the Biomedical Physics, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
| | - Farida Mohsin Ambu-Saidi
- From the Department of Radiology, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
| | - Ahmed Masawi
- From the Biomedical Physics, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
| | - Lamya Alabdulaziz
- From the Department of Radiology, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
| | - Faisal Bin Hussain
- From the Department of Radiology, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
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Garnitschnig L, Weinzirl J, Andrae L, Scheffers T, Ostermann T, Heusser P. Postprandial dynamics of splenic volume in healthy volunteers. Physiol Rep 2020; 8:e14319. [PMID: 31981412 PMCID: PMC6981305 DOI: 10.14814/phy2.14319] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023] Open
Abstract
Throughout the history of medicine, many functions have been attributed to the spleen and numerous researchers have focused on a postulated digestive function. Beginning in 1825, systematic animal studies showed evidence for a postprandial increase in splenic volume (SV) with a peak 30 min to five hours after food intake. Since the introduction of imaging techniques, two studies have been conducted on humans, revealing a decrease in SV 30 to 45 min postprandially. The aim of this study was to examine possible postprandial changes in SV over a period of seven hours. The ethics-approved, randomized crossover study included 10 healthy volunteers, who received a standardized meal (3,600 kJ) on one study day and fasted on the other. Sonographic measurements were obtained at six measurement points on each day. Thirty minutes after the meal, SV increased significantly by 38.2 ± 51.2 cm3 (17.3%; p = .04) compared to the baseline measurement and decreased gradually afterward. In males, SV 30 min after the meal was 70.2 ± 21.6 cm3 higher (p = .002) compared to the fasting condition and 60 min later it was still significantly increased. The apparent SV increase after food intake is discussed in relation to hemodynamic changes in the splanchnic region. It seems plausible that the spleen has a rhythmic and regulative function within the portal system, something which warrants further research and should be taken more into account in nutritional physiology.
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Affiliation(s)
- Lydia Garnitschnig
- Institute for Integrative MedicineFaculty of HealthWitten/Herdecke UniversityHerdeckeGermany
| | - Johannes Weinzirl
- Institute for Integrative MedicineFaculty of HealthWitten/Herdecke UniversityHerdeckeGermany
| | - Lukas Andrae
- Department of Internal MedicineCommunity Hospital HerdeckeHerdeckeGermany
| | - Tom Scheffers
- Institute for Integrative MedicineFaculty of HealthWitten/Herdecke UniversityHerdeckeGermany
| | - Thomas Ostermann
- Institute for Integrative MedicineFaculty of HealthWitten/Herdecke UniversityHerdeckeGermany
| | - Peter Heusser
- Institute for Integrative MedicineFaculty of HealthWitten/Herdecke UniversityHerdeckeGermany
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9
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Cristancho Torres L, Granada Camacho JC. Ecografía en cirugía general. REVISTA COLOMBIANA DE CIRUGÍA 2019. [DOI: 10.30944/20117582.517] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
La ecografía es un estudio de imágenes diagnósticas con una amplia historia de uso en todas las especialidades de la Medicina; su advenimiento ha ayudado al enfoque diagnóstico e, incluso, al abordaje terapéutico de los pacientes.
Desde su origen en el siglo XIX con mediciones de la velocidad del sonido en el agua, hasta el desarrollo de las máquinas de ultrasonografía sustentadas en los avances de la tecnología, la física y la ingeniería, se ha utilizado de manera notable en la Medicina.
No hay duda de que, en el campo de la Cirugía General, ha sido útil para el manejo de los pacientes con enfermedad abdominal. La tecnología ecográfica permite identificar las características de un órgano normal y, cuando este patrón se afecta, orienta sobre la causa o determina la enfermedad que puede estar produciendo la alteración.
En la presente revisión, se hace un recuento histórico del nacimiento de la ecografía, su aplicación en el campo de la medicina y su utilidad para el cirujano general en diversas circunstancias de la práctica quirúrgica.
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Tarantino G, Citro V, Conforti P, Balsano C, Capone D. Is There a Link between Basal Metabolic Rate, Spleen Volume and Hepatic Growth Factor Levels in Patients with Obesity-Related NAFLD? J Clin Med 2019; 8:jcm8101510. [PMID: 31547124 PMCID: PMC6832562 DOI: 10.3390/jcm8101510] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2019] [Revised: 09/10/2019] [Accepted: 09/16/2019] [Indexed: 01/30/2023] Open
Abstract
Background: Recent pieces of research point to a link between basal metabolic rate (BMR) and non-alcoholic fatty liver disease (NAFLD) or hepatic steatosis (HS). The spleen in obese patients is associated with the cardiovascular system. Enlargement of the spleen is suggestive of nonalcoholic steatohepatitis (NASH). Patients with NASH present an increase in growth factor (HGF) as well as those with advanced heart failure. Interleukin-16 and interleukin-12p40 levels were found to correlate significantly with BMI, and waist circumference. Aim: We tried to find a relationship between BMR, spleen length and HGF. Methods: We analysed retrospective data from 80 obese patients with NAFLD. We evaluated indices of indirect calorimetry by the bioimpendance analysis; carotid intima-media thickness (IMT), spleen length (SLD) and HS by ultrasonography; serum HGF, IL-16, IL-12p40 and IL-6 concentrations by a magnetic bead-based multiplex immunoassays and the severity of NAFLD by BARD score > 2. Results: HGF levels of the obese were higher than those of controls, p < 0.001. At linear regression, BMR was foreseen by spleen length (p < 0.001), which was predicted by HGF (p = 0.04). BMR was predicted by IL-16 (p = 0.005), which predicted HGF, p = 0.034. Only fat mass, among other factors, predicted early atherosclerosis, p = 0.017; IL-12p40 did not predict IMT, HGF and BMR (p = 0.57, 0.09 and 0.59, respectively). The BARD score > 2 was negatively predicted by BMR and FFM (p =0.032 and 0.031, respectively), at the logistic regression. Interesting findings at the extended regression (mediation effect) were: IL-16 was likely causal in predicting BMR by HGF levels; HGF was influential in predicting BMR by SLD level. HS was predicted by SLD in males (p = 0.014), of advanced age (p < 0.001) and by BMR (p < 0.001). IL-6 concentrations, but not BMR were influential in the prediction of HS by SLD. Conclusion: These data reinforce the concept that the immune system is a sensor of the metabolic state, showing a link between HGF levels and BMR, which is mediated by IL-16 (cytokine inducing a cascade of inflammatory factors), and ascertaining the influential effect of the spleen, as main immune organ.
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Affiliation(s)
- Giovanni Tarantino
- Department of Clinical Medicine and Surgery, Federico II University Medical School of Naples, 80131 Napoli NA, Italy.
| | - Vincenzo Citro
- Department of General Medicine, "Umberto I" Hospital, Nocera Inferiore (Sa), 84014 Nocera Inferiore SA, Italy.
| | - Paolo Conforti
- "Federico II" University Medical School of Naples, 80131 Napoli NA, Italy.
| | - Clara Balsano
- Department of Clinical Medicine, Life, Health & Environmental Sciences-MESVA, University of L'Aquila, 67100 L'Aquila AQ, Italy.
| | - Domenico Capone
- Care Department of Public Health and Drug-Use, Section of Medical Pharmacology and Toxicology, "Federico II" University, 80131 Naples NA, Italy.
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11
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Indiran V, Kokilavani J. Bright band sign. Abdom Radiol (NY) 2019; 44:1613-1614. [PMID: 30341584 DOI: 10.1007/s00261-018-1806-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Venkatraman Indiran
- Department of Radiodiagnosis, Sree Balaji Medical College and Hospital, 7 Works Road, Chromepet, Chennai, Tamilnadu, 600044, India.
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12
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Focal spleen lesions in visceral leishmaniasis, a neglected manifestation of a neglected disease: report of three cases and systematic review of literature. Infection 2019; 47:507-518. [PMID: 30771194 DOI: 10.1007/s15010-019-01279-5] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2018] [Accepted: 02/05/2019] [Indexed: 02/07/2023]
Abstract
BACKGROUND The Mediterranean area is endemic for the zoonotic form of visceral leishmaniasis (VL) caused by Leishmania infantum, a species which has been recently associated with unexpected epidemiological and clinical features. METHOD We report the result of a systematic review of the literature on VL unusually presenting with spleen focal lesions, including three previously unpublished cases. RESULTS A total of 28 cases of VL with multiple spleen focal lesions were retrieved. Twenty-six (93%) were acquired in the Mediterranean area, where L. infantum is endemic. Thirteen cases were diagnosed in children, and the remaining 15 cases in middle-aged adults, of whom 9 were immunosuppressed. Four patients (14%) underwent diagnostic splenectomy, while the diagnosis was confirmed by less invasive techniques in the remaining patients. The most common radiological patterns were: multiple subcentimetric or centimetric spleen lesions (size ≤ 1 cm in 14 of 19 cases, 74%), hypoechoic at ultrasonography (25 of 26 cases, 99%) and hypodense at CT scan (9 of 10 cases, 90%). PET-CT (available for four patients) showed an intense FDG spleen uptake. MRI and contrast-enhanced ultrasonography, available for two and one cases each, showed complex patterns. CONCLUSIONS VL must be added to the list of possible differential diagnosis of spleen focal lesions and health care provider awareness about this condition will avoid unnecessary invasive diagnostic procedures.
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13
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Farr C, Thoirs K. The sonographic measurement of the spleen: A clinical audit. SONOGRAPHY 2018. [DOI: 10.1002/sono.12165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Affiliation(s)
- Christina Farr
- Main Ultrasound, Department of Radiology; Royal Prince Alfred Hospital; New South Wales Australia
| | - Kerry Thoirs
- International Centre for Allied Health Research; University of South Australia; South Australia Australia
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14
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Pelizzo G, Guazzotti M, Klersy C, Nakib G, Costanzo F, Andreatta E, Bassotti G, Calcaterra V. Spleen size evaluation in children: Time to define splenomegaly for pediatric surgeons and pediatricians. PLoS One 2018; 13:e0202741. [PMID: 30138410 PMCID: PMC6107197 DOI: 10.1371/journal.pone.0202741] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2017] [Accepted: 08/08/2018] [Indexed: 01/14/2023] Open
Abstract
Background We determined the range of normal spleen dimensions evaluated by ultrasonography (US) in children according to sex and age and the relationship between splenic measurements, auxological data and body proportions, in order to define splenomegaly parameters in support of the surgical mini-invasive approaches in pediatrics. Methods We prospectively examined 317 caucasian children of both sexes. The patients were divided into three groups: 0–3 years; 4–10 years; 11–18 years. Sex, weight, height/length, body mass index (BMI), waist circumference and xipho-pubic distance were determined for each child. US spleen evaluation included longitudinal/antero-posterior/transverse diameters, transverse area and volume. Spleen volume/abdominal volume, longitudinal spleen diameter/longitudinal left kidney diameter and longitudinal spleen diameter/xipho-pubic distance ratios were also calculated. Results For caucasian subjects, in different age groups spleen volume, transverse area and diameter increased while the spleen/abdominal volume ratio decreased significantly (p<0.001). A significant (p<0.001) decrease in longitudinal spleen diameter/xipho-pubic distance ratio was noted between the 0–3 years group and both 4–10 and 11–18 years group. Age and auxological data, except BMI, showed a high correlation with spleen dimension (r≥0.8). Conclusions The current concept of splenomegaly is not applicable in pediatric surgery. A dedicated classification of splenomegaly is needed for children and would improve the safety and feasibility of treatment.
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Affiliation(s)
- Gloria Pelizzo
- Pediatric Surgery Unit, Children's Hospital, Istituto Mediterraneo di Eccellenza Pediatrica, Palermo, Italy
| | - Marinella Guazzotti
- Pediatric Surgery Unit, Department of the Mother and Child Health, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Catherine Klersy
- Biometry & Clinical Epidemiology, Scientific Direction, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Ghassan Nakib
- Department of Paediatric Surgery, Medclinic Middle East, Mediclinic City Hospital, Dubai, United Arab Emirates
| | - Federico Costanzo
- Pediatric Surgery Unit, Department of the Mother and Child Health, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Erika Andreatta
- Pediatric Surgery Unit, Department of the Mother and Child Health, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Gabrio Bassotti
- Gastroenterology Section, Department of Medicine, University of Perugia Medical School, Perugia, Italy
| | - Valeria Calcaterra
- Pediatric Unit, Department of the Mother and Child Health Fondazione IRCCS Policlinico San Matteo and Department of Internal Medicine University of Pavia, Pavia, Italy
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Walsh JJ, Tschakovsky ME. Exercise and circulating BDNF: Mechanisms of release and implications for the design of exercise interventions. Appl Physiol Nutr Metab 2018; 43:1095-1104. [PMID: 29775542 DOI: 10.1139/apnm-2018-0192] [Citation(s) in RCA: 135] [Impact Index Per Article: 22.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Engagement in regular bouts of exercise confers numerous positive effects on brain health across the lifespan. Acute bouts of exercise transiently improve cognitive function, while long-term exercise training stimulates brain plasticity, improves brain function, and helps to stave off neurological disease. The action of brain-derived neurotrophic factor (BDNF) is a candidate mechanism underlying these exercise-induced benefits and is the subject of considerable attention in the exercise-brain health literature. It is well established that acute exercise increases circulating levels of BDNF and numerous studies have sought to characterize this response for the purpose of improving brain health. Despite the interest in BDNF responses to exercise, little focus has been given to understanding the sources and mechanisms that underlie this response for the purpose of deliberately increasing circulating levels of BDNF. Here we review evidence to support that exploiting these mechanisms of BDNF release can help to optimize brain plasticity outcomes via exercise interventions, which could be especially relevant in the context of multimodal training (i.e., exercise and cognitive stimulation). Therefore, the purpose of this paper is to review the candidate sources of BDNF during exercise and the mechanisms of release. As well, we discuss strategies for maximizing BDNF responses to exercise, and propose novel research directions for advancing our understanding of these mechanisms.
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Affiliation(s)
- Jeremy J Walsh
- a Children's Hospital of Eastern Ontario Research Institute, Ottawa, ON K1H 8L1, Canada
| | - Michael E Tschakovsky
- b School of Kinesiology and Health Studies, Queen's University, Kingston, ON K7L 3N6, Canada
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16
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Ali HM. Bilobed spleen: an extremely rare imaging finding. BJR Case Rep 2017; 3:20170021. [PMID: 30363262 PMCID: PMC6159183 DOI: 10.1259/bjrcr.20170021] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2017] [Revised: 06/07/2017] [Accepted: 06/12/2017] [Indexed: 11/16/2022] Open
Abstract
The spleen has a wide range of congenital anomalies regarding its shape, location, number and size. Unsuspected splenic congenital anomalies are commonly depicted on sonography orCT and sometimes pose a diagnostic dilemma for the radiologists and clinicians. The bilobed spleen is an extremely rarely encountered condition. It is most commonly detected during abdominal surgeries. The bilobed spleen is usually bigger in size than the normal spleen, so it is more predisposed to trauma. In this case report, we have presented a case of the bilobed spleen, which was incidentally suspected during abdominal ultrasonography of an 11-year-old girl complained of recurrent left hypochondrium pain. The bilobed configuration is confirmed with CT examination of the abdomen.
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Quantified kidney echogenicity in mice with renal ischemia reperfusion injury: evaluation as a noninvasive biomarker of acute kidney injury. Med Mol Morphol 2017; 50:161-169. [DOI: 10.1007/s00795-017-0157-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2017] [Accepted: 03/11/2017] [Indexed: 01/07/2023]
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Saddekni S, Moustafa AS, Tahoon HA, Setita M, Abdel-Aal AK. Treatment of Hypersplenism by Partial Splenic Embolization Through Gastric Collaterals. J Radiol Case Rep 2016; 10:28-35. [PMID: 27200164 PMCID: PMC4861616 DOI: 10.3941/jrcr.v10i3.2581] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
We report a case of Chronic lymphocytic leukemia (CLL) with associated hypersplenism, that was referred to us for partial splenic embolization (PSE) as the patient was not a surgical candidate for splenectomy. Initially, we were not successful in catheterizing the splenic artery from the celiac trunk due to significant atherosclerotic disease. Therefore, we successfully managed to access the distal splenic artery through patent gastro-epiploic collateral circulation along the greater curvature of the stomach. Partial splenic embolization was successfully performed and resulted in improvement of the patient's peripheral blood cell count as well as 60-70% reduction in the size of the spleen on follow up. Our case highlights an alternative pathway for splenic artery embolization when catheterization of the splenic artery is not feasible. To our knowledge, the use of gastro-epiploic collaterals to embolize the spleen has not been previously reported in literature.
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Affiliation(s)
- Souheil Saddekni
- Department of Radiology, University of Alabama at Birmingham (UAB), Birmingham, Alabama, USA
| | - Amr Soliman Moustafa
- Department of Radiology, University of Alabama at Birmingham (UAB), Birmingham, Alabama, USA
- Department of Radiology, Zagazig University, Zagazig, Egypt
| | - Hany A Tahoon
- Department of Radiology, University of Alabama at Birmingham (UAB), Birmingham, Alabama, USA
| | - Mostafa Setita
- Department of Radiology, University of Alabama at Birmingham (UAB), Birmingham, Alabama, USA
| | - Ahmed Kamel Abdel-Aal
- Department of Radiology, University of Alabama at Birmingham (UAB), Birmingham, Alabama, USA
- Department of Radiology, University of Cairo, Cairo, Egypt
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Hemophagocytic Lymphohistiocytosis Complicating Dengue and Plasmodium vivax Coinfection. Case Rep Med 2015; 2015:696842. [PMID: 26504465 PMCID: PMC4609418 DOI: 10.1155/2015/696842] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2015] [Revised: 07/26/2015] [Accepted: 08/05/2015] [Indexed: 02/05/2023] Open
Abstract
Hemophagocytic lymphohistiocytosis (HLH) is a rare disorder. Dysfunction of cytotoxic T and natural killer (NK) cells causes uncontrolled activity of lymphocytes and histiocytes which leads to HLH. Infections, malignancies, and autoimmune disorders are associated with development of HLH. Dengue and Plasmodium vivax are rare causes of HLH. We report the first ever case of a young man who developed fatal HLH that complicated Dengue Hemorrhagic Fever (DHF) and Plasmodium vivax infection.
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Olson APJ, Trappey B, Wagner M, Newman M, Nixon LJ, Schnobrich D. Point-of-care ultrasonography improves the diagnosis of splenomegaly in hospitalized patients. Crit Ultrasound J 2015; 7:13. [PMID: 26383010 PMCID: PMC4574040 DOI: 10.1186/s13089-015-0030-8] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2015] [Accepted: 08/17/2015] [Indexed: 12/19/2022] Open
Abstract
Background It is important to detect splenomegaly as it can have important diagnostic implications. Previous studies, however, have shown that the traditional physical examination is limited in its ability to rule in or rule out splenomegaly. Objective To determine if performing point-of-care ultrasonography (POCUS) in addition to the traditional physical examination improves the sensitivity and specificity for diagnosing splenomegaly. Methods This was a prospective trial of diagnostic accuracy. Physical and sonographic examinations for splenomegaly were performed by students, residents and attending physicians enrolled in an ultrasound training course. Participants received less than 1 h training for ultrasound diagnosis of splenomegaly. The findings were compared to radiographic interpretation of gold standard studies. Setting/patients Hospitalized adult patients at an academic medical center without severe abdominal pain or recent surgery who had abdominal CT, MRI or ultrasound performed within previous 48 h. Results Thirty-nine subjects were enrolled. Five patients had splenomegaly (12.5 %). The physical examination for splenomegaly had a sensitivity of 40 % (95 % CI 12–77 %) and specificity of 88 % (95 % CI 74–95 %) while physical examination plus POCUS had a sensitivity of 100 % (95 % CI 57–100 %) and specificity of 74 % (95 % CI 57–85 %). Physical examination alone for splenomegaly had an LR+ of 3.4 (95 % CI 0.83–14) and LR− of 0.68 (95 % CI 0.33–1.41); for physical exam plus POCUS the LR+ was 3.8 (2.16–6.62) and LR− was 0. Conclusions Point-of-care ultrasonography significantly improves examiners’ sensitivity in diagnosing splenomegaly.
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Affiliation(s)
- Andrew P J Olson
- Department of Medicine, University of Minnesota Medical School, 420 Delaware St, MMC 741, Minneapolis, MN, 55455, USA. .,Department of Pediatrics, University of Minnesota Medical School, Minneapolis, MN, USA.
| | - Bernard Trappey
- Department of Medicine, University of Minnesota Medical School, 420 Delaware St, MMC 741, Minneapolis, MN, 55455, USA. .,Department of Pediatrics, University of Minnesota Medical School, Minneapolis, MN, USA.
| | - Michael Wagner
- Department of Medicine, Weill Cornell Medical College, New York, NY, USA.
| | - Michael Newman
- Department of Medicine, University of Minnesota Medical School, 420 Delaware St, MMC 741, Minneapolis, MN, 55455, USA. .,Minneapolis VA Medical Center, Minneapolis, MN, USA.
| | - L James Nixon
- Department of Medicine, University of Minnesota Medical School, 420 Delaware St, MMC 741, Minneapolis, MN, 55455, USA. .,Department of Pediatrics, University of Minnesota Medical School, Minneapolis, MN, USA.
| | - Daniel Schnobrich
- Department of Medicine, University of Minnesota Medical School, 420 Delaware St, MMC 741, Minneapolis, MN, 55455, USA. .,Department of Pediatrics, University of Minnesota Medical School, Minneapolis, MN, USA.
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Bassuner KJ, Kirkpatrick DL, Northrup M, Connors JP. Multiple Targetoid Lesions in the Spleen. JOURNAL OF DIAGNOSTIC MEDICAL SONOGRAPHY 2015. [DOI: 10.1177/8756479315572228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Chronic lymphocytic leukemia (CLL) is the most prevalent hematologic malignancy of adults in the western hemisphere. Involvement of the spleen is not uncommon, often presenting as diffuse enlargement due to infiltration of neoplastic cells. A case is presented of an 81-year-old woman with a past medical history of CLL who was incidentally found to have multiple, focal splenic infiltrates on sonography. The patient had a normal sized spleen, which is a less common occurrence with splenic invasion by CLL. As current CLL guidelines discourage imaging but rely on evidence of organ involvement, this finding was critical in staging the patient properly. The sonographic appearance of this rare condition is described, and the advantages of sonography in its evaluation are discussed.
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22
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Balaban DV, Popp A, Lungu AM, Costache RS, Anca IA, Jinga M. Ratio of spleen diameter to red blood cell distribution width: a novel indicator for celiac disease. Medicine (Baltimore) 2015; 94:e726. [PMID: 25881851 PMCID: PMC4602504 DOI: 10.1097/md.0000000000000726] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
Celiac disease (CD) is currently considerably underdiagnosed, setting the need for developing tools to select patients with probability of CD, who warrant further testing. Red blood cell distribution width (RDW) has been shown in previous studies to be a sensitive predictor for CD, but it lacks specificity. Splenic hypotrophy is also noted frequently in celiac patients. Our aim was to evaluate if spleen diameter to RDW ratio can be used as an indicator for CD. We evaluated 15 newly diagnosed CD patients, 52 patients with inflammatory bowel disease, and 35 patients with irritable bowel syndrome (IBS). We evaluated the differences in spleen diameter, RDW, and their ratio among the four groups. Two-thirds of the CD patients had elevated RDW, compared to 9% in the IBS group. A small spleen was seen in 80% of the celiacs, compared to 21.9% in the ulcerative colitis group, 10% in the Crohn disease group, and 9% in the IBS group. A spleen diameter to RDW ratio under 6 had a sensitivity of 73.3% and specificity of 88.5% in predicting CD, with an AUROC of 0.737. Spleen diameter to RDW ratio is a simple, widely available score, which can be used to select adult patients with probability of CD.
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Affiliation(s)
- Daniel Vasile Balaban
- From the "Dr Carol Davila" Central Military Emergency University Hospital (BDV, LAM, CRS, JM); "Carol Davila" University of Medicine and Pharmacy (BDV, PA, CRS, AIA, JM); "Alfred Rusescu" Institute for Mother and Child Care (PA, AIA), Bucharest, Romania; and Tampere Center for Child Health Research (PA), University of Tampere and Tampere University Hospital, Finland
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Rafailidis V, Apostolou D, Kaitartzis C, Rafailidis D. Ultrasonography of the healing process during a 3-month follow-up after a splenic injury. Ultrasonography 2015; 34:226-30. [PMID: 25623053 PMCID: PMC4484285 DOI: 10.14366/usg.14057] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2014] [Revised: 12/29/2014] [Accepted: 12/30/2014] [Indexed: 11/22/2022] Open
Abstract
We present a 14-year-old boy with a grade III splenic injury due to a bicycle accident, who was treated conservatively. The boy’s medical history included splenomegaly due to thalassemia. The splenic lesion was initially investigated with computed tomography (CT) and then, was followed by ultrasonography for 3 months. CT revealed a large intraparenchymal hematoma which appeared hyperechoic on ultrasonography. During follow-up, the hematoma developed a more complex echogenicity and became gradually hypoechoic. The hematoma increased in size during the first week but then, started decreasing until it eventually resolved completely. The patient had an uneventful full recovery. In this report, we discuss the ultrasonographic changes of the hematoma throughout the healing process.
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Affiliation(s)
- Vasileios Rafailidis
- Postgraduate Programme in Medical Research Methodology, Aristotle University of Thessaloniki, Thessaloniki, Greece
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24
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Zha Y, Zhou M, Hari A, Jacobsen B, Mitragotri N, Rivas B, Ventura OG, Boughton J, Fox JC. Ultrasound diagnosis of malaria: examination of the spleen, liver, and optic nerve sheath diameter. World J Emerg Med 2015; 6:10-5. [PMID: 25802560 PMCID: PMC4369524 DOI: 10.5847/wjem.j.1920-8642.2015.01.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2014] [Accepted: 11/28/2014] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Over 90% of all cases of malaria worldwide occur in Africa. Current methods of diagnosis are time and labor intensive, and could lead to delayed treatment. METHODS In this study we investigated the effectiveness of measurements of spleen, liver, and optic nerve sheath diameter (ONSD) in identifying patients with malaria or severe malaria through the use of hand-held ultrasound devices. We recruited 40 adult patients with malaria and 16 adult control subjects at two hospitals in Mwanza, Tanzania. Ultrasonographic diagnosis was compared with rapid antigen diagnostic test and peripheral blood smear as the gold standards. An receiver operating characteristic curve test was performed to determine the most optimal diagnostic threshold for malaria and severe malaria, using each of the measurements for liver size, spleen size, and ONSD. The thresholds were determined to be >12 cm for spleen length and >15.1 cm for liver length, whereas ONSD was not significant in this study. RESULTS The sensitivities for malaria diagnosis were 66.7% and 58.3% for liver and spleen length respectively, suggesting that these measurements may not be suitable for identifying patients with severe malaria. However, the high specificity of 90.9% for spleen length and the acceptable specificity of 75.0% for liver length suggest that these measurements can be used as a method to eliminate false-positive diagnoses (i.e. patients who do not have severe malaria but are classified as having it by a test with a high sensitivity), giving a high positive predictive value. CONCLUSIONS We report a high specificity for spleen size and a moderate specificity for liver size in the ultrasonographic diagnosis of severe malaria. Thus when paired with a highly sensitive method of malaria diagnosis, ultrasonographic measurement of spleen and liver size is promising as part of a diagnostic algorithm for malaria. It could be used to stratify risk in patients diagnosed with malaria and assist in their triage. If no sensitive tests are available, ultrasound might be useful to suggest malaria as a cause of a patient's constellation of clinical symptoms.
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Affiliation(s)
- Yuanting Zha
- Irvine School of Medicine, University of California, 1001 Health Sciences Road, 252 Irvine Hall, Irvine, CA 92697, USA
| | - Michelle Zhou
- Irvine School of Medicine, University of California, 1001 Health Sciences Road, 252 Irvine Hall, Irvine, CA 92697, USA
| | - Anjali Hari
- Irvine School of Medicine, University of California, 1001 Health Sciences Road, 252 Irvine Hall, Irvine, CA 92697, USA
| | - Bradley Jacobsen
- Irvine School of Medicine, University of California, 1001 Health Sciences Road, 252 Irvine Hall, Irvine, CA 92697, USA
| | - Neha Mitragotri
- Irvine School of Medicine, University of California, 1001 Health Sciences Road, 252 Irvine Hall, Irvine, CA 92697, USA
| | - Bianca Rivas
- Irvine School of Medicine, University of California, 1001 Health Sciences Road, 252 Irvine Hall, Irvine, CA 92697, USA
| | - Olga Gabriela Ventura
- Irvine School of Medicine, University of California, 1001 Health Sciences Road, 252 Irvine Hall, Irvine, CA 92697, USA
| | - Janice Boughton
- Gritman Medical Center, 700 S Main Street, Moscow, ID, 83843, USA
| | - John Christian Fox
- Irvine School of Medicine, University of California, 1001 Health Sciences Road, 252 Irvine Hall, Irvine, CA 92697, USA
- Department of Emergency Medicine, Irvine Medical Center, University of California, 101 The City Drive, Orange, CA, 92868, USA
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Koskela SM, Laine OK, Paakkala AS, Mäkelä SM, Mustonen JT. Spleen enlargement is a common finding in acute Puumala hantavirus infection and it does not associate with thrombocytopenia. ACTA ACUST UNITED AC 2014; 46:723-6. [DOI: 10.3109/00365548.2014.930967] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Lee M, Roberts JM, Chen L, Chang S, Hatala R, Eva KW, Meneilly GS. Estimation of spleen size with hand-carried ultrasound. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2014; 33:1225-1230. [PMID: 24958409 DOI: 10.7863/ultra.33.7.1225] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
OBJECTIVES Physical examination can identify palpable splenomegaly easily, but evaluating lesser degrees of splenomegaly is problematic. Hand-carried ultrasound allows rapid bedside assessment of patients. We conducted this study to determine whether hand-carried ultrasound can reliably assess spleen size. METHODS Patients with varying degrees of splenomegaly were studied. Two sonographers blindly measured spleen size in each patient using either a hand-carried or conventional ultrasound device in random order. Sonographers completed a data sheet indicating the adequacy of the image, clinical measurements of enlargement, and confidence in their observations. RESULTS Sixteen patients (10 male and 6 female; mean age ± SEM, 60 ± 4 years) were recruited. Image quality was adequate or better in all scans with conventional ultrasound and in 15 of 16 scans with hand-carried ultrasound. The greatest longitudinal measurement recorded was statistically equivalent across ultrasound techniques, with mean values of 16.4 cm (95% confidence interval, 14.8-18.0 cm) for conventional ultrasound and 15.8 cm (95% confidence interval, 14.1-17.4 cm) for hand-carried ultrasound. The correlation between measurement techniques was r = 0.89 (P < .0001). Sonographers were somewhat or very confident in the outcomes of all scans with conventional ultrasound and in 15 of 16 cases with hand-carried ultrasound. In general, it took longer for sonographers to obtain images with hand-carried ultrasound. CONCLUSIONS We have shown that hand-carried ultrasound can be used at the point of care by trained individuals to diagnose splenomegaly. However, hand-carried ultrasound images were less likely to be judged excellent, were accompanied by less diagnostic certainty, and took longer to obtain.
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Affiliation(s)
- Mitchell Lee
- Departments of Medicine (M.L., J.M.R., L.C., R.H., K.W.E, G.S.M.) and Radiology (S.C.) and Center for Health Education Scholarship (R.H., K.W.E.), Vancouver Hospital and University of British Columbia, Vancouver, British Columbia, Canada
| | - J Mark Roberts
- Departments of Medicine (M.L., J.M.R., L.C., R.H., K.W.E, G.S.M.) and Radiology (S.C.) and Center for Health Education Scholarship (R.H., K.W.E.), Vancouver Hospital and University of British Columbia, Vancouver, British Columbia, Canada
| | - Luke Chen
- Departments of Medicine (M.L., J.M.R., L.C., R.H., K.W.E, G.S.M.) and Radiology (S.C.) and Center for Health Education Scholarship (R.H., K.W.E.), Vancouver Hospital and University of British Columbia, Vancouver, British Columbia, Canada
| | - Silvia Chang
- Departments of Medicine (M.L., J.M.R., L.C., R.H., K.W.E, G.S.M.) and Radiology (S.C.) and Center for Health Education Scholarship (R.H., K.W.E.), Vancouver Hospital and University of British Columbia, Vancouver, British Columbia, Canada
| | - Rose Hatala
- Departments of Medicine (M.L., J.M.R., L.C., R.H., K.W.E, G.S.M.) and Radiology (S.C.) and Center for Health Education Scholarship (R.H., K.W.E.), Vancouver Hospital and University of British Columbia, Vancouver, British Columbia, Canada
| | - Kevin W Eva
- Departments of Medicine (M.L., J.M.R., L.C., R.H., K.W.E, G.S.M.) and Radiology (S.C.) and Center for Health Education Scholarship (R.H., K.W.E.), Vancouver Hospital and University of British Columbia, Vancouver, British Columbia, Canada
| | - Graydon S Meneilly
- Departments of Medicine (M.L., J.M.R., L.C., R.H., K.W.E, G.S.M.) and Radiology (S.C.) and Center for Health Education Scholarship (R.H., K.W.E.), Vancouver Hospital and University of British Columbia, Vancouver, British Columbia, Canada.
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Llewellyn ME, Jeffrey RB, DiMaio MA, Olcott EW. The sonographic "bright band sign" of splenic infarction. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2014; 33:929-938. [PMID: 24866600 DOI: 10.7863/ultra.33.6.929] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
OBJECTIVES To evaluate the frequency of the "bright band sign" in patients with splenic infarcts as well as control patients and to thereby assess whether the bright band sign has potential utility as a sonographic sign of splenic infarction. METHODS Using an electronic search engine and image review, 37 patients were retrospectively identified with noncystic parenchymal splenic infarcts on sonography. Nineteen abnormal control patients with noninfarcted splenic lesions on sonography and 100 normal control patients with sonographically normal spleens were also identified. The sonographic appearance of each splenic lesion was evaluated by 2 reviewers and assessed for the bright band sign, defined as thin specular reflectors perpendicular to the sound beam within hypoechoic parenchymal lesions, and for the presence or absence of the classic sonographic appearance of splenic infarction. Possible histologic counterparts of the bright band sign were assessed in archival infarct specimens. RESULTS The bright band sign was present in 34 (91.9%; 95% confidence interval [CI], 78.1%-98.3%) of 37 patients with splenic infarcts on sonography, including 12 (85.7%; 95% CI, 57.2%-98.2%) of 14 with classic and 22 (95.7%; 95% CI, 78.1%-99.9%) of 23 with nonclassic infarct appearances. No normal or abnormal control patients had the bright band sign. Histologic sections suggested that preserved splenic trabeculae within infarcts may generate the bright band sign. CONCLUSIONS The bright band sign is a potentially useful sonographic sign of splenic infarction, which may confer additional sensitivity and specificity and may be particularly helpful with infarcts having nonclassic appearances.
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Affiliation(s)
- Michael E Llewellyn
- Departments of Radiology (M.E.L., R.B.J., E.W.O.) and Pathology (M.A.D.), Stanford University School of Medicine, Stanford, California USA; and Radiology Service, Veterans Affairs Palo Alto Health Care System, Palo Alto, California USA (E.W.O.)
| | - R Brooke Jeffrey
- Departments of Radiology (M.E.L., R.B.J., E.W.O.) and Pathology (M.A.D.), Stanford University School of Medicine, Stanford, California USA; and Radiology Service, Veterans Affairs Palo Alto Health Care System, Palo Alto, California USA (E.W.O.)
| | - Michael A DiMaio
- Departments of Radiology (M.E.L., R.B.J., E.W.O.) and Pathology (M.A.D.), Stanford University School of Medicine, Stanford, California USA; and Radiology Service, Veterans Affairs Palo Alto Health Care System, Palo Alto, California USA (E.W.O.)
| | - Eric W Olcott
- Departments of Radiology (M.E.L., R.B.J., E.W.O.) and Pathology (M.A.D.), Stanford University School of Medicine, Stanford, California USA; and Radiology Service, Veterans Affairs Palo Alto Health Care System, Palo Alto, California USA (E.W.O.)
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Li W, Liu G, Wang W, Wang Z, Huang Y, Xu Z, Xie X, Lu M. Real-time contrast enhanced ultrasound imaging of focal splenic lesions. Eur J Radiol 2014; 83:646-53. [PMID: 24529592 DOI: 10.1016/j.ejrad.2014.01.011] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2013] [Revised: 01/11/2014] [Accepted: 01/13/2014] [Indexed: 12/11/2022]
Abstract
OBJECTIVE To investigate the imaging features of focal splenic lesions (FSLs) on contrast-enhanced ultrasound (CEUS). METHODS Thirty two patients with FSLs proved by pathology were retrospectively analyzed. CEUS was performed using intravenous bolus injection of 2.4 ml sulfur hexafluoride-filled microbubble contrast agent and real time scanning. There were hemangioma (n=7), lymphoma (n=8), true cyst (n=3), infarction (n=4), hematolymphangioma (n=2), metastasis tumor (n=2), and one for each of the following entities extramedullary hemopoiesis, hamartoma, tuberculosis, Langerhans' cell histiocytosis, inflammatory pseudotumor and myxofibrosarcoma. RESULTS Among 21 benign lesions, 4 infarctions and 3 cysts presented non-enhancement throughout CEUS scanning, and the other 14 lesions displayed various enhancement levels with 6 (42.9%) hyper-enhancement, 2 (14.3%) iso-enhancement and 6 (42.9%) hypo-enhancement in arterial phase and 11 (78.6%) hypo-enhancement, 1 (7.1%) iso-enhancement and 2 (14.3%) hyper-enhancement in late phase, respectively. The enhancement pattern included 9 (64.3%) homogeneous, 4 (28.6%) heterogeneous and 1 (7.1%) rim-like enhancement. As for the malignant FSLs, all the lesions became completely or extensively hypo-enhancement during the late phase no matter their vascularity during arterial phase. CONCLUSIONS The CEUS features reported in this series may enrich the knowledge for CEUS characterization of FSLs.
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Affiliation(s)
- Wei Li
- Department of Medical Ultrasonics, The First Affiliated Hospital of Sun Yat-Sen University, Institute of Diagnostic and Interventional Ultrasound, Sun Yat-Sen University, Guangzhou, China
| | - Guangjian Liu
- Department of Medical Ultrasonics, The First Affiliated Hospital of Sun Yat-Sen University, Institute of Diagnostic and Interventional Ultrasound, Sun Yat-Sen University, Guangzhou, China.
| | - Wei Wang
- Department of Medical Ultrasonics, The First Affiliated Hospital of Sun Yat-Sen University, Institute of Diagnostic and Interventional Ultrasound, Sun Yat-Sen University, Guangzhou, China
| | - Zhu Wang
- Department of Medical Ultrasonics, The First Affiliated Hospital of Sun Yat-Sen University, Institute of Diagnostic and Interventional Ultrasound, Sun Yat-Sen University, Guangzhou, China
| | - Yang Huang
- Department of Medical Ultrasonics, The First Affiliated Hospital of Sun Yat-Sen University, Institute of Diagnostic and Interventional Ultrasound, Sun Yat-Sen University, Guangzhou, China
| | - ZuoFeng Xu
- Department of Medical Ultrasonics, The First Affiliated Hospital of Sun Yat-Sen University, Institute of Diagnostic and Interventional Ultrasound, Sun Yat-Sen University, Guangzhou, China
| | - XiaoYan Xie
- Department of Medical Ultrasonics, The First Affiliated Hospital of Sun Yat-Sen University, Institute of Diagnostic and Interventional Ultrasound, Sun Yat-Sen University, Guangzhou, China
| | - MingDe Lu
- Department of Medical Ultrasonics, The First Affiliated Hospital of Sun Yat-Sen University, Institute of Diagnostic and Interventional Ultrasound, Sun Yat-Sen University, Guangzhou, China; Department of Hepatobiliary Surgery, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China
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The spleen revisited: an overview on magnetic resonance imaging. Radiol Res Pract 2013; 2013:219297. [PMID: 24377046 PMCID: PMC3859258 DOI: 10.1155/2013/219297] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2013] [Revised: 10/08/2013] [Accepted: 10/10/2013] [Indexed: 12/26/2022] Open
Abstract
Despite being well visualized by different cross-sectional imaging techniques, the spleen is many times overlooked during the abdominal examination. The major reason is the low frequency of splenic abnormalities, the majority consisting of incidental findings. There has been a steady increase in the number of performed abdominal magnetic resonance imaging (MRI) studies; therefore, it is important to be familiar to the major MRI characteristics of disease processes involving the spleen, in order to interpret the findings correctly, reaching whenever possible the appropriate diagnosis. The spleen may be involved in several pathologic conditions like congenital diseases, trauma, inflammation, vascular disorders and hematologic disorders, benign and malignant tumors, and other disease processes that focally or diffusely affect the spleen. This paper presents a description and representative MRI images for many of these disorders.
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Approach to improving sonographic visualization of elongated left lobe of the liver and its implications. J Med Ultrason (2001) 2013; 40:425-8. [PMID: 27277456 DOI: 10.1007/s10396-013-0447-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2013] [Accepted: 03/26/2013] [Indexed: 10/26/2022]
Abstract
PURPOSE To determine whether visualization of the elongated left lobe of the liver can be improved by distending the stomach with water and the implications of this technique. METHODS Forty-three out of 87 patients with elongated left lobe of the liver found at abdominal CT were included in this study after obtaining informed consent. Their livers were examined using ultrasound before and after drinking water. The left lobe of the liver was scanned from the subxiphoid and left subcostal approaches, with the sound beam directed to the spleen and the left lobe of the liver neighboring or behind the stomach; the elongated left lobe of the liver overlying the spleen was detected by scanning from the 9th-11th intercostal approach of the left flank. RESULTS The overall visualization of the elongated left lobe of the liver before and after filling the stomach with water was 4.7 % (2/43) and 100.0 % (43/43), respectively (P < 0.001); and the overall visualization of the spleen before and after filling the stomach with water was 4.7 % (2/43) and 100.0 % (43/43), respectively (P < 0.001). CONCLUSION Distending the stomach with sufficient water can substantially improve visualization of elongated left lobe of the liver at ultrasound, potentially improving detection of tumors in the liver and preventing misdiagnosis.
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Raza Siddiqui T, Hassan N, Gul P. Effect of anthropometrical measurements on portal vein and hepatosplenic span. Pak J Med Sci 2013; 29:1077-80. [PMID: 24353693 PMCID: PMC3817760 DOI: 10.12669/pjms.294.3617] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2013] [Revised: 04/03/2013] [Accepted: 05/23/2013] [Indexed: 11/02/2022] Open
Affiliation(s)
- Tanya Raza Siddiqui
- Dr. Tanya Raza Siddiqui, MBBS, M. Phil Candidate, Senior Lecturer, Department of Anatomy, Ziauddin Hospital, Karachi, Pakistan
| | - Nuzhat Hassan
- Dr. Nuzhat Hassan, M.phil- Anatomy, Head of Department of Anatomy, Ziauddin Hospital, Karachi, Pakistan
| | - Pashmina Gul
- Dr. Pashmina Gul, FCPS, Assistant Professor, Department of Radiology, Ziauddin Hospital, Karachi, Pakistan
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Abstract
Ultrasound (US) imaging of the spleen was considered of little use in the past and was performed only to distinguish between cystic and solid lesions. However, in the last decade due to experience acquired and the introduction of second-generation contrast agents, this technique has been re-evaluated as contrast-enhanced US (CEUS) allows detection and characterization of most focal lesions of the spleen with a high sensitivity and a good specificity. Gray-scale US presents a low specificity in splenic infarctions with a high rate of false negative cases, whereas specificity reaches 100 %, if the examination is performed using US contrast agents. Gray-scale US can provide a correct diagnosis in simple cysts, whereas CEUS is useful when cystic lymphangioma is suspected. In the study of splenic lesions, the most important problem is to differentiate between angioma, hamartoma, lymphoma, and metastasis. CEUS reaches a good specificity in the differentiation of benign from malignant splenic lesions, as hypo-enhancement in the parenchymal phase is predictive of malignancy in 87 % of cases. In conclusion, Gray-scale US and particularly CEUS are at present widely indicated in the study of focal splenic lesions.
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Karakas E, Kann S, Höffken H, Bartsch DK, Celik I, Görg C, Pfestroff A. Does contrast-enhanced cervical ultrasonography improve preoperative localization results in patients with sporadic primary hyperparathyroidism? J Clin Imaging Sci 2012; 2:64. [PMID: 23230546 PMCID: PMC3515932 DOI: 10.4103/2156-7514.103054] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2012] [Accepted: 09/08/2012] [Indexed: 01/14/2023] Open
Abstract
OBJECTIVE Pre-operative localization studies are inevitable in patients with primary hyperparathyroidism (pHPT), who are eligible for focused or minimally invasive parathyroidectomy (MIP). High-resolution ultrasonography (US) in combination with planar (99m)Tc-Sestamibi-scintigraphy (MIBI) and additional single-photon emission computed tomography (SPECT) are the standard procedures to localize enlarged parathyroid glands. Our aim was to evaluate the practicability and significance of contrast-enhanced ultrasonography (CEUS) in patients with pHPT. MATERIALS AND METHODS All investigations were performed at the University Hospital Marburg. Totally, 25 patients with biochemical proven pHPT underwent preoperative US, MIBI/SPECT, and CEUS. For CEUS, a suspension of phospholipid-stabilized sulfur-hexafluoride (SF6) microbubbles in combination with a special 12 MHz linear US probe was used. All patients were investigated by two sonographers, who did not get to view the findings noted by the other. Finally, surgery was performed and histopathological results were obtained from 24 patients. RESULTS In 17 (68%) patients, US and MIBI/SPECT already raised suspicion of parathyroid lesions and all suspected lesions were reassessed by CEUS. However, no additional information was obtained using CEUS. Especially in eight patients with negative or inconsistent US and MIBI/SPECT results, CEUS did not provide additional information regarding the site of the suspected parathyroid adenoma. Overall, no side effects were observed using CEUS. Surgical cure was achieved in all patients. CONCLUSION In this limited cohort of patients, no additional information could be obtained using the costly CEUS compared to results of US and MIBI/SPECT.
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Affiliation(s)
- Elias Karakas
- Department of Visceral, Thoracic and Vascular Surgery, University Hospital Marburg, Germany
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Motyckova G, Steensma DP. Why does my patient have lymphadenopathy or splenomegaly? Hematol Oncol Clin North Am 2012; 26:395-408, ix. [PMID: 22463834 DOI: 10.1016/j.hoc.2012.02.005] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Lymph node or spleen enlargement may be innocent or the first sign of a serious disorder. Lymphadenopathy and splenomegaly can be found in symptomatic or asymptomatic patients. Lymph node enlargement in a single region or multiple sites can be seen in various diseases, including infections, noninfectious inflammatory conditions, or malignancies; a similar differential diagnosis applies to splenomegaly, but splenomegaly can also be caused by vascular abnormalities and hemolysis. Frequently, lymphadenopathy is detected incidentally during screening examinations or imaging procedures. This review focuses on causes of lymphadenopathy and splenomegaly and an appropriate diagnostic approach to patients with lymphadenopathy or splenomegaly.
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