[Littoral cell angioma]. / Dongasejtes angioma.

Splenic rupture secondary to blunt trauma is a common condition. Non-traumatic, also known as spontaneous or pathological splenic rupture is an uncommon, but potentially life-threatening condition. Spontaneous splenic rupture caused by a primary splenic tumor is rare. In this case study, we present a special, benign tumor causing splenic rupture. Our 78-year-old female patient was hospitalized due to left shoulder pain and chest discomfort. Her blood pressure was low, the laboratory tests showed anemia, and the chest CT scan involving also the upper abdomen raised the suspicion of a splenic rupture. During the emergency splenectomy, there was a large amount of blood in the abdominal cavity. Macroscopic pathological examination of the removed spleen showed multifocal cystic lesions that led to splenic rupture. Immunhistochemical analyses revealed a littoral cell angioma. Littoral cell angioma is a rare, benign vascular tumor of the spleen, which is thought to originate from the red pulp sinuses lined with littoral cells. The aim of our report is to describe an unusual cause of sudden splenic rupture without traumatic history, the histologically benign littoral cell angioma that has not been published in Hungary. Orv Hetil. 2023; 164(10): 393-397.

[Operative treatment of acute mesenteric ischaemia]. / Az acut mesenterialis ischaemia mutéti kezelése.

INTRODUCTION: The incidence of acute mesenteric ischemia (AMI) appears to be increasing due to aging in the population with increasing prevalence of comorbidities. Despite the wide-scale availability of diagnostic technologies, the timely detection and correct treatment are not ensured. This is due to the fact that the required CT angiography is not immediately performed and that vascular surgical reconstruction can be performed within the short ischemic tolerance window of the bowels amounting 4-6 hours. METHOD: In our case report, we retrospectively analysed the time of the operation after the onset of the complaint, the types of occlusions, the surgical interventions that could be performed and the progress of the disease. RESULTS: Case 1: In the case of superior mesenteric artery (SMA) emboli, without bowel necrosis and ischemia, embolectomy is the treatment. Case 2: In the case of complete superior mesenteric artery occlusion, proper bowel circulation will not restore despite the delayed arterial reconstruction, as a result, the patient will not survive. Case 3: In the case of incomplete SMA occlusion, even if the diagnosis is confirmed several days after the onset of complaints and the patient has an acute abdomen, extensive bowel necrosis will not evolve in every case. Case 4: Acute complete occlusion on chronic mesenteric ischemia. The bowels were found macroscopically healthy during the operation. We performed vascular reconstruction. CONCLUSION: Acute mesenteric ischemia is a rare disease, which is recognised and treated mostly late. A proportion of patients can be saved, if vascular reconstruction and bowel resection can be performed at the same time at the first operation.

[Raynaud's syndrome, 2011]. / Raynaud-szindróma, 2011.

Raynaud's phenomenon is characterized by intense vasospasm of the digital arteries on cold exposure or emotional stress, leading to well-defined colour changes in the skin of the fingers. Behind the clinical manifestations, there is an imbalance between vasoconstrictor and vasodilator factors. It may be primary or secondary to an underlying condition, including autoimmune diseases. Physical examination, nail fold capillaroscopy and immunological tests can differentiate primary forms from secondary ones. The treatment is based on preventing exposure to cold, emotional stress and the administration of certain drugs and, if attacks are present, vasodilators, prostaglandin analogues and anticoagulants may be given. This review focuses on the characteristics of Raynaud's phenomenon and the available diagnostic and therapeutic options.

Hemorheological consequences of hind limb ischemia-reperfusion differs in normal and gonadectomized male and female rats.

It is known that hemorheological parameters show gender differences that might be altered by gonadectomy (GoE). Since micro-rheological parameters (erythrocyte deformability and aggregation) sensitively change during and after ischemia-reperfusion (I/R), the question arises whether the hemorheological effects of I/R may show gender differences and further changes might be expected when GoE and I/R are additive. Sprague-Dawley rats were divided into six groups: Control males and females, I/R males and females with 1-hour hind limb ischemia, GoE + I//R males and females when 3 months after bilateral gonadectomy the I/R was induced. Before and just after ischemia, and on the 1st-3rd-5th-7th postoperative days blood samples were taken (lateral tail vein, 0.3-0.5 mL) for analyzing hematological parameters, erythrocyte's deformability (slit-flow ektacytometer) and aggregation (light-transmission aggregometer). Leukocyte and platelet counts raised markedly in gonadectomized animals during the investigated days. Hemorheological changes of I/R showed gender differences: significant impairment of erythrocyte deformability was found on the 1st-3rd postoperative days, expressed mostly in females. In gonadectomized females the postischemic deformability values were impaired. Erythrocyte aggregation index significantly raised by the 1st postoperative day, dominantly in males. It is suggested that gonadectomy may act as an additional rheological 'risk factor' related to blood micro-rheological parameters in ischemia-reperfusion.

Morphological, hemodynamical and hemorheological changes of mature artificial saphenous arterio-venous shunts in the rat model.

Artificial femoral arterio-venous (AV) shunts are widely used in rodent models for studying shunt maturation and to optimize various surgical techniques. However, little is known about complex circulatory, microcirculatory, and hemorheological effects of end-to-side saphenous AV shunts. We aimed to study these parameters in mature AV shunts. Studying these questions in CD rats, end-to-side anastomoses were made between the left saphenous artery and vein. On the right-side the nonoperated saphenous vessels served as own control. Furthermore healthy control animals were also investigated. On the 8th to 12th postoperative week microcirculatory and blood flow measurements were performed and blood samples were taken both from the shunt's arterial and venous limbs and from the nonoperated side vessels. Hematological parameters, erythrocyte aggregation, and deformability were determined. The entire shunt and the control vessels were removed for histological examinations. The skin microcirculation on shunt side slightly increased on thigh and decreased on paws versus the nonoperated side. Blood flow measurements made directly on the vessels showed that arterial to venous blood flow rate ratio was 1.59 ± 0.29 on nonoperated side and 1.2 ± 0.13 on the shunt side, and 1.49 ± 0.05 in control animals. Erythrocyte aggregation and deformability worsened on the shunt side. Histologically increased number of smooth muscle elements and connective tissue were found in venous limb of the shunts. The artificial AV shunt between the saphenous artery and vein seems to be a suitable model for further functional-morphological and hemorheological examinations of hemodialysis in various states and diseases.

Application of leukocyte antisedimentation rate calculation in investigation of spleen salvaging experimental surgical techniques.

Clinical studied showed leukocyte antisedimentation rate (LAR) changes in various conditions that modulate the immune system. There is a lack of LAR data in animal experiments concerning splenic function after splenectomy or spleen preserving operations, thus we aimed to include LAR in our ongoing inbred canine study on following-up spleen salvaging surgical techniques. Blood samples of healthy beagle dogs served as normal control. The experimental groups were: "SH"-sham operated, "SE"-splenectomy, "R1/3" and "R2/3"-one-third/two-third of the spleen resected, "AU-5" and "AU-10"-autotransplantation with 5/10 spleen chips using Furka's techniques. On the 12th postoperative month Rabigen-Mono+Vanguard-Plus-5 vaccines were given to the animals, which provoked immune response. Blood samples were taken before and one week after the vaccination. LAR was calculated by Bogar's method. In normal control group LAR was 3.11, leukocyte count was 12.04 G/l. In the experimental groups LAR varied between 2.4-7.3 before vaccination. After vaccination LAR increased in all groups. Although "SE" group expressed the largest changes (LAR = 16.56; 135%), the leukocyte count increased only by 12%. In "AU" groups the increase was smaller, while "R" groups showed slight changes only. LAR can be applicable in animal experiments and may serve as a supplementary parameter in hemorheological investigations of hyposplenic-asplenic states.

Changes of local and systemic hemorheological properties in intestinal ischemia-reperfusion injury in the rat model.

The aim of this study was to investigate intestinal ischemia-reperfusion and its local and systemic hemorheological relations in the rat. Ten anaesthetized female CD outbred rats were equally divided into 2 experimental groups. (1) Ischemia-reperfusion (I/R): the superior mesenterial artery was clipped for 30 minutes. After removing the clip, 60 minutes of the reperfusion was observed before extermination. Blood samples were taken from the caudal caval vein and from the portal vein before ischemia, 1 minute before and after clip removal, and at the 15th, 30th, and 60th minutes of the reperfusion. (2) Sham operation: median laparotomy and blood sampling were done according to the timing as in I/R group. Hematological parameters, red blood cell aggregation, and deformability were determined. Leukocyte count and mean volume of erythrocytes increased slightly but continuously in portal venous samples during the reperfusion period. Red blood cell aggregation values were higher in portal blood by the end of ischemia, and then became elevated further comparing to the caval venous blood. Both in caval and portal venous samples of I/R group red blood cell deformability significantly worsened during the experimental period compared to its base and Sham group. In portal blood red blood cell deformability was impaired more than in caval vein samples. Histology showed denuded villi, dilated capillaries, and the inflammatory cells were increased after a 30 minutes ischemia. In conclusion, intestinal ischemia-reperfusion causes changes in erythrocyte deformability and aggregation, showing local versus systemic differences in venous blood during the first hour of reperfusion.

Effects of storage duration and temperature of human blood on red cell deformability and aggregation.

Blood samples used in hemorheological studies may be stored for a period of time, the effects of storage have yet to be fully explored. This study evaluated the effects of storage temperature (i.e., 4 degrees C or 25 degrees C) and duration on RBC deformability and aggregation for blood from healthy controls and from septic patients. Our results indicate that for normal blood, RBC deformability over 0.3-50 Pa is stable up to six hours regardless of storage temperature; at eight hours there were no significant differences in EI but SS1/2 calculated via a Lineweaver-Burk method indicated impaired deformability. Storage temperature affected the stable period for RBC aggregation: the safe time was shorter at 25 degrees C whereas at 4 degrees C aggregation was stable up to 12 hours. Interestingly, blood samples from septic patients were less affected by storage. Blood can thus be stored at 25 degrees C for up to six hours for deformability studies, but should be limited to four hours for RBC aggregation; storage at 4 degrees C may prolong the storage period up to 12 hours for aggregation but not deformability measurements. Therefore, the time period between sampling and measurement should be as short as possible and reported together with results.