Atraumatic splenic rupture was attributed to intra-cystic haemorrhage and hypersplenism in a patient with cirrhosis and portal hypertension: A case report.

Liver cirrhosis with splenomegaly and portal hypertension has been described in the medical literature as increasing the risk of splenic rupture. We report a case of atraumatic splenic rupture in a male with liver cirrhosis associated with splenomegaly, which was further complicated by hypersplenism and intra-cystic haemorrhage in the spleen. The 56-year-old man was hospitalized because of sudden onset of intermittent pain in the left quadrant abdomen with no history of trauma. Upon admission, the patient presented no fever, palpable abdominal tenderness, splenomegaly, and hypersplenism. Enhanced computed tomography revealed a splenic subcapsular haematoma connected to a cystic mass located at the splenic hilum and free fluid in the abdomen, which is indicative of splenic rupture. The patient underwent immediate laparotomy and splenectomy followed by proper management. Post-surgery diagnostic microscopy indicated liver steatosis, perivenular fibrosis, and regenerative nodules, which are suggestive of cirrhosis. The patient was discharged from the hospital with an uneventful recovery.

MRI-visible liposome-polyethylenimine complexes for DNA delivery: preparation and evaluation.

To noninvasively monitor the effect of gene therapy and achieve an optimal therapeutic effect, liposomes encapsulated polyethylenimine (PEI)-coated superparamagnetic iron oxide nanoparticles (SPION) with dual functions of MRI diagnosis and gene therapy were prepared. SPION was synthesized via co-precipitation, and then modified with PEI via thiourea reaction. The liposomes encapsulating PEI-SPION (LP-PEI-SPION) were prepared by ethanol injection. Fourier transform infrared spectra confirmed that PEI was successfully modified onto SPION, and thermogravimetric analysis indicated that the PEI content was about 17.1%. The LP-PEI-SPION/DNA had a small particle size of 253.07 ± 0.90 nm. LP-PEI-SPION/DNA had low cytotoxicity with more than 80% of the cell survival rates and high transfection efficiency compared with Lipofectamine® 2000/DNA. Additionally, it also showed good MRI effect on three cell lines. The liposomes encapsulating PEI-SPION (lipopolyplexes) have been successfully prepared as MRI contrast agents and gene delivery vectors, which may have great theoretical research significance and clinical potentials. Abbreviations: PEI, polyethylenimine; SPION, superparamagnetic iron oxide nanoparticles; LP-PEI-SPION, liposomes encapsulating PEI-SPION; MTT, 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl tetrazolium bromide; ICP-MS, inductively coupled plasma mass spectrometry; XRD, X-ray diffraction; TEM, transmission electron microscope; TGA, thermogravimetric analysis; DOTAP, 1,2-dioleoyl-3-trimethylammonium-propane; DOPE, 1,2-dioleoyl-sn-glycero-3-phosphoethanolamine; Chol, cholesterol.

Calibrated magnetic resonance hydrometry to quantify pancreatic juice: a preliminary study.

PURPOSE: To investigate the effectiveness of the calibrated MR hydrometry (CMRH) method for accurately measuring pancreatic secretion. MATERIALS AND METHODS: All studies were performed on a 1.5-T MR system using a fat-suppressed, single-shot half-Fourier fast spin-echo sequence with a standard body coil. A certain volume (20 mL) of saline solution was employed as an extrabody calibrator. The validity of the CMRH method was tested both in vitro and in vivo, and actual and calculated volumes were compared. RESULTS: The in vitro study yielded a high correlation (r = 0.99; P < 0.0001) between the actual volume of saline solution in the imaging field and the calculated volume. In the in vivo study, for all volunteers, there was a very strong and significant positive correlation between the measured signal intensities or calculated volumes and actual volumes (correlation coefficient range: 0.94-0.99; P < 0.0001). CONCLUSION: This preliminary study shows that CMRH is an effective tool to measure the amount of pancreatic fluid secretion.

[Follow-up dynamic CT study for hypovascular nodules in patients with cirrhotic liver].

It is important to clarify the process by which hypovascular nodules progress to hypervascular hepatocellular carcinoma (HCC). In this study, we used dynamic computed tomography(CT) to retrospectively investigate serial changes in 24 hypovascular nodules of 24 patients until they progressed to hypervascular HCC. The mean time to hypervascular transformation(THT) was 726 days, with a minimum of 208 days and maximum of 2,728 days. Mean nodular diameter at the final examination was 21.2 +/- 8.0 mm, and was significantly larger than that(11.4 +/- 4.8 mm) at the initial time. THT was the shortest(463 days) in a group that had an initial nodular diameter larger than 15 mm. In a group with the low-iso-low contrast enhancement pattern, THT was 361 days, and was shorter than that in the other groups. In a group with the low-low-low contrast enhancement pattern, nodules containing fat were frequently detected(5 patients, 75%). In patients with HCC apart from the nodules, THT for the nodules was 464 days, shorter than that(767.5 days) in other patients. The findings suggest that hypovascular nodules larger than 15 mm in diameter with the low-iso-low contrast enhancement pattern and HCC progress to hypervascular HCC at an early stage.