Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0036690 (sepsis)
 59,461 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The presence of increased levels of suppressor T cells after thermal injury and their relevance remain controversial. It is unclear whether suppressor T cells are the cause or result of sepsis complicating thermal injury. Spleen cells from a standardized murine burn model and sham burn controls were studied and the relationship between the levels of suppressor cytotoxic T cells (CD8, Lyt-2+), helper T cells (CD4, L3T4+), response to concanavalin A (ConA) and to phytohemagglutinin (PHA) and interleukin-2 (IL-2) production was examined. Mortality following infection via cecal ligation and puncture (CLP) of matched controls was also studied. At day 7 postburn, mean ConA (70 +/- 12% of control) and PHA response (58% +/- 5.2% of controls) and IL-2 production (43% +/- 5.4%) were significantly less than sham burn values (100%; p less than 0.05). However, the mean percentage of cells staining with anti-Lyt-2 and anti-L3T4 (9.1 +/- 0.59 and 13.9 +/- 0.65) was similar to the mean percentage in sham burn animals (9.4 +/- 0.65 and 16.6 +/- 1.1). Furthermore, no significant differences were observed between burned mice and controls in helper (17.3% +/- 1.8% burn vs. 21.2% +/- 1.7% sham) or suppressor cell levels (7.8% +/- 1.2% burn vs. 8.6% +/- 0.7% sham) or helper-suppressor ratios on day 10 postburn. Mortality of 20 litter-matched controls subjected to CLP on day 10 postburn was 90%, which was significantly greater than the sham burn mortality of 20%.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Suppressor T-cell levels are unreliable indicators of the impaired immune response following thermal injury. 153 80

A patient with inactive systemic lupus erythematosus was successfully treated for pneumococcal sepsis complicated by disseminated intravascular coagulation, shock, renal failure, and functional asplenia. Functional asplenia was diagnosed from the total absence of uptake of intravenously administered 99mtechnetium-labeled sulfur colloid. Ten similar cases of functional asplenia occurring in patients with systemic lupus erythematosus were noted in a review of the literature. Six of these cases, including the current report, were complicated by pneumococcal (5) or salmonella (1) sepsis. The patient presented here had an excellent antibody response to pneumococcal vaccination. Spleen scan abnormalities fully reversed at 1 year. Although functional asplenia is a rare event in systemic lupus erythematosus, it appears to predispose to severe septic complications.
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PMID:Functional asplenia in systemic lupus erythematosus. 228 43

Post-splenectomy sepsis is a possible consequence, following traumatic loss of the spleen. An incidence of 1.05 per cent and mortality of 0.5 per cent may be assumed. The risk of infection for patients with traumatic loss of the spleen was found to be 60 times higher than that facing the general population. Spleen-preserving operations were found to ensure immune competence only in patients with not less than 30 per cent of intact spleen substance and under conditions of unimpaired blood supply. Occupational disablement usually occurs to 30 per cent of post-splenectomy patients during the first year from operation. Ten per cent were disabled for good, provided absence of complications.
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PMID:[Expert assessment following total and partial loss of the spleen]. 335 67

The authors performed autotransplantation of the spleen in 45 dogs. They found that, the pieces of the transplanted spleen underwent necrosis, but new malphigian bodies formed on their surface. These latter took over the sepsis-inhibiting function of the spleen. Thus the grafting of spleen can be useful and worth doing. Spleen should be transplanted in thin slices since in case of a larger piece they may necrotize and give rise to abscesses.
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PMID:Partial experimental autotransplantation of the spleen. 375 35

Expert opinion after splenectomy: In splenectomized patients after trauma the risk of infection is up to 60 times increased. The incidence of sepsis amounts to 1.05, mortality to 0.5%. Spleen-preserving surgery guarantees an immunocompetence only if at least 30% of the spleen is preserved. The professional performance of people having undergone splenectomy is restricted by 30% during the first year ("MdE" of 30%), later by 10% if additional complications occur.
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PMID:[Assessment following total or partial splenic loss]. 380 55

A 66-year-old female patient complained of loss of body weight and fatigue. The clinical examination revealed a thrombocytosis with a maximum count of 3.200 . 10(9) platelets and a leukocytosis with maximally 25 . 10(9) white cells in the peripheral blood. The bone marrow showed a large increase of megakaryocytes. Under the diagnosis of megakaryocytic myelosis a chemotherapy with 186 mg busulfan was performed. In the course of this treatment the clinical picture of a sepsis occurred which could not be controlled by antibiotics. The patient died four months after her admission to the clinic. The essential findings in autopsy were a caseous tuberculosis of the lymph nodes with haematogenic generalization which appeared as a septic tuberculosa gravissima ("typhobacillosis" Landouzy). The bone marrow was atrophic. Spleen liver and lymph nodes were without evidence for a myeloproliferative disorder. Thus, the initial diagnosis had to be changed to a megakaryocytic pseudomyelosis with massive thrombocytosis as a reaction to the tuberculous infection. The differential diagnosis of megakaryocytic myelosis, other disorders of the myeloproliferative syndrome, and the reactive thrombocytosis are discussed.
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PMID:[Megakaryocytic pseudomyelosis with severe thrombocytosis]. 617 Nov 9

Congenital splenic cysts are rare (only 40% of all true cysts). A case report is presented of a young male adolescent patient with a ruptured mesothelial splenic cyst causing acute peritonitis. Abdominal ultrasound and CT-scan are very useful tools to obtain the preoperative diagnosis. Spleen saving resections, if possible, are preferred to splenectomy because of the risk of severe post-splenectomy sepsis.
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PMID:Ruptured mesothelial cyst of the spleen causing acute peritonitis. 805 92

Experiments using a murine model of heat-killed Staphylococcus aureus-induced gram-positive bacterial sepsis indicate that the lethal bacterial effects can be prevented if mice are pretreated with CL 184,005, a platelet-activating factor (PAF) antagonist. CL 184,005 was ineffective when administered after bacterial challenge. Plasma of mice pretreated with CL 184,005 contained significantly less tumor necrosis factor (TNF), suggesting that CL 184,005 interferes with TNF synthesis induced by S. aureus. Spleen-associated TNF protein was also decreased by pretreatment with CL 184,005. Although TNF levels were significantly decreased in mice treated with CL 184,005, interleukin-6 levels in serum were significantly increased. Athymic mice were also susceptible to the lethal effects of S. aureus, suggesting that T cells were not involved. When rats rendered hypotensive with S. aureus were treated with CL 184,005, their blood pressure was normalized. Mice treated with enterotoxin B were not protected if they were pretreated with CL 184,005; however, TNF levels in these mice were significantly lower, suggesting that mediators other than PAF and TNF may contribute to the lethal effects of enterotoxin.
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PMID:Effect of CL 184,005, a platelet-activating factor antagonist in a murine model of Staphylococcus aureus-induced gram-positive sepsis. 827 76

Despite extensive world-wide research no effective therapy has been devised for the treatment and cure of patients exposed to sulfur mustard (S-M). A severe suppression of the immune system still remains the major cause of opportunist infections, septicemia and death in patients injured by S-M. In this report we present a model of S-M contamination in mice which is suitable for immunomodulation studies. Results show that differing doses of S-M caused an overall suppression of the immune response to SRBC as indicated by agglutination titers, (DTH) tests, spleen histology and spleen weight indices. In the second stage two immunomodulating agents; pyrimethamine and cimetidine were employed and their effectiveness in augmenting immune responses after S-M induced immunosuppression was evaluated. Pyrimethamine, at all doses employed, enhanced antibody titers to SRBC, augmented DTH responses, and restored splenic follicles as compared with controls only exposed to S-M. Cimetidine augmented antibody titers and enhanced DTH responses at doses of 10 and 15 mg/kg as compared with controls. At a dose of 5 mg/kg cimetidine did not exhibit any effect on titers or DTH responses. Histological studies revealed that cimetidine restored splenic follicles and increased macrophage numbers and phagocytic activity at all three doses. Spleen weight indices were not augmented by either drug. These data provide evidence that immunomodulating drugs may prove effective in countering the immunosuppressive effects of S-M.
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PMID:Effect of immunomodulators pyrimethamine and cimetidine on immunosuppression induced by sulfur mustard in mice. 836 27

The records of five patients treated in our department for splenic abscess are analysed and the literature is reviewed. Computed tomography revealed the correct diagnosis in all patients, while clinical presentation was often nonspecific. Spleen-preserving management was possible in two patients (40%). Outcome was uneventful for four patients. One patient with a splenic abscess caused by Mycobacterium tuberculosis and acquired immunodeficiency syndrome, died 4 months after splenectomy from sepsis. We discuss the clinical presentation of splenic abscess, its diagnostic approach, and treatment. Additionally, we studied whether spleen-preserving management is feasible or not.
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PMID:Splenic abscess: a diagnostic and therapeutic challenge. 983 May 44


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