<html><body><div style="color:#000; background-color:#fff; font-family:bookman old style, new york, times, serif;font-size:12pt"><div style="RIGHT: auto"><SPAN style="RIGHT: auto">Dear All, </SPAN></div>
<div style="BACKGROUND-COLOR: transparent; FONT-STYLE: normal; FONT-FAMILY: bookman old style, new york, times, serif; COLOR: rgb(0,0,0); FONT-SIZE: 16px; RIGHT: auto"><SPAN style="RIGHT: auto">In my experience with Kala azar (VL) patients in India, we have found even after splenectomy parasites were laden in hepatic aspirates. Splenectomy were done in patients with huge splenomegaly occupying more than half of the umblical area for improvement of anemia and to prevent splenic rupture after accidental abdominal trauma<VAR id=yui-ie-cursor></VAR>. There was no clinical response in patients after splenectomy.</SPAN></div>
<div style="RIGHT: auto">Dr.Prabhat Kumar Sinha,MD</div>
<div style="RIGHT: auto">HOD Clinical Medicine,</div>
<div style="RIGHT: auto">Rajendra Memorial Research Institute of Medical Sciences,</div>
<div style="RIGHT: auto">ICMR, Agam Kuan,Patna<BR style="RIGHT: auto"></div>
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<DIV style="BORDER-BOTTOM: #ccc 1px solid; BORDER-LEFT: #ccc 1px solid; PADDING-BOTTOM: 0px; LINE-HEIGHT: 0; MARGIN: 5px 0px; PADDING-LEFT: 0px; PADDING-RIGHT: 0px; HEIGHT: 0px; FONT-SIZE: 0px; BORDER-TOP: #ccc 1px solid; BORDER-RIGHT: #ccc 1px solid; PADDING-TOP: 0px" class=hr contentEditable=false readonly="true"></DIV><FONT size=2 face=Arial><B><SPAN style="FONT-WEIGHT: bold">From:</SPAN></B> Jacob Golenser <jacobg@ekmd.huji.ac.il><BR><B><SPAN style="FONT-WEIGHT: bold">To:</SPAN></B> Dr Omar Hamarsheh <ohamarsheh@gmail.com>; 'Carlos Costa' <chncosta@gmail.com>; 'Leish-L' <Leish-l@lineu.icb.usp.br> <BR><B><SPAN style="FONT-WEIGHT: bold">Sent:</SPAN></B> Sunday, September 1, 2013 3:30 PM<BR><B><SPAN style="FONT-WEIGHT: bold">Subject:</SPAN></B> Re: [Leish-l] spleen<BR></FONT></DIV>
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<div dir=ltr class=yiv5195842521MsoNormal><FONT color=navy size=3 face="Times New Roman"><SPAN style="COLOR: navy; FONT-SIZE: 12pt">Dear all</SPAN></FONT></div>
<div dir=ltr class=yiv5195842521MsoNormal><FONT color=navy size=3 face="Times New Roman"><SPAN style="COLOR: navy; FONT-SIZE: 12pt"> </SPAN></FONT></div>
<div dir=ltr class=yiv5195842521MsoNormal><FONT color=navy size=3 face="Times New Roman"><SPAN style="COLOR: navy; FONT-SIZE: 12pt">Please note that leishmaniasis is an immunopathological disease (at least partially) and splenectomy reduces the autoimmune- like capacity. This may decrease pathology.</SPAN></FONT></div>
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<div dir=ltr class=yiv5195842521MsoNormal><FONT color=navy size=3 face="Times New Roman"><SPAN style="COLOR: navy; FONT-SIZE: 12pt">Jacob Golenser</SPAN></FONT></div>
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<div dir=ltr class=yiv5195842521MsoNormal><B><FONT size=2 face=Tahoma><SPAN style="FONT-FAMILY: Tahoma; FONT-SIZE: 10pt; FONT-WEIGHT: bold">From:</SPAN></FONT></B><FONT size=2 face=Tahoma><SPAN style="FONT-FAMILY: Tahoma; FONT-SIZE: 10pt"> leish-l-bounces@lineu.icb.usp.br [mailto:leish-l-bounces@lineu.icb.usp.br] <B><SPAN style="FONT-WEIGHT: bold">On Behalf Of </SPAN></B>Dr Omar Hamarsheh<BR><B><SPAN style="FONT-WEIGHT: bold">Sent:</SPAN></B> </SPAN></FONT><FONT size=2 face=Tahoma><SPAN style="FONT-FAMILY: Tahoma; FONT-SIZE: 10pt" dir=rtl lang=HE>ג</SPAN></FONT><SPAN dir=ltr></SPAN><FONT size=2 face=Tahoma><SPAN style="FONT-FAMILY: Tahoma; FONT-SIZE: 10pt"><SPAN dir=ltr></SPAN> 27 </SPAN></FONT><FONT size=2 face=Tahoma><SPAN style="FONT-FAMILY: Tahoma; FONT-SIZE: 10pt" dir=rtl lang=HE>אוגוסט</SPAN></FONT><SPAN dir=ltr></SPAN><FONT size=2 face=Tahoma><SPAN style="FONT-FAMILY: Tahoma; FONT-SIZE: 10pt"><SPAN dir=ltr></SPAN> 2013 11:28<BR><B><SPAN
style="FONT-WEIGHT: bold">To:</SPAN></B> 'Carlos Costa'; 'Leish-L'<BR><B><SPAN style="FONT-WEIGHT: bold">Subject:</SPAN></B> Re: [Leish-l] spleen</SPAN></FONT></div></DIV>
<div dir=ltr class=yiv5195842521MsoNormal><FONT size=3 face="Times New Roman"><SPAN style="FONT-SIZE: 12pt"> </SPAN></FONT></div>
<div dir=ltr class=yiv5195842521MsoNormal><FONT color=#1f497d size=2 face=Calibri><SPAN style="FONT-FAMILY: Calibri; COLOR: #1f497d; FONT-SIZE: 11pt">Dear All,</SPAN></FONT></div>
<div dir=ltr class=yiv5195842521MsoNormal><FONT color=#1f497d size=2 face=Calibri><SPAN style="FONT-FAMILY: Calibri; COLOR: #1f497d; FONT-SIZE: 11pt">I am not an immunologist but I have an opinion that I would like to share; splenectomy cures patients with Visceral Leishmaniasis. </SPAN></FONT></div>
<div dir=ltr class=yiv5195842521MsoNormal><FONT color=#1f497d size=2 face=Calibri><SPAN style="FONT-FAMILY: Calibri; COLOR: #1f497d; FONT-SIZE: 11pt">large masses of Leishmania in case of visceral Leishmaniasis is existed in reticuloendothelial system including spleen. Removal of spleen will remove huge masses of the parasite infected cells. In cases of serious splenomegaly and cytopenia, spelenectomy become a good option.</SPAN></FONT></div>
<div dir=ltr class=yiv5195842521MsoNormal><FONT color=#1f497d size=2 face=Calibri><SPAN style="FONT-FAMILY: Calibri; COLOR: #1f497d; FONT-SIZE: 11pt"> </SPAN></FONT></div>
<div dir=ltr class=yiv5195842521MsoNormal><FONT color=#1f497d size=2 face=Calibri><SPAN style="FONT-FAMILY: Calibri; COLOR: #1f497d; FONT-SIZE: 11pt">All the best,</SPAN></FONT></div>
<div dir=ltr class=yiv5195842521MsoNormal><FONT color=#1f497d size=2 face=Calibri><SPAN style="FONT-FAMILY: Calibri; COLOR: #1f497d; FONT-SIZE: 11pt">omar</SPAN></FONT></div>
<div dir=ltr class=yiv5195842521MsoNormal><FONT color=#1f497d size=2 face=Calibri><SPAN style="FONT-FAMILY: Calibri; COLOR: #1f497d; FONT-SIZE: 11pt"> </SPAN></FONT></div>
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<div dir=ltr class=yiv5195842521MsoNormal><B><FONT color=black size=3 face="Times New Roman"><SPAN style="COLOR: black; FONT-SIZE: 12pt; FONT-WEIGHT: bold">Omar Hamarsheh, MSc., PhD</SPAN></FONT></B></div>
<div dir=ltr class=yiv5195842521MsoNormal><B><FONT color=black size=3 face="Times New Roman"><SPAN style="COLOR: black; FONT-SIZE: 12pt; FONT-WEIGHT: bold">Al-Quds</SPAN></FONT></B><B><FONT color=black><SPAN style="COLOR: black; FONT-WEIGHT: bold"> University</SPAN></FONT></B><B><FONT color=black><SPAN style="COLOR: black; FONT-WEIGHT: bold"></SPAN></FONT></B></div>
<div dir=ltr class=yiv5195842521MsoNormal><B><FONT color=black size=3 face="Times New Roman"><SPAN style="COLOR: black; FONT-SIZE: 12pt; FONT-WEIGHT: bold">Department of Biological Sciences</SPAN></FONT></B></div>
<div dir=ltr class=yiv5195842521MsoNormal><B><FONT color=black size=3 face="Times New Roman"><SPAN style="COLOR: black; FONT-SIZE: 12pt; FONT-WEIGHT: bold">P.O.Box</SPAN></FONT></B><B><FONT color=black><SPAN style="COLOR: black; FONT-WEIGHT: bold"> 51000</SPAN></FONT></B><B><FONT color=black><SPAN style="COLOR: black; FONT-WEIGHT: bold"></SPAN></FONT></B></div>
<div dir=ltr class=yiv5195842521MsoNormal><B><FONT color=black size=3 face="Times New Roman"><SPAN style="COLOR: black; FONT-SIZE: 12pt; FONT-WEIGHT: bold">Jerusalem</SPAN></FONT></B><B><FONT color=black><SPAN style="COLOR: black; FONT-WEIGHT: bold"></SPAN></FONT></B></div>
<div dir=ltr class=yiv5195842521MsoNormal><B><FONT color=black size=3 face="Times New Roman"><SPAN style="COLOR: black; FONT-SIZE: 12pt; FONT-WEIGHT: bold">PALESTINE</SPAN></FONT></B><B><FONT color=black><SPAN style="COLOR: black; FONT-WEIGHT: bold"></SPAN></FONT></B></div>
<div dir=ltr class=yiv5195842521MsoNormal><B><FONT color=black size=3 face="Times New Roman"><SPAN style="COLOR: black; FONT-SIZE: 12pt; FONT-WEIGHT: bold"> </SPAN></FONT></B></div>
<div dir=ltr class=yiv5195842521MsoNormal><B><FONT color=black size=3 face="Times New Roman"><SPAN style="COLOR: black; FONT-SIZE: 12pt; FONT-WEIGHT: bold">Tel: 00970-599197097</SPAN></FONT></B></div>
<div dir=ltr class=yiv5195842521MsoNormal><B><FONT color=black size=3 face="Times New Roman"><SPAN style="COLOR: black; FONT-SIZE: 12pt; FONT-WEIGHT: bold">Fax: 00970-22796960</SPAN></FONT></B></div>
<div dir=ltr class=yiv5195842521MsoNormal><B><FONT color=black size=3 face="Times New Roman"><SPAN style="COLOR: black; FONT-SIZE: 12pt; FONT-WEIGHT: bold"> </SPAN></FONT></B></div>
<div dir=ltr class=yiv5195842521MsoNormal><B><FONT color=black size=3 face="Times New Roman"><SPAN style="COLOR: black; FONT-SIZE: 12pt; FONT-WEIGHT: bold">Email: <A href="mailto:ohamarsheh@gmail.com" rel=nofollow target=_blank ymailto="mailto:ohamarsheh@gmail.com">ohamarsheh@gmail.com</A></SPAN></FONT></B></div>
<div dir=ltr class=yiv5195842521MsoNormal><B><FONT color=black size=3 face="Times New Roman"><SPAN style="COLOR: black; FONT-SIZE: 12pt; FONT-WEIGHT: bold"> <A href="http://mail.alquds.edu/~f3706/" rel=nofollow target=_blank>mail.alquds.edu/~f3706/</A></SPAN></FONT></B></div>
<div dir=ltr class=yiv5195842521MsoNormal><FONT color=#1f497d size=2 face=Calibri><SPAN style="FONT-FAMILY: Calibri; COLOR: #1f497d; FONT-SIZE: 11pt"> </SPAN></FONT></div>
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<div dir=ltr class=yiv5195842521MsoNormal><B><FONT size=2 face=Tahoma><SPAN style="FONT-FAMILY: Tahoma; FONT-SIZE: 10pt; FONT-WEIGHT: bold">From:</SPAN></FONT></B><FONT size=2 face=Tahoma><SPAN style="FONT-FAMILY: Tahoma; FONT-SIZE: 10pt"> leish-l-bounces@lineu.icb.usp.br [mailto:leish-l-bounces@lineu.icb.usp.br] <B><SPAN style="FONT-WEIGHT: bold">On Behalf Of </SPAN></B>Carlos Costa<BR><B><SPAN style="FONT-WEIGHT: bold">Sent:</SPAN></B> Wednesday, August 21, 2013 3:53 PM<BR><B><SPAN style="FONT-WEIGHT: bold">To:</SPAN></B> Leish-L<BR><B><SPAN style="FONT-WEIGHT: bold">Subject:</SPAN></B> [Leish-l] spleen</SPAN></FONT></div></DIV>
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<div dir=ltr class=yiv5195842521MsoNormal><FONT color=black size=3 face=Verdana><SPAN style="FONT-FAMILY: Verdana; COLOR: black; FONT-SIZE: 12pt">Dear leishimmunologists,</SPAN></FONT></div></DIV>
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<div dir=ltr class=yiv5195842521MsoNormal><FONT color=black size=3 face=Verdana><SPAN style="FONT-FAMILY: Verdana; COLOR: black; FONT-SIZE: 12pt"> </SPAN></FONT></div></DIV>
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<div dir=ltr class=yiv5195842521MsoNormal><FONT color=black size=3 face=Verdana><SPAN style="FONT-FAMILY: Verdana; COLOR: black; FONT-SIZE: 12pt">Do you have any guess on why splenectomy cures kala-azar? Would it be the absence of spleen-derived IL-10?</SPAN></FONT></div></DIV>
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<div dir=ltr class=yiv5195842521MsoNormal><FONT color=black size=3 face=Verdana><SPAN style="FONT-FAMILY: Verdana; COLOR: black; FONT-SIZE: 12pt"> </SPAN></FONT></div></DIV>
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<div dir=ltr class=yiv5195842521MsoNormal><FONT color=black size=3 face=Verdana><SPAN style="FONT-FAMILY: Verdana; COLOR: black; FONT-SIZE: 12pt">All my best,</SPAN></FONT></div></DIV>
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<div dir=ltr class=yiv5195842521MsoNormal><FONT color=black size=3 face=Verdana><SPAN style="FONT-FAMILY: Verdana; COLOR: black; FONT-SIZE: 12pt"> </SPAN></FONT></div></DIV>
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<div dir=ltr class=yiv5195842521MsoNormal><FONT color=black size=3 face=Verdana><SPAN style="FONT-FAMILY: Verdana; COLOR: black; FONT-SIZE: 12pt">Carlos.</SPAN></FONT></div></DIV>
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<div dir=ltr class=yiv5195842521MsoNormal><FONT size=3 face="Times New Roman"><SPAN style="FONT-SIZE: 12pt"> </SPAN></FONT></div></DIV>
<div dir=ltr class=yiv5195842521MsoNormal><FONT size=3 face="Times New Roman"><SPAN style="FONT-SIZE: 12pt">-- </SPAN></FONT></div>
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<div dir=ltr class=yiv5195842521MsoNormal><FONT size=3 face=Verdana><SPAN style="FONT-FAMILY: Verdana; FONT-SIZE: 12pt">Carlos H. N. Costa, MD, DSc.</SPAN></FONT></div>
<div dir=ltr class=yiv5195842521MsoNormal><FONT size=3 face=Verdana><SPAN style="FONT-FAMILY: Verdana; FONT-SIZE: 12pt">Coordenador</SPAN></FONT></div>
<div dir=ltr class=yiv5195842521MsoNormal><FONT size=3 face=Verdana><SPAN style="FONT-FAMILY: Verdana; FONT-SIZE: 12pt">Laboratório de Leishmanioses - LabLeish</SPAN></FONT></div>
<div dir=ltr class=yiv5195842521MsoNormal><FONT size=3 face=Verdana><SPAN style="FONT-FAMILY: Verdana; FONT-SIZE: 12pt">Universidade Federal do Piauí</SPAN></FONT></div>
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<div dir=ltr class=yiv5195842521MsoNormal><FONT size=3 face=Verdana><SPAN style="FONT-FAMILY: Verdana; FONT-SIZE: 12pt">64001-450 Teresina-PI</SPAN></FONT></div>
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