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Ascitic Fluid (ascitic + fluid)
Selected AbstractsDo cytogenetic abnormalities precede morphologic abnormalities in a developing malignant condition?EUROPEAN JOURNAL OF HAEMATOLOGY, Issue 2 2007Jill K. Northup Abstract Cytogenetic evaluation of bone marrow and neoplastic tissues plays a critical role in determining patient management and prognosis. Here, we highlight two cases in which the cytogenetic studies challenge the common practice of using hematologic and morphologic changes as key factors in malignant disease management. The first case is that of a lymph node sample from a 40-yr-old non-Hodgkin's lymphoma (NHL) patient sent for determination of disease progress. Hematologic studies showed no evidence of transformation to high-grade NHL (>15% blasts with rare mitotic figures). Cytogenetic studies of lymph node showed multiple clonal abnormalities, most notably a der(18) from a t(14;18) which is associated with high-grade NHL. After two cycles of chemotherapy with fludarabine, the patient did not show any clinical response, suggesting possible progression to high-grade lymphoma. The second case is of a patient with a history of human immunodeficiency virus and blastic natural killer leukemia/lymphoma. Hematologic studies of ascitic fluid classified the patient as having pleural effusion lymphoma whereas bone marrow analysis showed no malignancy. Bone marrow cytogenetic studies showed multiple clonal abnormalities including a t(8;14), which is commonly associated with Burkitt's lymphoma (BL). To our knowledge, this is the first case wherein a morphologically normal bone marrow showed presence of clonal abnormalities consistent with BL or Pleural effusion lymphoma. After two cycles of CHOP (cyclophosphamide, doxorubicin, vincristine and prednisone) chemotherapy, the patient's general condition and ascitis improved and she was discharged. These studies clearly demonstrate that genetic changes often precede morphologic changes in a developing malignant condition. Therefore, the critical information needed for care of patients with malignant disorders may be incomplete or inaccurate if cytogenetic evaluation is overlooked. [source] Glycan profiling of urine, amniotic fluid and ascitic fluid from galactosialidosis patients reveals novel oligosaccharides with reducing end hexose and aldohexonic acid residuesFEBS JOURNAL, Issue 14 2010Cees Bruggink Urine, amniotic fluid and ascitic fluid samples of galactosialidosis patients were analyzed and structurally characterized for free oligosaccharides using capillary high-performance anion-exchange chromatography with pulsed amperometric detection and online mass spectrometry. In addition to the expected endo-,- N- acetylglucosaminidase-cleaved products of complex-type sialylated N -glycans, O -sulfated oligosaccharide moieties were detected. Moreover, novel carbohydrate moieties with reducing-end hexose residues were detected. On the basis of structural features such as a hexose,N -acetylhexosamine,hexose,hexose consensus sequence and di-sialic acid units, these oligosaccharides are thought to represent, at least in part, glycan moieties of glycosphingolipids. In addition, C1 -oxidized, aldohexonic acid-containing versions of most of these oligosaccharides were observed. These observations suggest an alternative catabolism of glycosphingolipids in galactosialidosis patients: oligosaccharide moieties from glycosphingolipids would be released by a hitherto unknown ceramide glycanase activity. The results show the potential and versatility of the analytical approach for structural characterization of oligosaccharides in various body fluids. [source] Systemic, renal, and hepatic hemodynamic derangement in cirrhotic patients with spontaneous bacterial peritonitisHEPATOLOGY, Issue 5 2003Luis Ruiz-del-Arbol M.D. Spontaneous bacterial peritonitis (SBP) is frequently associated with renal failure. This study assessed if systemic and hepatic hemodynamics are also affected by this condition. Standard laboratory tests, tumor necrosis factor , (TNF-,) in plasma and ascitic fluid, plasma renin activity (PRA) and norepinephrine (NE), and systemic and hepatic hemodynamics were determined in 23 patients with SBP at diagnosis and after resolution of infection. Eight patients developed renal failure during treatment. At diagnosis of infection, patients developing renal failure showed significantly higher values of TNF-,, blood urea nitrogen (BUN), PRA and NE, peripheral vascular resistance, and hepatic venous pressure gradient (HVPG) and lower cardiac output than patients not developing renal failure. During treatment, a significant reduction in cardiac output and arterial pressure and increase in PRA and NE, HVPG, and Child-Pugh score were observed in the first group but not in the second. Peripheral vascular resistance remained unmodified in both groups. Changes in PRA and NE correlated inversely with changes in arterial pressure and directly with changes in BUN, Child-Pugh score, and HVPG. Five patients in the renal failure group developed encephalopathy, and 6 died. In the group without renal failure, none of the patients developed encephalopathy or expired. In conclusion, patients with SBP frequently develop a rapidly progressive impairment in systemic hemodynamics, leading to severe renal and hepatic failure, aggravation of portal hypertension, encephalopathy, and death. This occurs despite rapid resolution of infection and is associated with an extremely poor prognosis. [source] Increase of granzyme B-positive cells in ascitic fluid of patients with spontaneous bacterial peritonitisHEPATOLOGY RESEARCH, Issue 4 2008Alessandro Perrella Spontaneous bacterial peritonitis (SBP) occurs as a direct consequence of bacteria entering ascitic fluid (AF) from the intestinal lumen trough in several ways, including the hematogenous and mesenteric lymph nodes route. There are few studies on the cytokine profile of ascitic-derived mononuclear cells of patients with SBP, particularly on granzyme B (GZB). The aim of the present study was to verify whether patients with SBP have GZB-positive cells, whether they are increased in patients with aseptic ascites, and their trend after antibiotic treatment. We enrolled 36 consecutive patients (24 males and 12 females) with SBP on histologically-proven hepatitis C virus cirrhosis (group A) and 20 patients (11 males and nine females with ascites, but without evidences of SBP (group B). The diagnosis of SBP was made according to the following criteria: positive colture in AF or blood (at least two cultures) and neutrophils in AF (>250 mL polymorphonuclear leukocytes). For these patients we used ELISpot to assay GZB production on purified mononuclear cells in ascitesand peripheral blood, coupled with tumor necrosis factor-, tested using ELISA. A non-parametric statistical analysis was used to assess significant differences and correlations. We found positive culture in all of the patients with SBP (80% Escherichia coli; 20% Enterococcus faecium). Furthermore, the patients in group A had a higher number of GZB spot-forming colonies than the patients in group B (P < 0.001). GZB-positive cells were lower in the peripheral blood than those found in the AF of patients with SBP, while no differences were found between blood and AF in group B. Furthermore, after antibiotic treatment, GZB was reduced in the patients with SBP (P < 0.05). In conclusion, GZB may be an important mediator of the immune response towards bacteria in AF and could be used as a diagnostic tool. [source] Can the smallest depth of ascitic fluid on sonograms predict the amount of drainable fluid?JOURNAL OF CLINICAL ULTRASOUND, Issue 8 2009Abid Irshad MD Abstract Purpose To investigate the correlation between the ,smallest fluid depth' (SFD) measured on sonography (US) at the ,paracentesis pocket' with the amount of fluid drained in patients referred for US-guided large-volume paracentesis. Methods US examinations performed to guide 60 paracenteses in 29 patients with large-volume ascites were reviewed and the SFD measured at the site of the paracentesis. The SFD was measured from the most superficial bowel loop to the abdominal wall. The SFD measurements were compared with the drained fluid volume (DFV) measurements. Results The average DFV per paracentesis was 5.2 L with an average SFD measurement of 5.4 cm. For every 1-cm increase in the measured SFD, there was an average 1-L increase in the DFV. After applying this relationship to the measured depth in each case, the comparison between the estimated fluid volume (EFV) on US and the DFV demonstrated a <1-L difference in 38 of 60 paracenteses (63.3%) and a <2-L difference in 51 of 60 paracenteses (85%). Conclusion The SFD measured at the site of paracentesis shows a correlation with the drained fluid volume and can be used for fluid volume estimation on US. © 2009 Wiley Periodicals, Inc. J Clin Ultrasound, 2009 [source] A sandwich enzyme linked immunosorbent assay (S-ELISA) for detection of MrNV in the giant freshwater prawn, Macrobrachium rosenbergii (de Man)JOURNAL OF FISH DISEASES, Issue 2 2003B Romestand Abstract A sandwich enzyme-linked immunosorbent assay (S-ELISA) was developed to improve diagnosis of white tail disease of the giant freshwater prawn, Macrobrachium rosenbergii, caused by the nodavirus, Mr NV. Polyclonal antibodies were produced by immunization of Balb/C mice using a purified suspension of the virus and IgG anti- MrNV were purified from ascitic fluid. A sandwich method was successfully developed, coating first with unlabelled antibody and detecting trapped antigens with a second biotinylated antibody. Reaction was demonstrated using an avidin,peroxidase conjugate. Tissue extracts from M. rosenbergii infected with MrNV or purified viral extracts (control) were successfully identified in an individual ELISA, thus confirming the validity of the method. This S-ELISA should be the technique of choice for epidemiological studies of this disease and is a rapid and inexpensive assay with high specificity and sensitivity. [source] Spontaneous bacterial peritonitis and bacterascites prevalence in asymptomatic cirrhotic outpatients undergoing large-volume paracentesisJOURNAL OF GASTROENTEROLOGY AND HEPATOLOGY, Issue 2 2008José Castellote Abstract Background and Aim:, Spontaneous bacterial peritonitis and bacterascites prevalence in asymptomatic cirrhotic patients on large-volume paracentesis is unknown. The aim of this study was to investigate spontaneous bacterial peritonitis and bacterascites prevalence in a prospective cohort of cirrhotic outpatients following large-volume paracentesis with low risk of infection. Methods:, We prospectively studied all large-volume paracenteses performed in cirrhotic outpatients for 1 year. Patients with fever, abdominal pain, peritonism or hepatic encephalopathy were excluded from the study. The ascitic fluid was analyzed by means of a reagent strip with a colorimetric scale from 0 to 4. A strip test of 0 or 1 was considered negative. In those cases with a reagent strip ,2, conventional polymorphonuclear count was performed. Ascitic fluid culture was done into blood culture bottles in all cases. Results:, We performed 204 paracenteses in 40 patients. Nine cases were excluded. Culture-negative neutrocytic ascites was diagnosed in one case (0.5%), while bacterascites was diagnosed in six out of 195 cases (3%), mainly by gram-positive cocci. Conclusion:, The spontaneous bacterial peritonitis prevalence in outpatient cirrhotics with low risk of infection undergoing large-volume paracentesis is very low. Moreover, the prevalence of bacterascites is low and without clinical consequences. The routine analysis of ascitic fluid may be unnecessary in this clinical setting. Nevertheless, the use of reagent strips is a reasonable alternative due to its accessibility and low cost. [source] Candida albicans aggravates duodenal ulcer perforation induced by administration of cysteamine in ratsJOURNAL OF GASTROENTEROLOGY AND HEPATOLOGY, Issue 5 2007Tetsuya Nakamura Abstract Background:,Candida sp are frequently isolated from the ascitic fluid of patients with perforated ulcers. The present study was performed to examine whether Candida infection may be involved in the process of ulcer perforation. Methods:, Male Wistar rats were divided into a saline group (n = 15) and a Candida group (n = 17). Cysteamine-HCl (Sigma; 31 mg/100 g) was administered thrice on day 1 to both groups of animals. Candida albicans at a density of 108 in 0.5 mL of saline was administered 1 h before, and 12 h and 24 h after the first administration of cysteamine in the Candida group. Results:, Perforated duodenal ulcers were observed in 94.1% of the rats in the Candida group, but only 26.7% of the rats in the saline group (P < 0.01). The area of the duodenal ulcers in the Candida group was 40.89 ± 33.07 mm2, whereas that in the saline group was 16.53 ± 20.4 mm2 (P < 0.05). The mortality rate was significantly higher in the Candida group than in the saline group. In the Candida group, colonization by C. albicans was recognized at the ulcer base, surrounded by marked granulocytic infiltration. The number of eosinophils infiltrating the ulcer base was also significantly greater in the Candida group than in the saline group. Immunohistochemical analysis revealed the expression of secretory aspartyl protease (SAP) in the region of the ulcer showing colonization by C. albicans in the Candida group. Conclusion:,Candida albicans aggravates duodenal ulcer perforation in the experimental model of cysteamine-induced duodenal ulcer perforation. The present findings suggest that SAP and host,parasite relationships, including granulocyte-dependent mechanisms, may be involved in the aggravation of ulcer perforation by C. albicans. [source] Neonatal ascites and hyponatraemia following umbilical venous catheterizationJOURNAL OF PAEDIATRICS AND CHILD HEALTH, Issue 6 2002MS Mohan Abstract: The complications associated with umbilical venous catheterization in neonates range from pericardial effusion, portal hypertension, and peritoneal perforation with ascites, to Wharton's jelly embolism. The case of a term neonate who developed ascites and severe hyponatraemia (serum sodium 119 mmol/L) most probably following peritoneal perforation by an umbilical venous catheter is reported. The presenting feature was convulsions associated with dilutional hyponatraemia, probably following absorption of a large quantity of ascitic fluid across the peritoneum. Conservative management was associated with gradual recovery over 24 h. The case highlights that, irrespective of the route, excessive administration of salt-free fluids can lead to dilutional hyponatraemia with adverse consequences. The present case illustrates the importance of confirming intravascular positioning of umbilical catheters by ensuring free flow of blood on aspiration, to prevent/detect inadvertent peritoneal perforation. Ideally, echocardiographic confirmation of optimal intravascular placement of such catheters is preferred as radiographic confirmation is reported to be unreliable. [source] Usefulness of reagent strips for checking cure in spontaneous bacterial peritonitis after short-course treatmentALIMENTARY PHARMACOLOGY & THERAPEUTICS, Issue 1 2010J. CASTELLOTE Summary Background, The usefulness of reagent strips to check cure of spontaneous bacterial peritonitis have not been evaluated to date. Aim, To assess the usefulness of ascitic fluid analysis by means of reagent strips to check cure after a 5-day antibiotic course. Methods, We prospectively included all cirrhotic patients diagnosed with spontaneous bacterial peritonitis. On day 5, conventional and reagent strip ascitic fluid analyses were performed. Results, Fifty-three episodes of spontaneous bacterial peritonitis in 51 cirrhotic patients were included. Five patients died before the fifth day and in two patients, the control paracentesis yielded no ascitic fluid. In nine out of 46 cases (19.6%), spontaneous bacterial peritonitis had not resolved by day 5. In 32 out of 33 cases in which the ascitic fluid polymorphonuclear count was <250/,L at day five, the reagent strips was negative. The negative predictive value of the reagent strip at fifth day was 97% and the LR, 0.13. Conclusions, Almost 20% of episodes of spontaneous bacterial peritonitis do not resolve with a short-course of antibiotic treatment. In view of the high negative predictive value and low likelihood ratio for a negative test, reagent strips analysis may be an alternative to conventional cytology if a 5-day antibiotic therapy is planned. [source] Bacterial infections in cirrhosisLIVER INTERNATIONAL, Issue 4 2004Miguel Navasa Abstract: Spontaneous bacterial peritonitis, urinary tract infections, respiratory infections and bacteremia are the most frequent infective complications in cirrhosis. These infections are due to the concomitant presence of different facilitating mechanisms including changes in the intestinal flora and in the intestinal barrier, depression of activity of the reticuloendothelial system, decreased opsonic activity of the ascitic fluid, neutrophil leukocyte dysfunction and iatrogenic factors among others. The fact, that the probability of having a microorganism responsible for the infection quinolone resistant is higher than 30% should be taken into account when treating any infection in a cirrhotic patient receiving selective intestinal decontamination with quinolones, and therefore, quinolones as empiric treatment are not indicated. [source] Ascites in infants with severe sepsis , treatment with peritoneal drainagePEDIATRIC ANESTHESIA, Issue 12 2006ANDRZEJ PIOTROWSKI MD PhD Summary Background:, Ascites in neonates and infants is usually caused by cardiac failure and urinary or biliary tract obstruction. The objective of this study was to characterize our experience with ascites as a complication of sepsis. Methods:, We retrospectively collected and analyzed data of patients treated in the intensive care unit (ICU) of the university-based children's hospital, in whom ascites developed during nosocomial sepsis. Ten infants admitted to the ICU in the first 2 days of life developed sepsis on the mean 31.5 (±21.9) postnatal day. Gram-negative bacteria were the causative organism in nine cases, and Staphylococcus hemolyticus in one. Because of sepsis, reintubation and mechanical ventilation were necessary. All patients received broad spectrum antibiotics (including meropenem and ciprofloxacin), blood transfusions, catecholamines and intravenous immunoglobulin preparations. Ascites was observed on the median 13.5 day of sepsis (range 3,36), and severely compromised gas exchange. Continuous peritoneal drainage was applied by means of an intravascular catheter placed in the right lower abdominal quadrant. Results:, The mean drained fluid volume was 44.7 (±20.4) ml·kg,1·day,1, drainage was continued for a median of 5.5 (range 1,56) day, and enabled significant reduction of ventilator settings 24 h after its implementation. No severe complications related to drainage occurred; six of 10 babies survived. Conclusions:, Ascites can develop in infants with sepsis and cause respiratory compromise. Continuous drainage of ascitic fluid by means of an intravenous catheter is relatively safe and can improve gas exchange. [source] Massive ascites after living donor liver transplantation with a right lobe graft larger than 0.8% of the recipient's body weightCLINICAL TRANSPLANTATION, Issue 4 2010Yasumasa Shirouzu Shirouzu Y, Ohya Y, Suda H, Asonuma K, Inomata Y. Massive ascites after living donor liver transplantation with a right lobe graft larger than 0.8% of the recipient's body weight. Clin Transplant 2010: 24: 520,527. © 2009 John Wiley & Sons A/S. Abstract:, Background:, There are only limited data on post-transplant ascites unrelated to small-sized grafts in living donor liver transplantation (LDLT). Methods:, The subjects were 59 adult patients who had received right lobe LDLT with a graft weight-to-recipient weight ratio (GRWR) > 0.8%. Patients were divided into either Group 1 (n = 14, massive ascites, defined as the production of ascitic fluid > 1000 mL/d that lasted longer than 14 d after LDLT) or Group 2 (n = 45, no development of massive ascites). Patients were followed for a median period of 3.0 yr (range, 0.5,7.5 yr). Results:, Group 1 had both higher Model for End-Stage Liver Disease score and Child-Pugh score than Group 2. Portal venous flow volume just after reperfusion was significantly greater in Group 1 than Group 2 (307.8 ± 268.8 vs. 176.2 ± 75.0 mL/min/100 g graft weight, respectively; p < 0.05). Post-transplant infectious complications including ascites infection developed more frequently within the first post-transplant month in Group 1. Massive ascites was significantly associated with early graft loss (p < 0.05). Conclusion:, Post-transplant massive ascites associated with portal over-perfusion into the graft liver can develop in patients with a GRWR over 0.8%. Recipients with post-transplant massive ascites require careful management to prevent infection. [source] | ||||||||||||||||||||||