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Sample records for acute chylous ascites

  1. Hypertriglyceridemia-associated Acute Pancreatitis with Chylous Ascites in Pregnancy

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    Shih-Chang Chuang

    2006-01-01

    Full Text Available Both cholesterol and triglyceride levels in serum increase progressively during pregnancy. Hypertrigly-ceridemia is a well-recognized cause of acute pancreatitis, while pancreatitis-associated chylous ascites has rarely been reported. We report a 28-year-old female with coexistence of hypertriglyceridemia, acute pancreatitis, and chylous ascites during pregnancy. After emergency cesarean section, she was treated with nil per os, intravenous hydration, antibiotics, and analgesics as required. Due to the development of positive peritonitis 5 days later, an exploratory laparotomy was performed. Surgical interventions included pancreatic necrosec-tomy, right hemicolectomy and ileostomy, cholecystostomy, gastrostomy, and feeding jejunostomy. Postoperative treatment included antibiotics, total parenteral nutrition, and then low-fat diet with medium-chain triglyceride supplementation. She was discharged on the 43rd day after surgery and was free of symptoms during 6 months of follow-up. Ileocolostomy was performed 6 months after discharge. Fasting lipid profile should be regularly monitored during pregnancy due to the association of hypertriglyceridemia with development of acute pancreatitis in the mother.

  2. Chylous ascites post open cholecystectomy after severe pancreatitis.

    LENUS (Irish Health Repository)

    Cheung, Cherry X

    2012-05-01

    Chylous ascites a rare complication post cholecystectomy. There are to our knowledge only 3 reported cases in the literature. We describe a case of chylous ascites post open cholecystectomy in a patient with recent severe pancreatitis. We propose a potential relationship between acute biliary pancreatitis and the development of chylous ascites.

  3. Chylous ascites and chylothorax: a case study

    African Journals Online (AJOL)

    2010-09-07

    Sep 7, 2010 ... The treatment of the chylothorax and chylous ascites usually involves the treatment of the underlying cause. Malignant chylous serositis requires specific therapy directed at the primary cause with chemotherapy, radia- tion, and surgery with supportive therapy (8). Treatment of chylous pleural effusions with ...

  4. Four Cases of Chylous Ascites following Robotic Gynecologic Oncological Surgery

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    Ahmet Göçmen

    2014-01-01

    Full Text Available Chylous ascites is an uncommon form of ascites characterized by milky-appearing fluid caused by blocked or disrupted lymph flow through chyle-transporting vessels. The most common causes of chylous ascites are therapeutic interventions and trauma. In this report, we present four cases of chylous ascites following robot-assisted surgery for endometrial staging and the treatment strategies that we used. After retroperitoneal lymph node dissection, leaving a drain is very useful in diagnosing chylous ascites and observing its resolution; furthermore, the use of octreotide in conjunction with TPN appears to be an efficient treatment modality for chylous ascites and should be considered before any invasive intervention.

  5. Chylous ascites due to signet ring cell gastric adenocarcinoma | de ...

    African Journals Online (AJOL)

    Chylous ascites is a rare presentation of peritoneal effusion. The signet ring cell gastric adenocarcinoma is also relatively rare presentation of gastric cancer. We present a quite rare case of chylous ascites associated with signet ring cell gastric adenocarcinoma. Case report: a 47-years-old Caucasian man presented to our ...

  6. [Chylous ascites in cirrhotic and non-cirrhotic patients].

    Science.gov (United States)

    Casafont, F; López-Arias, M J; Crespo, J; Dueñas, C; Sánchez-Antolín, G; Rivero, M; Pons Romero, F

    1997-01-01

    Chylous ascites is an accumulation of lymph in the abdominal cavity. The diagnosis is established when the concentration of triglycerides in plasma is greater than in ascitic fluid over a level of 200 mg/dl. The clinical and biochemical characteristics of 22 patients with chylous ascites (11 cirrhotics and 11 non cirrhotics) were studied in order to assess differences between patients with and without hepatic cirrhosis. The cirrhotic patients with chylous ascites showed lower protein (1.3 +/- 0.74 mg/dl, p = 0.002) and cholesterol concentration (46.0 +/- 45.2 mg/dl, p = 0.02) in ascitic fluid than non cirrhotic patients (3.1 +/- 1.09 mg/dl, and 100.85 +/- 41.7 mg/dl, respectively). In addition, the cellularity in the ascitic fluid was also lower in cirrhotic patients (209.09 +/- 113.96 cel/mm3) versus (831.8 +/- 945.08 cel/mm3; p < 0.05). Four patients (18.18%) presented high adenosine deaminase levels (ADA) in the ascitic fluid in the absence of tuberculous peritonitis. The authors conclude that the biochemical differences observed in the ascitic fluid of the cirrhotic patients with chylous ascites may be explained by a dilutional mechanism due to the combination of "clear" ascites secondary to portal hypertension and chylous ascites. Furthermore, chylous ascites could be the cause of an elevation in ADA in the absence of tuberculous peritonitis.

  7. Chylous ascites following radical nephrectomy: a case report

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    Shah Shahzad S

    2008-01-01

    Full Text Available Abstract Introduction Chylous ascites may result from diverse pathologies. Ascites results either due to blockage of the lymphatics or leak secondary to inadvertent trauma during surgery. Case presentation We report the first case of chylous ascites following radical nephrectomy for a renal cell carcinoma involving the right half of a crossed fused renal ectopia. The patient was managed conservatively. Conclusion Post-operative chylous ascites is a rare complication of retroperitoneal and mediastinal surgery. Most cases resolve with conservative treatment which aims at decreasing lymph production and optimizing nutritional requirements along with palliative measures. Refractory cases need either open or laparoscopic ligation of the leaking lymphatic channels. A review of the current literature on the management of post-operative chylous ascites is presented.

  8. Chylous ascites due to signet ring cell gastric adenocarcinoma

    African Journals Online (AJOL)

    2011-09-04

    Sep 4, 2011 ... and anorexia. He had medical history of high alcohol consumption about 100 g daily, myocardial infarction in. 1997, and percutaneous coronary angioplasty with stent placement. He had no surgical and familial relevant history. On physical examination, he had ascites without signs. Chylous ascites due to ...

  9. Successful radiation treatment of chylous ascites following pancreaticoduodenectomy

    Energy Technology Data Exchange (ETDEWEB)

    Corradini, Stefanie; Niemoeller, Olivier M. [University of Munich, Department of Radiation Oncology, Munich (Germany); Liebig, Sylke [Gemeinschaftspraxis Prof. Zwicker and Partner, Konstanz (Germany); Zwicker, Felix [Gemeinschaftspraxis Prof. Zwicker and Partner, Konstanz (Germany); German Cancer Research Center (DKFZ), Clinical Cooperation Unit Molecular and Radiation Oncology, Heidelberg (Germany); Lamade, Wolfram [Helios Privatklinik, Allgemein- and Viszeralchirurgie, Ueberlingen (Germany)

    2015-05-01

    Chylous ascites is a rare complication following pancreaticoduodenectomy. We report on a case of chylous ascites following pancreaticoduodenectomy in a 76-year-old patient diagnosed with pancreatic cancer. There are various known conservative management strategies, including dietary measures or total parenteral nutrition. Unfortunately, conservative treatment - with total parenteral nutrition and fasting over a period of 4 weeks - was not successful in the present case. The daily output volume of chylous ascites was up to 2500 ml/day. Based on clinical experiences with successfully treated lymphocutaneous fistulas, low-dose radiotherapy was initiated. External beam radiotherapy comprising a total dose of 8.0 Gy to the paraaortic lymph node region was administered in daily single fractions of 1.0 Gy (five fractions/week). Throughout the course of external beam radiotherapy, the secretion of abdominal ascites rapidly decreased, resulting in complete resolution after 2 weeks. There was no clinical evidence of chylous ascites on follow-up. As a result of this experience, we believe that external beam radiotherapy should be considered as an alternative therapy in refractory cases of chylous ascites. (orig.) [German] Das Chyloperitoneum ist eine seltene Komplikation nach Pankreatikoduodenektomie. Wir berichten ueber einen 76-jaehrigen Patienten mit Chyloperitoneum nach Resektion eines Pankreaskarzinoms. Die konservativen Therapiestrategien, wie beispielsweise diaetetische Massnahmen oder totale parenterale Ernaehrung, waren im vorliegenden Fall ueber einen Zeitraum von 4 Wochen nicht erfolgreich. Es bestand eine persistierende Sekretion von Chylaszites von bis zu 2500 ml/Tag. Basierend auf den klinischen Erfahrungen bei erfolgreich behandelten lymphokutanen Fisteln, wurde eine perkutane Radiotherapie eingeleitet. Die Bestrahlung des paraaortalen Lymphabflusses ueber ventrodorsale Gegenfelder wurde bis zu einer Gesamtdosis von 8,0 Gy in 1,0 Gy Einzeldosis (5 Fraktionen

  10. Chylous Ascites in a Patient with Inflammatory Myofibroblastic Tumor

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    Sascha Dietrich

    2009-08-01

    Full Text Available Background: We present the case of a 64-year-old patient who presented to his primary care physician with fatigue, worsening shortness of breath, abdominal discomfort and a rapidly growing abdominal girth, although he had lost 5 kg of weight within 3 months. He had a history of untreated hypertension, compensated renal insufficiency and COPD. Despite weight loss and fatigue, the patient did not experience any other constitutional symptoms such as fever, night sweats or loss of appetite. Investigations: Physical examination, blood tests, CT scan of the abdomen, MRI scan of the abdomen, fine needle biopsy, excisional biopsy, Video Capsule Endoscopy, histology, PET scan. Diagnosis: Inflammatory myofibroblastic tumor, chylous ascites, chyloperitoneum. Management: Systemic chemotherapy, total parenteral nutrition and octreotide therapy. Conclusion: We describe the case of a patient in whom two extremely rare phenomena are present in combination: the diagnosis of an inflammatory myofibroblastic tumor and chylous ascites. While the tumor could be stabilized by different regimens of chemotherapy, the chyloperitoneum was treated with parenteral nutrition and subcutaneous octreotide injections, which resulted in a significant reduction of the amount of chylous ascites drained during regular paracentesis.

  11. Tratamento cirúrgico da ascite quilosa Surgical treatment of chylous ascites

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    Claudia Stein Gomes

    2009-06-01

    Full Text Available A ascite quilosa é uma complicação rara após procedimentos cirúrgicos e trauma abdominal, apresentando elevada morbidade e difícil manejo. Nos casos refratários ao tratamento clínico habitual, o tratamento cirúrgico se impõe, apesar da baixa taxa de sucesso. Dois casos são apresentados: o primeiro paciente foi vítima de trauma abdominal contuso e o segundo foi submetido a hernioplastia hiatal a Nissen videolaparoscópica, ambos evoluindo com ascite quilosa que necessitou de tratamento cirúrgico através da ligadura do ducto torácico, junto aos pilares diafragmáticos. Os pacientes evoluíram com melhora clínica e ausência de ascite após 24 meses de seguimento.Chylous ascites is a rare complication after abdominal procedures and blunt abdominal trauma, associated with high morbidity and difficult management. When clinical treatment fails, surgical intervention is necessary, despite the limited success rate. Two cases are reported: the first patient had a blunt abdominal trauma and the second patient underwent laparoscopic Nissen fundoplication; both developed chylous ascites and required surgical treatment with suture repair of the thoracic duct, close to the diaphragm. There was clinical improvement and ascites was absent at a 24-month follow-up.

  12. Chylous ascites and chylothorax due to constrictive pericarditis in a patient infected with HIV: a case report

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    Summachiwakij Sarawut

    2012-06-01

    Full Text Available Abstract Introduction Chylothorax and chylous ascites are uncommon and usually associated with trauma or neoplasms. To the best of our knowledge, constrictive pericarditis leading to chylothorax and chylous ascites in a person infected with HIV has never previously been described. Case presentation A 39-year-old Thai man was referred to our institute with progressive dyspnea, edema and abdominal distension. His medical history included HIV infection and pulmonary tuberculosis that was complicated by tuberculous pericarditis and cardiac tamponade. Upon further investigation, we found constrictive pericarditis, chylothorax and chylous ascites. A pericardiectomy was performed which resulted in gradual resolution of the ascites and chylous effusion. Conclusions Although constrictive pericarditis is an exceptionally rare cause of chylothorax and chylous ascites, it should nonetheless be considered in the differential diagnosis as a potentially reversible cause.

  13. Spontaneous resolution of chylous ascites following delivery: a case report

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    Babic Inas

    2012-07-01

    Full Text Available Abstract Introduction Chyloascites or chyloperitoneum, which can be caused by different factors, is a process of eruption of one or many lymphatic vessels spontaneously. Malignant processes, inflammation or trauma can cause a sudden burst in a lymphatic vessel which will lead to a collection of milky fluid in any space of the human body with the abdominal cavity being the most common location. Chyloperitoneum is rare during pregnancy and this case is the fifth described worldwide. Case presentation We describe a case of chyloascitis in a 27-year-old primigravida Middle Eastern woman, found coincidentally during cesarean section. Free fluid was found in the abdominal cavity with no source of trauma or masses. An abdominal drain remained in situ for six days. The milky fluid was sent for biochemical analysis and found to be positive for triglycerides. Her postoperative course was uneventful. A computed tomography scan of the abdomen and pelvis was negative for fluid collection, tumors or other lesions. While this is the fifth case of chylous ascitis associated with pregnancy, it is the second found to be spontaneous with no obvious cause described to date. Conclusion Chylous ascitis is not always associated with tumors, inflammation or trauma. It can, although rarely, be associated with pregnancy. The course of pregnancy is usually uncomplicated in the cases published to date. This fifth case serves as a reminder for obstetricians, when presented with similar findings, to consider chylous ascitis as one of the differential diagnoses. Early diagnosis and appropriate treatment is vital for improved outcomes for the mother and the fetus.

  14. Delayed-Onset Chylous Ascites After a Living-Donor Liver Transplant: First Case Successfully Treated With Conservative Treatment?

    Science.gov (United States)

    Chen, Jian-Han; Chang, Chun-Ming; Lu, Min-Chi; Wei, Chang-Kuo; Yin, Wen-Yao

    2016-06-01

    Chylous ascites is a rare complication in liver transplant. Few cases have been reported to date. In most cases, chylous ascites is diagnosed within 1 month after surgery because of intraoperative injury of the hilar lymphatic system. Preoperative massive ascites and use of a LigaSure vessel sealing system for hilar dissection have been reported as risk factors. We report a case of chylous ascites after a living-donor liver transplant that was diagnosed after 6 months of uneventful follow-up. Sirolimus was added to cyclosporine early (2 wk after the operation) owing to poor renal function and it was found to be high (> 22 ng/mL) when the chylous ascites occurred. The patient was treated with total parenteral nutrition in combination with Sandostatin and rapid tapering of sirolimus after the failed initial conservative treatment. Residual abdominal fullness after meals and lymphedema of the legs disappeared 1 month after discontinuing sirolimus. This is the first case of delayed-onset chylous ascites after a liver transplant that was successfully treated conservatively.

  15. Late onset of chylous ascites following distal gastrectomy with D1(+ dissection for gastric cancer: A case report

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    Hüseyin Çiyiltepe

    2015-12-01

    Full Text Available Chyloperitoneum is the accumulation of lymphatic fluid in the peritoneal cavity. Chylous ascites can occur if it is not recognized during surgery. The incidence of chylous ascites after oncological surgery was approximately 7.4% however, the incidence of lymphorrhea after radical gastrectomy for gastric cancer is so low. Extensive lymph node dissection leads to a higher incidence of lymphorrhea. There have been few cases associated with D1 dissection In most patients conservative treatment is recommended that includes paracentesis, total parenteral nutrition (TPN, a medium chain triglyceride (MCT based diet, and somatostatin. Surgery is the last choice only when conservative treatment fails. In this case we aimed to present a late onset of chylous ascites after subtotal gastrectomy and D1+ dissection that was treated with percutaneous drainage and conservative management.

  16. Transjugular intrahepatic portosystemic shunt for chylous ascites in a patient with recurrent cirrhosis following liver transplantation

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    Jason T. Salsamendi, MD

    2017-03-01

    Full Text Available Chylous ascites (CA is the extravasation of lipid-rich lymphatic fluid into the peritoneal space following trauma or obstruction of the lymphatic system. Refractory cases of cirrhosis-related CA may be amendable to transjugular intrahepatic portosystemic shunting (TIPS. We present a case of TIPS in the setting of refractory CA secondary to cirrhosis of a transplanted liver graft. Following TIPS, the patient reported immediate improvement in abdominal pain and no longer requires paracentesis. Our case suggests TIPS to be a safe and effective treatment option for CA in liver transplant patients with cirrhosis.

  17. A case of the yellow nail syndrome associated with massive chylous ascites, pleural and pericardial effusions.

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    Malek, N P; Ocran, K; Tietge, U J; Maschek, H; Gratz, K F; Trautwein, C; Wagner, S; Manns, M P

    1996-11-01

    A 26-year-old male patient with a history of chronic peripheral lymphedema, yellowish coloured slow growing nails and pleural effusions since early childhood is described. After 23 years he developed a chylous ascites and scintigraphy with technetium-99m labeled albumin clearly demonstrated a diffuse protein loss involving the whole jejunum and ileum. Subsequent jejunal and duodenal biopsies showed the typical histological findings of intestinal lymphangiectasia thereby confirming a diffuse intestinal lymphatic damage. In addition to the gastrointestional symptoms the patient developed a pericardial effusion diagnosed by echocardiographic imaging. Dietary treatment with middle chained triglycerides and intravenous human albumin supplementation was followed by the reduction of the ascites and improvement of the peripheral lymphedema. To our knowledge this is the first description of the yellow nail syndrome associated with a diffuse lymphangiectasia involving the whole small bowel.

  18. Chylous ascytes secondary to acute pancreatitis: a case report and review of literature Ascitis quilosa secundaria a pancreatitis: caso clínico y revisión de la bibliografía

    OpenAIRE

    J. M. Gómez-Martín; Martínez-Molina, E; Sanjuanbenito, A.; E. Martín-Illana; F. Arrieta; J. A. Balsa; I. Zamarrón; Vázquez, C.; J. I. Botella-Carretero

    2012-01-01

    Chylous ascites is an uncommon finding which is due to the presence of thoracic or intestinal lymph in the abdominal cavity. It is usually caused by a chronic disruption of the lymphatic system. The present report is one of the rare cases in the literature of chylous ascites secondary to idiopathic acute pancreatitis, which showed a complete resolution with a combination of low fat enteral nutrition with MCT and somatostatin analogs.La ascitis quilosa es un hallazgo infrecuente producido por ...

  19. Establishment of triglyceride cut-off values to detect chylous ascites and pleural effusions.

    Science.gov (United States)

    Thaler, Markus A; Bietenbeck, Andreas; Schulz, Christoph; Luppa, Peter B

    2017-02-01

    Lipoprotein electrophoresis is the gold standard for the detection of chylous ascites and pleural effusions. It is, however, not suitable as a front-line test and not widely available. Most clinicians must rely solely on the quantitative determination of lipids. The aim of this work was to establish lipid cut-off values for the presence of chylomicrons in pleural and peritoneal fluid. Triglyceride and cholesterol levels from 113 peritoneal and 154 pleural fluid samples investigated for chylomicrons via lipoprotein electrophoresis were considered. Receiver operating characteristic analyses were performed and cut-off levels determined. 54 peritoneal and 59 pleural fluid samples were positive for chylomicrons. In peritoneal fluid, triglycerides and triglycerides/cholesterol ratio exhibited areas under the curve (AUC) not significantly different from each other, but significantly larger than cholesterol alone. The AUC for triglycerides in pleural fluid was significantly larger than the AUCs for cholesterol and the triglycerides/cholesterol ratio. Triglyceride cut-offs with maximum Youden-Index, sensitivity >95%, and specificity >95% were calculated to be 187, 148, and 246mg/dl (2.13, 1.69, and 2.80mmol/l) for peritoneal fluid, and 240, 94, and 240mg/dl (2.74, 1.07, and 2.74mmol/l) for pleural fluid. Triglyceride levels are the best parameter to detect chylous body fluids when lipoprotein electrophoresis is not available. Single-point triglyceride cut-offs of 187 and 240mg/dl (2.13 and 2.74mmol/l) or alternatively equivocal ranges of 148-246 and 94-240mg/dl (1.69-2.80 and 1.07-2.74mmol/l) were established for peritoneal and pleural fluid, respectively. Copyright © 2016 The Canadian Society of Clinical Chemists. Published by Elsevier Inc. All rights reserved.

  20. Congenital fetal and neonatal visceral chylous effusions: neonatal chylothorax and chylous ascites revisited. A multicenter retrospective study.

    Science.gov (United States)

    Bellini, C; Ergaz, Z; Radicioni, M; Forner-Cordero, I; Witte, M; Perotti, G; Figar, T; Tubaldi, L; Camerini, P; Bar-Oz, B; Yatsiv, I; Arad, I; Traverso, F; Bellini, T; Boccardo, F; Campisi, C; Dalmonte, P; Vercellino, N; Manikanti, S; Bonioli, E

    2012-09-01

    This retrospective study was carried out at eight Neonatal Intensive Care Units (NICU) Centers worldwide on 33 newborns presenting at birth with pleural, pericardial, or abdominal chylous effusions. Diagnosis of chylous effusion is based on findings of fluid with a milk-like appearance, a concentration of triglycerides in pleural effusion >1.1 mmol/l, and a total cell count >1,000 cells/ml with a predominance of >80% lymphocytes. Thirty-three newborns met the inclusion criteria and were studied. Six subjects who presented at birth with fetal effusion were treated by in-utero pleuro-amniotic shunt. Five of these patients are alive at follow-up. At birth, pleural drainage was performed in 29/33 patients and abdominal drainage was carried out in 3/33. Total parenteral nutrition (TPN) was given to 32/33 patients; 19/23 patients were fed a medium-chain triglycerides (MCT). No adverse effects were observed. Eight patients were treated with Octreotide at dosages ranging from 1 to 7 mcg/kg/hour for 8 to 35 days. All patients showed decreased chylous production. Two patients were treated by pleurodesis. Twenty-two babies are alive after at least 6 months follow-up, 9/33 are deceased, and 2 were lost to follow-up. Clinical conditions of survivors are basically good except for lung involvement [chronic lung disease (CLD) or lung lymphangiectasia] and lymphedema. All patients were using a MCT diet at follow-up with good control of chylous effusion. Visceral chylous effusions of the fetus and neonate are rare disorders, and there currently is only partial agreement on decision-making strategies. We suggest the need for an international prospective trial in an effort to establish the efficacy and effectiveness of diagnostic and therapeutic options described in this article.

  1. Chylous Ascites in a Patient with HIV/AIDS: A Late Complication of Mycobacterium avium Complex-Immune Reconstitution Inflammatory Syndrome

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    Imam H. Shaik

    2014-01-01

    Full Text Available Chylous ascites is very rare in HIV/AIDS and its association with Mycobacterium avium complex-immune reconstitution inflammatory syndrome (MAC-IRIS has been rarely reported. Here, we report a case of a young African-American male who developed chylous ascites as a late sequela to immune reconstitution inflammatory syndrome while on treatment for MAC. Antiretroviral drug-naive patients who start HAART in close proximity to the diagnosis of an opportunistic infection and have a rapid decline in HIV RNA level should be monitored for development of IRIS. Although the long term prognosis is poor, early diagnosis and treatment help to improve quality of life.

  2. Reinfusion of ascites during hemodialysis as a treatment of massive refractory ascites and acute renal failure

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    Ta-Wei Hsu

    2011-02-01

    Full Text Available Ta-Wei Hsu1, Yi-Chuan Chen2, Meei-Ju Wu2, Anna Fen-Yau Li3, Wu-Chang Yang2, Yee-Yung Ng21Department of Medicine, I-Lan Hospital, 2Division of Nephrology, Department of Medicine, 3Department of Pathology, Taipei Veterans General Hospital, School of Medicine, National Yang-Ming University, Taipei, TaiwanAbstract: Refractory ascites can occur in patients with various conditions. Although several procedures based on the reinfusion of ascitic fluid have been reported after the failure of bed rest, salt and water restriction, diuretics, intravenous administration of albumin, and repeated paracentesis, these procedures are performed for ascitic fluid removal without dialytic effect. In this study, a flow control reinfusion of ascites during hemodialysis (HD was performed to demonstrate the efficacy of this method in a lupus patient with massive refractory ascites and respiratory and acute renal failure (ARF. The alleviation of ascites and ARF attests to the success of the flow control reinfusion of ascites during HD. This procedure can control the rate of ascites and body fluid removal simultaneously during HD using the roller pump. In conclusion, with a normal coagulation profile, the procedure of flow control reinfusion of ascites during HD is an effective alternative treatment for the alleviation of refractory ascites with renal failure.Keywords: ascites, lupus, renal failure, reinfusion

  3. Ascites

    DEFF Research Database (Denmark)

    Henriksen, Jens Henrik Sahl; Møller, Søren

    is put on the description of this entity. Ascites of other aetiologies are mentioned along with hepatic ascites, in particular, if the pathophysiology differs from ascites of hepatic origin. Table of Contents: Abbreviations / Introduction / Pathophysiology of Ascites / Systemic Elements in the Ascites......-stage congestive heart failure. The addition of complications like the hepatorenal syndrome and bacterial peritonitis, whether spontaneous or secondary, adds heavily to the bad prognosis. Since hepatic ascites are by far the most complex with respect to pathophysiology, complications, and treatment, emphasis...

  4. Ascites

    DEFF Research Database (Denmark)

    Henriksen, Jens Henrik Sahl; Møller, Søren

    This volume deals with the history, aetiology, pathophysiology, symptoms, signs, prognosis, and rational treatment of ascites. During the past decade, our knowledge of the pathophysiology of ascites has increased substantially and more specific therapies are now based on aetiology and pathophysio...

  5. Ascites

    Science.gov (United States)

    ... the lining of the abdomen and abdominal organs. Causes Ascites results from high pressure in the blood vessels of the liver (portal hypertension) and low levels of a protein called albumin . Diseases that ...

  6. Bilateral chylothorax, chylopericardium and chylous ascitis

    Directory of Open Access Journals (Sweden)

    Anil Kashyap

    2011-01-01

    Full Text Available Non-Hodgkin′s lymphoma (NHL can commonly present as chylothorax and rarely as chylopericardium. Here we are presenting a case of a 21-years-old female with bilateral chylothorax, chylopericardium and chylous ascites all together finally diagnosed to have NHL as the etiology. To the best of our knowledge, it has been reported very infrequently.

  7. Chylous ascites and chylothorax: a case study

    African Journals Online (AJOL)

    2010-09-07

    Sep 7, 2010 ... cell adenocarcinoma (Fig. 1). Computed tomography. (CT) of the thorax was done after thoracocentesis to find out the possible etiology. It showed bilateral pleural effusion, pericardial effusion, paratracheal, and mediast- inal lymph nodes up to 8 mm with a calcified granuloma in the left upper lobe (Fig. 2).

  8. Pancreatic ascites hemoglobin contributes to the systemic response in acute pancreatitis.

    Science.gov (United States)

    Pérez, Salvador; Pereda, Javier; Sabater, Luis; Sastre, Juan

    2015-04-01

    Upon hemolysis extracellular hemoglobin causes oxidative stress and cytotoxicity due to its peroxidase activity. Extracellular hemoglobin may release free hemin, which increases vascular permeability, leukocyte recruitment, and adhesion molecule expression. Pancreatitis-associated ascitic fluid is reddish and may contain extracellular hemoglobin. Our aim has been to determine the role of extracellular hemoglobin in the local and systemic inflammatory response during severe acute pancreatitis in rats. To this end we studied taurocholate-induced necrotizing pancreatitis in rats. First, extracellular hemoglobin in ascites and plasma was quantified and the hemolytic action of ascitic fluid was tested. Second, we assessed whether peritoneal lavage prevented the increase in extracellular hemoglobin in plasma during pancreatitis. Third, hemoglobin was purified from rat erythrocytes and administered intraperitoneally to assess the local and systemic effects of ascitic-associated extracellular hemoglobin during acute pancreatitis. Extracellular hemoglobin and hemin levels markedly increased in ascitic fluid and plasma during necrotizing pancreatitis. Peroxidase activity was very high in ascites. The peritoneal lavage abrogated the increase in extracellular hemoglobin in plasma. The administration of extracellular hemoglobin enhanced ascites; dramatically increased abdominal fat necrosis; upregulated tumor necrosis factor-α, interleukin-1β, and interleukin-6 gene expression; and decreased expression of interleukin-10 in abdominal adipose tissue during pancreatitis. Extracellular hemoglobin enhanced the gene expression and protein levels of vascular endothelial growth factor (VEGF) and other hypoxia-inducible factor-related genes in the lung. Extracellular hemoglobin also increased myeloperoxidase activity in the lung. In conclusion, extracellular hemoglobin contributes to the inflammatory response in severe acute pancreatitis through abdominal fat necrosis and inflammation

  9. Ascitic fluid of experimental severe acute pancreatitis modulates the function of peritoneal macrophages.

    Science.gov (United States)

    Satoh, A; Shimosegawa, T; Masamune, A; Fujita, M; Koizumi, M; Toyota, T

    1999-10-01

    Although the pathophysiology of acute pancreatitis appears to be greatly influenced by the production of ascites, little is known about the mechanism. To investigate the effects of pancreatitis-associated ascitic fluid (PAAF) on macrophage function, we examined the effects of PAAF obtained from a rat model of severe acute pancreatitis on the ability of peritoneal macrophages to produce tumor necrosis factor-alpha (TNF-alpha). In addition, we compared the responses of PAAF-treated and PAAF-untreated macrophages to lipopolysaccharide (LPS) by evaluating their TNF-alpha production and nuclear factor-kappaB (NFkappaB) activation. Incubation of peritoneal macrophages with the PAAF led to the rapid and prolonged activation of NF-kappaB and to TNF-alpha production. Pyrrolidine dithiocarbamate, a potent inhibitor of NF-kappaB activation, attenuated the macrophage TNF-alpha production by PAAF. Macrophages produced TNF-alpha in response to LPS, but the cytokine production was significantly reduced when macrophages were pretreated with PAAF. The suppression of TNF-alpha production by PAAF pretreatment accompanied the impairment of NF-kappaB activation in response to LPS. These results indicate that the PAAF of severe acute pancreatitis may play important roles in the pathologic course of this disease through its effects on macrophage function.

  10. [Medical treatment of chylous effusions in newborn infants. Apropos of 3 cases].

    Science.gov (United States)

    Jernite, M; Donato, L; Favre, R; Haddad, J; Esposito, M; Messer, J

    1992-11-01

    Chylous effusions are the most frequent cause of non immunologic hydrops fetalis. They can be recognized antenatally by ultrasonography. Their evacuation is sometimes necessary and medical treatment often effective. Case n. 1: fetal ascites was detected by ultrasonography at the 30th week of gestation. Paracentesis was performed at 36 weeks, followed 3 days later by spontaneous delivery. The newborn was fed milk formula. A second paracentesis showed a milky fluid, rich in cholesterol, triglycerides and chylomicrons. The child was fed formula rich in medium-chain triglycerides and the chylous ascites disappeared completely within 2 weeks. Case n. 2: a diagnosis of bilateral hydrothorax and hydramnios was made at the 27th week of gestation. An in utero evacuation of the hydrothorax performed at the 30th week was ineffective and a pleuro-amniotic drainage was performed 2 weeks later. The baby was born at the 35th week, and presented a moderate respiratory distress due to the hydrothorax and ascites. Aspiration of the thoracic fluid confirmed its chylous origin. The chylous effusions completely disappeared when the child was fed a high medium chain triglycerides diet. A lymphedema of legs appeared at the age of 1 month. Case n. 3: ascites, hydramnios, hydrothorax and peripheral edema were found at the 21st week of a third pregnancy (the 2 first pregnancies were complicated by lethal hydrops fetalis). Bilateral hydrothorax and peripheral edema were found again after birth at the 37th week. Diuresis and albumin-infusion led to recovery, but chylothorax and chylous ascites reaccumulated after introduction of milk formula, despite repeated evacuations and feeding medium-chain triglycerides formula. The thoracic fluid remains chylous at the age of 9 months. In utero, and sometimes post-natal, evacuation of fluid present in the thoracic and peritoneal cavities can be necessary, depending of the functional tolerance. Medical management including feeding a low fat and/or high

  11. Chylous mesenteric cyst: A diagnostic dilemma

    Directory of Open Access Journals (Sweden)

    Doreen L.P. Lee

    2016-07-01

    Full Text Available A mesenteric cyst is defined as a cyst that is located in the mesentery of the gastrointestinal tract and may extend from the base of the mesentery into the retroperitoneum. A case report of a patient with mesenteric cyst is presented. In addition, a systematic review was performed of English language literature on chylous mesenteric cysts in adult humans. Of the 18 articles included in the review, there were 19 cases of chylous mesenteric cysts reported. Male to female ratio was 1.4:1 with a median age of 46 years. A preoperative diagnosis of mesenteric cyst was made in four patients based on computed tomography. All patients underwent surgery and there were no reports of recurrence on follow up. Chylous mesenteric cyst is a rare entity that needs to be recognized whenever a preliminary diagnosis of intra-abdominal cystic mass is made.

  12. A case of chronic lymphocytic leukemia with massive ascites

    Directory of Open Access Journals (Sweden)

    Meliha Nalcaci

    2012-10-01

    Full Text Available An 81-year old woman with a history of chronic lymphocytic leukemia (CLL was admitted with night sweats and abdominal distension. A complete blood count showed hemoglobin 5 g/dL, white blood cell (WBC count 28.5x109/L and platelets 38.4x109/L. Peripheral blood smear examination showed a large number of smudge cells and lymphocytosis composed of mature-looking lymphocytes with clumped nuclear chromatin. Computed tomography scan demonstrated enlarged cervical, axillary, paraaortic, retroperitoneal and mesenteric lymph nodes with concomitant omental thickening and ascites. Also, the liver and the spleen were enlarged in the presence of multiple ill-defined hypoechoic areas in the latter. Histopathological analysis of the cervical lymph node biopsy was consistent with CLL. Bone marrow examination showed diffuse infiltration of the marrow with small lymphocytes. Analysis of the ascitic fluid revealed an exudate with WBC 1220 cells/mL. Cytocentrifuge preparation of the ascitic fluid showed small mature lymphoid cells containing hyperchromatic nuclei with coarsely gran- ular chromatin. On flow cytometric analysis of the ascitic fluid, expression of CD5, CD19, CD20, CD22, CD23, CD45 and HLA-DR was compatible with a diagnosis of CLL, in accordance with the results of the peripheral blood analysis. The patient was treated with chemotherapy consisting of cyclophosphamide, vincristine and prednisolone but died within one month after development of non-chylous ascites.

  13. [Conservative therapy in the treatment of cervical chylous leakage].

    Science.gov (United States)

    Wu, Gao-song; Huang, Li-li; Tu, Shun-gui; Liu, Yan-yan; Liu, Jie; Yan, Qun; Yi, Ji-lin; Zou, Sheng-quan

    2009-05-01

    To explore and evaluate the combined conservative managements in the treatment of cervical chylous leakage. Thirty nine cases of cervical chylous leakage from June 1992 to June 2008 were retrospectively analyzed in this hospital. All of the 39 cases were cured by treating with conservative individualized therapy, including the applying of diet with high calorie, high protein and low fat and fatty food should only contains medium-chain triglycerides, total parenteral nutrition, keep the balance of hydrogen and electrolyte and correct hypoproteinemia, local pressure dressing, high persistent vacuum drainage (-50 approximately -80 kPa) and/or somatostatin analogue. All the cases of chylous leakage happened 2nd to 5th days after the operation. Among the 39 cases, 7 were high flow (drainage>or=500 ml/d) chylous leakage, the amount of drainage reached as high as 1440 ml per day. The time of chylous leakage closure was 3 approximately 12 days, and the mean time was 7 days. No one experienced re-operation, wound hydrops or wound infection. The conservative individualized therapy may play a key role in the treatment of cervical chylous leakage.

  14. Evolution of chylous fistula management after neck dissection.

    Science.gov (United States)

    Campisi, Corrado C; Boccardo, Francesco; Piazza, Cesare; Campisi, Corradino

    2013-04-01

    The present review is focused on the management of lymphatic, chylous, and thoracic duct lesions following head and neck surgery, with particular attention to these complications after neck dissection. Postoperative scenarios may include chylous fistula, chylothorax, chylomediastinum, chylopericardium, lymphocele, persistent lymphorrhea, and secondary lymphedema. There is a paucity of literature on the treatment of lymphatic, chylous, and thoracic duct injuries following head and neck surgery; however, this review suggests that the most appropriate treatment should include both conservative and surgical approaches. Nonsurgical options consist of low-fat diet with medium-chain triglycerides, total parenteral nutrition, careful monitoring of fluid and electrolytes, drainage of the leakage, somatostatin analogs such as octreotide, and negative-pressure wound therapy. On the other hand, surgical management includes therapeutic percutaneous lymphography-guided thoracic duct cannulation and embolization, thoracic duct ligation, excision and imbrication of leaking lymphatics, chylous fistula surgical/microsurgical repair, fistula closure by locoregional flaps, video-assisted thoracoscopic surgery, thoracotomy, pleurodesis and decortication, pericardial 'window', and pleura-venous/pleura-peritoneal shunts. In addition, single or, preferably, multiple lymphovenous anastomoses may be taken into account. The various possible clinical presentations of such challenging lymphatic, chylous, and thoracic duct injuries require an appropriate multidisciplinary approach by experienced teams. Primary prevention of these complications can be achieved through adequate surgical planning to minimize lesions, including structured and thorough patient assessment, and centralization of resources and teams.

  15. Management of cirrhotic ascites

    DEFF Research Database (Denmark)

    Pedersen, Julie Steen; Bendtsen, Flemming; Møller, Søren

    2015-01-01

    in the natural history of chronic liver failure it predicts a poor outcome with a 50% mortality rate within 3 years. Patients with ascites are at high risk of developing complications such as spontaneous bacterial peritonitis, hyponatremia and progressive renal impairment. Adequate management of cirrhotic......The most common complication to chronic liver failure is ascites. The formation of ascites in the cirrhotic patient is caused by a complex chain of pathophysiological events involving portal hypertension and progressive vascular dysfunction. Since ascites formation represents a hallmark...

  16. Chylous leak following left anterior spine decompression: Case report

    African Journals Online (AJOL)

    Chylous leakage is an unusual complication following anterior spinal surgery. This leakage can occur as a result of traumatic injury to the thoracic duct, the cisterna chyli, or the retroperitoneal lymphatic vessels. We report a case of a 56 year old female with thoracic spine disc prolapses with cord compression. She had ...

  17. [Ascites drainage at home

    NARCIS (Netherlands)

    Lutjeboer, J.; Erkel, A.R. van; Hoeven, J.J.M. van der; Meer, R.W. van der

    2015-01-01

    Ascites can lead to many symptoms, and often occurs in patients with an end-stage malignancy such as ovarian, pancreatic, colonic, or gastric cancer. Intermittent ascites drainage is applied in these patients as a palliative measure. As frequent drainage is necessary, a subcutaneously tunnelled

  18. A case report of chylous ascites after gastric bypass for morbid obesity.

    Science.gov (United States)

    Capristo, Esmeralda; Spuntarelli, Valerio; Treglia, Giorgio; Arena, Vincenzo; Giordano, Alessandro; Mingrone, Geltrude

    2016-01-01

    We described the case of a highly aggressive antral gastric carcinoma with a scarce symptomatology, in a patient undergone Roux-en-Y Gastric Bypass (RYGB) for obesity. A 61 year-old white man in apparent good health, who underwent laparoscopic RYGB for obesity 18 months earlier, with a loss of 30kg, reported a sudden abdominal distension and breath shortness with a weight gain of 5kg in few days. Endoscopy of both upper gastro-intestinal tract and the colon were performed along with CT-scan and positron-emission tomography (PET) CT- scan. A biopsy of the palpable lymph node in the left supraclavicular fossa was taken for analysis. Abdominal paracentesis produced milky fluid, while citrine pleural fluid was aspirated by thoracentesis. Immunochemistry studies of the lymph node biopsy revealed tumor cells positive for cytokeratin (CK)7 and CK20, CDX2 and CAM 5.2 and negative for HER2 and TTF1 suggesting colon cancer. The colon and upper gastro-intestinal endoscopy were normal. A CT-scan and positron-emission tomography (PET) with 2-[fluorine-18]fluoro-2-deoxy-d-glucose (FDG) showed an intense FDG-uptake in the gastric antrum and in the lymph nodal chains. Given these findings, a diagnosis of poorly differentiated antral gastric carcinoma with multiple lymph node metastases was raised.The patients died 4 months after diagnosis. RYGB is a widely performed bariatric operation and no data are reported on the risk of developing gastric cancer in the excluded stomach. This case report suggests that great attention should be devoted to post-RYGB patients for an early diagnosis of malignant gastric cancer. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

  19. Ergotamine-Associated Valvulopathy with Recurrent Chylous Pleural Effusion

    OpenAIRE

    Bois, John P.; Ponnada, Vara Venkata; O'Cochlain, D. Fearghas; Brady, Peter A.; Edwards, William D.; Klarich, Kyle W.

    2012-01-01

    We report a rare case of ergotamine-associated mitral stenosis in a 55-year-old woman who presented with recurrent chylous pleural effusion. Echocardiographic, gross, and microscopic features of the mitral valve were consistent with chronic ergotamine-induced valvulopathy. We conclude that medication-induced valvulopathy should be included in the differential diagnosis of valvular heart disease. In addition, cardiac function should be monitored before and during long-term therapy with ergotam...

  20. Ergotamine-associated valvulopathy with recurrent chylous pleural effusion.

    Science.gov (United States)

    Bois, John P; Ponnada, Vara Venkata; O'Cochlain, D Fearghas; Brady, Peter A; Edwards, William D; Klarich, Kyle W

    2012-01-01

    We report a rare case of ergotamine-associated mitral stenosis in a 55-year-old woman who presented with recurrent chylous pleural effusion. Echocardiographic, gross, and microscopic features of the mitral valve were consistent with chronic ergotamine-induced valvulopathy. We conclude that medication-induced valvulopathy should be included in the differential diagnosis of valvular heart disease. In addition, cardiac function should be monitored before and during long-term therapy with ergotamine or ergotamine-derived dopamine agonists.

  1. [Treatment of refractory ascites].

    Science.gov (United States)

    Martínez, Javier; Albillos, Agustín

    2014-07-01

    Ascites is a common complication of hepatic cirrhosis and portal hypertension. Patients present systemic and splanchnic circulation disorders, which cause central hypovolemia and arterial hypotension, with the subsequent activation of vasoconstrictor systems and increased renal reabsorption of sodium and water. Approximately 5%-10% of patients present refractory ascites. Refractory ascites is considered when it is not controllable with standard dietary (sodium restriction) and diuretic (furosemide up to 160 mg a day and spironolactone up to 400mg a day) treatment or when patients present adverse effects due to diuretics that impede their administration at optimum dosages. The current therapeutic options for these patients are repeated evacuative paracentesis and the percutaneous intrahepatic portosystemic shunt. Despite these treatments, refractory ascites has a poor prognosis; patients should therefore be assessed for liver transplantation. Copyright © 2014 Elsevier España, S.L. All rights reserved.

  2. Chylous leakage after thoracolumbar fracture may cause paraplegia.

    Science.gov (United States)

    von Knoch, Marius; Michiels, Ivo; Mueller, Stefan; Siahkamary, Leila

    2004-01-15

    Retrospective case report. This case demonstrates that paraplegia can develop due to chylous leakage into the spinal canal without obvious retroperitoneal or intrathoracic involvement. This clinical presentation of chylous leakage has not been reported previously. RESULTS A 61-year-old female with osteoporosis suffered a pathologic fracture of the vertebral bodies T12 and L1 and developed partial paraplegia two weeks later. Imaging showed expansive pooling of intraspinal fluid without intrathoracic or retroperitoneal involvement. A blood-tinged fluid was aspirated from dorsal. Repeated surgery by a posterior approach with drainage of the fluid did not improve the patient's condition, so she was finally transferred to our hospital. Under the suspected diagnosis of lymphatic leakage a scintiscan with 123I-iodinephenylpentadekanacid-marked cream verified the presumption of a lymph fistula at the level of T12/L1, originating from the thoracic duct. By permanent draining of the posterior fistula without suction and strict intravenous alimentation the fluid production decreased continuously and finally ceased completely. Simultaneously, the neurologic state improved gradually without returning to normal completely. This case demonstrates that paraplegia can develop due to chylous leakage into the spinal canal without obvious retroperitoneal or intrathoracic involvement. This differential diagnosis should be kept in mind when treating patients with abundant fluid drainage into or from the spinal canal.

  3. Indocyanine green lymphography and lymphaticovenous anastomosis for generalized lymphatic dysplasia with pleural effusion and ascites in neonates.

    Science.gov (United States)

    Mihara, Makoto; Hara, Hisako; Shibasaki, Jun; Seki, Yukio; Hayashi, Akitatsu; Iida, Takuya; Adachi, Shinya; Uchida, Yasushi; Kaneko, Hideo; Haragi, Makiko; Murakami, Arata

    2015-08-01

    The fatality rate of generalized lymphatic dysplasia (GLD) with chylous pleural effusion and ascites is particularly high when it persists over a prolonged period. The purpose of this report was to determine the utility of indocyanine green (ICG) lymphography and lymphaticovenous anastomosis (LVA) in GLD with chylous pleural effusion and ascites in neonates. We tested the lymphatic function in the 4 extremities for 8 GLD neonate patients using ICG lymphography, and on the basis of the results, we performed LVA for 5 of them. LVA was performed at the extremities under general anesthesia using incisions drainage tube. In all cases, ICG lymphography showed varying degrees of dermal backflow in the limbs with lymphostasis. After LVA surgery, effusion stopped in 2 cases and decreased in 1 case. In the cases where effusion stopped, backflow as observed with ICG lymphography was minimal, and in the case where effusion decreased but did not stop, backflow was moderate. The application of ICG and LVA could possibly be used to diagnose and treat lymphatic pleural effusion or ascites. Copyright © 2015 Elsevier Inc. All rights reserved.

  4. Ascites: Pathogenesis and therapeutic principles

    DEFF Research Database (Denmark)

    Møller, Søren; Henriksen, Jens H; Bendtsen, Flemming

    2009-01-01

    Ascites is a classic complication of advanced cirrhosis and it often marks the first sign of hepatic decompensation. Ascites occurs in more than 50% of patients with cirrhosis, worsens the course of the disease, and reduces survival substantially. Portal hypertension, splanchnic vasodilatation......, liver insufficiency, and cardiovascular dysfunction are major pathophysiological hallmarks. Modern treatment of ascites is based on this recognition and includes modest salt restriction and stepwise diuretic therapy with spironolactone and loop-diuretics. Tense and refractory ascites should be treated...

  5. Evaluation of ascitic soluble human leukocyte antigen-G for distinguishing malignant ascites from benign ascites.

    Science.gov (United States)

    Sun, Juan; Chang, Yan-Xiang; Niu, Chun-Yan

    2017-11-01

    The overexpression of soluble human leukocyte antigen-G is associated with malignant tumours. The purpose of our study was to detect soluble human leukocyte antigen-G concentrations in ascites and to evaluate the value of ascitic soluble human leukocyte antigen-G for the diagnosis of malignant ascites. Enzyme-linked immunosorbent assay was used to detect soluble human leukocyte antigen-G levels in 64 patients with malignant ascites and 30 patients with benign ascites. Receiver operating characteristic curves were used to evaluate the diagnostic efficacy of ascitic soluble human leukocyte antigen-G for the detection of malignant ascites. Ascitic soluble human leukocyte antigen-G levels were significantly higher in the malignant ascites group than in the benign ascites group (20.718 ± 3.215 versus 12.467 ± 3.678 µg/L, t = 7.425, p human leukocyte antigen-G was 0.957 (95% confidence interval, 0.872-0.992). At a cut-off value of 19.60 µg/L, the sensitivity and specificity of ascitic soluble human leukocyte antigen-G were 87.5% (95% confidence interval, 71.0%-96.5%) and 100% (95% confidence interval, 88.4%-100%), respectively. With respect to area under the receiver operating characteristic curve, sensitivity and specificity, ascitic carcinoembryonic antigen (0.810, 68.75% and 83.33%, respectively) and carbohydrate antigen 19-9 (0.710, 65.63% and 70%, respectively) significantly differed (all p human leukocyte antigen-G was 75%, which was higher than the corresponding rates for ascitic carcinoembryonic antigen (31.25%) and carbohydrate antigen 19-9 (6.25%; both p human leukocyte antigen-G exhibited good performance for diagnosing malignant ascites, and particularly those that were cytology-negative and biopsy-positive.

  6. A case of inflammatory ascites

    Directory of Open Access Journals (Sweden)

    Marco Biolato

    2008-03-01

    Full Text Available Even ascites appears mainly as sign of portal hypertension in patiens with liver cirrhosis, in some case depends on a different lying condition such as right congestive heart failure, peritoneal carcinomatosis or tuberculosis. In these cases, paracentesis represents the key tool for diagnosis. We report a case of cardiac ascites in a 71-years-old woman who developed in four-month an abdominal distension. Preliminary exams showed exudative ascites related to portal hypertension, a pelvic mass with caseous apparence, and inflammatory status ad an elevation of CA-125. Successive evaluation exluded peritoneal carcinomatosis or tuberculosis, underlyng a tricuspidal regurgitation. The literature on ascites has also been reviewed.

  7. Chronic lupus peritonitis with ascites.

    OpenAIRE

    Kaklamanis, P; Vayopoulos, G; Stamatelos, G; Dadinas, G; Tsokos, G C

    1991-01-01

    A 28 year old woman with systemic lupus erythematosus who developed chronic lupus peritonitis and ascites is described. Lupus peritonitis appeared with abdominal fullness, postprandial abdominal discomfort, and painless ascites. Four months later the patient developed vertigo, headaches, visual disturbances, serositis, and glomerulonephritis. Lupus peritonitis and the other disease manifestations responded to treatment with intravenous pulse methylprednisolone (four 1 g/m2 injections at one w...

  8. Urinary ascites in late onset of bladder injury post laparoscopic hysterectomy

    Directory of Open Access Journals (Sweden)

    Josette C. Dawkins

    2017-10-01

    Vesicoperitoneal fistulae (VPF are rare and should be included in the differential diagnosis of the patient with acute onset ascites following gynecologic surgery. This case is the first case report of a VPF occurring 5 years following surgery.

  9. Chylous pleural effusion associated with primary lymphedema and lymphangioma-like malformations

    NARCIS (Netherlands)

    Bresser, P.; Kromhout, J. G.; Reekers, J. A.; Verhage, T. L.

    1993-01-01

    We describe a patient with a chylous pleural effusion associated with primary lymphedema of his right leg and abdominal wall. On evaluation a generalized, severe hypoplasia of the lymphatic system turned out to be associated with hyperplastic, lymphangioma-like malformations

  10. Ascite meconial - relato de caso

    Directory of Open Access Journals (Sweden)

    Celeste Gomez Sardinha Oshiro

    2016-10-01

    Full Text Available INTRODUÇÃO: A ascite meconial resultante da perfuração intestinal fetal tem baixa incidência (1:30.000 nascimentos e elevada mortalidade (50%. Os achados ecográficos fetais incluem ascite e calcificações intra-abdominais. OBJETIVO: Relatar um caso de ascite meconial neonatal no Conjunto Hospitalar de Sorocaba. METODOLOGIA: Descrição do referido caso e revisão de literatura. RELATO DE CASO: Recém-nascido de J.A.P., masculino, de parto cesáreo por iteratividade em 12/05/2016, cuja mãe com 44 anos, sem intercorrências no pré-natal, negou consanguinidade, vícios e infecções; ultrassonografia obstétrica evidenciou ascite moderada, circunferência abdominal >p95, hepatomegalia e hidrocele. Ao nascimento, idade gestacional 3 8 2 /7 semanas, peso=3630g, comprimento=49 cm, Apgar 8/9. Apresentava abdome globoso, fígado a 4 cm do rebordo costal direito e hidrocele volumosa. Realizada paracentese com saída de 310 ml de líquido esverdeado (meconial. No 5o dia de vida, durante laparotomia, observou-se aderência de alças intestinais, perfuração de íleo terminal a 8 cm da vávula íleo-cecal, sendo realizada ileostomia. O anátomo-patológico de apêndice cecal evidenciou processo inflamatório crônico, neovascularização e fibrose. Paciente recebeu nutrição parenteral por 14 dias; houve progressão da dieta do 6o ao 36o dia de vida, recebendo alta em aleitamento materno e boa recuperação clínica. CONCLUSÃO: A ascite meconial por perfuração intestinal deve ser considerada no diagnóstico diferencial de ascite fetal. O diagnóstico ecográfico pré-natal é fundamental para o prognóstico pós-natal.

  11. Chylous effusion presenting in a 37-year-old woman with severe hypothyroidism: a case report

    Directory of Open Access Journals (Sweden)

    Chen Weichia

    2010-10-01

    Full Text Available Abstract Introduction We report what is to the best of our knowledge the second adult case of chylothorax clearly associated with severe hypothyroidism in the English-language medical literature. To the best of our knowledge, this is the first case of its kind reported without a prior history of malignancy. Case presentation A 37-year-old Hispanic woman with no reported significant past medical history initially presented with shortness of breath and inability to lose weight. She was found to have a large chylous effusion requiring chest-tube drainage, as well as severe hypothyroidism. After several weeks of thyroid hormone-replacement therapy, the formation of chylous pleural fluid in the patient greatly diminished, and the chest tube was removed. Upon long-term follow-up her minimal residual effusion remains stable on serial chest radiographs. Conclusion Although the exact pathophysiologic relation between low thyroid hormone levels and chyle formation remains to be elucidated, hypothyroidism should be a diagnostic consideration in patients with chylous effusions, especially those refractory to conventional treatments.

  12. Continuous Furosemide Infusion in the Management of Ascites

    Science.gov (United States)

    Rogers, Nicholas A.; Gupta, Samir; Cuthbert, Jennifer A.

    2012-01-01

    Background The current therapy for patients hospitalized with ascites requires titration of oral diuretics and often needs several days. A faster method for predicting the response to a given dose of diuretic may allow this process to be completed more rapidly. Aim Describe the short-term safety and efficacy of a diuretic infusion to predict net sodium excretion in patients with cirrhosis, ascites and edema using a fractional excretion of sodium (FENa) of ≥1% as the target. Methods We conducted a retrospective case series of patients admitted for management of ascites who received intravenous furosemide by continuous infusion in ascites management. Patients were stratified depending on whether they had edema, received an intravenous bolus of furosemide or a large-volume paracentesis. The primary outcome was the proportion of patients achieving a FENa of ≥1% during the infusion. Secondary outcomes included development of electrolyte abnormalities or acute kidney injury (AKI) during or immediately following the infusion and natriuresis on titrated oral furosemide. Results 47 patients meeting criteria were identified from 721 patients seen in consultation. 10 of the patients had edema and received neither bolus intravenous diuretic therapy nor therapeutic paracentesis; all ten achieved a FENa ≥1%. One patient had transient hypokalemia. Of 37 patients who either had no edema or received additional treatment options, all but six patients achieved a FENa of ≥1%. Transient complications in the 31/37 patients with natriuresis included hyponatremia (n = 1), hypokalemia (n = 5) and AKI (n = 3). 24 hour urine sodium averaged > 4 g/d on the titrated oral furosemide regimen in 19 patients completing the collection. Conclusion Use of a short continuous furosemide infusion can achieve a FENa ≥ 1% in patients with cirrhotic ascites and may be safe and efficacious for diuresis, meriting further study. PMID:22373660

  13. Nephrogenic ascites - Still an intractable problem?

    Directory of Open Access Journals (Sweden)

    Shobhana Nayak-Rao

    2015-01-01

    Full Text Available Nephrogenic ascites or ascites associated with renal failure is seen in end-stage renal disease in-patients on hemodialysis but has been described occasionally in earlier stages of renal failure. The cause can be multifactorial and a combination of inadequate dialysis and ultrafiltration, poor nutrition and increased peritoneal membrane permeability in uremia. Generally, the onset of nephrogenic ascites is insidious and portends a grim long-term prognosis. We describe herein three patients who presented with refractory ascites of nephrogenic origin and review this entity.

  14. Ascites revisited: the value of serum-ascites albumin gradient (SAAG ...

    African Journals Online (AJOL)

    Ascites is derived from the Greek word “askos”, meaning bag or sack. Approximately 85% of patients (in the USA) with ascites have liver cirrhosis. Ascites may be reversible in the setting of alcoholic hepatitis if the patient ceases consumption of alcohol, as well as in non-alcoholic cirrhosis, with effective therapy.

  15. Ultrasonic Diagnosis of Fetal Ascites and Toxoplasmosis

    DEFF Research Database (Denmark)

    Blaakær, Jan

    1986-01-01

    The ultrasonic diagnosis of fetal ascites caused by Toxoplasma Gondii is presented. When a diagnosis of fetal ascites without obvious etiological malformation is established, toxoplasmosis should be suspected. A serological test should be performed, in view of the possibility of antenatal treatment...

  16. Massive Ascites Complicating Pre-eclampsia

    Directory of Open Access Journals (Sweden)

    Ma-Lee Ko

    2005-09-01

    Conclusion: Clinicians should be aware of the possible presence of ascites in patients with severe pre-eclampsia. If the hypertension is controlled and the fetus is healthy, abdominal paracentesis without pregnancy termination is an efficacious procedure for the management of massive ascites complicating severe pre-eclampsia.

  17. Novel management of intractable chylous fistula with the application of an impression paste.

    Science.gov (United States)

    Mingxing, Lu; Guowen, Sun; Zhiyong, Wang; Wei, Han

    2013-01-01

    Chylous fistula is a kind of complication during neck dissection that rarely happens, but might lead to some serious clinical outcome. The standard treatments include local compressive bandaging, negative pressure drainage, ligation of the fistula orifice, alimentary control, and, occasionally, the use of somatostatin. Among them, the simplest is compressive bandaging, but the bandage can easily become loosened and cannot achieve the necessary pressure effect. In this paper, the novel application of an impression paste, which is normally used in prosthodontic treatments, will be introduced. It might be a very practical method for the treatment of these surgical complications in hospitals where advanced treatment modalities are not available.

  18. A successful experience in managing a chylous reflux: importance of lymphoscintigraphy.

    Science.gov (United States)

    Kazemzadeh, Gholam Hossein; Sadeghi, Ramin; Ebrahimi, Emad; Rad, Mohammad Ali Ghodsi

    2014-05-01

    Chylous reflux is described as the backflow of chyle through the varicose lymphatics with incompetent lymph valves and leakage of the lymph. The valves in the dilated, varicose, tortuous lymph vessels become incompetent, and as a result, the lymph blended with chyle, reflux into the lower limbs or the genitalia. Reflux causes delayed lymphatic transport in the affected lower extremity and chronic lymphedema can develop. Vesicles containing chyle could appear on the skin of the involved parts, and milky fluid discharge of the lymph and chyle interferes greatly with quality of life.

  19. Minocycline induced lupus with yellow colored chylous exudative pleural effusion.

    Science.gov (United States)

    Starobin, Daniel; Guller, Vladimir; Gurevich, Alexander; Tal, Sari

    2017-01-01

    Ninety years old male was admitted to hospital due to breathlessness. The prominent findings were extensive blue-grey skin pigmentation and large left chylothorax. Drug induced lupus was diagnosed due to either minocycline chronic treatment or no alternative illness to explain his sub-acute disease. Minocycline therapy was stopped with gradual improvement of pleural effusion and skin discoloration. This case is the first presentation of minocycline induced lupus with chylothorax.

  20. Minocycline induced lupus with yellow colored chylous exudative pleural effusion

    Directory of Open Access Journals (Sweden)

    Daniel Starobin

    2017-01-01

    Full Text Available Ninety years old male was admitted to hospital due to breathlessness. The prominent findings were extensive blue-grey skin pigmentation and large left chylothorax. Drug induced lupus was diagnosed due to either minocycline chronic treatment or no alternative illness to explain his sub-acute disease. Minocycline therapy was stopped with gradual improvement of pleural effusion and skin discoloration. This case is the first presentation of minocycline induced lupus with chylothorax.

  1. Cerebrospinal fluid ascites. a case report and literature review ...

    African Journals Online (AJOL)

    Liver, cardiac and renal causes of ascites were diagnostically ruled out. Cerebrospinal fluid biochemistry was normal but ascitic fluid biochemistry and electrophoresis of the ascitic fluid were deranged. The ascites resolved gradually within two weeks of endoscopic third ventriculostomy. Cases recorded in literature are ...

  2. The role of pleurodesis in the management of chylous pleural effusion after surgery for congenital heart disease.

    Science.gov (United States)

    Katanyuwong, Poomiporn; Dearani, Joseph; Driscoll, David

    2009-11-01

    This study aimed to determine the incidence and outcome of postoperative chylous pleural effusion as well as the efficacy of pleurodesis for its management after surgery for congenital heart disease. Medical and surgical databases were used to identify all patients who had surgery for congenital heart disease and subsequently experienced postoperative chylous pleural effusion. Medical records were reviewed and daily chest drainage and management strategies were recorded. From January 2000 to June 2006, 1,166 cardiac operations were followed by 19 cases of chylous pleural effusion, for an incidence of 1.6%. The diagnosis was made a mean of 9 days after the operation. The patients were divided into two groups according to treatment strategy. Group 1 included 9 patients who had received only conventional medical treatment consisting of parenteral nutrition and/or medium-chain triglyceride formula and/or a low-fat diet and/or somatostatin. Group 2 included 10 patients who initially received conventional medical treatment, then subsequently received chemical or mechanical pleurodesis. The amount of the chylous drainage was significantly less in group 1 (14 ml/kg/day) than in group 2 (24 ml/kg/day) (P congenital heart disease, especially after failed conservative treatment. However, some patients may need more than one pleurodesis.

  3. Umbilical hernia rupture with evisceration of omentum from massive ascites: a case report.

    LENUS (Irish Health Repository)

    Good, Daniel W

    2011-01-01

    The incidence of hernias is increased in patients with alcoholic liver disease with ascites. To the best of our knowledge, this is the first report of an acute rise in intra-abdominal pressure from straining for stool as the cause of a ruptured umbilical hernia.

  4. Premature parturition, edema, and ascites in an alpaca infected with Anaplasma phagocytophilum

    OpenAIRE

    Tinkler, Stacy H.; Firshman, Anna M.; Sharkey, Leslie C.

    2012-01-01

    An 8-year-old alpaca was presented for fever, anorexia, edema, ascites, and premature parturition. She was determined to have Anaplasma phagocytophilum infection based on positive blood polymerase chain reaction (PCR) and positive acute and convalescent serum titers. Antibiotics and supportive therapies were administered and the alpaca made a complete recovery.

  5. Premature parturition, edema, and ascites in an alpaca infected with Anaplasma phagocytophilum

    Science.gov (United States)

    Tinkler, Stacy H.; Firshman, Anna M.; Sharkey, Leslie C.

    2012-01-01

    An 8-year-old alpaca was presented for fever, anorexia, edema, ascites, and premature parturition. She was determined to have Anaplasma phagocytophilum infection based on positive blood polymerase chain reaction (PCR) and positive acute and convalescent serum titers. Antibiotics and supportive therapies were administered and the alpaca made a complete recovery. PMID:23633715

  6. Congenital transmesenteric hernia presenting as neonatal ascites

    Directory of Open Access Journals (Sweden)

    Andreia Felizes

    2018-01-01

    Full Text Available Transmesenteric hernia is an internal hernia without sac, which forms through a congenital mesentery defect. Mostly diagnosed intraoperatively, it as a variable prognosis, which can lead to high morbidity and mortality.The authors describe a case of transmesenteric hernia that presented as isolated fetal ascites. A 34 week preterm baby was delivered by forceps, with respiratory compromise due to abdominal distension. Orotracheal intubation and evacuation paracentesis were performed. After excluding major causes of neonatal ascites and persistent bowel loop distension, the newborn underwent an exploratory laparotomy, where a transmesenteric hernia and pellets of meconium were identified. Hernia reduction, enterectomy and enterostomies were performed, with good outcome. Cystic fibrosis was diagnosed during post-operatory period.This is the first reported case of transmesenteric hernia presenting as fetal ascites, without associated morbidity or mortality due to an early intervention. Keywords: Transmesenteric hernia, Fetal ascites, Cystic fibrosis

  7. Ascites Neutrophil Gelatinase-Associated Lipocalin Identifies Spontaneous Bacterial Peritonitis and Predicts Mortality in Hospitalized Patients with Cirrhosis.

    Science.gov (United States)

    Cullaro, Giuseppe; Kim, Grace; Pereira, Marcus R; Brown, Robert S; Verna, Elizabeth C

    2017-12-01

    Neutrophil gelatinase-associated lipocalin (NGAL) is a marker of both tissue injury and infection. Urine NGAL levels strongly predict acute kidney injury and mortality in patients with cirrhosis, but ascites NGAL is not well characterized. We hypothesized that ascites NGAL level is a marker of spontaneous bacterial peritonitis (SBP) and mortality risk in patients with cirrhosis. Hospitalized patients with cirrhosis and ascites undergoing diagnostic paracentesis were prospectively enrolled and followed until death or discharge. Patients with secondary peritonitis, prior transplantation, or active colitis were excluded. NGAL was measured in the ascites and serum. Ascites NGAL level was evaluated as a marker of SBP (defined as ascites absolute neutrophil count > 250 cells/mm 3 ) and predictor of in-patient mortality. A total of 146 patients were enrolled, and of these, 29 patients (20%) had SBP. Baseline characteristics were similar between subjects with and without SBP. Median (IQR) ascites NGAL was significantly higher in patients with SBP compared to those without SBP (221.3 [145.9-392.9] vs. 139.2 [73.9-237.2], p peritonitis in hospitalized patient with cirrhosis and an independent predictor of short-term in-hospital mortality, even controlling for SBP and MELD.

  8. Chlamydia Peritonitis and Ascites Mimicking Ovarian Cancer

    Directory of Open Access Journals (Sweden)

    Anar Gojayev

    2016-01-01

    Full Text Available Background. Pelvic inflammatory disease (PID rarely results in diffuse ascites. Severe adhesive disease secondary to PID may lead to the formation of inclusion cysts and even pelvic peritoneal nodularity due to postinflammatory scarring and cause an elevation of serum CA-125 levels. The constellation of these findings may mimic an ovarian neoplasm. Case. We report a case of a 22-year-old female who presented with multiple pelvic cysts and diffuse ascites due to Chlamydia trachomatis infection. The initial gynecologic exam did not reveal obvious evidence of PID; however, a positive Chlamydia trachomatis test, pathologic findings, and the exclusion of other etiologies facilitated the diagnosis. Conclusion. Chlamydia trachomatis and other infectious agents should be considered in the differential diagnosis of a young sexually active female with abdominal pain, ascites, and pelvic cystic masses. Thorough workup in such a population may reduce the number of more invasive procedures as well as unnecessary repeat surgical procedures.

  9. Treatment of ascites and spontaneous bacterial peritonitis - Part I

    DEFF Research Database (Denmark)

    Bendtsen, Flemming; Grønbæk, Henning; Hansen, Jesper Bach

    2012-01-01

    National guidelines for treatment of ascites, spontaneous bacterial peritonitis, hepatorenal syndrome, and hyponatremia have been approved by the Danish Society of Gastroenterology and Hepatology. Ascites develops in approximately 60% of patients with cirrhosis during a 10 year period and is freq......National guidelines for treatment of ascites, spontaneous bacterial peritonitis, hepatorenal syndrome, and hyponatremia have been approved by the Danish Society of Gastroenterology and Hepatology. Ascites develops in approximately 60% of patients with cirrhosis during a 10 year period...

  10. Umbilical arterial necrotic vasculopathy associated with fetal ascites.

    Science.gov (United States)

    Rossi, Giuliana; Cosmi, Erich; Trevisanuto, Daniele; Cappellari, Ambra; Andrisani, Alessandra; Visentin, Silvia; Chiarelli, Silvia; Zanardo, Vincenzo

    2010-01-01

    Immune and nonimmune neonatal ascites may be part of hydrops fetalis or may be an isolated finding. However, a significant percentage of nonimmune ascites do not have an identifiable pathogenesis and are considered idiopathic. We report a case of fetal ascites and umbilical arterial necrotic vasculopathy, an association not previously described. 2010 S. Karger AG, Basel.

  11. Clinical Features of Refractory Ascites in Outpatients

    Directory of Open Access Journals (Sweden)

    Wanda Regina Caly

    Full Text Available OBJECTIVES: To present the clinical features and outcomes of outpatients who suffer from refractory ascites. METHODS: This prospective observational study consecutively enrolled patients with cirrhotic ascites who submitted to a clinical evaluation, a sodium restriction diet, biochemical blood tests, 24 hour urine tests and an ascitic fluid analysis. All patients received a multidisciplinary evaluation and diuretic treatment. Patients who did not respond to the diuretic treatment were controlled by therapeutic serial paracentesis, and a transjugular intrahepatic portosystemic shunt was indicated for patients who required therapeutic serial paracentesis up to twice a month. RESULTS: The most common etiology of cirrhosis in both groups was alcoholism [49 refractory (R and 11 non-refractory ascites (NR]. The majority of patients in the refractory group had Child-Pugh class B cirrhosis (p=0.034. The nutritional assessment showed protein-energy malnutrition in 81.6% of the patients in the R group and 35.5% of the patients in the NR group, while hepatic encephalopathy, hernia, spontaneous bacterial peritonitis, upper digestive hemorrhage and type 2 hepatorenal syndrome were present in 51%, 44.9%, 38.8%, 38.8% and 26.5% of the patients in the R group and 9.1%, 18.2%, 0%, 0% and 0% of the patients in the NR group, respectively (p=0.016, p=0.173, p=0.012, p=0.012, and p=0.100, respectively. Mortality occurred in 28.6% of the patients in the R group and in 9.1% of the patients in the NR group (p=0.262. CONCLUSION: Patients with refractory ascites were malnourished, suffered from hernias, had a high prevalence of complications and had a high postoperative death frequency, which was mostly due to infectious processes.

  12. An Extremely Uncommon Case of Parasitic Infection Presenting as Eosinophilic Ascites in a Young Patient

    Directory of Open Access Journals (Sweden)

    Kemal Oncu

    2011-04-01

    Full Text Available We report the case of a 24-year-old male patient admitted for recent ascites and splenomegaly of unknown origin. The patient was referred to our institution with complaints of diarrhea, epigastric pain, abdominal cramping and weight loss over the past three weeks. The acute onset presented with colicky abdominal pain and peritoneal effusion. History revealed reduced appetite and weight gain of 7 kg over the last one month. His past medical history and family history was negative. He had no history of alcohol abuse or viral hepatitis infection. Laboratory data revealed normal transaminases and bilirubin levels, and alkaline phosphatase and gammaglutamyltransferase were within normal range. A diagnostic laparoscopy was performed which showed free peritoneal fluid and normal abdominal viscera. Upper gastrointestinal system endoscopy performed a few days later revealed diffuse severe erythematous pangastritis and gastroduodenal gastric reflux. Duodenal biopsies showed chronic nonspecific duodenitis. Antrum and corpus biopsies showed chronic gastritis. The ascitic fluid was straw-colored and sterile with 80% eosinophils. Stool exam was negative for parasitic infection. Treatment with albendazole 400 mg twice daily for 5 days led to the disappearance of ascites and other signs and symptoms. Three months after albendazole treatment the eosinophilic cell count was normal. The final diagnosis was consistent with parasitic infection while the clinical, sonographic and histological findings suggested an eosinophilic ascites. We emphasize the importance of excluding parasitic infection in all patients with eosinophilic ascites. We chose an alternative way (albendazole treatment to resolve this clinical picture. With our alternative way for excluding this parasitic infection, we treated the patient and then found the cause.

  13. Prevalence of spontaneous bacterial peritonitis in liver cirrhosis with ascites

    OpenAIRE

    Oladimeji, Ajayi Akande; Temi, Adegun Patrick; Adekunle, Ajayi Ebenezer; Taiwo, Raimi Hassan; Ayokunle,Dada Samuel

    2013-01-01

    Introduction Spontaneous bacterial peritonitis (SBP) is a common bacterial infection in patients with cirrhosis and ascites requiring prompt recognition and treatment. The aim of this study was to determine the prevalence, and characteristics of SBP among in-patients with cirrhosis and ascites seen at our facility. Methods Thirty one patients with liver cirrhosis and ascites who were admitted into the Medical ward of the Ekiti State University Teaching Hospital (EKSUTH), Ado-Ekiti, Nigeria fr...

  14. Ascite: estado da arte baseado em evidências Ascite: state of the art based on evidences

    Directory of Open Access Journals (Sweden)

    Dahir Ramos de Andrade Júnior

    2009-01-01

    Full Text Available A ascite é o acúmulo de líquido livre de origem patológica na cavidade abdominal, fenômeno presente em várias doenças da prática clínica. A doença mais associada com ascite é a cirrose hepática. Na sua fisiopatologia destacam-se três teorias que ocorrem sempre em determinado paciente, porém em momentos diferentes de sua doença: vasodilatação, "overflow" e "underfill". O conceito mais moderno sugere que as três teorias estão presentes no mesmo paciente com cirrose, dependendo do tempo de evolução de sua doença. A teoria da vasodilatação estaria presente desde a fase pré-ascítica até a ascite de longa data. A teoria do overflow seria predominante nos primeiros meses de ascite e a teoria underfill explicaria a maioria dos achados em pacientes com ascite por longo tempo. Neste artigo são comentadas em detalhes as várias doenças que produzem ascite, os métodos diagnósticos empregados na pesquisa clínica da ascite, as complicações da ascite e as opções terapêuticas disponíveis. Em cada item é mostrado o grau de evidência (A até C presente na literatura médica.The accumulation of free fluid of pathological origin in the peritoneal cavity is named ascites, and, in clinical practice this phenomenon is present in several diseases. The most common cause of ascites is liver cirrhosis. In the pathophysiology of ascites three theories are noteworthy: vasodilation, overflow and underfill. The modern concept suggest that these three theories are present in the same patient with cirrhosis depending on the disease evolution time. The vasodilation theory would be important in the pre-ascitic phase as well as during all the ascites evolution time. The overflow theory would be important in the first months of development of ascites in cirrhosis, and the underfill theory would explain most of the findings in patients with ascites for a long time. This article comments in detailed, several diseases that produce ascites, the

  15. Comparative Analysis of Intranodal Lymphangiography with Percutaneous Intervention for Postsurgical Chylous Effusions.

    Science.gov (United States)

    Yannes, Michael; Shin, Donghoon; McCluskey, Kevin; Varma, Rakesh; Santos, Ernesto

    2017-05-01

    To evaluate clinical success and time to resolution of intranodal lymphangiography (INL) alone or with thoracic duct embolization (TDE) or thoracic duct disruption (TDD) based on initial effusion volume for postsurgical chylothorax. Retrospective review was performed of 57 patients (mean age 63 y; 65% male) undergoing INL alone or in conjunction with other percutaneous techniques for postsurgical chylous effusions. INL alone was performed when chylothorax output was ≤ 500 mL/d and no leak was identified during fluoroscopy. INL was technically successful in all patients. There was 1 major and 2 minor complications. Clinical success rate was 71% (40/56). Clinical success rate meeting algorithmic inclusion criteria was 71.4% (5/7) for INL only, 41.7% (5/12) in INL with TDD, and 90.5% (19/21) in INL with TDE. Hazard ratio (HR) of clinical success of INL with TDE versus INL only was not statistically significant (HR 2.3, 95% confidence interval [CI], 0.70-5.87, P = .19). Median time to resolution was 14 days for INL only (95% CI, 0 days to not reached), 7 days for INL with TDD (95% CI, 4 days to not reached), and 3 days for INL with TDE (95% CI, 2 to 5 days) (P = .007). No statistically significant difference in median time to resolution existed between INL with TDE and INL only (P = .04). In patients with postsurgical chylothorax, INL alone had similar rates of clinical success and time to resolution compared with INL with TDE when initial effusion volume was ≤ 500 mL/d and no leak was visualized during fluoroscopy. Copyright © 2016 SIR. Published by Elsevier Inc. All rights reserved.

  16. Modern management of chylous leak following head and neck surgery: a discussion of percutaneous lymphangiography-guided cannulation and embolization of the thoracic duct.

    Science.gov (United States)

    Scorza, Leslie B; Goldstein, Bradley J; Mahraj, Rickhesvar P

    2008-12-01

    High-output chylous leak beyond 5 to 7 days of conservative medical treatment should be treated promptly to avoid the risk for nutritional and imunologic depletion. Given the effectiveness and low morbidity of this minimally invasive treatment, this is a reasonable first option before surgical repair of thoracic duct leak not responsive to conservative medical treatment.

  17. The validity of the proteins concentrations in the ascitic liquid and serum for the differential diagnosis of the ascitis

    National Research Council Canada - National Science Library

    Valdivia R, Mario; Llanos C, Alejandro; Zapata S, Carlos; Muñoz O, Norvinda

    2002-01-01

    ... in the ascitic serum and fluid, for the discrimination of possible etiological causes of ascites, including in these parameters Protein Concentration in the Ascitic Fluid, the Serum-Ascites Albumin Gradient...

  18. Fetal ascites. A report of 3 autopsy cases.

    Science.gov (United States)

    Sakamoto, A; Matsuo, K; Kawai, K; Yoshida, K; Fukuda, K; Nakano, M; Nakatani, A; Tsuchiyama, H; Tagawa, H

    1987-09-01

    Three rare autopsy cases of fetal ascites were presented and the etiology of each case was described. Case 1 was a male neonate, delivered by cesarean section at 32 weeks' gestation, and died of respiratory failure. The abdomen was remarkably distended with 1020 ml of ascites. The etiology of Case 1 remained unknown even after macroscopic and microscopic examinations. We considered this as "idiopathic" fetal ascites. Case 2 was a female neonate, delivered at 31 weeks' gestation, with marked abdominal distension and cyanosis. Autopsy revealed 435 ml of ascites, and she was considered to have had "polysplenia syndrome" with cardiovascular malformations. Intrauterine heart failure due to cardiac anomalies was thought to be the cause of this ascites. In case 3 embryotomy was carried out under the diagnosis of fetal ascites by ultrasound examination at 22 weeks' gestation. An urachal cyst connected to the dilated urinary bladder and deficiency of musculature of the abdominal wall composed of loose connective tissue with calcification were observed. The abdominal wall was ruptured and 1,960 ml of ascites was measured. Polycystic kidney with renal dysplasia was also found. Case 3 showed "Prune-Berry syndrome" and fetal ascites may have arisen from these anomalies.

  19. Massive Haemorrhagic Ascites and Pleural effusion: An Unusual ...

    African Journals Online (AJOL)

    The association between endometriosis and haemorrhagic (bloody) ascites is rare.Since its first description by Brews in 1954,only a few sporadic cases have been reported in the literature. We report a case of massive haemorrhagic ascites associated with right-sided pleural effussion.Therapeutic paracentesis of eight litres ...

  20. Beta-blockers in cirrhosis and refractory ascites

    DEFF Research Database (Denmark)

    Kimer, Nina; Feineis, Martin; Møller, Søren

    2015-01-01

    OBJECTIVE: It is currently discussed if beta-blockers exert harmful effects and increase mortality in patients with cirrhosis and refractory ascites. In this study, we provide an overview of the available literature in this field in combination with a retrospective analysis of 61 patients...... with cirrhosis and refractory ascites in a tertiary unit. MATERIAL AND METHODS: We performed a systematic search of literature in May 2014. In addition, 61 patients with cirrhosis and ascites were identified and followed from development of refractory ascites until death or end of follow-up. RESULTS: Fourteen...... trials (9 trials on propranolol, 1 case-control study and 4 retrospective analyses) were identified. One trial suggested an increased mortality in patients treated with beta-blockers and refractory ascites. The results of the remaining trials were inconclusive. No increase in mortality among beta...

  1. Disaggregation and invasion of ovarian carcinoma ascites spheroids

    Directory of Open Access Journals (Sweden)

    Pambuccian Stefan E

    2006-01-01

    Full Text Available Abstract Background Malignant ascites often develops in advanced stages of ovarian carcinoma, consisting of single and aggregated tumor cells, or spheroids. Spheroids have commonly been used as tumor models to study drug efficacy, and have shown resistance to some chemotherapies and radiation. However, little is known about the adhesive or invasive capabilities of spheroids, and whether this particular cellular component of the ascites can contribute to dissemination of ovarian cancer. Here, we examined the invasive ability of ascites spheroids recovered from seven ovarian carcinoma patients and one primary peritoneal carcinoma (PPC patient. Methods Ascites spheroids were isolated from patients, purified, and immunohistochemical analyses were performed by a pathologist to confirm diagnosis. In vitro assays were designed to quantify spheroid disaggregation on a variety of extracellular matrices and dissemination on and invasion into normal human mesothelial cell monolayers. Cell proliferation and viability were determined in each assay, and statistical significance demonstrated by the student's t-test. Results Spheroids from all of the patients' ascites samples disaggregated on extracellular matrix components, with the PPC spheroids capable of complete disaggregation on type I collagen. Additionally, all of the ascites spheroid samples adhered to and disaggregated on live human mesothelial cell monolayers, typically without invading them. However, the PPC ascites spheroids and one ovarian carcinoma ascites spheroid sample occasionally formed invasive foci in the mesothelial cell monolayers, suggestive of a more invasive phenotype. Conclusion We present here in vitro assays using ascites spheroids that imitate the spread of ovarian cancer in vivo. Our results suggest that systematic studies of the ascites cellular content are necessary to understand the biology of ovarian carcinoma.

  2. Umbilical hernia rupture with evisceration of omentum from massive ascites: a case report

    LENUS (Irish Health Repository)

    Good, Daniel W

    2011-05-03

    Abstract Introduction The incidence of hernias is increased in patients with alcoholic liver disease with ascites. To the best of our knowledge, this is the first report of an acute rise in intra-abdominal pressure from straining for stool as the cause of a ruptured umbilical hernia. Case presentation An 81-year-old Caucasian man with a history of alcoholic liver disease presented to our emergency department with an erythematous umbilical hernia and clear, yellow discharge from the umbilicus. On straining for stool, after initial clinical assessment, our patient noted a gush of fluid and evisceration of omentum from the umbilical hernia. An urgent laparotomy was performed with excision of the umbilicus and devitalized omentum. Conclusion We report the case of a patient with a history of alcoholic liver disease with ascites. Ascites causes a chronic increase in intra-abdominal pressure. A sudden increase in intra-abdominal pressure, such as coughing, vomiting, gastroscopy or, as in this case, straining for stool can cause rupture of an umbilical hernia. The presence of discoloration, ulceration or a rapid increase in size of the umbilical hernia signals impending rupture and should prompt the physician to reduce the intra-abdominal pressure.

  3. A Trial Diagnosis of Ascites Syndrome in Broiler Chickens.

    Science.gov (United States)

    Liu, Wuyi

    Ascites syndrome is currently a serious disease issue for the global chicken industry. Ascites syndrome is a metabolic disorder frequently found in fast growing broilers including abdominal distention and standing fluid collection in chicken abdomen. It is one of the most common nutrition metabolic disorders. In this study, the clinical diagnosis technology of broiler ascites symptoms mainly included the trial inquiry of feeders and administrators, local observation, detection of farm gas and faeces and pathological autopsy. The study investigated the case of broiler ascites syndrome of local commercial broiler chickens at the age of 4-5 weeks to reduce outburst of ascites syndrome in broiler chickens. Through the trial clinical diagnosis of broiler ascites symptoms and pathological autopsy and observation, it came to the definite diagnosis of broiler ascites. Subsequent investigation found that the rearing houses were closed and sealed with poor ventilation and a high breeding density and much ammonia gas. Under the comprehensive management and drug treatments, there were 800 chickens found ill and later came back to normal from illness after the treatments, except for the death of 38 sick chickens. The appetite and drink of broiler chicken came to normal gradually.

  4. Intraperitoneal pressure: ascitic fluid and splanchnic vascular pressures, and their role in prevention and formation of ascites

    DEFF Research Database (Denmark)

    Henriksen, Jens Henrik Sahl; Stage, J G; Schlichting, P

    1980-01-01

    pressure, (b) decreased interstitial fluid colloid osmotic pressure, (c) increased lymph flow, and it is concluded that the peritoneal space can be considered as a special part of the interstitium in which IFP is considered to play an important role in regulation of ascitic fluid........005). After diuretic therapy WHVP decreased to an average of 20 mmHg. Mean plasma colloid osmotic pressures were 20 mmHg (range 18-24 mmHg)( and 23 mmHg (range 19-29 mmHg) in patients with and without ascites, the values being significantly different (P Colloid osmotic pressure of ascitic fluid...

  5. Ascites and other incidental findings revealing undiagnosed systemic rheumatoid arthritis.

    Science.gov (United States)

    Szeto, Matthew Chak Hin; Disney, Benjamin; Perkins, Philip; Wood, Gordon

    2015-06-08

    We describe a case of a 43-year-old man presenting to the gastroenterology outpatient department with exudative ascites. Mediastinal lymphadenopathy, pericardial effusion and pleural effusion were detected on further imaging. Further clinical examination revealed subcutaneous nodules on the left arm, which were confirmed to be rheumatoid nodules on histology. Inflammatory markers were elevated with positive serology for rheumatoid factor and anticyclic citrullinated protein antibody. Our investigations excluded tuberculosis, pancreatitis and malignancy in the patient. Following review by a rheumatologist, a diagnosis of systemic rheumatoid arthritis (RA) was made. Pleuritis and pericarditis are well recognised as extra-articular manifestation of RA. Ascites, however, is rarely recognised as a manifestation of RA. Our literature search revealed two other cases of ascites due to RA disease activity, and both patients had long-standing known RA. This case adds to the discussion on whether ascites and peritonitis should be classified as extra-articular manifestations of RA. 2015 BMJ Publishing Group Ltd.

  6. Cases with Refractory Ascites and a Delayed Response to Tolvaptan

    Science.gov (United States)

    Hagiwara, Satoru; Nishida, Naoshi; Chishina, Hirokazu; Ida, Hiroshi; Sakurai, Toshiharu; Komeda, Yoriaki; Kitano, Masayuki; Kudo, Masatoshi

    2016-01-01

    The patient was a 67-year-old female with liver cirrhosis due to hepatitis C. She was administered furosemide at 20 mg/day and spironolactone at 25 mg/day, but the ascites did not improve. Despite the additional administration of tolvaptan at 3.75 mg/day, the response to ascites was still poor. While the dose of tolvaptan was thereafter increased to 7.5 mg/day on the 7th hospital day, the ascites still persisted. However, she continued to receive tolvaptan (7.5 mg/day) because the worsening of her subjective symptoms was mild and she wished to do so. The ascites was later found to have almost completely disappeared on computed tomography (CT) at 6 months. PMID:27853068

  7. Giant Renal Cyst Mimicking Ascites on Abdominal Ultrasonography

    Directory of Open Access Journals (Sweden)

    Martin Borovec

    2009-01-01

    Full Text Available An article describes diagnostic difficulties in patient with giant renal cyst, erroneously diagnosed as ascites on ultrasonographic examination. Patient was initially suspected to have disseminated intraabdominal malignancy. Abdominal paracentesis of supposed ascites was performed. The diagnosis of giant renal cyst was finally made by CT and patient was treated surgically. The limitations of ultrasonographic examination are pointed out are and a brief review of similar cases is given.

  8. Clinical Meaning of Ascites in Patients with Endomyocardial Fibrosis

    Directory of Open Access Journals (Sweden)

    Barretto Antonio Carlos Pereira

    2002-01-01

    Full Text Available OBJECTIVE: To evaluate the clinical meaning of ascites and the main features of patients with ascites and endomyocardial fibrosis. METHODS: We studied 166 patients with endomyocardial fibrosis (mean age 37 years, 114 women treated over the last 20 years. Ventriculography findings, surgery or necropsy confirmed the diagnosis in all patients. Most patients belonged to New York Heart Association Functional Class III/IV (134, 83.7%. Eighty-one (50.6% had biventricular, 28 (17.5% had right ventricular, and 51 (31.8% had left ventricular involvement. During follow-up, 56 patients died. RESULTS: Ascites was present in 67 (41.8% patients, and right ventricular involvement was present in 59 (88%. In the comparison between patients with or without ascites, those with ascites had higher mortality (49.2% and 24.7%, respectively. Patients with ascites had a higher incidence of edema (95% vs. 43%, hepatomegaly (5.8cm vs. 4.1cm, mean right atrium pressure (19.3 vs. 12mmHg, and final right ventricle diastolic pressure (18.7 vs. 12.9mmHg. Also, patients with ascites had a longer history of illness (5.1 and 3.9 years, respectively and had atrial fibrillation more frequently (44.7% vs. 30.1%. CONCLUSION: Ascites was observed in less than 50% of cases of endomyocardial fibrosis and was associated with greater involvement of the right ventricle and with a longer duration of the disease, thus being a characteristic of a worse prognosis.

  9. Palliative treatment of malignant ascites: profile of catumaxomab

    Directory of Open Access Journals (Sweden)

    Lila Ammouri

    2010-05-01

    Full Text Available Lila Ammouri, Eric E PrommerMayo Clinic Hospice and Palliative Medicine Program, Mayo Clinic College of Medicine, Mayo Clinic Hospital, Scottsdale, AZ, USAAbstract: Malignant ascites is the abnormal accumulation of fluid in the peritoneal cavity associated with several intrapelvic and intra-abdominal malignancies. The development of ascites leads to significant symptoms and poor quality of life for the cancer patient. Available therapies for palliation include treatment of the underlying disease, but when there are no treatment options, the use of diuretics, implantation of drainage catheters, and surgical shunting techniques are considered. None of these symptom palliation options affect the course of disease. The development of trifunctional antibodies, which attach to specific overexpressed surface markers on tumor cells, and trigger an immune response leading to cytoreductive effects, represents a new approach to the management of malignant ascites. The purpose of this review is to highlight current therapies for malignant ascites and review data as to the effectiveness of a new trifunctional antibody, catumaxomab.Keywords: catumaxomab, ascites, trifunctional

  10. Radiologically placed tunneled peritoneal catheter in palliation of malignant ascites

    Energy Technology Data Exchange (ETDEWEB)

    Akinci, Devrim; Erol, Bekir; Ciftci, Tuerkmen T. [Hacettepe University, Faculty of Medicine, Department of Radiology, 06100 Ankara (Turkey); Akhan, Okan, E-mail: akhano@tr.net [Hacettepe University, Faculty of Medicine, Department of Radiology, 06100 Ankara (Turkey)

    2011-11-15

    The purpose of this study was to evaluate retrospectively the safety and effectiveness of radiologically placed tunneled peritoneal catheter in palliation of malignant ascites. Between July 2005 and June 2009, 41 tunneled peritoneal catheters were placed under ultrasonographic and fluoroscopic guidance in 40 patients (mean age, 55 years; 22 women) who had symptomatic malignant ascites. No procedure related mortality was observed. Major complication occurred in one patient (2.5%) in the form of serious bacterial peritonitis that necessitated catheter removal. Minor complications such as minor bacterial peritonitis, catheter dislodgement, tunnel infection, and catheter blockage occurred in 11 patients (27.5%). The mean duration of survival after catheter placement was 11.8 weeks. All patients expired of their primary malignancies in the follow-up. Radiologically placed tunneled peritoneal catheter is safe and effective in palliation of symptomatic malignant ascites.

  11. Long-evolution ascites in a patient with constrictive pericarditis

    Directory of Open Access Journals (Sweden)

    Gonçalo Nunes

    Full Text Available Constrictive pericarditis (CP is an uncommon disease resulting from chronic pericardial inflammation, fibrosis and calcification. Since there are atypical forms of presentation, with subtle or nonexistent cardiorespiratory symptoms, diagnosis may be challenging and difficult. Recurrent ascites in patients with congestive hepatopathy due to constrictive pericarditis is, in most cases, reversible after pericardiectomy. Nevertheless, development of persistent liver dysfunction may be a long-term complication. The present case describes a 23 years old man with growth delay, dyspnoea and long evolution ascites, whose exhaustive etiological investigation led to diagnosis. Afterwards the patient underwent elective surgery with symptom and general condition improvement. Ascites differential diagnosis and its association with constrictive pericarditis are briefly reviewed in this article.

  12. Selection strategies for body weight and reduced ascites susceptibility in broilers

    OpenAIRE

    A Pakdel; Bijma, P; Ducro, B.J.; Bovenhuis, H.

    2005-01-01

    Ascites syndrome is a metabolic disorder in broilers. Mortality due to ascites results in significant economic losses and has a negative impact on animal welfare. It has been shown that genetic factors play a considerable role in susceptibility of birds to ascites, which offers perspectives for selection against this syndrome. The aim of the present study was to evaluate the consequences of alternative selection strategies for BW and resistance to ascites syndrome using deterministic simulati...

  13. [Isolation of Candida spp. from ascites in cirrhotic patients].

    Science.gov (United States)

    Saludes, Paula; Araguás, Cristina; Sánchez-Delgado, Jordi; Dalmau, Blai; Font, Bernat

    2016-10-01

    The isolation of Candida spp. in ascites of cirrhotic patients is an uncommon situation in clinical practice. Factors that have been associated with increased susceptibility to primary fungal peritonitis are exposure to broad-spectrum antibiotics and immunosuppression, a typical situation of these patients. We report seven episodes of Candida spp. isolation in ascites of cirrhotic patients detected in our hospital during the past 15years. Copyright © 2015 Elsevier España, S.L.U. and Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

  14. Association between ascites and primary hyperfibrinolysis : A cohort study in 210 dogs

    NARCIS (Netherlands)

    Zoia, Andrea; Drigo, Michele; Simioni, Paolo; Caldin, Marco; Piek, Christine J|info:eu-repo/dai/nl/304828807

    2017-01-01

    Coagulation profiles were determined in 70 dogs with ascites, 70 healthy control dogs and 70 sick control dogs without ascites. Dogs with ascites were divided into four sub-groups based on the pathophysiology of fluid formation. Coagulation profile, serum C-reactive protein and frequency of

  15. Selection strategies for body weight and reduced ascites susceptibility in broilers

    NARCIS (Netherlands)

    Pakdel, A.; Bijma, P.; Ducro, B.J.; Bovenhuis, H.

    2005-01-01

    Ascites syndrome is a metabolic disorder in broilers. Mortality due to ascites results in significant economic losses and has a negative impact on animal welfare. It has been shown that genetic factors play a considerable role in susceptibility of birds to ascites, which offers perspectives for

  16. [The inhibitory effects of Realgar bioleaching solution on S180 ascites-tumor and its toxicity].

    Science.gov (United States)

    Xie, Qin-Jian; Zhang, Xu; Wang, Xin; Bai, Lu; Li, Hong-Yu

    2009-06-01

    To investigate the inhibitory effect of Realgar bioleaching solution (RBS) on tumor S180 cells line and estimate its toxicity, to provide experimental evidence for the further exploit of Realgar. 24 hours after the models of ascites-tumor bearing mice were established, the mice were injected RBS once a day. The survival rates of S180 ascites-tumor bearing mice injected in RBS was studied, and the RBS acute toxicity of mice produced by oral, intraperitoneal or intravenous was evaluated by Drug Median Lethal Dose (LD50). The inhibitory effect of S180 cells in vivo had a dose-dependent manner. The survival rates of mice were 10% - 60% in the different dose in 15 days. The LD50 values of RBS by oral, intraperitoneal or intravenous were 5.27 mg/kg, 3.63 mg/kg and 2.68 mg/kg, respectively. RBS has potent antitumor effect, LD50 value of RBS is lower than that of traditional medicine.

  17. Variability of hydrostatic hepatic vein and ascitic fluid pressure, and of plasma and ascitic fluid colloid osmotic pressure in patients with liver cirrhosis

    DEFF Research Database (Denmark)

    Henriksen, Jens Henrik Sahl

    1980-01-01

    The variability of hydrostatic hepatic vein and ascitic fluid pressures and of plasma and ascitic fluid colloid osmotic (oncotic) pressures was assessed during hepatic venous catheterization by repeated measurements on different days and at different locations in patients with cirrhosis of the li......The variability of hydrostatic hepatic vein and ascitic fluid pressures and of plasma and ascitic fluid colloid osmotic (oncotic) pressures was assessed during hepatic venous catheterization by repeated measurements on different days and at different locations in patients with cirrhosis...... during catheterization give a good reproducibility in determination of the hydrostatic pressures in hepatic vein and ascitic fluid and of the colloid osmotic (oncotic) pressure in plasma and ascitic fluid in the resting supine patient with cirrhosis, which substantiates the use of measurements during...

  18. Ehrlich ascites tumor-bearing mice treated with aqueous ethanol ...

    African Journals Online (AJOL)

    Purpose: To evaluate the antitumor effect of a latex extract from Euphorbia tirucalli Linn. (Euphorbiaceae) and its toxicity. Methods: Aqueous ethanol and petroleum ether extracts were obtained through maceration. .Maximum tolerated dose was determined in healthy mice. Antitumor activity was measured in Ehrlich ascites.

  19. Therapy of the refractory ascites: Total paracentesis vs. TIPS.

    Science.gov (United States)

    La Mura, Vincenzo; Salerno, Francesco

    2016-01-01

    This revision was aimed to report the evidences on the treatment of patients with cirrhosis and refractory ascites. Mainly, we wished to explore which of the predicting variables could be used to prefer large-volume paracentesis or TIPS. Copyright © 2015 Elsevier España, S.L.U. y AEEH y AEG. All rights reserved.

  20. Fetal Ascites and Second Trimester Maternal Hepatitis C Virus Infection

    Directory of Open Access Journals (Sweden)

    Pei-Ying Ling

    2006-09-01

    Conclusion: Second trimester perinatal HCV infection with possible CMV coinfection associated with fetal ascites is a rare event. Fetal therapy resulting in a successful outcome has not been reported. Prompt fetal therapy with paracentesis in this case led to the delivery of a healthy term liveborn baby with anti-HCV seropositivity.

  1. CLINICAL EVALUATION OF OOGS WITH ASCITES IN JOS ...

    African Journals Online (AJOL)

    BSN

    The postmortem findings of dogs (carcasses) that died "ith ascites showed granular or nodular contracted kidneys i.e chronic nephritis and the li,cr appears cirrhotic with rough and granular or nodular lesion. About IOOO milliliter (I litre) of clear fluid was aspirated from the peritoneal cavit) of three Alsatian dogs (li,e) and.

  2. Aetiological considerations in 96 consecutive cases of ascites ...

    African Journals Online (AJOL)

    Results: The three most common causes of ascites in this series were liver diseases-36.5% (chronic liver disease 27.1%, hepatocellular carcinoma 9.4%), renal diseases 30.2% (chronic renal failure 23.9%, nephrotic syndrome 6.3%), and cardiac diseases 23.9% (congestive cardiac failure 22.9%, Endomyocardial fibrosis ...

  3. Ascites alone as the presentation of Congenital Tuberculosis

    Directory of Open Access Journals (Sweden)

    S Purkait

    2015-06-01

    Full Text Available Congenital tuberculosis is a rare disease. It usually presents with respiratory distress, fever and organomegaly. We report a case of congenital tuberculosis presenting with ascites only.DOI: http://dx.doi.org/10.3126/jcmsn.v10i1.12766 Journal of College of Medical Sciences-Nepal, 2014, Vol.10(1; 37-40

  4. Predictive parameter of tolvaptan effectiveness in cirrhotic ascites.

    Science.gov (United States)

    Kawaratani, Hideto; Fukui, Hiroshi; Moriya, Kei; Noguchi, Ryuichi; Namisaki, Tadashi; Uejima, Masakazu; Kitade, Mitsuteru; Takeda, Kosuke; Okura, Yasushi; Kaji, Kosuke; Nishimura, Norihisa; Takaya, Hiroaki; Aihara, Yousuke; Sawada, Yasuhiko; Sato, Shinya; Seki, Kenichiro; Mitoro, Akira; Yamao, Junichi; Yoshiji, Hitoshi

    2017-08-01

    The efficacy of the vasopressin V2 receptor antagonist tolvaptan for difficult-to-treat cirrhotic ascites has recently been reported. However, its effect is variable among patients. This study aimed to clarify the predictive factors for obtaining a good response to tolvaptan in patients with difficult-to-treat ascites. Data were collected from 50 patients with liver cirrhosis having ascites (hepatitis B, n = 1; hepatitis C, n = 22; alcoholism, n = 11; and others, n = 16) after treatment with tolvaptan (3.75-7.5 mg/day) in addition to conventional diuretics. A follow-up assessment was carried out after 7-day tolvaptan treatment for all patients. After an uneventful 7-day tolvaptan treatment, 18 patients (36.0%) lost more than 2 kg of their body weight (responders). Twenty-six patients (52.0%) showed an increase in urine volume (>300 mL) on day 2. Tolvaptan was also effective for patients with pleural effusion, portal vein thrombosis, and hepatocellular carcinoma. Basal blood urea nitrogen (BUN) levels, plasma renin activity, and aldosterone levels were significantly higher in the poor responders (Tolvaptan is useful and safe for the treatment of cirrhotic ascites. This report showed that BUN will predict the response of tolvaptan even when measured before tolvaptan treatment. © 2016 The Japan Society of Hepatology.

  5. Successful treatment of Ascites of hepatic origin in Dog

    Directory of Open Access Journals (Sweden)

    Pradhan M. S.

    2008-01-01

    Full Text Available Detailed clinico-pathological study of a Doberman pinsiner female, 8 years of age confirmed the ascites of hepatic origin. Administration of diuretic, liver tonic, antibiotics and hepatobiliary drug resulted in complete recovery. [Vet World 2008; 1(1.000: 23-23

  6. Role of ascitic fluid C3 in spontaneous bacterial peritonitis

    African Journals Online (AJOL)

    Amany Talaat Kamal

    2012-02-29

    Feb 29, 2012 ... Spontaneous bacterial peritonitis;. Complement 3;. Opsonic activity;. Cirrhosis. Abstract Background: The C3 component of complement tends to be reduced in cirrhosis and patients with reduced ascitic fluid C3 concentration and reduced opsonic activities have been shown to be predisposed to SBP [1].

  7. Ehrlich ascites carcinoma | Ozaslan | African Journal of Biotechnology

    African Journals Online (AJOL)

    Experimental tumors have great importance in modeling, and Ehrlich ascites carcinoma (EAC) is one of the commonest tumors. EAC is referred to as an undifferentiated carcinoma and is originally hyperdiploid, has high transplantable capability, no-regression, rapid proliferation, shorter life span, 100% malignancy and also ...

  8. Detection and Comparison of Cytomegalovirus DNA Levels in Amniotic Fluid and Fetal Ascites in a Second-Trimester Fetus With Massive Ascites, Hyperechogenic Bowel, Ventriculomegaly and Intrauterine Growth Restriction

    Directory of Open Access Journals (Sweden)

    Chih-Ping Chen

    2010-06-01

    Conclusion: A prenatal diagnosis of fetal ascites in association with ventriculomegaly, hyperechogenic bowel and intrauterine growth restriction should alert physicians to congenital CMV infection in addition to aneuploidy. The present case provides evidence that CMV DNA levels are higher in amniotic fluid (amniocytes and amniotic fluid supernatant than in ascites (ascitic cells and ascitic supernatant in cases of congenital CMV infection.

  9. Selection strategies for body weight and reduced ascites susceptibility in broilers.

    Science.gov (United States)

    Pakdel, A; Bijma, P; Ducro, B J; Bovenhuis, H

    2005-04-01

    Ascites syndrome is a metabolic disorder in broilers. Mortality due to ascites results in significant economic losses and has a negative impact on animal welfare. It has been shown that genetic factors play a considerable role in susceptibility of birds to ascites, which offers perspectives for selection against this syndrome. The aim of the present study was to evaluate the consequences of alternative selection strategies for BW and resistance to ascites syndrome using deterministic simulation. In addition to the consequences of current selection (i.e., selection for increased BW only) alternative selection strategies including information on different ascites-related traits measured under normal or cold conditions and the consequences of having information on the underlying genes (i.e., MAS) were quantified. Five different breeding schemes were compared based on the selection response for BW, ascites susceptibility, and the rate of inbreeding. Traits investigated in the index as indicators for ascites were hematocrit value (HCT) and ratio of right ventricle to the total ventricular weight of the heart (RV:TV). The results indicated that by ignoring ascites susceptibility in the breeding goal, the gain for BW is 130 g and the birds will become more susceptible to ascites. Testing 50% of the birds under cold temperature conditions and including information of ascites related traits (HCT and RV:TV) measured under normal and cold conditions makes it possible to achieve a relatively high gain for BW (111.4 g) while controlling the genetic level for ascites susceptibility (selection response was 0). The results of scenarios including QTL information of ascites susceptibility showed that QTL information could be used very effectively in controlling ascites susceptibility.

  10. Eosinophilic Enteritis with Ascites in a Patient with Overlap Syndrome

    Directory of Open Access Journals (Sweden)

    Spyros Aslanidis

    2009-01-01

    Full Text Available Gastrointestinal involvement is frequent in patients with systemic lupus erythematosus (SLE. Eosinophilic gastroenteritis, however, has only rarely been described in rheumatological conditions, despite its reported connection to autoimmune diseases, such as hypereosinophilic syndrome, vasculitides, and systemic mastoidosis. It presents typically with abdominal pain and diarrhea and is only exceptionally associated with ascites. Diagnosis can be problematic, as several other clinical conditions (malignancies, infection/tuberculosis, and inflammatory bowel diseases have to be ruled out. It is basically a nonsurgical disease, with excellent recovery on conservative treatment. We report the rare case of a young woman with overlap syndrome who presented with abdominal pain and ascites. The diagnosis of eosinophilic enteritis was made based on clinical, radiological, and laboratory criteria. The patient was treated with corticosteroids with excellent response.

  11. Pathogenic background for treatment of ascites and the hepatorenal syndrome

    DEFF Research Database (Denmark)

    Møller, Søren; Henriksen, Jens Henrik; Bendtsen, Flemming

    2008-01-01

    Abstract Ascites and hepatorenal syndrome (HRS) are the major and challenging complications of cirrhosis and portal hypertension that significantly affect the course of the disease. Liver insufficiency, portal hypertension, arterial vasodilatation, and systemic cardiovascular dysfunction are major...... or transjugular intrahepatic portosystemic shunt. New treatment strategies include the use of vasopressin V2-receptor antagonists and vasoconstrictors. The HRS denotes a functional and reversible impairment of renal function in patients with severe cirrhosis with a poor prognosis. Attempts of treatment should...

  12. Eosinophilic ascites: A case report and literature review

    Directory of Open Access Journals (Sweden)

    Raed M Alsulaiman

    2015-01-01

    Full Text Available Eosinophilic gastroenteritis is a rare gastrointestinal (GI disorder characterized by nonspecific GI symptoms, peripheral eosinophilia, and eosinophilic infiltration of the intestinal wall. The disorder is classified into mucosal, muscular, and sub-serosal types, depending on the clinical picture and the depth of eosinophilic infiltration within the GI wall. Sub-serosal disease, which is complicated by ascites, usually results in the most severe clinical form of eosinophilic gastroenteritis and requires early corticosteroid therapy. In such cases, a favorable outcome can be achieved after a short course of corticosteroids. We present the case of a 28-year-old female with diffuse abdominal pain and distention for 2 weeks. Her physical examination was significant for moderate ascites. Initial work-up demonstrated severe peripheral blood eosinophilia, normal liver function tests, and elevated serum immunoglobulin E (IgE. Upper endoscopy, colonoscopy showed a thickening of the stomach and colon, and biopsies showed marked eosinophilic infiltration of the mucosa. Ascitic fluid analysis showed significant eosinophilia. Subsequent treatment with oral prednisone resulted in the normalization of laboratory and radiologic abnormalities 45 days after the start of the treatment. Despite its rarity, eosinophilic gastroenteritis needs to be recognized by the clinician because the disease is treatable, and timely diagnosis and initiation of treatment could be of major importance.

  13. Tratamiento dietético de la ascitis quilosa postquirúrgica: caso clínico y revisión de la literatura Postsurgical chylous ascites: case report and literature review

    OpenAIRE

    J. Olivar Roldán; Fernández Martínez, A.; Martínez Sancho, E.; Díaz Gómez, J.; V. Martín Borge; C. Gómez Candela

    2009-01-01

    La ascitis quilosa es la acumulación de quilo en la cavidad peritoneal debido a la ruptura u obstrucción de los conductos linfáticos abdominales. Clínicamente se manifiesta por distensión abdominal. El criterio diagnóstico más útil es el aumento de los triglicéridos en el líquido ascítico. Las neoplasias son la causa más frecuente, aunque también deben considerarse etiologías menos comunes como la cirugía abdominal. El tratamiento consiste en dieta hiperproteica con restricción de la grasa y ...

  14. Incidence of spontaneous bacterial peritonitis in patients with ascites. Diagnostic value of white blood cell count and pH measurement in ascitic fluid

    DEFF Research Database (Denmark)

    Storgaard, J S; Svendsen, Jesper Hastrup; Hegnhøj, J

    1991-01-01

    During a 21-month period, 65 consecutive patients admitted with ascites were included in a prospective study of the incidence of spontaneous bacterial peritonitis, and paracentesis was performed on admission. The ascitic fluid was cultured, ascitic leucocytes were counted and pH was measured....... Bacterial growth was found in five patients with chronic liver disease, who were diagnosed as having spontaneous bacterial peritonitis (SBP), since no intra-abdominal focus could be demonstrated. Thus, the incidence of SBP in this material was 7.7% (95% confidence limits: 2.5-17%). SBP was caused...

  15. Impact of ascites volume on clinical outcomes in ovarian cancer: A cohort study.

    Science.gov (United States)

    Szender, J Brian; Emmons, Tiffany; Belliotti, Sarah; Dickson, Danielle; Khan, Aalia; Morrell, Kayla; Khan, A N M Nazmul; Singel, Kelly L; Mayor, Paul C; Moysich, Kirsten B; Odunsi, Kunle; Segal, Brahm H; Eng, Kevin H

    2017-09-01

    To investigate the impact of ascites volume on ovarian cancer outcomes. Clinicopathologic features of a cohort of patients with ovarian cancer were obtained from a curated database at a single institution. Progression free survival (PFS) and overall survival (OS) were recorded. Ascites volume at primary surgery was dichotomized at 2000mL and comparisons for high and low volume ascites were made. Additionally, to elucidate interactions between ascites and ovarian tumor progression, we evaluated the effect of intraperitoneal administrations of murine cell-free ascites versus saline in a syngeneic mouse model of epithelial ovarian cancer. Out of 685 patients identified, 58% had ascites present at the time of initial surgery. Considering the volume of ascites continuously, each liter of ascites was associated with shorter PFS (HR=1.12, 95% CI: 1.07-1.17) and OS (HR=1.12, 95%CI: 1.07-1.17). Patients with ascites greater than the median of 2000mL had significantly shorter PFS (14.5months vs. 22.7months; povarian cancer progression in mice. The volume of ascites at initial diagnosis of ovarian cancer correlated with worse PFS and OS. The effect of large volume on prognosis is likely to be in part related to reduced likelihood for complete resection of tumor (R0). If these findings are confirmed in independent studies, consideration should be made to add the presence of large volume ascites at diagnosis to the staging criteria for ovarian cancer. Copyright © 2017 Elsevier Inc. All rights reserved.

  16. Development and Validation of a Symptom Scale Specific for Ascites Accompanied with Cirrhosis: The ASI-7.

    Science.gov (United States)

    Onishi, Yoshihiro; Wakita, Takafumi; Fukuhara, Shinichi; Noguchi, Yoshinori; Okada, Mitsuru; Sakaida, Isao; Sasaki, Yutaka; Kobayashi, Kenji

    2014-02-06

    Ascites markedly affects the quality of life of patients with cirrhosis; however, there is currently no scale to measure the symptoms of ascites. We developed a scale to measure ascites-specific symptoms according to psychometric procedures. A team consisting of specialists developed constructs representing the symptoms of ascites and question item pool. The constructs were verified in a qualitative study involving a small number of patients. The item pool was improved through a pilot study, and a prototype of the scale was prepared. To establish the scale and assess its properties, a questionnaire survey was conducted on 175 patients with ascites accompanied with cirrhosis. On the basis of the results of factor analysis and item response theory-based analyses, seven items, covering a wide range of severities and diverse symptoms, were selected to comprise the final scale (Ascites Symptom Inventory-7; ASI-7). The ASI-7 had a unidimensional factorial structure and high reliability (Cronbach's α coefficient of 0.96). The scale score was correlated with the degree of ascites evaluated by physicians, Short Form-36 (SF-36) physical functioning (PF), and SF-36 vitality (VT; P<0.001 each), indicating the criterion validity. The responsiveness after treatment was demonstrated by the mean standardized response of 1.18. Moreover, responses in the scale score were correlated with those in the degree of ascites, body weight, SF-36 PF, and SF-36 VT, respectively (P<0.001 each). An ascites-specific symptom scale was developed and its reliability, validity, and responsiveness were demonstrated. This simple scale may be used for the evaluation of ascites treatment and monitoring of treatment responses in patients with ascites.

  17. Monovalent ions control proliferation of Ehrlich Lettre ascites cells

    DEFF Research Database (Denmark)

    Klausen, Thomas Kjaer; Preisler, Sarah; Pedersen, Stine Helene Falsig

    2010-01-01

    of Ehrlich Lettre ascites (ELA) cells. We measured the intracellular concentration of each ion in G(0), G(1), and S phases of the cell cycle following synchronization by serum starvation and release. We show that intracellular concentrations and content of Na+ and Cl(-) were reduced in the G(0)-G(1) phase...... effect. Western blots showed reduced chloride intracellular channel CLIC1 and chloride channel ClC-2 expression in the plasma membrane in S compared with G(1). Our results suggest that Na+ regulates ELA cell proliferation by regulating intracellular pH while Cl(-) may regulate proliferation by fine...

  18. Urinary ascites secondary to delayed diagnosis of laparoscopic bladder injury

    Directory of Open Access Journals (Sweden)

    Al-Mandeel Hazem

    2010-01-01

    Full Text Available We present a case of urinary ascites in a young woman secondary to unrecognized bladder injury during gynaecologic laparoscopic surgery. Delayed diagnosis occurred due to the absence of expected changes in serum biochemistry, which made the diagnosis of urinoma less likely. High suspicion of bladder injury following laparoscopic surgery should be present in patients with ill-defined symptoms even if no biochemical changes are seen. The case demonstrates important points in relation to the consequences of delayed diagnosis as well as overview on detection and prevention of such injury.

  19. Cytochemical and immunocytochemical characterization of Yoshida ascites sarcoma cells.

    Science.gov (United States)

    Nicotina, P A; Ruggeri, P; Ferlazzo, G; Fimiani, V

    1991-01-01

    Some cytochemical and immunocytochemical investigations were carried out on actively growing Yoshida ascites sarcoma cells. These cells displayed an intense granular alpha-naphthylacetate esterase (ANAE) staining while the alpha-naphthylbutyrate esterase (ANBE) reaction was in part fluoride-sensitive and marked particularly in the large-size malignant cells. Acid phosphatase as well as peroxidase activities were not detected. The lack of immunoreactive lysozyme and alpha 1-antitrypsin suggested a poor differentiation of the above-mentioned tumor cells, but fibronectin and S-100 protein where highly expressed, as in tumors arising from the mononuclear phagocyte system.

  20. Toxicity and metabolism of 3'-deoxyadenosine N*O1-oxide in mice and Ehrlich ascites tumor cells

    DEFF Research Database (Denmark)

    Svendsen, Karsten Ramløv; Overgaard-Hansen, Kay; Frederiksen, Sune

    1992-01-01

    Medicinsk biokemi, 3'-deoxyadenosine N*O1-oxide, metabolism, Ehrlich ascites cells, toxicity, mice......Medicinsk biokemi, 3'-deoxyadenosine N*O1-oxide, metabolism, Ehrlich ascites cells, toxicity, mice...

  1. Stability of artemisinin in aqueous environments : Impact on its cytotoxic action to Ehrlich ascites tumour cells

    NARCIS (Netherlands)

    Beekman, A.C; Woerdenbag, H.J.; van Uden, W; Pras, N.; Konings, A.WT; Wikström, H.V

    1997-01-01

    We have recently shown artemisinin to be cytotoxic against Ehrlich ascites tumour cells. The aim of this study was to investigate the stability of this compound in the aqueous environment of the in-vitro Ehrlich ascites tumour cell system (RPMI 1640 cell culture medium supplemented with 10% foetal

  2. Role of ascitic fluid C3 in spontaneous bacterial peritonitis | Kamal ...

    African Journals Online (AJOL)

    Background: The C3 component of complement tends to be reduced in cirrhosis and patients with reduced ascitic fluid C3 concentration and reduced opsonic activities have been shown to be predisposed to SBP. Aim of the work: To compare the level of ascitic fluid C3 concentration in cirrhotic patients with and without ...

  3. An experimental study on the anti-Ehrlich ascites carcinoma effect of ...

    African Journals Online (AJOL)

    The objective of this paper was to study the anti-Ehrlich ascites carcinoma effect of purified toad venom extract and its mechanism. Mouse model of Ehrlich ascites carcinoma was established with cisplatin as the control to observe the inhibitory effect of purified toad venom extract on malignant peritoneal effusion in mice.

  4. Ascites in chickens : oxygen consumption and requirement related to its occurrence

    NARCIS (Netherlands)

    Scheele, C.W.

    1996-01-01


    The present thesis describes the etiology of heart failure syndrome (HFS) and ascites in broiler chickens.

    In The Netherlands, ascites, as a cause of mortality in broiler chickens, is increasing steadily. Rates of mortality in broiler flocks in practice, related to HFS and

  5. Genetic and phenotypic relationships between blood gas parameters and ascites-related traits in broilers

    NARCIS (Netherlands)

    Closter, A.M.; As, van P.; Groenen, M.A.M.; Vereijken, A.L.J.; Arendonk, van J.A.M.; Bovenhuis, H.

    2009-01-01

    Ascites, also called pulmonary hypertension syndrome, is a metabolic disorder in chickens that have an insufficient pulmonary vascular capacity. The tendency of broilers to develop ascites is heritable, and successful selection against this susceptibility would benefit from good and easy-to-measure

  6. Direct and maternal genetic effects for ascites-related traits in broilers

    NARCIS (Netherlands)

    Pakdel, A.; Arendonk, van J.A.M.; Vereijken, A.L.J.; Bovenhuis, H.

    2002-01-01

    The objective of the present study was to estimate heritabilities for ascites-related traits in broilers and to assess the importance of maternal genetic effects for these traits. Several traits related to ascites were measured on more than 4,000 broilers kept under cold conditions. Heritabilities

  7. Management of refractory ascites in cirrhosis: Are we out of date?

    Science.gov (United States)

    Annamalai, Alagappan; Wisdom, Lauren; Herada, Megan; Nourredin, Mazen; Ayoub, Walid; Sundaram, Vinay; Klein, Andrew; Nissen, Nicholas

    2016-01-01

    Cirrhosis is a major cause of morbidity and mortality worldwide with liver transplantations as it only possible cure. In the face of a significant organ shortage many patients die waiting. A major complication of cirrhosis is the development of portal hypertension and ascites. The management of ascites has barely evolved over the last hundred years and includes only a few milestones in our treatment approach, but has overall significantly improved patient morbidity and survival. Our mainstay to ascites management includes changes in diet, diuretics, shunt procedures, and large volume paracentesis. The understanding of the pathophysiology of cirrhosis and portal hypertension has significantly improved in the last couple of decades but the changes in ascites management have not seemed to mirror this newer knowledge. We herein review the history of ascites management and discuss some its current limitations. PMID:27729954

  8. Terlipressin improves renal function in patients with cirrhosis and ascites without hepatorenal syndrome

    DEFF Research Database (Denmark)

    Krag, Aleksander; Møller, Søren; Henriksen, Jens H

    2007-01-01

    was to evaluate if terlipressin also improves renal function in patients with ascites without HRS. Twenty-three patients with cirrhosis participated; 15 with nonrefractory ascites were randomized to either terlipressin (N group, n = 11) or a placebo (P group, n = 4), and 8 had refractory ascites and received......Patients with advanced cirrhosis and ascites are characterized by circulatory dysfunction with splanchnic vasodilatation and renal vasoconstriction, which often lead to ascites. The vasoconstrictor terlipressin improves renal function in hepatorenal syndrome (HRS). The aim of this study...... terlipressin (R group). The glomerular filtration rate (GFR), sodium clearance (C(Na)), lithium clearance (C(Li)), osmolal clearance (C(Osm)), and urine sodium concentration (U(Na)) were assessed before and after the injection of 2 mg of terlipressin or the placebo. GFR increased in the N group (69 +/- 19...

  9. Prognosis assessment of cirrhotic patients with refractory ascites treated with a peritoneovenous shunt.

    Science.gov (United States)

    Guardiola, J; Xiol, X; Escribá, J M; Castellví, J M; Castellote, J; Baliellas, C; Rafecas, A; Casais, L A

    1995-12-01

    The role of peritoneovenous shunt in the management of refractory ascites has not been clearly established. The aim of this study was to determine readily accessible predictive survival factors in cirrhotic patients with refractory ascites treated with a peritoneovenous shunt. We studied a cohort of 100 cirrhotic patients with refractory ascites who underwent peritoneovenous-shunt placement in a university-based reference hospital. The estimated median survival of patients after shunt placement was 11 months (95% CI, 7-14 months). Multivariate analysis based on the proportional hazards model disclosed four independent variables associated with poor survival: high Pugh score, nonalcoholic etiology, low ascitic fluid protein concentration, and history of spontaneous bacterial peritonitis. Mortality of cirrhotic patients treated with a peritoneovenous shunt can be determined by a prognostic index using four easily available variables. Such a prognostic index, once prospectively validated, could be used as an adjunct in planning treatment of cirrhotic patients with refractory ascites.

  10. Lymphatic ascites after retroperitoneal lymphadenectomy in gynecologic cancer.

    Science.gov (United States)

    Perez-Medina, Tirso; Pereira, Augusto; San-Frutos, Luis; García-Espantaleón, Manuel; Chiverto, Yoana; Engels, Virginia; Ronchas, Marina; Troyano, Juan

    2015-09-01

    The incidence, diagnosis, treatment and outcome of lymphatic ascites (LA) are studied on 85 consecutive patients with gynecologic cancer who had undergone pelvic and/or paraaortic lymphadenectomy by means of laparotomy or laparoscopy. Patients were distributed in two groups depending in the access: Laparoscopy (study group: 44 patients) and laparotomy (control group: 41 patients). All surgical parameters were collected and patients underwent ultrasound examination on postoperative days 7, 14, and 28. The main outcome measure was the development of symptomatic or asymptomatic LA. Prospective cohort study. LA developed in 3 patients (6.8%) in the study group and 9 in the control group (22%), with statistical difference (p < 0.05). The relative risk to develop lymphatic ascites after surgery performed by laparotomy was 3.2 (95% CI 1.05-11.07). Mean nodes harvested during the surgery was 18.6 (SD 6.6) in the LA group and 20.4 (SD 9.1) in the group with no LA (p = 0.527). The incidence of LA after retroperitoneal lymphadenectomy in gynecologic cancer patients is lower in the patients treated by laparoscopy. Copyright © 2015 Elsevier Ltd. All rights reserved.

  11. Malignant ascites in ovarian cancer and the role of targeted therapeutics.

    Science.gov (United States)

    Smolle, Elisabeth; Taucher, Valentin; Haybaeck, Johannes

    2014-04-01

    Ovarian cancer (OC) is the eighth most lethal gynecological malignancy and the main cause of gynecological cancer death in industrialized countries. Malignant ascites is often found in OC, with about 10% of patients suffering from recurrent OC. Tumor cells in OC-associated malignant ascites promote disease recurrence and patient mortality is mainly associated with widespread metastasis to serosal surfaces and accompanying peritoneal effusions. Targeted therapies have recently been developed as novel therapeutic options for malignant ascites. The tri-functional anti-epithelial cell adhesion molecule and anti-cluster of differentiation 3 monoclonal antibody catumaxumab has been assessed in the therapy of malignant ascites, and proven to significantly reduce the ascitic flow rate when applied into the peritoneal cavity. The anti-angiogenic targeted agent bevacizumab has also shown good effects in the symptomatic treatment of malignant ascites, significantly prolonging the time until the next paracentesis. Vascular endothelial growth factor (VEGF) Trap, or aflibercept, is a fusion protein that inhibits VEGF-receptor binding. Aflibercept has proven to be effective in reduction of ascites, diminishing clinical symptoms of ascites and prolonging the time to next paracentesis. All three agents we review in the present article are effective in symptomatic control of ascites, leading to a rapid reduction of effusion and prolonging the time interval between paracenteses. However, no improvement in overall survival was observed in any of the clinical trials reported. We, thus, conclude that further investigations on larger patient series are needed to clarify whether the reduction of ascites by these targeted agents leads to a prolongation in tumor-related survival or not.

  12. Multi-generational genome wide association studies identify chromosomal regions associated with ascites phenotype.

    Science.gov (United States)

    Tarrant, K J; Dey, S; Kinney, R; Anthony, N B; Rhoads, D D

    2017-06-01

    Ascites is a multi-faceted disease commonly observed in fast growing broilers, which is initiated when the body is insufficiently oxygenated. A series of events follow, including an increase in pulmonary artery pressure, right ventricle hypertrophy, and accumulation of fluid in the abdominal cavity and pericardium. Advances in management practices along with improved selection programs have decreased ascites incidence in modern broilers. However, ascites syndrome remains an economically important disease throughout the world, causing estimated losses of $100 million per year. In this study, a 60 K Illumina SNP BeadChip was used to perform a series of genome wide association studies (GWAS) on the 16th and 18th generation of our relaxed (REL) line descended from a commercial elite broiler line beginning in 1995. Regions significantly associated with ascites incidence were identified on chromosome 2 around 70 megabase pairs (Mbp) and on chromosome Z around 60 Mbp. Five candidate single nucleotide polymorphisms (SNP) were evaluated as indicators for these 2 regions in order to identify association with ascites and right ventricle to total ventricle weight (RVTV) ratios. Chromosome 2 SNP showed an association with RVTV ratios in males phenotyped as ascites resistant and ascites susceptible (P = 0.02 and P = 0.03, respectively). The chromosome Z region also indicates an association with resistant female RVTV values (P = 0.02). Regions of significance identified on chromosomes 2 and Z described in this study will be used as proposed candidate regions for further investigation into the genetics of ascites. This information will lead to a better understanding of the underlying genetics and gene networks contributing to ascites, and thus advances in ascites reduction through commercial breeding schemes. © 2017 Poultry Science Association Inc.

  13. [Supportive care for malignant ascites in palliative phase: Place of paracentesis and diuretics].

    Science.gov (United States)

    Gamblin, Vincent; Da Silva, Arlette; Villet, Stéphanie; El Hajbi, Farid

    2015-11-01

    Malignant ascites, occurring in advanced stages of cancer, is linked with poor prognosis and can cause invalidating symptoms. Physiopathological mechanisms of ascites formation are complex and have yet to be fully elucidated. In most cases, ascites is due to peritoneal carcinomatosis in which vascular permeability is enhanced by VEGF production while lymphatic drainage decreases. Ascites can also be secondary to portal hypertension, for example in case of multiple liver metastases, or due to lymphatic obstruction. While paracentesis and diuretics are commonly used, their efficiency has never been compared in a randomized controlled study. Paracentesis brings immediate but temporary relief in over 90% of cases, and implies multiple hospitalizations. Literature reports ascites control by aldosterone alone or in association with furosemide. But, available data is controversial, and there is no predictive factor to identify patients that respond to diuretic treatment. The indication of diuretic treatment is left to the appreciation of physicians. Existing recommendations are old, and practices influenced by results obtained in non-neoplastic ascites. Additional evidences are required before guidelines can be established for the palliative management of malignant ascites. Copyright © 2015 Société Française du Cancer. Published by Elsevier Masson SAS. All rights reserved.

  14. Nonimmune fetal ascites: identification of ultrasound findings predictive of perinatal death.

    Science.gov (United States)

    Baccega, Felipe; de Lourdes Brizot, Maria; Jornada Krebs, Vera Lúcia; Vieira Francisco, Rossana Pulcineli; Zugaib, Marcelo

    2016-03-01

    To determine the ultrasonographic findings that predict death in fetal ascites. This was a retrospective cohort study involving pregnancies with ultrasonographic findings related to fetal ascites. The inclusion criteria were as follows: single pregnancy with a live fetus; ultrasound findings of ascites; ascites unrelated to maternal fetal alloimmunization; and pregnancy follow-up at our institution. The χ2-test was used to evaluate the association of ultrasound findings and death. Multiple logistic regression analysis was performed to determine the ultrasound findings that are predictive of death prior to hospital discharge. A total of 154 pregnancies were included in the study. In 8 (5.19%) cases, ascites was an isolated finding, and in 146 cases, other alterations were observed during the ultrasound evaluation. Death before hospital discharge occurred in 117 cases (76.00%). The following ultrasonographic findings were significantly associated with death: gestational age at diagnosis death. Based on ultrasound examination, the presence of hydrops, malformation of the respiratory tract, and stable/progressive evolution of ascites increase the chances of death in cases of fetal ascites.

  15. Midodrine and tolvaptan in patients with cirrhosis and refractory or recurrent ascites: a randomised pilot study.

    Science.gov (United States)

    Rai, Nitish; Singh, Baljinder; Singh, Akash; Vijayvergiya, Rajesh; Sharma, Navneet; Bhalla, Ashish; Singh, Virendra

    2017-03-01

    Splanchnic arterial vasodilatation and subsequent sodium and water retention play an important role in cirrhotic ascites. Midodrine and tolvaptan have been used separately in these patients. However, there are no reports on the use of combination of midodrine and tolvaptan in the control of ascites. The aim of this study was to evaluate the safety and efficacy of midodrine, tolvaptan and their combination in control of refractory or recurrent ascites in cirrhotics. Fifty cirrhotic patients with refractory or recurrent ascites were randomised to receive midodrine (n=13), tolvaptan (n=12) or both (n=13) plus standard medical therapy (SMT) or SMT alone (n=12). A significant increase in urinary volume and urinary sodium at 1 and 3 months (Ptolvaptan but not tolvaptan alone was superior to SMT in control of ascites at 3 months (Ptolvaptan better controls ascites without any renal or hepatic dysfunction. The combination therapy rapidly controls ascites as compared to midodrine or tolvaptan alone. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  16. Evaluation of magnetization transfer ratio in ascites and pelvic cystic masses

    Energy Technology Data Exchange (ETDEWEB)

    Okada, Susumu [Nippon Medical School, Inba, Chiba (Japan). Chiba-Hokuso Hospital; Kato, Tomoyasu; Yamashita, Takashi [and others

    1997-12-01

    To investigate the feasibility of magnetization transfer contrast (MTC) in characterization of pelvic cystic masses and ascites, in vitro studies were performed. Cystic fluids were taken from operative specimens of ten ovarian cystic masses (five mucinous cystadenomas, one cystadenocarcinoma, two serous cystadenocarcinomas, two clear cell carcinomas) and three non-ovarian pelvic cysts (one paraovarian cyst, one pseudomyxoma peritonei, one pelvic abscess). Samples of ascitic flied were drawn by peritoneal puncture in twenty patients (thirteen with peritonitis carcinomatosa, five with liver dysfunction, two with renal dysfunction). Total protein content in ascitic fluids was measured. Magnetization transfer ratio (MTR) was calculated by the signal intensities under the gradient echo sequence with and without the application of off-resonance pulses. The relative signal intensities (RSI) relative to water in T{sub 1} and T{sub 2} weighted images were obtained using spin echo sequence. There was no correlation between histological type of pelvic mass and MTR and RSI. Good correlation (R{sup 2}=0.761) was obtained between MTR and protein content in ascitic fluids, whereas no correlation was noted between RSI and protein content in ascitic fluids. These results suggest that MTC is not useful in the characterization of pelvic masses but is applicable in the differentiation between exudative ascites and transudative ascites. (author)

  17. Toxicity and antitumor efficacy of Croton polyandrus oil against Ehrlich ascites carcinoma cells

    Directory of Open Access Journals (Sweden)

    Déborah R.P. Meireles

    Full Text Available ABSTRACT The essential oil from Croton polyandrus Spreng., Euphorbiaceae, leaves was tested for the toxicity and antitumor activity. The concentration producing 50% hemolysis was 141 µg/ml on mice erythrocytes. In the acute toxicological study, the estimated LD50 was 447.18 mg/kg. The essential oil did not induce increase in number of micronucleated erythrocytes, suggesting low genotoxicity. Essential oil (100 or 150 mg/kg showed significant antitumor activity in Ehrlich ascitic carcinoma model. We observed that essential oil induces cell-cycle arrest at the G0/G1 phase, and increases the sub-G1 peak, which represents a marker of cell death by apoptosis. Survival also increased for the treated animals. The toxicological analyses revealed reduction in body weight, increased aspartate aminotransferase and alanine aminotransferase activity, hematological changes, and a thymus index reduction. These data suggest gastrointestinal and liver toxicity, anemia, leukopenia/lymphocytopenia, and immunosuppressive effects. Histopathological analysis revealed the weak hepatotoxicity of essential oil. In summary, essential oil of C. polyandrus displays in vivo antitumor activity and moderate toxicity.

  18. Ascitic microbiota composition is correlated with clinical severity in cirrhosis with portal hypertension.

    Directory of Open Access Journals (Sweden)

    Geraint B Rogers

    Full Text Available Identification of pathogenic bacteria in ascites correlates with poor clinical outcomes. Ascites samples are commonly reported culture-negative, even where frank infection is indicated. Culture-independent methods have previously reported bacterial DNA in ascites, however, whether this represents viable bacterial populations has not been determined. We report the first application of 16S rRNA gene pyrosequencing and quantitative PCR in conjunction with propidium monoazide sample treatment to characterise the viable bacterial composition of ascites. Twenty five cirrhotic patients undergoing paracentesis provided ascites. Samples were treated with propidium monoazide to exclude non-viable bacterial DNA. Total bacterial load was quantified by 16S rRNA Q-PCR with species identity and relative abundance determined by 16S rRNA gene pyrosequencing. Correlation of molecular microbiology data with clinical measures and diagnostic microbiology was performed. Viable bacterial signal was obtained in 84% of ascites samples, both by Q-PCR and pyrosequencing. Approximately 190,000 ribosomal pyrosequences were obtained, representing 236 species, including both gut and non gut-associated species. Substantial variation in the species detected was observed between patients. Statistically significant relationships were identified between the bacterial community similarity and clinical measures, including ascitic polymorphonuclear leukocyte count and Child-Pugh class. Viable bacteria are present in the ascites of a majority of patients with cirrhosis including those with no clinical signs of infection. Microbiota composition significantly correlates with clinical measures. Entry of bacteria into ascites is unlikely to be limited to translocation from the gut, raising fundamental questions about the processes that underlie the development of spontaneous bacterial peritonitis.

  19. L-lactate transport in Ehrlich ascites-tumour cells.

    Science.gov (United States)

    Spencer, T L; Lehninger, A L

    1976-01-01

    Ehrlich ascites-tumour cells were investigated with regard to their stability to transport L-lactate by measuring either the distribution of [14C]lactate or concomitant H+ ion movements. The movement of lactate was dependent on the pH difference across the cell membrane and was electroneutral, as evidenced by an observed 1:1 antiport for OH- ions or 1:1 symport with H+ ions. 2. Kinetic experiments showed that lactate transport was saturable, with an apparent Km of approx. 4.68 mM and a Vmax. as high as 680 nmol/min per mg of protein at pH 6.2 and 37 degrees C. 3. Lactate transport exhibited a high temperature dependence (activation energy = 139 kJ/mol). 4. Lactate transport was inhibited competitively by (a) a variety of other substituted monocarboxylic acids (e.g. pyruvate, Ki = 6.3 mM), which were themselves transported, (b) the non-transportable analogues alpha-cyano-4-hydroxycinnamate (Ki = 0.5 mM), alpha-cyano-3-hydroxycinnamate (Ki = 2mM) and DL-p-hydroxyphenyl-lactate (Ki = 3.6 mM) and (c) the thiol-group reagent mersalyl (Ki = 125 muM). 5. Transport of simple monocarboxylic acids, including acetate and propionate, was insensitive to these inhibitors; they presumably cross the membrane by means of a different mechanism. 6. Experiments using saturating amounts of mersalyl as an "inhibitor stop" allowed measurements of the initial rates of net influx and of net efflux of [14C]lactate. Influx and efflux of lactate were judged to be symmetrical reactions in that they exhibited similar concentration dependence. 7. It is concluded that lactate transport in Ehrlich ascites-tumour cells is mediated by a carrier capable of transporting a number of other substituted monocarboxylic acids, but not unsubstituted short-chain aliphatic acids. PMID:7237

  20. Myelomatous ascites as an initial manifestation of extramedullary involvement of multiple myeloma

    Energy Technology Data Exchange (ETDEWEB)

    Choi, Seo Youn; Lee, Hae Kyung; Yi, Boem Ha; Lee, Min Hee; Kim, Hee Kyung; Park, Seong Kyu [Soonchunhyang University Bucheon Hospital, Bucheon (Korea, Republic of)

    2017-03-15

    Multiple myeloma is a common hematological malignancy. Aggressive myeloma invades the organs outside the bone marrow, lymph, or reticuloendothelial systems. Among the extramedullary involvements of multiple myeloma, myelomatous ascites are extremely rare and are associated with a poor prognosis. We describe a case of myelomatous ascites as an initial manifestation of extramedullary involvement of multiple myeloma in 39-year-old patient. The patient was treated with high-dose chemotherapy, but extensive extramedullary involvement progressed, and the patient expired approximately five months after the initial detection of ascites.

  1. Portal Hypertension and Ascites Due to an Arterioportal Fistula: Sequela of a Remote Traumatic Liver Laceration.

    Science.gov (United States)

    Hulkower, Benjamin M; Butty, Sabah; Ghabril, Marwan

    2016-08-01

    Arterioportal fistulas (APFs) are a group of vascular disorders, in which systemic arteries communicate with the portal circulation, presenting as a congenital syndrome or more commonly acquired from iatrogenic instrumentation or abdominal trauma. We report the case of a 58-year-old man who developed ascites without underlying risk factors for portal hypertension, which was attributed to an APF found on imaging, manifesting 43 years after sustaining a liver laceration. After angiographic embolization of the APF, the patient's ascites resolved completely. The prolonged latent period between the patient's abdominal trauma and eventual presentation with ascites highlights the need to consider vascular malformations in the differential diagnosis of unexplained noncirrhotic portal hypertension.

  2. Low cardiac output predicts development of hepatorenal syndrome and survival in patients with cirrhosis and ascites

    DEFF Research Database (Denmark)

    Krag, A; Bendtsen, F; Møller, S

    2010-01-01

    compared to those with a higher CI (N = 16), padvanced cirrhosis and ascites seem to be related to a cardiac......OBJECTIVES: Recent studies suggest that cardiac dysfunction precedes development of the hepatorenal syndrome. In this follow-up study, we aimed to investigate the relation between cardiac and renal function in patients with cirrhosis and ascites and the impact of cardiac systolic function...... on survival. Patients and DESIGN: Twenty-four patients with cirrhosis and ascites were included. Cardiac function was investigated by gated myocardial perfusion imaging (MPI) for assessment of cardiac index (CI) and cardiac volumes. The renal function was assessed by determination of glomerular filtration...

  3. PAPP-A proteolytic activity enhances IGF bioactivity in ascites from women with ovarian carcinoma

    DEFF Research Database (Denmark)

    Thomsen, Jacob; Hjortebjerg, Rikke; Espelund, Ulrick

    2015-01-01

    Pregnancy-associated plasma protein-A (PAPP-A) stimulates insulin-like growth factor (IGF) action through proteolysis of IGF-binding protein (IGFBP)-4. In experimental animals, PAPP-A accelerates ovarian tumor growth by this mechanism. To investigate the effect of PAPP-A in humans, we compared...... serum and ascites from 22 women with ovarian carcinoma. We found that ascites contained 46-fold higher PAPP-A levels as compared to serum (P PAPP-A was enzymatically active. This is supported by the finding that ascites contained more cleaved than intact IGFBP-4 (P ... of IGF-IR in all but one tumor, whereas all tumors expressed PAPP-A, IGFBP-4, IGF-I and IGF-II. Addition of recombinant PAPP-A to ascites increased the cleavage of IGFBP-4 and enhanced IGF-IR activation (P PAPP-A, IGFBP-4 and IGFs and these proteins...

  4. Percutaneous Radiofrequency Ablation with Artificial Ascites for Hepatocellular Carcinoma in the Hepatic Dome: Initial Experience

    National Research Council Canada - National Science Library

    Rhim, Hyunchul; Lim, Hyo K; Kim, Young-sun; Choi, Dongil

    2008-01-01

    ...) in the hepatic dome. MATERIALS AND METHODS. Sonographically guided percutaneous radiofrequency ablation with artificial ascites was performed in 25 patients with 34 HCCs using an internally cooled electrode radiofrequency system...

  5. Pregnancy complicated by haemorrhagic ascites in a woman with newly diagnosed HIV.

    Science.gov (United States)

    Morgan, Catrin; Nicholls, Kate; Gangat, Nusraat; Sansome, Stafford

    2016-07-29

    A young pregnant Zambian woman was referred from a district hospital in South Zambia to the university teaching hospital, Lusaka with severe anaemia and ascites. The ascites had developed over a month and the woman was currently 15 weeks pregnant. Further workup revealed that the patient was HIV-positive and the ascitic tap showed haemorrhagic fluid. After being reviewed by multiple doctors, the cause of the haemorrhagic ascites remained unclear; therefore, the decision was made to do a laparotomy. The laparotomy revealed haemoperitoneum and a large cyst attached to the liver containing 5 L of bloodstained fluid. The histopathology report revealed features consistent with a giant haemangioma. There were many barriers to accessing optimum healthcare in this case. These included limited access to blood, poor communication resulting in the patient being unaware of her HIV status and lack of patient education about HIV. 2016 BMJ Publishing Group Ltd.

  6. Association Between Proton Pump Inhibitor Use and Spontaneous Bacterial Peritonitis in Cirrhotic Patients with Ascites

    Directory of Open Access Journals (Sweden)

    Mélissa Ratelle

    2014-01-01

    Full Text Available BACKGROUND: There are data suggesting a link between proton pump inhibitor (PPI use and the development of spontaneous bacterial peritonitis (SBP in cirrhotic patients with ascites; however, these data are controversial.

  7. Urinary ascites and anuria caused by bilateral fungal balls in a premature infant.

    Science.gov (United States)

    Ku, J H; Kim, M E; Jeon, Y S; Lee, N K; Park, Y H

    2004-01-01

    A case is reported of anuria and urinary ascites secondary to bilateral ureteropelvic obstruction by fungal balls. Management consisted of bilateral nephrostomy drainage with local irrigation with amphotericin B, and systemic antifungal treatment without surgery. Aspiration by paracentesis was performed for the urinary ascites and continuous drainage through an 8 Fr pig tail catheter for the urinoma. The literature on renal fungus balls in neonates and infants is reviewed.

  8. Post-Bypass Extensive Ascites due to Splanchnic Bypass and the Effectiveness of Hyperalimentation Treatment

    Directory of Open Access Journals (Sweden)

    Veysel Temizkan

    2013-04-01

    Full Text Available Reperfusion edema may develop in the early periods of chronic ischemic tissue reperfusion. Reperfusion edema may be represented after the splanchnic bypass with ascites, abdominal distension, and liver and kidney function impairment. In this article, we are reporting the hyperalimentation treatment and its results for the common ascites and hepatorenal syndrome, after a coeliac and superior mesenteric artery bypass. [Arch Clin Exp Surg 2013; 2(2.000: 124-128

  9. [Dielectric parameters of ascitic and pleural fluids in the microwave range in different nosologies].

    Science.gov (United States)

    Romanov, A N; Kovrigin, A O; Grigorchuk, O G; Lubennikov, V A; Lazarev, A F

    2011-01-01

    The dielectric parameters of ascitic and pleural fluids formed in the human body in oncological and nononcological diseases of different nosology have been estimated in the range between 400 MHz and 1.2 GHZ. The dependence of refractive and absorption indices of ascitic and pleural liquids on the signal frequency and mass concentration of dissolved substances was found. Common regularities and distinctions in the behavior of their dielectric properties were revealed.

  10. A case of delayed-onset ventriculo-peritoneal shunt infection with Corynebacterium presented as ascites

    Directory of Open Access Journals (Sweden)

    Tong Yang

    2016-06-01

    Full Text Available Shunt infection is one of the most common complications related to VPS insertion. Most shunt infections occur within the first year of surgery. We present a case of delayed infection 4 years after shunt insertion without intervening shunt manipulation. Our patient presented with recurrent ascites, and cultures of peritoneal fluid and CSF both recovered Corynebacterium afermentans. This case demonstrates that a delayed onset of ascites after shunt insertion can be secondary to infection with uncommon indolent pathogen.

  11. A rare case of normotensive HELLP syndrome complicated with massive ascites: Spontaneous resolution

    Directory of Open Access Journals (Sweden)

    Ahmed Samy El-Agwany

    2016-01-01

    Full Text Available HELLP develops in approximately 0.1–0.8% of pregnancies overall and as many as 15–20% of patients with HELLP syndrome do not have antecedent hypertension or proteinuria. The risk factor for development of ascites is extensive structural damage of the microvasculature in patients complicated by HELLP. The aim of this study is to report a case with HELLP syndrome complicated with massive ascites after vaginal delivery that eventually resolved spontaneously.

  12. Evolution of sarcoma 180 (ascitic tumor) in mice infected with Schistosoma mansoni

    OpenAIRE

    Fausto Edmundo Lima Pereira; Pedro Raso; Paulo Marcos Zech Coelho

    1986-01-01

    Mice infected with 60 cercariae of Schistosoma mansoni were more resistant to the sarcoma 180 ascites tumor. Tumor inoculation was performed 50 days after schistosoma infection and the animals were observed and weighed at 48 hours intervals for development and progression of malignancy. In infected mice the weight gain (ascites formation) started later and was shorter than in uninfected Controls. Also, the number of tumor cells into the peritoneal cavity 72h after tumor implantation was short...

  13. PAPP-A proteolytic activity enhances IGF bioactivity in ascites from women with ovarian carcinoma

    Science.gov (United States)

    Thomsen, Jacob; Hjortebjerg, Rikke; Espelund, Ulrick; Ørtoft, Gitte; Vestergaard, Poul; Magnusson, Nils E.; Conover, Cheryl A.; Tramm, Trine; Hager, Henrik; Høgdall, Claus; Høgdall, Estrid; Oxvig, Claus; Frystyk, Jan

    2015-01-01

    Pregnancy-associated plasma protein-A (PAPP-A) stimulates insulin-like growth factor (IGF) action through proteolysis of IGF-binding protein (IGFBP)-4. In experimental animals, PAPP-A accelerates ovarian tumor growth by this mechanism. To investigate the effect of PAPP-A in humans, we compared serum and ascites from 22 women with ovarian carcinoma. We found that ascites contained 46-fold higher PAPP-A levels as compared to serum (P PAPP-A was enzymatically active. This is supported by the finding that ascites contained more cleaved than intact IGFBP-4 (P PAPP-A, IGFBP-4, IGF-I and IGF-II. Addition of recombinant PAPP-A to ascites increased the cleavage of IGFBP-4 and enhanced IGF-IR activation (P PAPP-A, IGFBP-4 and IGFs and these proteins are also present in ascites. We suggest that both soluble PAPP-A in ascites and tissue-associated PAPP-A serve to increase IGF bioactivity and, thereby, to stimulate IGF-IR-mediated tumor growth. PMID:26336825

  14. Peritoneal tuberculosis as a cause of ascites in a patient with cirrhosis.

    Science.gov (United States)

    Vaz, Ana Margarida; Peixe, Bruno; Ornelas, Rita; Guerreiro, Horácio

    2017-07-14

    A 59-year-old Portuguese Caucasian man with a history of heavy alcohol intake and no significant medical history presented with ascites, weight loss and general malaise. The ascitic fluid analysis showed 921 cells/mm(3) with mononuclear predominance (93.6%), elevated total proteins and a slightly elevated serum-ascites albumin gradient. The abdominal ultrasound confirmed the presence of chronic liver disease with ascites, and additionally on CT there was evidence of peritoneal thickening. On repeat paracentesis, the ascitic fluid analysis showed elevated adenosine deaminase but it was negative for the presence of mycobacteria by Ziehl-Neelsen stain, Löwenstein-Jensen culture and PCR amplification. Due to the persistent suspicion of tuberculosis, a laparoscopy was performed showing multiple small white tubercles scattered over the peritoneum. Peritoneal biopsies showed the presence of necrotising granulomas and cultures were positive for Mycobacterium tuberculosis complex. After a 6-month course of tuberculostatics, the ascites resolved completely. The patient remained asymptomatic. © BMJ Publishing Group Ltd (unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  15. Exudative v/s transudative ascites: differentiation based on fluid echogenicity on high resolution sonography.

    Directory of Open Access Journals (Sweden)

    Malde H

    1993-07-01

    Full Text Available Real time sonography was performed in 52 patients with ascites to evaluate the accuracy of sonography in differentiating an exudative from a transudative collection. The echogenicity of ascites was graded I, II and III using the echogenicity of normal abdominal viscera as comparative standard reference points. Grade I collections (31 patients were either absolutely anechoic, or showed few internal echoes secondary to particulate matter. Grade II collections (7 patients were hypoechoic as compared to the liver and spleen. Grade III collections (14 patients had an echogenicity similar to or greater than that of the liver and spleen. The results of diagnostic aspiration in all patients were then compared to the sonographic grade of the ascitic fluid. All transudates (28 patients had a Grade I echogenicity. Only 3 patients with an exudative ascites had a Grade I echogenicity. The remaining 21 patients with an exudative collection had an echogenicity equal to or greater than Grade II. Using these results, an ascitic fluid echogenicity of Grade I had a 92.32% sensitivity, 100% specificity, a positive predictive value of 1 and a negative predictive value of 0.875 in diagnosing transudates. An ascitic fluid echogenicity of Grade II or more had a sensitivity of 87.5%, specificity of 100%, a positive predictive value of 1 and a negative predictive value of 0.903 in diagnosing transudates.

  16. Transport of calcium ions by Ehrlich ascites-tumour cells.

    Science.gov (United States)

    Landry, Y; Lehninger, A L

    1976-01-01

    Ehrlich ascites-tumour cells accumulate Ca2+ when incubated aerobically with succinate, phosphate and rotenone, as revealed by isotopic and atomic-absorption measurements. Ca2+ does not stimulate oxygen consumption by carefully prepared Ehrlich cells, but des so when the cells are placed in a hypo-osmotic medium. Neither glutamate nor malate support Ca2+ uptake in 'intact' Ehrlich cells, nor does the endogenous NAD-linked respiration. Ca2+ uptake is completely dependent on mitochondrial energy-coupling mechansims. It was an unexpected finding that maximal Ca2+ uptake supported by succinate requires rotenone, which blocks oxidation of enogenous NAD-linked substrates. Phosphate functions as co-anion for entry of Ca2+. Ca2+ uptake is also supported by extra-cellular ATP; no other nucleoside 5'-di- or tri-phosphate was active. The accumulation of Ca2+ apparently takes place in the mitochondria, since oligomycin and atractyloside inhibit ATP-supported Ca2+ uptake. Glycolysis does not support Ca2+ uptake. Neither free mitochondria released from disrupted cells nor permeability-damaged cells capable of absorbing Trypan Blue were responsible for any large fraction of the total observed energy-coupled Ca2+ uptake. The observations reported also indicate that electron flow through energy-conserving site 1 promotes Ca2+ release from Ehrlich cells and that extra-cellular ATP increase permeability of the cell membrane, allowing both ATP and Ca2+ to enter the cells more readily. PMID:988829

  17. Incidence of spontaneous bacterial peritonitis in patients with ascites. Diagnostic value of white blood cell count and pH measurement in ascitic fluid

    DEFF Research Database (Denmark)

    Storgaard, J S; Svendsen, J H; Hegnhøj, J

    1991-01-01

    by Escherichia coli (n = 3), coagulase negative staphylococcus (n = 1), and Bacteroides species (n = 1). Abdominal tenderness, abnormal intestinal sounds, fever and hepatic encephalopathy were equally frequent in the group with SBP and in patients with sterile ascites. Infection was not anticipated in any...

  18. Successful treatment of massive ascites due to lupus peritonitis with hydroxychloroquine in old- onset lupus erythematosus.

    Science.gov (United States)

    Hammami, Sonia; Bdioui, Fethia; Ouaz, Afef; Loghmari, Hichem; Mahjoub, Sylvia; Saffar, Hamouda

    2014-01-01

    Systemic lupus erythematous (SLE) is an auto-immune disease with multiple organ involvements that occurs mainly in young women. Literature data suggest that serositis is more frequent in late-onset SLE. However, peritoneal serositis with massive ascites is an extremely rare manifestation. We report a case of old-onset lupus peritonitis treated successfully by Hydroxychloroquine. A 77-year-old Tunisian woman was hospitalized because of massive painful ascites. Her family history did not include any autoimmune disease. She was explored 4 years prior to admission for exudative pleuritis of the right lung without any established diagnosis. Physical examination showed only massive ascites. Laboratory investigations showed leucopenia: 3100/mm3, lymphopenia: 840/mm3 and trace protein (0.03 g/24 h). Ascitic fluid contained 170 cells mm(3) (67% lymphocytes), 46 g/L protein, but no malignant cells. The main etiologies of exudative ascites were excluded. She had markedly elevated anti-nuclear antibody (ANA) titer of 1/1600 and a significantly elevated titer of antibody to double-stranded DNA (83 IU/mL) with hypo-complementemia (C3 levl was at 67 mg/dL). Antibody against the Smith antigen was also positive. Relying on these findings, the patient was diagnosed with SLE and treated with Hydroxychloroquine 200 mg daily in combination with diuretics. One month later, there was no detectable ascitic fluid and no pleural effusions. Five months later she remained free from symptoms while continuing to take chloroquine. This case was characterized by old age of onset of SLE, the extremely rare initial presentation with lupus peritonitis and massive painful ascites with dramatic response to only hydroxychloroquine treatment.

  19. Difficulties in differentiating the nature of ascites based on ultrasound imaging

    Directory of Open Access Journals (Sweden)

    Andrzej Smereczyński

    2017-06-01

    Full Text Available Transabdominal ultrasound not always allows to determine the nature of ascites based solely on its characteristics. Aim: The aim of the study was to present difficulties in determining the nature of ascites using transabdominal ultrasonography solely based on extra-organ lesions as well as, after the inclusion of the overall abdominal assessment and the clinical picture. Materials and methods: A total of 18 patients with non-neoplastic ascites and 62 patients with neoplastic ascites whose final diagnosis was based on cytological and histopathological findings were evaluated between 2005 and 2015. Abdominal ultrasound was performed to detect the presence of fluid in all accessible spaces, and, additionally, to determine the presence of potential peritoneal tumor implants as well as to evaluate the parietal peritoneum and the greater omentum. Different digital ultrasound machines equipped with 3–6 MHz and linear 7–12 MHz transducers were used in the study. Double-sided Fisher’s exact test with statistical significance at p < 0.05 was used for the analysis of the obtained results. Results: Statistically significant differences between benign and neoplastic ascites were found for: anechoic peritoneal fluid (<0.0001; fluid and thickened omentum with smooth surface (<0.0001; fluid and thickened omentum with smooth surface and varices (0.01; fluid and thickened omentum with hypoechoic foci (0.049; fluid and thickened omentum with tumor implants (0.009. The inclusion of the overall assessment of abdominal organs and the clinical data allowed for an improvement in ultrasonographic diagnostic accuracy in benign and neoplastic ascites from 83.3% and 67.7% to 94.4% and 93.5%, respectively. Conclusions: When used alone, an assessment of acoustic fluid characteristics and extra-organ peritoneal lesions limits the possibility to differentiate between benign and malignant ascites. These results improve after the inclusion of sonographic assessment of all

  20. Maternal ascites an independent prognostic factor in severe preeclampsia: a matched cohort study.

    Science.gov (United States)

    Suriya, J Yavana; Keepanasseril, Anish; Manikandan, K; Maurya, Dilip Kumar; Veena, P; Soundara Raghavan, S

    2017-07-01

    Preeclampsia is a multi-systemic, multi-organ dysfunction associated with increased maternal and perinatal complications. The presence of maternal ascites, a manifestation of endothelial dysfunction and increased capillary permeability, is shown to be associated with adverse outcomes. We aim to investigate the impact of maternal ascites on pregnancy outcome in women with severe preeclampsia. A matched cohort study was conducted in a tertiary care teaching hospital in South India between March 2014 and March 2015. One hundred and twenty-one severe preeclamptic women with ascites formed the study cohort while age-, parity-, and gestational age-matched group of 121 severe preeclamptic women without ascites formed the control. Primary outcome was the composite maternal adverse outcome defined as the development of any of eclampsia, pulmonary edema, renal failure, or disseminated intravascular coagulation (DIC). Secondary outcome was the composite perinatal outcome defined as the occurrence of any of still birth, hypoxic ischemic encephalopathy or early neonatal death. Four maternal deaths occurred in the study group. The rates of pregnancies with composite maternal adverse outcome [42 vs 9% RR 4.6 (95% CI 2.5-8.4)] and composite perinatal adverse outcome [36 vs 17% RR 2.1, (95% CI 1.3-3.3)] were significantly more in ascites group than in control group. After adjusting for other confounding variables, ascites was independently associated with adverse maternal events [adjusted OR 16.40 (95% CI 2.88-93.31)] but not adverse perinatal outcome. In women with severe preeclampsia, maternal ascites is an independent risk factor for adverse maternal outcome.

  1. Isolation and characterization of stromal progenitor cells from ascites of patients with epithelial ovarian adenocarcinoma

    Directory of Open Access Journals (Sweden)

    Ho Chih-Ming

    2012-02-01

    Full Text Available Abstract Background At least one-third of epithelial ovarian cancers are associated with the development of ascites containing heterogeneous cell populations, including tumor cells, inflammatory cells, and stromal elements. The components of ascites and their effects on the tumor cell microenvironment remain poorly understood. This study aimed to isolate and characterize stromal progenitor cells from the ascites of patients with epithelial ovarian adenocarcinoma (EOA. Methods Seventeen ascitic fluid samples and 7 fresh tissue samples were collected from 16 patients with EOA. The ascites samples were then cultured in vitro in varying conditions. Flow cytometry and immunocytochemistry were used to isolate and characterize 2 cell populations with different morphologies (epithelial type and mesenchymal type deriving from the ascites samples. The in vitro cell culture model was established using conditional culture medium. Results The doubling times of the epithelial type and mesenchymal type cells were 36 h and 48 h, respectively, indicating faster growth of the epithelial type cells compared to the mesenchymal type cells. Cultured in vitro, these ascitic cells displayed the potential for self-renewal and long-term proliferation, and expressed the typical cancer stem/progenitor cell markers CD44high, CD24low, and AC133+. These cells also demonstrated high BMP-2, BMP4, TGF-β, Rex-1, and AC133 early gene expression, and expressed EGFR, integrin α2β1, CD146, and Flt-4, which are highly associated with tumorigenesis and metastasis. The epithelial type cells demonstrated higher cytokeratin 18 and E-cadherin expression than the mesenchymal type cells. The mesenchymal type cells, in contrast, demonstrated higher AC133, CD73, CD105, CD117, EGFR, integrin α2β1, and CD146 surface marker expression than the epithelial type cells. Conclusion The established culture system provides an in vitro model for the selection of drugs that target cancer

  2. Isolation and characterization of stromal progenitor cells from ascites of patients with epithelial ovarian adenocarcinoma.

    Science.gov (United States)

    Ho, Chih-Ming; Chang, Shwu-Fen; Hsiao, Chih-Chiang; Chien, Tsai-Yen; Shih, Daniel Tzu-Bi

    2012-02-14

    At least one-third of epithelial ovarian cancers are associated with the development of ascites containing heterogeneous cell populations, including tumor cells, inflammatory cells, and stromal elements. The components of ascites and their effects on the tumor cell microenvironment remain poorly understood. This study aimed to isolate and characterize stromal progenitor cells from the ascites of patients with epithelial ovarian adenocarcinoma (EOA). Seventeen ascitic fluid samples and 7 fresh tissue samples were collected from 16 patients with EOA. The ascites samples were then cultured in vitro in varying conditions. Flow cytometry and immunocytochemistry were used to isolate and characterize 2 cell populations with different morphologies (epithelial type and mesenchymal type) deriving from the ascites samples. The in vitro cell culture model was established using conditional culture medium. The doubling times of the epithelial type and mesenchymal type cells were 36 h and 48 h, respectively, indicating faster growth of the epithelial type cells compared to the mesenchymal type cells. Cultured in vitro, these ascitic cells displayed the potential for self-renewal and long-term proliferation, and expressed the typical cancer stem/progenitor cell markers CD44(high), CD24(low), and AC133(+). These cells also demonstrated high BMP-2, BMP4, TGF-β, Rex-1, and AC133 early gene expression, and expressed EGFR, integrin α2β1, CD146, and Flt-4, which are highly associated with tumorigenesis and metastasis. The epithelial type cells demonstrated higher cytokeratin 18 and E-cadherin expression than the mesenchymal type cells. The mesenchymal type cells, in contrast, demonstrated higher AC133, CD73, CD105, CD117, EGFR, integrin α2β1, and CD146 surface marker expression than the epithelial type cells. The established culture system provides an in vitro model for the selection of drugs that target cancer-associated stromal progenitor cells, and for the development of ovarian

  3. Mean platelet volume as a novel predictor of systemic inflammatory response in cirrhotic patients with culture-negative neutrocytic ascites

    National Research Council Canada - National Science Library

    Gálvez-Martínez, Marisol; Servín-Caamaño, Alfredo I; Pérez-Torres, Eduardo; Salas-Gordillo, Francisco; Rivera-Gutiérrez, Xaira; Higuera-de la Tijera, Fátima

    2015-01-01

    .... Receiver operator characteristic curves were used to identify the best cutoff value of several parameters from hematic cytometry, including MPV, to predict the presence of ascites fluid infection...

  4. Differential diagnosis of human ascites: inhibitors of the contact system and total proteins.

    Science.gov (United States)

    Buø, L; Karlsrud, T S; Dyrhaug, G; Jacobsen, M B; Bell, H; Johansen, H T; Aasen, A O

    1993-09-01

    To assess their accuracies as markers for malignancy, we assayed alpha 2-macroglobulin, C1-inhibitor, alpha 1-protease inhibitor, and total proteins in ascites and plasma from patients with gastrointestinal cancer (n = 15) and non-malignant liver disease (n = 13), using functional and immunologic assays. For all inhibitors and total proteins determined in ascites, the values in the cancer group were significantly higher than the corresponding values in the group with non-malignant liver disease. The diagnostic accuracy for differentiating malignancy-related from non-malignant ascites was 93% for a alpha 1-protease inhibitor value > or = 50% of the pool plasma value and 90% for alpha 2-macroglobulin > or = 16%, C1-inhibitor > or = 40% (all functional assays), and total proteins > or = 20 g/l (biuret). In conclusion, functional assays for alpha 2-macroglobulin, C1-inhibitor, and alpha 1-protease inhibitor and determination of total proteins in ascites appeared to be very informative tests for the differential diagnosis of ascites. The test for alpha 1-protease inhibitor gave higher specificity (92% versus 77%) and likelihood ratio for a positive test (12 versus 4) compared with the other tests.

  5. Emerging treatment options for management of malignant ascites in patients with ovarian cancer

    Directory of Open Access Journals (Sweden)

    Eskander RN

    2012-08-01

    Full Text Available Ramez N Eskander, Krishnansu S TewariDivision of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of California at Irvine, Irvine, CA, USAAbstract: Malignant ascites affects approximately 10% of patients with recurrent epithelial ovarian cancer and is associated with troublesome symptoms, including abdominal pressure and distension, dyspnea, bloating, pelvic pain, and bowel/bladder dysfunction. To date, no effective therapy has been identified for the treatment of malignant ascites in patients with recurrent, advanced ovarian cancer. In this article, we discuss currently existing options for the treatment of ascites associated with ovarian cancer, and review the literature as it pertains to novel, targeted therapies. Specifically, preclinical and clinical trials exploring the use of the antiangiogenic agents, bevacizumab and vascular endothelial growth factor-trap, as well as the nonangiogenic agent, catumaxomab, will be reviewed. Despite current limitations in treatment, knowledge regarding management options in the palliation of ascites is critical to practicing physicians. Ultimately, as with all novel therapies, symptom relief and treatment goals must be weighed against patient discomfort and potentially significant adverse events.Keywords: angiogenesis, ascites, epithelial ovarian cancer

  6. Massive Ascites in a Renal Transplant Patient after Laparoscopic Fenestration of a Lymphocele

    Directory of Open Access Journals (Sweden)

    Shohei Kawaguchi

    2016-01-01

    Full Text Available Retroperitoneal lymphocele is a common complication of renal transplantation. Here, we report the case of a 67-year-old woman with massive ascites after fenestration surgery for a lymphocele that developed following renal transplantation. She had been on continuous ambulatory peritoneal dialysis for 9 years. Living donor renal transplantation was performed and an intrapelvic lymphocele subsequently developed. The lymphocele did not resolve after aspiration therapy; therefore, laparoscopic fenestration was performed. Although the lymphocele disappeared, massive ascites appeared in its stead. Half a year later, the ascites was surgically punctured, which then gradually resolved and disappeared 6 weeks later. Aspiration therapy should be considered in patients on long-term peritoneal dialysis, although laparoscopic fenestration is safe and effective.

  7. Improved migration of tumor ascites lymphocytes to ovarian cancer microenvironment by CXCR2 transduction

    DEFF Research Database (Denmark)

    Idorn, Manja; Olsen, Maria; Halldórsdóttir, Hólmfrídur Rósa

    2018-01-01

    suppressive tumor sites. We hypothesized that equipping T cells with chemokine receptors matching the chemokines of the tumor microenvironment, could improve tumor homing of T cells. T cells from malignant ascites (n = 13); blood from ovarian cancer (OC) patients (n = 14); and healthy donors (n = 13) were......Chemokines are essential mediators of cellular trafficking, interactions and tumor development. Though adoptive cell therapy (ACT) has been a tremendous success in the treatment of metastatic melanoma (MM), a major obstacle for successful ACT, is limited homing of effector T cells to immune...... analyzed by flow cytometry. We found that FoxP3+ regulatory T cells accumulation in patients with OC associates with CCR4 expression. We characterized a chemokine profile of ascites chemokines, and expression of corresponding receptors on circulating T cells and tumor ascites lymphocytes (TALs). CCL22...

  8. Serum and Ascitic Fluid Superoxide Dismutase and Malondialdehyde Levels in Patients with Cirrhosis

    Directory of Open Access Journals (Sweden)

    Ugur Coskun

    2008-01-01

    Full Text Available Serum and ascitic fluid superoxide dismutase (SOD and malondialdehyde (MDA levels were measured in 43 patients with cirrhosis and in a 10 healthy control group. Compensated cirrhotic patients had no clinically detectable ascites, but decompensated patients had massive ascites. Cirrhotic patients were divided into three groups: patients with compensated cirrhosis (n = 16, patients with decompensated cirrhosis with Spontaneous bacterial peritonitis (SBP (n = 14, and patients with decompensated cirrhosis without SBP (n = 13. All cirrhotic patients in the experimental group had significantly higher serum SOD (p 0.05. These results suggest that the increase in serum SOD and MDA levels are not related to the presence of SBP and the status of liver cirrhosis. To sum up, clarifying the impact of increased serum SOD and MDA levels in cirrhotic patients needs further investigation.

  9. Artificial ascites and pneumoperitoneum to facilitate thermal ablation of liver tumors: a pictorial essay.

    Science.gov (United States)

    Bhagavatula, Sharath K; Chick, Jeffrey F B; Chauhan, Nikunj R; Shyn, Paul B

    2017-02-01

    Image-guided percutaneous thermal ablation is increasingly utilized in the treatment of hepatic malignancies. Peripherally located hepatic tumors can be difficult to access or located adjacent to critical structures that can be injured. As a result, ablation of peripheral tumors may be avoided or may be performed too cautiously, leading to inadequate ablation coverage. In these cases, separating the tumor from adjacent critical structures can increase the efficacy and safety of procedures. Artificial ascites and artificial pneumoperitoneum are techniques that utilize fluid and gas, respectively, to insulate critical structures from the thermal ablation zone. Induction of artificial ascites and artificial pneumoperitoneum can enable complete ablation of otherwise inaccessible hepatic tumors, improve tumor visualization, minimize unintended thermal injury to surrounding organs, and reduce post-procedural pain. This pictorial essay illustrates and discusses the proper technique and clinical considerations for successful artificial ascites and pneumoperitoneum creation to facilitate safe peripheral hepatic tumor ablation.

  10. Strategies to alleviate the incidence of ascites in broilers: a review

    Directory of Open Access Journals (Sweden)

    U Aftab

    2005-12-01

    Full Text Available Ascites is a complex problem caused by many interacting factors such as genetics, environment and management. Many nutritional, medicinal and management strategies have been proposed to alleviate the problem. Higher levels of dietary vitamin C and E along with selenium yeast might be beneficial, presumably because of their role in improving cellular integrity. Oils rich in n-3 fatty acids have been shown to reduce pulmonary hypertension and, consequently, ascites incidence. The potential use of flax oil has already been demonstrated, whereas the effects of other oils rich in n-3 fatty acids (fish, linseed and canola oils remain to be investigated. The assessment of the effects of dietary electrolyte balance on ascites incidence seems to be a promising field of research in broiler nutrition. In general, reducing the dietary level of salt (NaCl and adding bicarbonates to the diet and drinking water have been proposed as potential "cost-effective" methods to reduce ascites incidence. The use of nutrients/drug agents that increase the vascular capacity of the lungs or decrease the pulmonary vascular resistance may help to alleviate the problem, but economic and local feed regulations might restrict such use. Diuretics have also shown positive effects, presumably because there is a reduction of sodium and fluid retention in the body; litter humidity however must be closely monitored if diuretics are continuously administered. As the high metabolic rate (fast growth is a major factor contributing to the susceptibility of broilers to ascites, early-age feed or nutrient restriction (qualitative or quantitative or light restriction in order to slow down the growth rate seem practically viable methods, since final body weight is not compromised. Optimization of the house temperature and ventilation in cold weather seem helpful practices to decrease ascites incidence. Under practical conditions, it might be interesting to test the additive effects of

  11. The Impact of Tunneled Catheters for Ascites and Peritoneal Carcinomatosis on Patient Rehospitalizations

    Energy Technology Data Exchange (ETDEWEB)

    Qu, Chuanxing [University of Pittsburgh School of Medicine, Division of Interventional Radiology, Department of Radiology (United States); Xing, Minzhi [Yale University School of Medicine, Division of Interventional Radiology, Department of Radiology and Biomedical Imaging, Yale Cancer Center (United States); Ghodadra, Anish; McCluskey, Kevin M.; Santos, Ernesto; Kim, Hyun S., E-mail: kevin.kim@yale.edu [University of Pittsburgh School of Medicine, Division of Interventional Radiology, Department of Radiology (United States)

    2016-05-15

    PurposeThe aim of the study is to assess patient outcomes, complications, impact on rehospitalizations, and healthcare costs in patients with malignant ascites treated with tunneled catheters.Materials and MethodsA total of 84 patients with malignant ascites (mean age, 60 years) were treated with tunneled catheters. Patients with peritoneal carcinomatosis and malignant ascites treated with tunneled drain catheter placement over a 3-year period were studied. Overall survival from the time of ascites and catheter placement were stratified by primary cancer and analyzed using the Kaplan–Meier method. Complications were graded by the Common Terminology Criteria for Adverse Events v3.0 (CTCAE). The differences between pre- and post-catheter admissions, hospitalizations, and Emergency Department (ED) visits, as well as related inpatient expenses were compared using paired t tests.ResultsThere were no significant differences in gender, age, or race between different primary cancer subgroups. One patient (1 %) developed bleeding (CTCAE-2). Four patients (5 %) developed local cellulitis (CTCAE-2). Three patients (4 %) had prolonged hospital stay (between 7 and 10 days) to manage ascites-related complications such as abdominal distention, discomfort, or pain. Comparison between pre- and post-catheter hospitalizations showed significantly lower admissions (−1.4/month, p < 0.001), hospital stays (−4.2/month, p = 0.003), and ED visits (−0.9/month, p = 0.002). The pre- and post-catheter treatment health care cost was estimated using MS-DRG IPPS payment system and it demonstrated significant cost savings from decreased inpatient admissions in post-treatment period (−$9535/month, p < 0.001).ConclusionsTunneled catheter treatment of malignant ascites is safe, feasible, well tolerated, and cost effective. Tunneled catheter treatment may play an important role in improving patients’ quality of life and outcomes while controlling health care expenditures.

  12. Few complications after paracentesis in patients with cirrhosis and refractory ascites

    DEFF Research Database (Denmark)

    Wiese, Signe Skovgaard; Mortensen, Christian; Bendtsen, Flemming

    2011-01-01

    The relevance of needle type and ultrasound guidance in connection with complications and technical problems in paracentesis in cirrhotic patients has only been sparsely described. The aim of this study was to evaluate paracentesis in cirrhotic patients with refractory ascites, focusing on techni......The relevance of needle type and ultrasound guidance in connection with complications and technical problems in paracentesis in cirrhotic patients has only been sparsely described. The aim of this study was to evaluate paracentesis in cirrhotic patients with refractory ascites, focusing...

  13. [Endometriosis with massive hemorrhagic ascites: a case report and review of the literature].

    Science.gov (United States)

    Ekoukou, D; Guilherme, R; Desligneres, S; Rotten, D

    2005-06-01

    Endometriosis is defined as the presence of endometrial tissue outside the uterine cavity. It generally involves the peritoneum, ovaries and rectovaginal septum. Its characteristic symptoms include dysmenorrhea, pelvic pain, deep dyspareunia and infertility. It may also involve the gastrointestinal tract, urinary tract or extra abdominal sites, giving rise to a wide variety of clinical symptoms such as bloody stools, renal haemorrhage, hemoptysis and pleural effusion during menstruation. Recurrent hemorrhagic ascites secondary to endometriosis is an unusual occurrence, 41 cases have been reported since 1954. Here we report an additional case, in order to draw attention to this condition. A 28 years-old black nulligravida woman was seen for the first time in april 2000 with a chief complaint of infertility. Her past medical history was unremarkable. She had regular menses but associated with severe dysmenorrhea. She also recalled abdominal and pelvic pain for several years. She underwent an ovulation induction with gonadotrophin, which resulted in a progressive increase of pelvic pain. A first laparoscopy was performed, revealing voluminous ascites (10 I). Two years later the ascites recurred spontaneously. Ultrasound examination revealed suspect "para uterine masses". A second exploratory laparoscopy showed a voluminous bloody ascites (71), and extensive adhesions. On histologic examination all specimens (peritoneal biopsies) were compatible with endometriosis and ruled out malignancy. Treatment with Gn RH analog was performed and full remission was obtained after 6 months. One year later the ascites recurred again spontaneously, leading to a third laparoscopy in an other medical institution. Histologic examination showed endometrial stromal tissue and fibrous proliferation. Later she became pregnant after in vitro fertilization. In the first trimester of pregnancy, the pelvic ultrasound showed only a small effusion in the pouch of Douglas. Still, the ascites did

  14. Cell Swelling Activates Phospholipase A2 in Ehrlich Ascites Tumor Cells

    DEFF Research Database (Denmark)

    Thoroed, S.M.; Lauritzen, L.; Lambert, I.H.

    1997-01-01

    Ehrlich ascites tumor cells! loaded with H-labeled arachidonic acid and C-labeled stearic acid for two hours, were washed and transferred to either isotonic or hypotonic media containing BSA to scavenge the labeled fatty acids released from the cells. During the first two minutes of hypo-osmotic ......Ehrlich ascites tumor cells! loaded with H-labeled arachidonic acid and C-labeled stearic acid for two hours, were washed and transferred to either isotonic or hypotonic media containing BSA to scavenge the labeled fatty acids released from the cells. During the first two minutes of hypo...

  15. Clinical study on the therapeutic role of midodrine in non azotemic cirrhotic patients with tense ascites

    DEFF Research Database (Denmark)

    Ali, Amjad; Farid, S; AminAmin, M

    2014-01-01

    BACKGROUND: Midodrine is an α-agonist prodrug of desglymidodrine used for the management of hypotension. Midodrine has demonstrated usefulness in hepatorenal syndrome. OBJECTIVE: The objective of the present work was to study the role of midodrine in patients with non-azotemic cirrhosis with tense...... ascites. METHODS: This prospective randomized double blind placebo-controlled study was conducted on 67 non azotemic inpatients with liver cirrhosis and tense ascites (52 men and 15 women; age range, 45-72). One patient declined to participate in the study, 33 patients were randomly assigned to take...

  16. Paracentesis with intravenous infusion of albumin as compared with peritoneovenous shunting in cirrhosis with refractory ascites.

    Science.gov (United States)

    Ginès, P; Arroyo, V; Vargas, V; Planas, R; Casafont, F; Panés, J; Hoyos, M; Viladomiu, L; Rimola, A; Morillas, R

    1991-09-19

    There is no satisfactory treatment for refractory ascites in patients with cirrhosis. Both peritoneovenous shunts and paracentesis have been used, but there is uncertainty about their relative merits. We studied 89 patients with cirrhosis and refractory ascites who were randomly assigned to receive either repeated large-volume paracentesis plus intravenous albumin or a LeVeen peritoneovenous shunt. Patients in the paracentesis group in whom recurrent tense ascites developed during follow-up were treated with paracentesis, and those in the peritoneovenous-shunt group with diuretic agents or by the insertion of a new shunt if there was shunt obstruction. During the first hospitalization, ascites was removed in all 41 patients in the paracentesis group and in 44 of the 48 patients in the peritoneovenous-shunt group. The mean (+/- SD) duration of hospitalization in the two groups was 11 +/- 5 and 19 +/- 9 days, respectively (P less than 0.01). There were no significant differences in the number of patients who had complications or died. During follow-up, 37 patients in each group were hospitalized again. In the paracentesis group, the number of rehospitalizations for any reason (174 vs. 97 in the peritoneovenous-shunt group) or for ascites (125 vs. 38) was significantly higher, and the median time to a first readmission for any reason (1 +/- 1 vs. 2 +/- 2 months) or for ascites (2 +/- 2 vs. 8 +/- 17 months) was significantly shorter than in the peritoneovenous-shunt group. The total times in the hospital during follow-up, however, were similar in the two groups (48 +/- 49 and 44 +/- 39 days, respectively). Three patients had obstructions of their peritoneovenous shunts during their first hospitalizations, and 15 patients had a total of 20 obstructions during follow-up. Survival was similar in both groups. The LeVeen shunt and paracentesis are equally effective in relieving refractory ascites. The former may provide better long-term control of ascites, but shunt

  17. Diagnosis of spontaneous bacterial peritonitis: Role of tween 80 and triton X in ascitic fluid cultures

    Directory of Open Access Journals (Sweden)

    Iyer R

    2009-01-01

    Full Text Available A patient with alcoholic cirrhosis of the liver, portal hypertension with hepatic encephalopathy and spontaneous bacterial peritonitis (SBP was admitted in an obtunded condition. Attempts at delineating the aetiology of the SBP using conventional cultures as well as automated systems were not successful. The use of non-anionic surfactant agents such as Tween 80-incorporated blood agar and Triton X treatment of the specimens facilitated the growth of Klebsiella pneumoniae from the ascitic fluid, which otherwise would have been concluded to represent culture-negative neutrocytic ascites. Thus, the use of the aforementioned agents could be explored in elucidating the aetiology of body cavity infections when conventional methods fail.

  18. Effect of paracentesis on metabolic activity in patients with advanced cirrhosis and ascites

    DEFF Research Database (Denmark)

    Knudsen, Anne Wilkens; Krag, Aleksander; Nordgaard-Lassen, Inge

    2016-01-01

    Objective Patients with decompensated cirrhosis often suffer from malnutrition. To enable appropriate nutritional supplementation a correct estimation of resting energy expenditure (REE) is needed. It is, however, unclear whether the volume of ascites should be included or not in the calculations...... of the REE. Material and methods In 19 patients with cirrhosis and ascites, measurements of REE by indirect calorimetry were performed before paracentesis, after paracentesis, and four weeks after paracentesis. Moreover, handgrip strength (HGS), dual X-ray absorptiometry (DXA), and biochemistry were assessed...

  19. Urinary ascites in a preterm female neonate: a rare case report ...

    African Journals Online (AJOL)

    Here we report a rare case of urinary ascites due to spontaneous bladder rupture in a preterm female neonate. The baby presented with respiratory distress, abdominal distension, anuria, and renal insufficiency. The diagnosis of bladder rupture was confirmed by peritoneal fluid aspiration with biochemical analysis and ...

  20. Liver cirrhosis associated wiht a non-responsive ascites in a 10 ...

    African Journals Online (AJOL)

    A ten month old Alsatian bitch presented with complaint of recurring ascites over a period of three months and had 'been refractory to diuretic therapy. The condition was diagnosed as liver cirrhosis by serum chemistry, exploratory laparotorny and histopathology of the liver. Result of the serum chemistry showed a ...

  1. Effect of ascitic liquid on growth in vitro of embryoid bodies derived from teratocarcinoma.

    Science.gov (United States)

    Monzó, M; Martínez-Rubio, G; de Anta, J M; Saltó, C; Ruano-Gil, D

    1992-01-01

    Embryoid bodies (EB) derived from teratocarcinoma (TC) OTT6050 were cultured with ascitic liquids (AL) from animals carrying 16-, 22- and 35-day evolved EB. At the same time the presence of fibronectin (FN) in AL were analyzed by immunoblotting. Results indicate the probable existence of growth-stimulatory factors for EB, as well as the presence of FN in the 22-day AL.

  2. Effect of ascitic liquid on growth in vitro of embryoid bodies derived from teratocarcinoma

    OpenAIRE

    Monzó, M.; Martínez Rubio, G.; Anta, J.M.de; Saltó, C.; Ruano-Gil, D.

    1992-01-01

    Embryoid bodies (EB) derived from teratocarcinoma (TC) OTT6050 were cultured with ascitic liquids (AL) from animals carrying 16-, 22- and 35-day evolved EB. At the same time the presence of fibronectin (FN) in AL were analyzed by immunoblotting. Results indicate the . probable existence of growth-stimulatory factors for EB, as well as the presence of FN in the 22-day AL.

  3. Hepatitis B-Surface Antigen In Ascitic Fluid Of Patients With Chronic ...

    African Journals Online (AJOL)

    A prospective evaluation of eleven consecutive cases of chronic liver disease over a twelve-month period was carried out clinically and ultrasonographically. By the use of the method of reverse passive haemagglutination, sera and ascitic fluid of the patients were tested for the presence of the Hepatitis B surface antigen.

  4. Infected ascites: Distinguishing secondary peritonitis from spontaneous bacterial peritonitis in a cirrhotic patient with classic symptoms

    Directory of Open Access Journals (Sweden)

    Marvin Louis Roy Lu

    2017-01-01

    Conclusion: Persistence of signs and symptoms of peritonitis despite improvement in ascitic fluid analysis in cirrhotic patients treated for or early relapse of peritonitis with the same organism should prompt the physician to evaluate for secondary peritonitis and surgical management should be considered for potentially correctable sources.

  5. Few complications after paracentesis in patients with cirrhosis and refractory ascites

    DEFF Research Database (Denmark)

    Wiese, Signe Skovgaard; Mortensen, Christian; Bendtsen, Flemming

    2011-01-01

    The relevance of needle type and ultrasound guidance in connection with complications and technical problems in paracentesis in cirrhotic patients has only been sparsely described. The aim of this study was to evaluate paracentesis in cirrhotic patients with refractory ascites, focusing...

  6. Study on anti-ehrlich ascites tumor effect of Pinellia Ternata ...

    African Journals Online (AJOL)

    The objectives of the study were to investigate the anti-tumour activity of Pinellia ternata polysaccharide in vivo, and to preliminarily explore the possible mechanism of its antitumour action. Mouse model of Ehrlich ascites tumour (solid tumour) was used to detect the serum SOD, MDA and GSH-Px levels in mouse and to ...

  7. Non-selective β-blockers do not affect mortality in cirrhosis patients with ascites

    DEFF Research Database (Denmark)

    Bossen, Lars; Krag, Aleksander; Vilstrup, Hendrik

    2016-01-01

    The safety of non-selective β-blockers (NSBBs) in advanced cirrhosis has been questioned. We used data from three satavaptan trials to examine whether NSBBs increase mortality in cirrhosis patients with ascites. The trials were conducted in 2006-2008 and included 1198 cirrhosis patients with asci...

  8. Haematological characteristics predicting susceptibility for ascites. 1. High carbon dioxide tensions in juvenile chickens.

    NARCIS (Netherlands)

    Scheele, C.W.; Klis, van der J.D.; Kwakernaak, C.; Buys, N.; Decuypere, E.

    2003-01-01

    1. Male broilers of two different genetic stocks, a pure broiler sire line (A) and commercially available Ross broilers (B), were used to study the effect of haematological characteristics in juvenile chickens on the development of clinical ascitic signs. Production performance (body weight gain

  9. Cell swelling activates separate taurine and chloride channels in Ehrlich mouse ascites tumor cells

    DEFF Research Database (Denmark)

    Lambert, Ian Henry; Hoffmann, Else Kay

    1994-01-01

    The taurine efflux from Ehrlich ascites tumor cells is stimulated by hypotonic cell swelling. The swelling-activated taurine efflux is unaffected by substitution of gluconate for extracellular Cl– but inhibited by addition of MK196 (anion channel blocker) and 4,4 -diisothiocyanostilbene-2...

  10. New-onset ascites as a manifestation of virologic relapse in patients with hepatitis C cirrhosis

    Directory of Open Access Journals (Sweden)

    Chua DL

    2014-01-01

    Full Text Available Deborah Lim Chua, Thomas Hahambis, Samuel H SigalDivision of Gastroenterology, Department of Medicine, New York University School of Medicine, New York, NY, USABackground: Chronic hepatitis C is the most common cause of cirrhosis in industrialized countries. Successful treatment of chronic hepatitis C in patients with advanced fibrosis or cirrhosis has significant benefits, including improvements in inflammation, fibrosis, and portal hypertension, with prevention of esophageal varices and clinical decompensation.Case: In this report, we present two patients with well-compensated hepatitis C cirrhosis who achieved an end-of-treatment response on a direct-acting antiviral therapy-based triple regimen for hepatitis C virus, but subsequently presented with new-onset ascites associated with virologic relapse.Conclusion: We propose that the development of ascites in this setting is due to the adverse impact of inflammation of the virologic relapse on portal hypertension. Our observation that ascites formation can be a manifestation of virologic relapse has potentially important clinical implications, as it highlights not only the importance of close monitoring of cirrhotic patients after achieving end-of-treatment response but also the impact of active inflammation on the severity of portal hypertension.Keywords: chronic hepatitis C, cirrhosis, virologic relapse, portal hypertension, ascites

  11. Comparison of clinical characteristics and outcomes of spontaneous bacterial peritonitis and culture negative neutrocytic ascites.

    Science.gov (United States)

    Na, Sun Hee; Kim, Eun Jung; Nam, Eun Young; Song, Kyoung-Ho; Choe, Pyoeng Gyun; Park, Wan Beom; Bang, Ji Hwan; Kim, Eu Suk; Park, Sang Won; Kim, Hong Bin; Oh, Myoung-Don; Kim, Nam Joong

    2017-02-01

    Ascitic fluid infections (AFI) in cirrhotic patients can be classified into two groups: spontaneous bacterial peritonitis (SBP) and culture-negative neutrocytic ascites (CNNA). The aim of this study was to compare the clinical characteristics and outcomes of the two groups of patients with AFI. We retrospectively reviewed the medical records of cirrhotic patients with AFI. We evaluated demographic data, clinical presentations of AFI, laboratory findings, liver function, and mortality rates. Between January 2005 and December 2014, 533 patients with AFI were evaluated; 259 (48.6%) had SBP and 274 (51.4%) CNNA. Ascites neutrophil count (4410/mm 3 versus 1046/mm 3 , p < .001) and the blood culture positive rate (38.1% versus 20.1%, p < .001) were higher in the SBP group, which also had a higher MELD score (24.29 versus 22.05, p = .004). Seven-day mortality was higher in the SBP group (9.4% versus 4.5%, p = .027) but there was no significant difference in 30-day (22.1% versus 17.5%) or 90-day mortality rate (36.1% versus 36.4%). Patients in the SBP group had a higher MELD score, ascites neutrophil count, and positive blood culture rate. Although seven-day mortality rate was higher in the SBP group, the 30-day and 90-day mortality rates were similar in the two groups.

  12. Risk factors for drainage-requiring ascites after refractory peritonitis in peritoneal dialysis patients.

    Science.gov (United States)

    Lee, Cheng-Chia; Tu, Kun-Hua; Chen, Hsiao-Hui; Chang, Ming-Yang; Hung, Cheng-Chieh

    2016-10-01

    Refractory peritonitis remains a thorny issue for patients with chronic peritoneal dialysis (PD). Shortly after catheter removal, some patients develop persistent peritoneal inflammation and ascites formation, which require percutaneous drainage for symptom relief. Our study aimed at finding the risk factors for this kind of event. A total of 47 PD patients complicated with refractory peritonitis who underwent catheter removal between January 2009 and December 2011 were enrolled in this study. Data were compared between patients with and without the development of symptomatic ascites requiring drainage during hospitalization. Among the 47 refractory peritonitis patients, 15 patients developed symptomatic ascites that needed further drainage shortly after catheter removal during hospitalization. The following factors were associated with an increased risk: longer dialysis duration, higher peritoneal Kt/V urea, and a significant rise in serum C-reactive protein (CRP) level after catheter removal. These patients had a prolonged hospital stay (62 vs 21 days, P peritonitis experienced ascites requiring drainage shortly after catheter removal, which led to a prolonged hospitalization. Whether routine drain placement at the time of catheter removal for this high-risk group would be of benefit warrants further prospective studies.

  13. Effect of magnetic fields on antioxidant system enzymes in mice with Ehrlich ascites carcinoma.

    Science.gov (United States)

    Sergeeva, E Yu; Titova, N M; Sherbinina, A S; Sergeev, N V; Shirokova, A V

    2011-01-01

    The combination of weak steady-state and weak low-frequency alternating magnetic fields activates SOD in Ehrlich ascites carcinoma cells and catalase in liver cells by 3.7 and 1.3 times, respectively (pmagnetic fields with the specified parameters.

  14. Effects of Atenolol on Growth Performance, Mortality Due to Ascites, Antioxidant Status and Some Blood Parameters in Broilers under Induced Ascites

    Directory of Open Access Journals (Sweden)

    mokhtar fathi

    2016-11-01

    Full Text Available Introduction Broiler chickens are intensively selected for productive traits. The management of these highly productive animals must be optimal to allow their full genetic potential to be expressed. If this is not done, inefficient production and several metabolic diseases such as ascites become apparent. Investigations in mammals indicated that the b- adrenoreceptor characteristics are differentially regulated by chronic hypoxia and play an important role in the cardiovascular system. The density of b-adrenergic receptors was higher in cardiac cells of ascites sensitive birds compared with ascites-resistant ones. Moreover, the characteristics of b-adreno receptors are different in cardiac cells of birds with right ventricular hypertrophy and heart failure compared with healthy birds. Treatment with the selective b1-adrenoceptor blocker, atenolol, abolished right ventricular hypertrophy in response to hypoxia compared with normoxic condition in rats. Materials and Methods This study investigated the comparative effects of different levels of atenolol Growth performance, Mortality due to ascites, antioxidant status and blood parameters in broilers under induced ascites. Six hundred one-day-old male broilers (Ross 308 in a completely randomized experimental design with four treatments (Positive control, negative control, and two levels of 30 and 60 ppm atenolol with five replicates of thirty birds were applied. Birds in positive control were reared in natural temperature without atenolol, the other bird groups were reared in cold temperature with 0, 30 and 60 ppm atenolol. The average daily feed intake (ADFI, average daily weight gain (ADWG and feed conversion ratio (FCR for each group of birds were calculated and mortality was daily weighed, recorded and used to correct the FCR. Observations were made daily to record the incidence of ascites and mortality. Diagnosis of ascites generally depends on observation of the following symptoms: (1 right

  15. Post-hepatectomy Refractory Ascites in Cirrhotic Patients with Hepatocellular Carcinoma: Risk Factor Analysis to Overcome this Problematic Complication.

    Science.gov (United States)

    Itoh, Shinji; Uchiyama, Hideaki; Ikeda, Yasuharu; Morita, Kazutoyo; Harada, Noboru; Sugimachi, Keishi; Kawanaka, Hirofumi; Korenaga, Daisuke; Yoshizumi, Tomoharu; Takenaka, Kenji; Maehara, Yoshihiko

    2017-03-01

    Refractory ascites is a serious post-hepatectomy complication in cirrhotic patients with hepatocellular carcinoma (HCC). In order to avoid this complication, surgeons should preserve as much liver parenchyma as possible in performing hepatectomy in such patients. However, we still occasionally encounter refractory ascites even after limited or small hepatectomy. The aim of this study was to identify risk factors for post-hepatectomy refractory ascites in cirrhotic patients, focusing on limited or small hepatectomy. The data of 73 cirrhotic patients with HCC who underwent limited or small hepatectomy were analyzed. Limited or small hepatectomy was defined as hepatectomy equal to or of less than subsegmentectomy. We compared the clinicopathological factors between patients with and without postoperative refractory ascites. Fourteen cirrhotic patients suffered postoperative refractory ascites. Total cholesterol, duration of operation, duration of Pringle maneuver, resection of segment VII, intraoperative blood loss, and intraoperative blood transfusion were found to be significant risk factors for postoperative refractory ascites in univariate analyses. Multivariate analysis revealed that resection of segment VII was an independent risk factor. Resection of segment VII necessitates extensive dissection of the right triangular or coronary ligaments, which could explain that it was an independent risk factor for post-hepatectomy refractory ascites. Surgeons should avoid extensive dissection of these ligaments in order to avoid this detrimental complication. Copyright© 2017, International Institute of Anticancer Research (Dr. George J. Delinasios), All rights reserved.

  16. Prognostic value of lectin pathway molecules and complement proteins in ascitic fluid and blood in patients with liver cirrhosis

    DEFF Research Database (Denmark)

    Glargaard, Signe; Boysen, Trine; Pilely, Katrine

    2018-01-01

    BACKGROUND AND AIM: Patients with liver cirrhosis and ascites have a poor prognosis with increased risk of infection related death, as advanced stages of cirrhosis are associated with immunodeficiency. We aimed to investigate immunologically active molecules in ascitic fluid and blood and their p......BACKGROUND AND AIM: Patients with liver cirrhosis and ascites have a poor prognosis with increased risk of infection related death, as advanced stages of cirrhosis are associated with immunodeficiency. We aimed to investigate immunologically active molecules in ascitic fluid and blood...... and their potential association to survival. MATERIALS AND METHODS: In an exploratory pilot study; blood and ascitic fluid from 34 patients with liver cirrhosis of different etiology were analyzed for pattern recognition molecules (ficolin-1, ficolin-2, ficolin-3 and MBL) and complement proteins (C4 and C3...... of Child-Pugh score. CONCLUSION: Levels of lectin-complement pathway molecules in ascitic fluid and blood are lower in patients with more advanced stage of cirrhosis. Low C4 and C3 in serum and C3 and ficolin-1 in ascitic fluid are risk factors for all-cause mortality or liver transplantation independently...

  17. Alpha-2A Adrenoceptor Agonist Guanfacine Restores Diuretic Efficiency in Experimental Cirrhotic Ascites: Comparison with Clonidine.

    Directory of Open Access Journals (Sweden)

    Giovanni Sansoè

    Full Text Available In human cirrhosis, adrenergic hyperfunction causes proximal tubular fluid retention and contributes to diuretic-resistant ascites, and clonidine, a sympatholytic drug, improves natriuresis in difficult-to-treat ascites.To compare clonidine (aspecific α2-adrenoceptor agonist to SSP-002021R (prodrug of guanfacine, specific α2A-receptor agonist, both associated with diuretics, in experimental cirrhotic ascites.Six groups of 12 rats were studied: controls (G1; controls receiving furosemide and potassium canrenoate (G2; rats with ascitic cirrhosis due to 14-week CCl4 treatment (G3; cirrhotic rats treated (over the 11th-14th CCl4 weeks with furosemide and canrenoate (G4, furosemide, canrenoate and clonidine (G5, or diuretics and SSP002021R (G6. Three rats of each group had their hormonal status and renal function assessed at the end of 11th, 12th, 13th, and 14th weeks of respective treatments.Cirrhotic rats in G3 and G4 gained weight over the 12th-14th CCl4 weeks. In G4, brief increase in sodium excretion over the 11th-12th weeks preceded worsening of inulin clearance and natriuresis (diuretic resistance. In comparison with G4, the addition of clonidine (G5 or guanfacine (G6 to diuretics improved, respectively, sodium excretion over the 11th-12th CCl4 weeks, or GFR and electrolytes excretion over the 13th-14th CCl4 weeks. Natriuretic responses in G5 and G6 were accompanied by reduced catecholamine serum levels.α2A-receptor agonists restore glomerular filtration rate and natriuresis, and delay diuretic-resistant ascites in experimental advanced cirrhosis. Clonidine ameliorates diuretic-dependent natriuresis just for a short time.

  18. Tolvaptan regulates aquaporin-2 and fecal water in cirrhotic rats with ascites.

    Science.gov (United States)

    Chen, Chao; Chen, Ren-Pin; Lin, Hai-Hua; Zhang, Wen-You; Huang, Xie-Lin; Huang, Zhi-Ming

    2016-03-28

    To investigate the role of tolvaptan in regulating aquaporin (AQP)-2 expression and fecal water content in cirrhotic rats with ascites. Cirrhosis with ascites was induced in rats by repetitive dorsal injection of CCl4 for 14 wk. In total, 84 cirrhotic rats with ascites divided into three groups (vehicle, 3 mg/kg and 5 mg/kg tolvaptan), and then further divided into five subgroups (days 1, 2, 3, 4, and 5). Blood samples were obtained to measure vasopressin and sodium concentrations. Rats were killed and colonic mucosa was scraped for analysis of protein expression and AQP-2 transcriptional level. The whole layer was fixed for hematoxylin&eosin (HE) staining and feces were collected for determination of fecal water content. Compared with vehicle, vasopressin decreased significantly in the tolvaptan groups from day 2 to a similar level in each treatment group. AQP-2 showed significant upregulation in cirrhotic rats with ascites compared with an untreated control group (100% ± 22.9% vs 22.2% ± 10.23%, P tolvaptan, AQP-2 expression began to decrease significantly from day 2 in each treatment group, but no significant difference was finally found between the treatment groups. Fecal water content in the distal colon was increased by 5 mg/kg tolvaptan on day 1 (66.8% ± 9.3% vs 41.4% ± 6.3%, in the vehicle group, P tolvaptan. Upregulation of AQP-2 in the distal colon is found in cirrhotic rats with ascites. Tolvaptan inhibits its expression and may decrease water reabsorption and induce diarrhea.

  19. Tolvaptan is effective in treating patients with refractory ascites due to cirrhosis.

    Science.gov (United States)

    Tahara, Toshiyuki; Mori, Kiyoto; Mochizuki, Mari; Ishiyama, Ryoko; Noda, Marin; Hoshi, Hitomi; Lefor, Alan Kawarai; Shinozaki, Satoshi

    2017-12-01

    The treatment of refractory ascites due to cirrhosis is a clinical challenge for hepatologists. Tolvaptan, a novel aquaporin modulator, was made available in Japan in 2013 for the treatment of patients with refractory ascites due to cirrhosis. Despite the potential of this drug, few reports are available regarding its clinical use. The aim of the present study was to clarify the efficacy of tolvaptan in patients with refractory ascites due to cirrhosis and to review the clinical outcomes of treatment. Medical records were retrospectively reviewed for 65 patients with refractory ascites due to cirrhosis who were treated daily with 7.5 mg tolvaptan. The median follow-up time, defined as the period between starting tolvaptan and the last clinic visit or date of mortality, was 175 days (interquartile range 56-406). After one week of tolvaptan treatment, the mean weight reduction was 3.4 kg, with a response rate of 69% (45/65). Subsequently, factors associated with the response to tolvaptan were analyzed. On univariate analysis, maintaining serum sodium (Na) ≥140 mEq/l and an estimated glomerular filtration rate (eGFR) ≥55 ml/min were significant predictors of response (Ptolvaptan was a predictor of long-term survival (P=0.002), and hyperbilirubinemia was associated with short-term survival (P=0.028). Additionally, Kaplan-Meier analysis with a log-rank test indicated longer survival times in tolvaptan responders than non-responders (P=0.011). In conclusion, tolvaptan was effective in treating patients with refractory ascites due to cirrhosis. In particular, tolvaptan treatment was highly effective for patients with hepatitis C virus etiology and normal serum Na and renal function. Furthermore, response to tolvaptan was associated with longer survival time while hyperbilirubinemia was associated with shorter survival time.

  20. Percutaneous microwave ablation with artificial ascites for symptomatic uterine adenomyosis: initial experience.

    Science.gov (United States)

    Hai, Ning; Zhang, Jing; Xu, Ruifang; Han, Zhi-Yu; Liu, Fang Yi

    2017-09-01

    To evaluate the feasibility, safety and technical efficacy of ultrasound-guided percutaneous microwave ablation with artificial ascites for adenomyosis. Between May 2015 and May 2016, a total of 25 patients with symptomatic adenomyosis who underwent ultrasound-guided percutaneous microwave ablation with artificial ascites were included in this retrospective study. A matching cohort of 50 patients underwent ultrasound-guided percutaneous microwave ablation without artificial ascites as controls. The technical efficacy, complications and short-term treatment effectiveness were assessed and compared with the controls. Artificial ascites was successfully achieved in all of the 25 patients with the administration of a median of 550 mL (range, 250-1200 mL) of solution. There was substantial improvement in achieving a better antenna path in 100% (20/20) of the cases with a poor antenna path. The complete separation was achieved in 23 of 25 patients. The mean ablation time was 26.5 ± 7.3 min and the median non-perfusion volume ratio was 76% which was similar to the control group (p > .05). No serious complications were observed. Patient pain scores for dysmenorrhoea showed a statistically significant decline from the baseline of 6.71 ± 0.96 to 2.92 ± 0.79 and the symptom severity score declined statistically significantly from 21.8 ± 5.5 to 16.4 ± 4.8 at 3 months follow-up. Percutaneous microwave ablation with artificial ascites is feasible, safe and can be effective in improving access for treatment of adenomyosis.

  1. Ascites interferes with the activity of lurbinectedin and trabectedin: Potential role of their binding to alpha 1-acid glycoprotein.

    Science.gov (United States)

    Erba, E; Romano, M; Gobbi, M; Zucchetti, M; Ferrari, M; Matteo, C; Panini, N; Colmegna, B; Caratti, G; Porcu, L; Fruscio, R; Perlangeli, M V; Mezzanzanica, D; Lorusso, D; Raspagliesi, F; D'Incalci, M

    2017-11-15

    Trabectedin and its analogue lurbinectedin are effective drugs used in the treatment of ovarian cancer. Since the presence of ascites is a frequent event in advanced ovarian cancer we asked the question whether ascites could modify the activity of these compounds against ovarian cancer cells. The cytotoxicity induced by trabectedin or lurbinectedin against A2780, OVCAR-5 cell lines or primary culture of human ovarian cancer cells was compared by performing treatment in regular medium or in ascites taken from either nude mice or ovarian cancer patients. Ascites completely abolished the activity of lurbinectedin at up to 10nM (in regular medium corresponds to the IC90), strongly reduced that of trabectedin, inhibited the cellular uptake of lurbinectedin and, to a lesser extent, that of trabectedin. Since α1-acid glycoprotein (AGP) is present in ascites at relatively high concentrations, we tested if the binding of the drugs to this protein could be responsible for the reduction of their activity. Adding AGP to the medium at concentration range of those found in ascites, we reproduced the anticytotoxic effect of ascites. Erythromycin partially restored the activity of the drugs, presumably by displacing them from AGP. Equilibrium dialysis experiments showed that both drugs bind AGP, but the affinity of binding of lurbinectedin was much greater than that of trabectedin. KD values are 8±1.7 and 87±14nM for lurbinectedin and trabectedin, respectively. The studies intimate the possibility that AGP present in ascites might reduce the activity of lurbinectedin and to a lesser extent of trabectedin against ovarian cancer cells present in ascites. AGP plasma levels could influence the distribution of these drugs and thus they should be monitored in patients receiving these compounds. Copyright © 2017 Elsevier Inc. All rights reserved.

  2. Liver failure after transarterial chemoembolization for patients with hepatocellular carcinoma and ascites: incidence, risk factors, and prognostic prediction.

    Science.gov (United States)

    Hsin, I-Fang; Hsu, Chia-Yang; Huang, Hui-Chun; Huang, Yi-Hsiang; Lin, Han-Chieh; Lee, Rheun-Chuan; Chiang, Jen-Huey; Lee, Fa-Yauh; Huo, Teh-Ia; Lee, Shou-Dong

    2011-07-01

    Transarterial chemoembolization (TACE) is widely used in patients with hepatocellular carcinoma (HCC). Post-TACE liver failure may occur, especially in patients with poor hepatic reserve. Ascites is often present in patients with HCC with coexisting cirrhosis. This study investigated the incidence, risk factors, and prognostic predictors in patients with HCC and ascites receiving TACE. A total of 614 patients with HCC were enrolled and analyzed. Liver failure was defined as an increase of serum bilirubin level (≥2.0 mg/dL), increasing or newly developed ascites, or hepatic encephalopathy within 2 weeks of TACE. Ascites that were present in 100 (16.2%) patients at study entry, independently predicted a poor prognosis in the Cox proportional hazard model [relative risk (RR)=1.75, P=0.004]. Post-TACE liver failure occurred in 17 (17.3%) of 98 patients with HCC who had ascites and long-term follow-up. Child-Turcotte-Pugh class B (odds ratio=10.1, P=0.038) and post-TACE gastrointestinal bleeding (odds ratio=10.86, P=0.006) were independent risk factors associated with liver failure in the multivariate analysis. Of the 17 patients with post-TACE liver failure, 16 (94%) died within the first year of treatment. Liver failure (RR: 2.13, P=0.029), serum α-fetoprotein level >51 ng/mL (RR=2.0, P=0.013) and poor performance status (RR: 2.17, P=0.003) independently predicted a poor prognosis in patients with ascites receiving TACE. Preexisting ascites increases the mortality in patients with HCC receiving TACE. In patients with HCC and ascites, Child-Turcotte-Pugh class B and gastrointestinal bleeding are associated with liver failure after TACE. Post-TACE liver failure is a common event and predicts a decreased survival in patients with HCC and ascites.

  3. Impaired free water excretion in child C cirrhosis and ascites: relations to distal tubular function and the vasopressin system

    DEFF Research Database (Denmark)

    Krag, A.; Møller, S.; Pedersen, Erling Bjerregaard

    2010-01-01

    Abstract Background: Water retention in advanced cirrhosis and ascites may involve disturbances in renal distal tubular function and in the vasopressin system. Methods: Twelve patients with Child B cirrhosis and ascites were compared with 11 patients with Child C cirrhosis and ascites. The subjects...... were studied during a 400 ml/h oral water load. Results: Child C patients had a lower baseline glomerular filtration rate (32 vs 63 ml/min, Purinary flow rate (V(u)) (0.86 vs 1.95 ml/min, P

  4. Genetic and phenotypic relationships between blood gas parameters and ascites-related traits in broilers.

    Science.gov (United States)

    Closter, A M; van As, P; Groenen, M A M; Vereijken, A L J; van Arendonk, J A M; Bovenhuis, H

    2009-03-01

    Ascites, also called pulmonary hypertension syndrome, is a metabolic disorder in chickens that have an insufficient pulmonary vascular capacity. The tendency of broilers to develop ascites is heritable, and successful selection against this susceptibility would benefit from good and easy-to-measure indicator traits. Blood gas parameters have been suggested as indicator traits for ascites susceptibility. Therefore, the aim of the present study was to estimate the heritability of blood gas parameters and the genetic and phenotypic correlations between blood gas parameters, heart ratio (postmortem indicator for ascites), and BW at 2 different ages. For this purpose, blood gas parameters, including the partial pressure of carbon dioxide in venous blood (pvCO(2)), the partial pressure of oxygen in venous blood (pvO(2)), and blood oxygen saturation, were measured at an average age of 22 d in nearly 3,000 broilers. To challenge the resistance of the birds to ascites, they were kept under cold conditions. Heritability for heart ratio was 0.43, and the heritability estimates were low: 0.02 for pvCO(2), 0.03 for pvO(2), and 0.07 for blood oxygen saturation. The estimated heritability for pH was 0.15, for bicarbonate was 0.19, and for total carbon dioxide content was 0.19. The genetic correlations between heart ratio and total carbon dioxide content (0.31 +/- 0.15) and between heart ratio and bicarbonate (0.31 +/- 0.15) were moderate and positive. For pvO(2), the genetic correlation with heart ratio was stronger and negative (-0.62 +/- 0.21); however, this correlation could not be estimated accurately because of the low heritability of pvO(2). For pvCO(2), the genetic correlation with the heart ratio was close to zero (-0.04 +/- 0.45). Phenotypic correlations between traits were, in general, similar to the genetic correlations. Heritabilities for blood gas parameters and the genetic correlations between blood gas parameters and the heart ratio estimated in the present study

  5. The effect of ascitic fluid hydrostatic pressure on albumin extravasation rate in patients with cirrhosis of the liver

    DEFF Research Database (Denmark)

    Henriksen, J H; Parving, H H; Christiansen, Lasse

    1981-01-01

    Overall transvascular escape rate of albumin [TERalb, i.e. the fraction of intravascular mass of albumin (IVMalb) passing to the extravascular space per unit time] was determined from the disappearance of i.v. injected radioiodinated serum albumin. Patients with tense ascites due to liver cirrhosis...... and pigs with posthepatic portal hypertension and intraperitoneally instilled fluid were studied before and after abdominal paracentesis in order to evaluate the effect of ascitic fluid hydrostatic pressure on the transvascular escape rate of albumin. TERalb of the ascitic patients (n = 6) were on average...... 7.8% IVMalb.h-1, which is somewhat higher but not significantly above normal (mean 5.6% IVMalb.h-1). After paracentesis and removal of the ascitic fluid, TERalb rose significantly to an average of 11.9% IVMalb.h-1 (P less than 0.05). The fraction of IVMalb passing into the peritoneal cavity...

  6. Plasma-to-ascitic fluid transport rate of albumin in patients with decompensated cirrhosis. Relation to intraperitoneal albumin

    DEFF Research Database (Denmark)

    Henriksen, Jens Henrik Sahl; Ring-Larsen, H; Lassen, N A

    1983-01-01

    Albumin-kinetics and haemodynamic studies were performed in 20 patients with decompensated liver cirrhosis in order to improve the knowledge on genesis and perpetuation of hepatic ascites, especially with respect to determinants of intraperitoneal protein. A positive relationship was found betwee...... in the 'lymph-imbalance' theory of ascites formation, whereas a 'fluid equilibrium' theory seems to be too simple, especially with respect to explain protein sequestration in the peritoneal cavity....

  7. Isolation and characterization of tumor cells from the ascites of ovarian cancer patients: molecular phenotype of chemoresistant ovarian tumors.

    Directory of Open Access Journals (Sweden)

    Ardian Latifi

    Full Text Available Tumor cells in ascites are a major source of disease recurrence in ovarian cancer patients. In an attempt to identify and profile the population of ascites cells obtained from ovarian cancer patients, a novel method was developed to separate adherent (AD and non-adherent (NAD cells in culture. Twenty-five patients were recruited to this study; 11 chemonaive (CN and 14 chemoresistant (CR. AD cells from both CN and CR patients exhibited mesenchymal morphology with an antigen profile of mesenchymal stem cells and fibroblasts. Conversely, NAD cells had an epithelial morphology with enhanced expression of cancer antigen 125 (CA125, epithelial cell adhesion molecule (EpCAM and cytokeratin 7. NAD cells developed infiltrating tumors and ascites within 12-14 weeks after intraperitoneal (i.p. injections into nude mice, whereas AD cells remained non-tumorigenic for up to 20 weeks. Subsequent comparison of selective epithelial, mesenchymal and cancer stem cell (CSC markers between AD and NAD populations of CN and CR patients demonstrated an enhanced trend in mRNA expression of E-cadherin, EpCAM, STAT3 and Oct4 in the NAD population of CR patients. A similar trend of enhanced mRNA expression of CD44, MMP9 and Oct4 was observed in the AD population of CR patients. Hence, using a novel purification method we demonstrate for the first time a distinct separation of ascites cells into epithelial tumorigenic and mesenchymal non-tumorigenic populations. We also demonstrate that cells from the ascites of CR patients are predominantly epithelial and show a trend towards increased mRNA expression of genes associated with CSCs, compared to cells isolated from the ascites of CN patients. As the tumor cells in the ascites of ovarian cancer patients play a dominant role in disease recurrence, a thorough understanding of the biology of the ascites microenvironment from CR and CN patients is essential for effective therapeutic interventions.

  8. Cross-infection enhancement among African flaviviruses by immune mouse ascitic fluids.

    Science.gov (United States)

    Fagbami, A H; Halstead, S B; Marchette, N J; Larsen, K

    1987-01-01

    Cross-infection enhancement of seven African flaviviruses by subneutralising concentrations of antibody in immune ascitic fluids was investigated in P388D1 cell culture. Infection by all the seven flaviviruses tested was enhanced by homologous and at least one of six heterologous immune mouse ascitic fluids (IMAF) tested. Enhancement ratios and enhancing antibody titres were higher in homologous than in heterologous enhancement. Zika, Wesselsbron, Uganda S and West Nile viruses were enhanced in culture by all the IMAF tested. Enhancement of Dakar bat and Yellow fever viruses was produced by five heterologous IMAF, but Potiskum virus was enhanced by one heterologous flavivirus antibody. The antibody to Potiskum virus was the most potent mediator of heterologous infection enhancement; all six heterologous flaviviruses were markedly enhanced by this antibody.

  9. Evolution of sarcoma 180 (ascitic tumor in mice infected with Schistosoma mansoni

    Directory of Open Access Journals (Sweden)

    Fausto Edmundo Lima Pereira

    1986-03-01

    Full Text Available Mice infected with 60 cercariae of Schistosoma mansoni were more resistant to the sarcoma 180 ascites tumor. Tumor inoculation was performed 50 days after schistosoma infection and the animals were observed and weighed at 48 hours intervals for development and progression of malignancy. In infected mice the weight gain (ascites formation started later and was shorter than in uninfected Controls. Also, the number of tumor cells into the peritoneal cavity 72h after tumor implantation was shorter in infected group than incontrols. This in creased resistance against a transplantable tumor probably is related to the effect of endotoxin on tumoricidal activity of macrophages activated by the infection. The immunodepression induced by Schistosoma mansoni infection enhances the proliferation of endogenous bacteria increasing the amount of endotoxin absorbed from the gut.

  10. Chronic Granulomatous Disease Presenting as Aseptic Ascites in a 2-Year-Old Child

    Directory of Open Access Journals (Sweden)

    J. F. Moreau

    2013-01-01

    Full Text Available Chronic granulomatous disease (CGD is a rare inherited immunodeficiency syndrome that results from abnormal nicotinamide adenine dinucleotide phosphate (NADPH oxidase function. This defect leads to recurrent catalase-positive bacterial and fungal infections as well as associated granuloma formation. We review the case of a 2-year-old boy who presented with ascites and fever of an unknown origin as manifestations of CGD. Cultures were negative for infection throughout his course, and CGD was suspected after identification of granulomas on peritoneal biopsy. Genetic testing revealed a novel mutation in the CYBB gene underlying his condition. This paper highlights the importance of considering CGD in the differential diagnosis of fever of unknown origin and ascites in children.

  11. Intraperitoneal xenon for the detection of early intestinal ischemia: effect of ascites, adhesions, and misdirected injections

    Energy Technology Data Exchange (ETDEWEB)

    Gharagozloo, F.; Bulkley, G.B.; LaFrance, N.; Zuidema, G.D.

    1983-06-01

    Significant delay in the washout of intraperitoneal xenon (/sup 133/Xe) in rats and dogs with decreased splanchnic blood flow (bowel strangulation, superior mesenteric artery and vein occlusion) has been previously demonstrated as the basis for radionuclide imaging to detect early (prenecrotic) intestinal ischemia. In this study, the effect of ascites, adhesions, and misdirected injections on the validity of this technique is evaluated. Xenon-133 (0.6 mCi) in 3 ml saline was injected into the peritoneal cavity of anesthetized rats and the washout of gamma activity monitored externally for 90 min. Gamma camera images were obtained at 30-min intervals. After 60 min, only 12 +/- 2% of injected activity remained in the controls. Sham option (13 +/- 1%) and simple obstruction (12 +/- 2) had been previously shown not to significantly slow washout, but segmental strangulation had done so dramatically (32 +/- 2%, P less than 0.0001). In these experiments, ascitic fluid (Ringer's lactate) in volumes of 10 ml (13 +/- 1%), 20 ml (13 +/- 1%), and 40 ml (13 +/- 1%), did not significantly slow washout in nonischemic rats. Sixty and eighty milliliters produced very tense ascites and slight but significant delay in washout (14 +/- 1%, 17 +/- 1%, respectively, P less than 0.05). Moderate (11 +/- 1%) and severe (11 +/- 1%) adhesions produced by serosal scarification did not delay washout nor affect imaging. Injections of isotope intentionally misdirected into the abdominal wall (32 +/- 2%), bowel wall (18 +/- 1%), and bowel lumen (19 +/- 2%), each significantly (P less than 0.001) slowed washout. However, such misdirected injections were easily recognizable as such on the 1-min gamma camera images and could thereby be excluded as artifactual. It is concluded that the intraperitoneal xenon technique is not invalidated by mild to moderate ascites nor by moderate to severe adhesions.

  12. Do vasopressin V2 receptor antagonists benefit cirrhotics with refractory ascites?

    OpenAIRE

    Fukui, Hiroshi

    2015-01-01

    Hyponatremia is a frequent complication of advanced cirrhosis with ascites associated with increased morbidity and mortality. It is caused by an impairment in the renal capacity to eliminate solute-free water and is considered to be related to persistent secretion of vasopressin despite low serum osmolality. This nonosmotic release of vasopressin is mediated by the autonomic nervous system, which senses the underfilling of arterial vascular component. This reduction of effective arterial bloo...

  13. The effects of midodrine on the natriuretic response to furosemide in cirrhotics with ascites

    Science.gov (United States)

    Misra, V. L.; Vuppalanchi, R.; Jones, D.; Hamman, M.; Kwo, P. Y.; Kahi, C.; Chalasani, N.

    2011-01-01

    SUMMARY Background Resistance to loop diuretics is common in patients with ascites. Diminished glomerular filtration rate (GFR) is thought to mediate resistance to loop diuretics. Midodrine, a commonly used alpha-1 agonist, has been shown to improve GFR in non-azotemic patients with cirrhosis. Aim To conduct a randomized, double-blind, placebo-controlled, cross-over study to test the hypothesis that midodrine significantly increases natriuretic response of IV furosemide in non-azotemic cirrhotics with ascites. Methods All subjects participated in both phases, which were (i) furosemide IV infusion + oral midodrine 15 mg administered 30 min before furosemide (ii) furosemide IV infusion + oral placebo administered 30 min before furosemide. Primary outcomes were 6-h urine sodium excretion and 6-h total urine volume. Results A total of 15 patients (men: 8; age: 52.7 ± 7.6 years; serum creatinine: 1.06 ± 0.2 mg/dL) were studied. Total 6-h urine sodium excretion was 109 ± 42 mmol in the furosemide + midodrine treatment phase and was not significantly different from that in the furosemide + placebo treatment phase (126 ± 69 mmol, P = 0.6). Similarly, mean 6-h total urine volume was not significantly different between two groups (1770 ± 262 mL vs. 1962 ± 170 mL, P = 0.25). Conclusions Oral midodrine does not increase the natriuretic response to furosemide in non-azotemic cirrhotic patients with ascites. Orally administered midodrine does not increase natriuretic response to furosemide in non-azotemic cirrhotic patients with ascites. PMID:20937051

  14. Diagnostic significance of ascites adenosine deaminase levels in suspected tuberculous peritonitis in adults

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    Anil Chander

    2013-09-01

    Full Text Available Objective: There are contradictory reports about the use of adenosine deaminase (ADA as a diagnostic marker intuberculous peritonitis patients. Reports evaluating significance of ADA activity in the diagnosis of tuberculous peritonitisin adults are lacking in Nepal. We thus set out to investigate the ascitic fluid ADA levels in suspected tuberculousperitonitis patients and to determine the diagnostic significance of the test statistically.Methods: This study population comprised of two different adult patients groups. Group I - 35 suspected cases oftuberculous peritonitis and Group II - 35 cases of transudative ascites - the control group (patients with biochemicallyproved transudates or hypoproteinaemia and peritoneal tap was done. ADA estimation was carried out by spectrophotometry.Results: ADA levels (Mean ± SD in suspected tuberculous peritonitis and transudative ascites cases were 48.5±17.9U/L and 19.8±7.7 U/L respectively (P<0.001. In the receiver operating characteristic (ROC curve for ascites, ADA cut-offlevel of 41.5 U/L was found to yield the best results of differential diagnosis; sensitivity, specificity, positive predictivevalue, negative predictive value and accuracy of the test in tuberculous peritonitis cases were 80.0%, 97.2 %, 96.6%,82.9%, 88.6% respectively.Conclusion: ADA levels are elevated in suspected tuberculous peritonitis cases and it is a simple, rapid, inexpensiveand the least invasive test. It is thus a useful biochemical marker for the early diagnosis of tuberculous peritonitis whilewaiting for the results of mycobacterial cultures or biopsies. J Microbiol Infect Dis 2013; 3(3: 104-108Key words: adenosine deaminase, sensitivity, specificity, diagnostic significance, tuberculous peritonitis

  15. The value of sonographic gallbladder wall patterns in differentiating malignant from benign ascites

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Young Rae; Park, Hae Won; Lee, Young Uk; Oh, Won Ja [Koryo General Hospital, Seoul (Korea, Republic of)

    1991-09-15

    This investigation evaluates whether the appearance and thickness of the gallbladder (GB) wall can be clinically useful to determine the etiology of ascites by ultrasonography. Another purpose of this study is to verify the existence of statistically significant relationship between GB wall patterns and serum albumin level. Findings on ultrasonogram were reviewed retrospectively in 90 patients with ascites. The statistical analysis of the results reveals no correlation between hypoalbuminemia and GB wall patterns (P>0.05). There was a significant difference in GB wall patterns between benign (group 1 and 2) and malignant (group 3 and 4) conditions (P>0.05). The carcinoma, with the exception of hepatocellular the gallbladder wall was significantly thicker in the cirrhosis brougs than in the malignant group. Twenty-seven patients (87%) in group 1 had thickened GB walls, whereas 16 patients (76%) in group 3 showed normal single layered GB walls. This difference was statistically significant (P>0.05). However no statistically significant difference was found between liver cirrhosis (group 1) and liver cirrhosis associated with hepatocellular carcinoma (group 4) (P>0.05). Also, with the except of hepatocellular carcinoma (group 3) there also was no significant difference found between benign noncirrhotic pathology (group 2) and malignancy. These results suggests that there is a distant sonographic appearance of the GB wall according to different ascitis etiologies. This can pathology be seen when comparing patients with liver carrhosis and malignancy other than hepatocellular carcinoma. However sonographic findings of the GB wall patterns in ascites lacks diagnostic value in differentiating benign from malignant disease causing ascites.

  16. Peritonite meconial como diagnóstico diferencial de ascite fetal: relato de caso Meconium peritonitis in the differential diagnosis of fetal ascites: a case report

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    Melania Maria Ramos de Amorim

    1999-07-01

    Full Text Available Introdução: a peritonite meconial, como resultado da perfuração intestinal fetal, apresenta baixa incidência (1:30.000 nascimentos e elevada mortalidade (em torno de 50%. Os achados ecográficos pré-natais incluem ascite e calcificações intra-abdominais. Há evidências de que o diagnóstico pré-natal possa melhorar o prognóstico pós-natal. Relato do Caso: R.C.M.S., 22 anos, II gesta O para, realizou ultra-sonografia em 02/12/98 com diagnóstico de ascite fetal. Fez investigação para hidropisia fetal, afastando-se causas imunes e não-imunes. Foram realizados ecografias seriadas em que se manteve a imagem de ascite fetal acentuada, sem calcificações. Parto normal em 02/01/99, com 36 semanas, observando-se volumoso poliidrâmnio. Recém-nascido do sexo feminino pesando 2.670 gramas, com sinais de desconforto respiratório, abdome distendido e com petéquias. Apresentou aumento progressivo da distensão abdominal, palpação de massa pétrea no hipocôndrio direito e eliminação de muco branco ao toque retal. Raios-x em 04/01/99 com imagem de extensas calcificações abdominais, distensão de alças intestinais e ausência de gás na ampola retal. Hipótese diagnóstica de peritonite meconial. Indicada laparotomia exploradora em 04/01/99, encontrando-se volumoso cisto meconial e atresia ileal, realizando-se lise de aderências e ileostomia em dupla boca. Evolução satisfatória nos primeiros dias de pós-operatório, complicada posteriormente por quadro séptico, verificando-se o óbito neonatal em 09/01/99. Conclusão: a peritonite meconial deve ser lembrada no diagnóstico diferencial das causas de ascite fetal. O diagnóstico pré-natal no presente caso poderia ter antecipado a indicação cirúrgica, com possível melhora da evolução neonatal.Introduction: meconium peritonitis as result of fetal intestinal perforation has a low incidence (1:30,000 deliveries and high mortality (50% or more. Prenatal ultrasound findings

  17. Post meningocele repair urinary ascites in a neonate--a rare presentation.

    Science.gov (United States)

    Ranjan, Ritesh; Kothari, Paras R; Gupta, Rahul K; Gupta, Abhaya R; Sandlas, Gursev; Karkera, Parag J; Kesan, Krushna K

    2012-05-01

    A full-term female neonate with a large lumbosacral meningocele developed sudden abdominal distension and urinary retention after meningocele repair. An erect abdominal radiograph showed homogeneously opacified areas with a paucity of intestinal gas. Abdominal ultrasound revealed ascites with multiple internal echoes. With a provisional diagnosis of hollow viscus perforation, an emergency laparotomy was performed, which failed to reveal any leak from the urinary tract. However, fluid analysis confirmed the diagnosis of urinary ascites. The patient developed repeated episodes of urinary retention after catheter removal. She was started on clean intermittent catheterization (CIC) to ensure adequate bladder drainage. At 6 months of follow-up, ultrasound of the urinary tract, voiding cystourethrogram, and magnetic resonance imaging of the spine were all within normal limits. The CIC was discontinued, and the patient was observed. At present, she is voiding normally with a good stream. Failure to establish normal micturition after meningocele repair and CIC requirements suggested a neurogenic cause. Bladder rupture, secondary to spinal shock resulting in bladder atonia, could not be ruled out. The perforation (leading to urinary ascites) could be owing to bladder atonia and spinal shock rather than detrusor sphincter dyssynergia. Copyright © 2012 Elsevier Inc. All rights reserved.

  18. Monitoring of transtubular potassium gradient in the diuretic management of patients with cirrhosis and ascites.

    Science.gov (United States)

    Lim, Young-Suk; Han, Jin Suk; Kim, Kyung-Ah; Yoon, Jung-Hwan; Kim, Chung Yong; Lee, Hyo-Suk

    2002-10-01

    Aldosterone antagonists are the diuretics of first choice in the treatment of cirrhotic ascites. However, there is still no reliable clinical parameter to evaluate their efficacy. Transtubular potassium gradient (TTKG), the accurate indicator of aldosterone bioactivity, may serve as a guide for the proper use of the aldosterone antagonists. In 23 patients with cirrhotic ascites, the daily administered initial dosage of 100 mg of spironolactone was increased by 100 mg/day at intervals of 5 days until either diuresis commenced or TTKG fell below 3.0, the value indicating complete blockade of aldosterone bioactivity. For the non-responders with TTKG lower than 3.0, furosemide was given in addition to spironolactone. Basal TTKG correlated significantly with plasma aldosterone concentration (r = 0.60, P = 0.002). Spironolactone induced the decrease of TTKG in 20 patients, from 5.3 +/- 0.5 to 2.9 +/- 0.2 (mean +/- SE, P < 0.001). A TTKG value of 3.0 could classify seven patients, who did not respond to low dose spironolactone, into two distinct groups at that time, indicating different further diuretic regimen. All patients achieved diuretic responses without complication by this TTKG-guided modification of diuretics. TTKG may be a suitable guide for the diuretic management of cirrhotic ascites by accurately reflecting the effect of aldosterone antagonists.

  19. Successful Treatment of Resistant Hypertension Associated Ascites in a Renal Transplant Patient

    Directory of Open Access Journals (Sweden)

    Ižhsan Yildiz

    2016-07-01

    Full Text Available Transplante renal artery stenosis (TRAS is defined as renal artery diameter reduction of more than 50%, which causes a reduction in glomerular filtration rate and a rise in plasma creatinine concentration. Current treatments are endovascular-balloon-angioplasty and stent implantation. We present the case with renal artery stenosis and ascites was treated with endovascular-balloon-dilatation. A 52-year-old female patient who was admitted to the nephrology clinic five months after the transplantation with blood pressure: 180/110 mmHg, ascites , and the chest radiograph did not show a pulmonary oedema, creatinine: 1.69 mg/dL other laboratory tests were normal. An occlusion of 80 % in a segment and the stenosis was reduced to 10 % by endovascular-balloon dilation. Following endovascular-balloon dilation, arterial blood pressure were normal and no ascites. Endovascular balloon dilation is minimally invasive method that is also successful, contemporary and valid procedures with easy applicability for the management of TRAS.

  20. Bilateral Ovarian Fibrothecoma Associated with Ascites, Bilateral Pleural Effusion, and Marked Elevated Serum CA-125

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    Védi André Serges Loué

    2013-01-01

    Full Text Available Background. The risk of ovarian cancer is increased in the association of ovarian tumor, ascites, and hydrothorax with the significant elevated tumor marker CA-125. However, this association can be observed in a rare clinical and benign pathological entity, that is Demons-Meigs’ syndrome. Objective. To describe a rare case of Demons-Meigs' syndrome observed in our department. Methods. A black African woman of 35 years old, seventh gravida and fourth parous, underwent a total abdominal hysterectomy with bilateral salpingoophorectomy for large bilateral ovarian masses associated with significant ascites, bilateral pleural effusion, and particular highly elevated tumor marker CA-125 (1835 UI/mL in a pronounced general alteration condition. Results. The postoperative course was uneventful characterized by a complete remission of hydrothorax and ascites with normal level of CA-125 three months after tumor excision. Histology of both masses revealed a bilateral ovarian fibrothecoma, a benign tumor of the ovary, thus confirming the diagnosis of Demons-Meigs’ syndrome. Conclusion. The Demons-Meigs syndrome, although it strongly mimics the clinical picture of malignant metastatic ovarian cancer, remains a disease with benign prognosis after surgical tumor resection. This is a rare condition that must be known and recognized by practitioners to avoid unnecessary practices.

  1. Influência da ascite na avaliação da função pulmonar em portadores de hipertensão portal Influence of ascites in the pulmonary function of patients with portal hypertension

    Directory of Open Access Journals (Sweden)

    Angela Maria Stiefano Nitrini

    2004-02-01

    Full Text Available INTRODUÇÃO: A oxigenação inadequada nos pacientes com hipertensão portal pode ser secundária a alterações na mecânica respiratória, determinadas pela presença da ascite. OBJETIVO: Avaliar a função pulmonar de doentes com hipertensão portal antes e após redução do volumeda ascite. Método: Quinze doentes com hipertensão portal e ascite foram submetidos a provas de função pulmonar, constituindo-se de espirometria e gasometria arterial, antes e após redução do volume da ascite. Os parâmetros analisados foram: capacidade vital forçada (CVF; volume expiratório no primeiro segundo (VEF1; fluxo expiratório entre 25 e 75% da CVF (FEF 25-75% ; volume de reserva expiratória (VRE; relação VEF1 / CVF; pressão arterial de oxigênio (PaO2, pressão arterial de dióxido de carbono (PaCO2 e saturação arterial de oxigênio (SaO2. RESULTADOS: Houve melhora significativa dos volumes pulmonares analisados após a diminuição da ascite com o tratamento diurético associado ou não à paracentese. CONCLUSÃO: Concluímos que nos doentes com hipertensão portal e ascite, há diminuição dos volumes pulmonares emrelação aos valores preditos, com melhora significativa após diminuição da ascite. Do mesmo modo, observamos aumento na PaO2 e na SaO2.BACKGROUND: Oxygen deficiency in patients with portal hypertension may be secondary to changes in respiratory mechanics due to ascites. OBJECTIVES: Evaluate pulmonary function in patients with portal hypertension before and after reduction of the ascites. METHOD: Fifteen patients with portal hypertension and ascites were submitted to pulmonary function tests, comprising spirometry and arterial blood gas determination, before and after reduction of ascites. The analysed parameters were: forced vital capacity (FVC; forced expiratory volume in one second (FEV1; forced expiratory flow between 25-75% of the forced vital capacity (FEF 25-75%; expiratory reserve volume (ERV; FEV1/CVF; arterial

  2. Ultrasound-guided biopsy of greater omentum: An effective method to trace the origin of unclear ascites

    Energy Technology Data Exchange (ETDEWEB)

    Que Yanhong [Department of Ultrasound, First Affiliated Hospital of China Medical University, Shenyang, Liaoning 110001 (China)], E-mail: quebaobao@yahoo.com.cn; Wang Xuemei [Department of Ultrasound, First Affiliated Hospital of China Medical University, Shenyang, Liaoning 110001 (China)], E-mail: wxmlmt@yahoo.com.cn; Liu Yanjun [Department of Ultrasound, First Affiliated Hospital of China Medical University, Shenyang, Liaoning 110001 (China)], E-mail: lyj7512@sina.com; Li Ping [Department of Ultrasound, First Affiliated Hospital of China Medical University, Shenyang, Liaoning 110001 (China)], E-mail: liping7213@sina.com; Ou Guocheng [Department of Ultrasound, First Affiliated Hospital of China Medical University, Shenyang, Liaoning 110001 (China)], E-mail: yang9951@126.com; Zhao Wenjing [Department of Ultrasound, First Affiliated Hospital of China Medical University, Shenyang, Liaoning 110001 (China)], E-mail: awk999@163.com

    2009-05-15

    Objectives: Thickened greater omentum is encountered with high frequency in patients with ascites. The purpose of our study was to assess the utility of greater omentum biopsy under the guidance of ultrasound (US) in tracing the origin of unclear ascites and differentiating benign and malignant ascites. Materials and methods: We retrospectively reviewed our institutional database for all records of greater omentum biopsy cases. One hundred and ninety-four patients with unclear ascites and thickened greater omentum were included in the study. The sonograms of greater omentum were evaluated before undergoing the ultrasound-guided biopsy and a biopsy was considered successful if a specific benign or malignant diagnosis was rendered by the pathologist. Results: Successful biopsy was rendered for 182 biopsy procedures (93.8%, 182/194) including tuberculosis (n = 114), chronic inflammation (n = 3), metastases (n = 58), malignant mesothelioma (n = 6) and pseudomyxoma peritonei (n = 1). Twelve biopsies were non-diagnostic. According to the results of biopsy and follow-up, the sensitivity and specificity of biopsy in distinguishing malignant ascites from benign ascities were respectively 95.6% (65/68) and 92.9% (117/126). The greater omentum of 84 cases of tuberculous peritonitis showed 'cerebral fissure' sign and was well seen as an omental cake infiltrated with irregular nodules when involved by carcinomatosis. No 'cerebral fissure' sign was observed in peritoneal carcinomatosis. The sensitivity and specificity of this sign in indicating the existence of tuberculous peritonitis were 73.5% (89/121) and 100% (73/73). Moreover, if the specific 'cerebral fissure' sign was combined with the biopsy results, the specificity of biopsy in distinguishing malignant ascites from benign ascits increased to 96.8% (122/126). Conclusion: Ultrasound-guided biopsy of greater omentum is an important and effective method to diagnose the unclear ascites for

  3. An Approach to Diagnosis and Endovascular Treatment of Refractory Ascites in Liver Transplant: A Pictorial Essay and Clinical Practice Algorithm.

    Science.gov (United States)

    Pereira, Keith; Salsamendi, Jason; Fan, Ji

    2015-10-01

    Recipients of liver transplant are surviving longer as both the surgical procedure and postsurgical care have improved. Despite improvements, serious complications from the procedure remain that significantly affect patient outcome and may result in retransplant. Refractory ascites is one complication, occurring in about 5.6% of transplant recipients. Management of refractory ascites after liver transplant presents a challenge to the multidisciplinary team caring for these patients. We discuss approaches to the diagnosis and treatment of refractory ascites after liver transplant, based on a literature review, with a primary focus on vascular causes. These approaches are illustrated by case examples highlighting our experiences at an academic tertiary medical center. We propose a clinical practice algorithm for optimal endovascular treatment of refractory ascites after liver transplant. The cornerstone of refractory ascites care is diagnosis and treatment of the cause. Vascular causes are not infrequently encountered and, if not treated early, are associated with graft loss and high morbidity and mortality and are major indications for retransplant. For patients with recurrent disease or graft rejection needing large volume paracentesis, the use of a transjugular intrahepatic portosystemic shunt may serve as a bridge to more definitive treatment (retransplant), although it may not be as effective for managing ascites as splenic artery embolization, arguably underused, which is emerging as a potential alternative treatment option. A multidisciplinary strategy for the diagnosis and care of patients with refractory ascites after liver transplant is crucial, with endovascular treatment playing an important role. The aim is for this document to serve as a concise and informative reference to be used by those who may care for patients with this rare yet serious diagnosis.

  4. Fibronectin in the ascitic fluid of cirrhotic patients: correlation with biochemical risk factors for the development of spontaneous bacterial peritonitis

    Directory of Open Access Journals (Sweden)

    R.C.A. Mesquita

    1997-07-01

    Full Text Available Cirrhotic patients (23 with alcoholic cirrhosis, 5 with posthepatitic cirrhosis and 2 with cryptogenic cirrhosis with ascites and portal hypertension were studied and divided into two groups corresponding to high or low risk to develop spontaneous bacterial peritonitis (SBP related to the concentration of total protein in the ascitic fluid (A-TP: group I (high risk: A-TP£1.5 g/dl and group II (low risk: A-TP>1.5 g/dl. Fibronectin (FN, C3 and C4 concentrations were measured by radial immunodiffusion while total protein was measured by the biuret method. The mean values (group I vs group II of C3 (12.59 ± 4.72 vs 24.53 ± 15.58 mg/dl, C4 (4.26 ± 3.87 vs 7.26 ± 4.14 mg/dl and FN (50.47 ± 12.49 vs 75.89 ± 24.70 mg/dl in the ascitic fluid were significantly lower (P<0.05 in the group considered to be at high risk for SBP. No significant difference was observed in the plasma/ascites fibronectin ratio (3.91 ± 1.21 vs 3.80 ± 1.26 or gradient (131.46 ± 64.01 vs 196.96 ± 57.38 between groups. Fibronectin in ascites was significantly correlated to C3 (r = 0.76, C4 (r = 0.58, total protein (r = 0.73 and plasma FN (r = 0.58 (P<0.05. The data suggest that the FN concentration in ascites is related to the opsonic capacity of this fluid, and that its concentration in the ascitic fluid may be a biochemical risk factor indicator for the development of spontaneous bacterial peritonitis

  5. Efficacy of entecavir combined with alprostadil in treatment of hepatitis B-related cirrhotic ascites

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    LI Huili

    2016-02-01

    Full Text Available ObjectiveTo investigate the efficacy of entecavir combined with alprostadil in the treatment of hepatitis B-related cirrhotic ascites. MethodsA total of 100 patients with hepatitis B-related cirrhotic ascites who were admitted to Dezhou Hospital of Traditional Chinese Medicine from May 2012 to February 2014 were selected and randomly divided into treatment group and control group, with 50 patients in each group. The patients in both groups received the liver-protecting treatment, diuretic treatment, and intermittent supplementation of albumin(Alb. Additionally, the patients in the treatment group received oral entecavir 0.5 mg once a day, combined with intravenous infusion of alprostadil 20 μg+5% glucose injection 100 ml once a day, and those in the observation group only received oral entecavir 0.5 mg once a day. The patients were hospitalized and treated for 4 weeks. Ascites regression, changes in the levels of alanine aminotransferase (ALT, total bilirubin (TBil, Alb, blood urea nitrogen (BUN, creatinine (Cr, and hepatitis B virus (HBV DNA, and prothrombin activity (PTA were observed in both groups. After discharge, the patients in both groups continued to take oral entecavir 0.5 mg once a day, and the long-term therapeutic effect was observed through follow-up for 3 months. The t-test was applied for comparison of continuous data between groups, and the chi-square test was applied for comparison of categorical data between groups. ResultsThe patients in both groups had varying degrees of reduction in the amount of ascites after treatment, and the treatment group had a significantly higher overall response rate than the control group (χ2=6.018, P<0.05. The patients in both groups had varying degrees of improvement in each index of liver and renal function (ALT, TBil, Alb, BUN, and Cr and PTA after treatment; the treatment group had a better treatment outcome than the control group, and there were significant differences in each index

  6. Origin of increased deoxycytidine excretion into urine of rats bearing Yoshida ascites sarcoma

    Energy Technology Data Exchange (ETDEWEB)

    Shimizu, M.; Fujimura, S.

    1984-06-01

    The metabolism of deoxycytidine (dCyd) and dCyd nucleotides in Yoshida ascites sarcoma (YS) cells and the host rat liver was investigated with reference to the increased excretion of urinary dCyd. Incorporation of (/sup 14/C)orotic acid into the livers of rats at the fifth day after the transplantation of YS cells, was 2 times higher than that into the normal rat livers. After the injection of (/sup 14/C)orotic acid, the ratio of the specific radioactivity of cytidylate to uridylate moieties of the host liver RNA was measured and found to be higher than that of normal rat liver RNA and to be similar to that of YS cell RNA. When (/sup 14/C)orotic acid was injected into rats followed by the transplantation of YS cells, the radioactivities present in the livers disappeared more rapidly than those in the control rat livers. The activities of pyrimidine de novo synthesis enzymes, such as cytidine triphosphate synthetase and cytidine diphosphate reductase, in YS were higher than those in both rat ascites hepatoma AH 7974 and Walker 256 carcinosarcoma, the transplantations of which did not induce increased excretion of dCyd into urine of the hosts. The activities of dCyd kinase and dCyd deaminase in YS cells were lower than those in the other two tumors investigated. The activities of cytidine triphosphate synthetase and cytidine diphosphate reductase in the livers of YS-bearing rats were elevated compared with those in the livers of rat ascites hepatoma AH 7974- or Walker 256 carcinosarcoma-bearing rats and normal rats, while the activities of dCyd kinase, 5'-nucleotidase, and dCyd deaminase were similar between normal rat livers and tumor-bearing rat livers.

  7. Clinical efficacy of tolvaptan for treatment of refractory ascites in liver cirrhosis patients.

    Science.gov (United States)

    Zhang, Xin; Wang, Shu-Zhen; Zheng, Jun-Fu; Zhao, Wen-Min; Li, Peng; Fan, Chun-Lei; Li, Bing; Dong, Pei-Ling; Li, Lei; Ding, Hui-Guo

    2014-08-28

    To evaluate the efficacy and safety of tolvaptan to treat refractory ascites in decompensated liver cirrhosis patients with or without further complications, such as hepatorenal syndrome and/or hepatocellular carcinoma. Thirty-nine patients (mean age 55 years, males: 32) with decompensated liver cirrhosis and refractory ascites were enrolled. All patients received a combination of tolvaptan (15 mg/d for 5-14 d) and diuretics (40-80 mg/d of furosemide and 80-160 mg/d of spironolactone). The etiology of cirrhosis included hepatitis B (69.2%), hepatitis C (7.7%) and alcohol-induced (23.1%). Changes in the urine excretion volume, abdominal circumference and edema were assessed. The serum sodium levels were also measured, and adverse events were recorded. A follow-up assessment was conducted 1 mo after treatment with tolvaptan. Tolvaptan increased the mean urine excretion volume (1969.2 ± 355.55 mL vs 3410.3 ± 974.1 mL, P tolvaptan in all patients was 89.7%; the efficacies in patients with hepatocellular carcinoma and hepatorenal syndrome were 84.2% and 77.8%, respectively. The incidence of hyponatremia was 53.8%. In patients with hyponatremia, the serum sodium levels increased after tolvaptan treatment (from 128.1 ± 4.22 mEq/L vs 133.1 ± 3.8 mEq/L, P Tolvaptan is a promising aquaretic for the treatment of refractory ascites in patients with decompensated liver cirrhosis.

  8. Performance of Xpert MTB/RIF on Ascitic Fluid Samples for Detection of Abdominal Tuberculosis.

    Science.gov (United States)

    Rufai, Syed Beenish; Singh, Sarman; Singh, Amit; Kumar, Parveen; Singh, Jitendra; Vishal, Anand

    2017-01-01

    Diagnosis of abdominal tuberculosis (TB) from ascitic fluid samples using routinely available diagnostic methods is challenging due to its paucibacillary nature. Although performance of Xpert MTB/RIF assay has been evaluated extensively on pulmonary samples, its performance on extrapulmonary samples is still under evaluation. The objective of this study was to find out the performance of Xpert MTB/RIF on ascitic fluid samples obtained from suspected cases of abdominal TB. Performance was compared with Mycobacterium growth indicator tube-960 (MGIT-960) culture and in-house multiplex polymerase chain reaction (PCR). The latter detects and differentiates Mycobacterium tuberculosis and nontuberculous mycobacteria simultaneously. Sixty-seven patients suspected of probable/possible abdominal TB were included in this observational, prospective study. All samples were tested by Ziehl-Neelsen staining, MGIT-960 culture, in-house multiplex PCR, and Xpert MTB/RIF assay. All 67 samples were smear negative. Seventeen (25.4%) were MGIT-960 culture positive while 12 (17.9%) were detected positive by the Xpert MTB/RIF assay and 9 (13.4%) by in-house multiplex PCR. Sensitivity and specificity of the Xpert MTB/RIF assay compared with the MGIT-960 culture were 70.6% (95%, confidence interval [CI]: 44.1-89.7) and 100% (95%, CI: 92.8-100) and that of in-house multiplex PCR were 52.9% (95%, CI: 30.9-73.8) and 100% (95%, CI: 92.8-100), respectively. Diagnostic yield of Xpert MTB/RIF assay on ascitic fluid samples was lower than MGIT-960 culture. We thus emphasize on the need for urgent discovery of new biomarkers for paucibacillary TB.

  9. Prenatal diagnosis of persistent urogenital sinus with duplicated hydrometrocolpos and ascites--a case report.

    Science.gov (United States)

    Pauleta, Joana; Melo, Maria Antonieta; Borges, Gertrudes; Carvalho, Rui; Marques, João Paulo; Dupont, Juliette; Monteiro, Cecília Pardal; Graça, Luís Mendes

    2010-01-01

    We report a successful case of persistent urogenital sinus associated with a duplicated nonsyndromic form of hydrometrocolpos and ascites diagnosed prenatally. Though urogenital malformations are extremely rare and variable in presentation, the conjugation of those anomalies in a newborn is reported here for the first time. Prenatal ultrasound diagnosis was suspected at 25 weeks' gestation and MRI imaging supported the diagnosis. Periodic ultrasound surveillance was conducted until birth at 35 weeks' gestation by cesarean section. The presumptive diagnosis was confirmed after birth. One month later, the newborn underwent reconstructive surgical intervention with good outcome. Copyright © 2010 S. Karger AG, Basel.

  10. Acute peritonitis as the first presentation of valvular cardiomyopathy.

    LENUS (Irish Health Repository)

    Higgins, Nikki

    2012-02-01

    Valvular cardiomyopathy can present a diagnostic challenge in the absence of overt cardiac symptoms. This report describes the case of a 46-year-old woman who presented with acute peritonitis associated with vomiting and abdominal distension. Subsequent abdominal computed tomography and ultrasound revealed bibasal pleural effusions, ascites, and normal ovaries. An echocardiogram revealed that all cardiac chambers were dilated with a global decrease in contractility and severe mitral, tricuspid, and aortic regurgitation. A diagnosis of cardiomyopathy with acute heart failure, secondary to valvular heart disease, was secured. Acute peritonitis as the presenting feature of valvular cardiomyopathy is a rare clinical entity.

  11. Acute peritonitis as the first presentation of valvular cardiomyopathy.

    Science.gov (United States)

    Higgins, Nikki; Burke, John P; McCreery, Charles J

    2012-01-01

    Valvular cardiomyopathy can present a diagnostic challenge in the absence of overt cardiac symptoms. This report describes the case of a 46-year-old woman who presented with acute peritonitis associated with vomiting and abdominal distension. Subsequent abdominal computed tomography and ultrasound revealed bibasal pleural effusions, ascites, and normal ovaries. An echocardiogram revealed that all cardiac chambers were dilated with a global decrease in contractility and severe mitral, tricuspid, and aortic regurgitation. A diagnosis of cardiomyopathy with acute heart failure, secondary to valvular heart disease, was secured. Acute peritonitis as the presenting feature of valvular cardiomyopathy is a rare clinical entity.

  12. Peritoneovenous shunt in treatment of ascites in patients with cirrhosis. A preliminary report with special reference to pathophysiology

    DEFF Research Database (Denmark)

    Henriksen, Jens Henrik Sahl; Malchow-Møller, A; Ring-Larsen, H

    1983-01-01

    Peritoneovenous shunts (LeVeen type) were implanted in seven patients with cirrhosis complicated by ascites refractory to diuretic treatment. Three patients died of gastrointestinal bleeding and hepatic coma 1 to 7 weeks after the shunt implantation. The patients who died were those with the most...... severely impaired liver and kidney function. In two of the four surviving patients (observation time, 5-24 months) the shunt was patent during the observation time, and ascites disappeared. In the other two the shunt closed, in one patient repeatedly following several re-implantations. Enhanced urinary...... sodium excretion was observed in patients with patent shunts. After disappearance of ascites, the splanchnic venous pressures became less deranged. Long-term change in plasma volume or circulating albumin mass could not be detected. A patent shunt increases the drainage from the peritoneal cavity...

  13. EXPERIENCE WITH INTRAPERITONEAL CHEMOTHERAPY USING ASCITIC FLUID AS A SOLVENT OF CHEMICALS IN THE TREATMENT OF OVARIAN CANCER

    Directory of Open Access Journals (Sweden)

    Yu. S. Sidorenko

    2009-01-01

    Full Text Available Thirty two with the ascitic form of Stages IIIC—IV ovarian cancer underwent 1 to 3 courses of intraperitoneal multidrug therapy using a protein ascitic fluid concentrate (PAFC as a solvent of drugs (cisplatin, cyclophosphan, doxorubicin according to the CAP regimen. The induction chemotherapy allowed remission to be achieved in 78.1% of cases (against 40% with standard intraperitoneal therapy, the stan- dard volume of surgical treatment was performed in 28 (87.5% patients (21 (70% receiving the control regime; with the use of PAFC, the size of minimum residual tumour (less than 1 cm was achieved in 81.3% versus 63.3% with standard intraperitoneal chemotherapy. This treatment enables the use large-dose chemotherapy regimens that cause no severe systemic toxic reactions. The method is highly-effective, low-toxic and may be recommended for the treatment of patients with the ascitic form of Stages III—IV ovarian cancer.

  14. Bacterial isolation with on-site inoculation of ascites fluid into hemoculture bottle in spontaneous bacterial peritonitis.

    Science.gov (United States)

    Charoenhirunyingyos, Sumittra; Dhiraputra, Chertsak; Leelarasamee, Amorn

    2004-05-01

    To compare the on-site bacterial inoculation of ascites fluid into hemoculture bottle with routine method in the patients who were preliminary diagnosed of SBP. A retrospective analysis of case records during January-December 2001. A total of 673 specimens from 325 patients were retrieved from the data records at the Department of Microbiology, Siriraj Hospital in 2001. The neutrocytic ascites were found in 163 specimens (94 patients). The routine method and on-site inoculation into the hemoculture bottle were employed in 107 and 56 specimens respectively. Culture-positive neutrocytic ascites was found in the routine method 16 (14.9%) specimens and in the on-site inoculation 26 (46.4%) specimens (p < 0.0001). Among these samples, the two methods were simultaneously performed in 42 specimens of which 18 paired specimens were eligible for analysis. Positive culture was found in 2 samples in which the routine method and in an additional 5 samples in which on-site inoculation into hemoculture bottle method. Using Kappa analysis (e score = 0.328, 95% CI = -0.172 to 0.829) that can be interpreted the on-site inoculation method had a higher yield than the routine technique. Moreover, 21 cases also had their blood and ascites samples simultaneously collected and cultured. 4 of ten (19%) and 5 of eleven (23.8%) cases were found in the routine and on-site and direct inoculation groups respectively. These finding suggested that the severity of infection in among two groups were similar and unlikely to be the cause of the difference of the positive isolation rate in both groups. The on-site and direct inoculation of ascites into hemoculture bottle method had a significantly higher isolation rate than routine method (i.e. 46.4% versus 14.9% p < 0.0001) either with separated or paired samples of ascites.

  15. The Denver Tube Combined with Antiviral Drugs In the Treatment of HBV-related Cirrhosis with Refractory Ascites: A Report of Three Cases

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    Wang Xiao-jin

    2014-03-01

    Full Text Available Treatment of nucleos(tide antiviral drugs for decompensated HBV-related cirrhosis can significantly improve the prognosis. But those patients with refractory ascites possibly deteriorate due to the complications of ascites before any benefit from anti-viral drugs could be observed. Therefore, it is important to find a way to help the patients with HBV-related cirrhosis and refractory ascites to receive the full benefits from antiviral therapy. Peritoneovenous shunt (PVS using Denver tube enables ascites to continuously bypass into systemic circulation, thereby reducing ascites and albumin input and improving quality of life. We report herein 3 cases of decompensated HBV-related cirrhosis with refractory ascites, PVS using Denver tube was combined with lamivudine for antiviral treatment before and after. Then, ascites was alleviated significantly or disapeared and viral responsed well. All patients achieved a satisfactory long-term survival from 6.7 to 14.7 years. It was suggested that the Denver shunt could be used as an adjuvant method to antiviral drugs for decompensated HBV-related cirrhosis with refractory ascites to help the patients reap the full benefits and maximize efficacy of antiviral treatment.

  16. Interaction among two subpopulations of Ehrlich ascites tumor in vivo: evidence of a contact mediated immune response

    DEFF Research Database (Denmark)

    Aabo, K; Vindeløv, L L; Skovsgaard, T

    1987-01-01

    .15) on a fast growing subpopulation (E1.95) was demonstrated only when the cells had contact during solid tumor growth. The effect was dependent on the relative proportion of the suppressing cell line. An identical effect was exerted by radiation killed inhibitor cells. The inhibition was only transient....... If the tumor cell lines were grown intraperitoneally as ascites tumors without cellular contact, no interaction was found using flow cytometric DNA analysis to determine alterations in the relative proportions of the cell lines. Ascites from the inhibitor cell line E1.15 had no inhibitory effect on E1.95. Pre...

  17. Interleukin 6 Present in Inflammatory Ascites from Advanced Epithelial Ovarian Cancer Patients Promotes Tumor Necrosis Factor Receptor 2-Expressing Regulatory T Cells

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    Nirmala Chandralega Kampan

    2017-11-01

    Full Text Available BackgroundEpithelial ovarian cancer (EOC remains a highly lethal gynecological malignancy. Ascites, an accumulation of peritoneal fluid present in one-third of patients at presentation, is linked to poor prognosis. High levels of regulatory T cells (Tregs in ascites are correlated with tumor progression and reduced survival. Malignant ascites harbors high levels of Tregs expressing the tumor necrosis factor receptor 2 (TNFR2, as well as pro-inflammatory factors such as interleukin 6 (IL-6 and tumor necrosis factor (TNF. IL-6 is also associated with poor prognosis. Herein, we study the effect of IL-6 and TNF present in ascites on the modulation of TNFR2 expression on T cells, and specifically Tregs.MethodsAscites and respective peripheral blood sera were collected from 18 patients with advanced EOC and soluble biomarkers, including IL-6, sTNFR2, IL-10, TGF-β, and TNF, were quantified using multiplexed bead-based immunoassay. Peripheral blood mononuclear cells (PBMC from healthy donors were incubated with cell-free ascites for 48 h (or media as a negative control. In some experiments, IL-6 or TNF within the ascites were neutralized by using monoclonal antibodies. The phenotype of TNFR2+ Tregs and TNFR2− Tregs were characterized post incubation in ascites. In some experiments, cell sorted Tregs were utilized instead of PBMC.ResultsHigh levels of immunosuppressive (sTNFR2, IL-10, and TGF-β and pro-inflammatory cytokines (IL-6 and TNF were present in malignant ascites. TNFR2 expression on all T cell subsets was higher in post culture in ascites and highest on CD4+CD25hiFoxP3+ Tregs, resulting in an increased TNFR2+ Treg/effector T cell ratio. Furthermore, TNFR2+ Tregs conditioned in ascites expressed higher levels of the functional immunosuppressive molecules programmed cell death ligand-1, CTLA-4, and GARP. Functionally, TNFR2+ Treg frequency was inversely correlated with interferon-gamma (IFN-γ production by effector T cells, and was

  18. Interleukin 6 Present in Inflammatory Ascites from Advanced Epithelial Ovarian Cancer Patients Promotes Tumor Necrosis Factor Receptor 2-Expressing Regulatory T Cells.

    Science.gov (United States)

    Kampan, Nirmala Chandralega; Madondo, Mutsa Tatenda; McNally, Orla M; Stephens, Andrew N; Quinn, Michael A; Plebanski, Magdalena

    2017-01-01

    Epithelial ovarian cancer (EOC) remains a highly lethal gynecological malignancy. Ascites, an accumulation of peritoneal fluid present in one-third of patients at presentation, is linked to poor prognosis. High levels of regulatory T cells (Tregs) in ascites are correlated with tumor progression and reduced survival. Malignant ascites harbors high levels of Tregs expressing the tumor necrosis factor receptor 2 (TNFR2), as well as pro-inflammatory factors such as interleukin 6 (IL-6) and tumor necrosis factor (TNF). IL-6 is also associated with poor prognosis. Herein, we study the effect of IL-6 and TNF present in ascites on the modulation of TNFR2 expression on T cells, and specifically Tregs. Ascites and respective peripheral blood sera were collected from 18 patients with advanced EOC and soluble biomarkers, including IL-6, sTNFR2, IL-10, TGF-β, and TNF, were quantified using multiplexed bead-based immunoassay. Peripheral blood mononuclear cells (PBMC) from healthy donors were incubated with cell-free ascites for 48 h (or media as a negative control). In some experiments, IL-6 or TNF within the ascites were neutralized by using monoclonal antibodies. The phenotype of TNFR2 + Tregs and TNFR2 - Tregs were characterized post incubation in ascites. In some experiments, cell sorted Tregs were utilized instead of PBMC. High levels of immunosuppressive (sTNFR2, IL-10, and TGF-β) and pro-inflammatory cytokines (IL-6 and TNF) were present in malignant ascites. TNFR2 expression on all T cell subsets was higher in post culture in ascites and highest on CD4 + CD25 hi FoxP3 + Tregs, resulting in an increased TNFR2 + Treg/effector T cell ratio. Furthermore, TNFR2 + Tregs conditioned in ascites expressed higher levels of the functional immunosuppressive molecules programmed cell death ligand-1, CTLA-4, and GARP. Functionally, TNFR2 + Treg frequency was inversely correlated with interferon-gamma (IFN-γ) production by effector T cells, and was uniquely able to suppress TNFR2

  19. The ratio of calprotectin to total protein as a diagnostic and prognostic marker for spontaneous bacterial peritonitis in patients with liver cirrhosis and ascites.

    Science.gov (United States)

    Lutz, Philipp; Pfarr, Kenneth; Nischalke, Hans Dieter; Krämer, Benjamin; Goeser, Felix; Glässner, Andreas; Wolter, Franziska; Kokordelis, Pavlos; Nattermann, Jacob; Sauerbruch, Tilman; Hoerauf, Achim; Strassburg, Christian P; Spengler, Ulrich

    2015-11-01

    Diagnosis of spontaneous bacterial peritonitis (SBP) is based on a differential ascites leukocyte count which does not provide prognostic information. We performed a pilot study to assess calprotectin in ascites as an alternative diagnostic and prognostic marker. We collected ascites from patients with liver cirrhosis from March 2012 to July 2013. Routine clinical and laboratory data of the patients were recorded. Ascites calprotectin levels were determined by ELISA. Overall, we collected 120 ascites samples from 100 patients with liver cirrhosis and from eight patients with malignant peritoneal effusion as disease control. Samples without infection had significantly lower calprotectin levels (median 34 ng/mL, range 5-795) than SBP samples (median 928 ng/mL, range 21-110,480; pmarker for SBP than calprotectin alone (AUROC=0.93; pdiagnostic and prognostic marker in patients with liver cirrhosis and SBP and should be evaluated further.

  20. Gracilaria edulis extract induces apoptosis and inhibits tumor in Ehrlich ascites tumor cells in vivo.

    Science.gov (United States)

    Patra, Satyajit; Muthuraman, Meenakshi Sundaram

    2013-11-25

    Marine environment is inestimable for their chemical and biological diversity and therefore is an extraordinary resource for the discovery of new anticancer drugs. Recent development in elucidation of the mechanism and therapeutic action of natural products helped to evaluate for their potential activity. We evaluated Gracilaria edulis J. Ag (Brown algae), for its antitumor potential against the Ehrlich ascites tumor (EAT) in vivo and in vitro. Cytotoxicity evaluation of Ethanol Extract of Gracilaria edulis (EEGE) using EAT cells showed significant activity. In vitro studies indicated that EEGE cytotoxicity to EAT cells is mediated through its ability to produce reactive oxygen species (ROS) and therefore decreasing intracellular glutathione (GSH) levels may be attributed to oxidative stress. Apoptotic parameters including Annexin-V positive cells, increased levels of DNA fragmentation and increased caspase-2, caspase-3 and caspase-9 activities indicated the mechanism might be by inducing apoptosis. Intraperitoneally administration of EEGE to EAT-bearing mice helped to increase the lifespan of the animals significantly inhibited tumor growth and increased survival of mice. Extensive hematology, biochemistry and histopathological analysis of liver and kidney indicated that daily doses of EEGE up to 300 mg/kg for 35 days are well tolerated and did not cause hematotoxicity nor renal or hepatotoxicity. Comprehensive antitumor analysis in animal model and in Ehrlich Ascites Tumor cells was done including biochemical, and pathological evaluations indicate antitumor activity of the extract and non toxic in vivo. It was evident that the mechanism explains the apoptotic activity of the algae extract.

  1. Antineoplastic activity of poly(L-lysine) with some ascites tumor cells.

    Science.gov (United States)

    Arnold, L J; Dagan, A; Gutheil, J; Kaplan, N O

    1979-01-01

    We have found that poly(L-lysine) can be a very effective agent in preventing the growth of Ehrlich ascites tumors in mice. When given optimal doses of poly(L-lysine) (Mr 60 x 10(3)) intraperitoneally for 5 consecutive days, beginning on day 1 after inoculation with Ehrlich ascites cells. White Swiss mice show nearly a 100% remission from subsequent tumor growth. Rechallenge of "cured" animals with tumor cells, however shows no long-term immunological protection. In tissue culture, poly(L-lysine) shows a related potent cytotoxicity with HeLa cells; interestingly, the D isomer. In addition, there is a strong molecular weight dependence in that the small polylysine (Mr 3 x 10(3)) possesses less than 1/20th the cytotoxicity of large polymers (Mr 70 x 10(3)) on a weight basis in both cell culture and animal studies. At the same time, none of these lysine polymers gives any significant increase in life span to BDF1 mice infected with L1210 murine leukemia cells. We have also further explored the mechanism by which the polylysines express their cytotoxicity. These data indicate that lysine polymers show cell specificity in their action and in some cases they may be beneficial as potent antineoplastic agents, particularly when molecular weight is taken into consideration. PMID:291000

  2. Unique proteome signature of post-chemotherapy ovarian cancer ascites-derived tumor cells

    Science.gov (United States)

    Ahmed, Nuzhat; Greening, David; Samardzija, Chantel; Escalona, Ruth M.; Chen, Maoshan; Findlay, Jock K.; Kannourakis, George

    2016-01-01

    Eighty % of ovarian cancer patients diagnosed at an advanced-stage have complete remission after initial surgery and chemotherapy. However, most patients die within <5 years due to episodes of recurrences resulting from the growth of residual chemoresistant cells. In an effort to identify mechanisms associated with chemoresistance and recurrence, we compared the expression of proteins in ascites-derived tumor cells isolated from advanced-stage ovarian cancer patients obtained at diagnosis (chemonaive, CN) and after chemotherapy treatments (chemoresistant/at recurrence, CR) by using in-depth, high-resolution label-free quantitative proteomic profiling. A total of 2,999 proteins were identified. Using a stringent selection criterion to define only significantly differentially expressed proteins, we report identification of 353 proteins. There were significant differences in proteins encoding for immune surveillance, DNA repair mechanisms, cytoskeleton rearrangement, cell-cell adhesion, cell cycle pathways, cellular transport, and proteins involved with glycine/proline/arginine synthesis in tumor cells isolated from CR relative to CN patients. Pathway analyses revealed enrichment of metabolic pathways, DNA repair mechanisms and energy metabolism pathways in CR tumor cells. In conclusion, this is the first proteomics study to comprehensively analyze ascites-derived tumor cells from CN and CR ovarian cancer patients. PMID:27470985

  3. Humanized mouse model of ovarian cancer recapitulates patient solid tumor progression, ascites formation, and metastasis.

    Directory of Open Access Journals (Sweden)

    Richard B Bankert

    Full Text Available Ovarian cancer is the most common cause of death from gynecological cancer. Understanding the biology of this disease, particularly how tumor-associated lymphocytes and fibroblasts contribute to the progression and metastasis of the tumor, has been impeded by the lack of a suitable tumor xenograft model. We report a simple and reproducible system in which the tumor and tumor stroma are successfully engrafted into NOD-scid IL2Rγ(null (NSG mice. This is achieved by injecting tumor cell aggregates derived from fresh ovarian tumor biopsy tissues (including tumor cells, and tumor-associated lymphocytes and fibroblasts i.p. into NSG mice. Tumor progression in these mice closely parallels many of the events that are observed in ovarian cancer patients. Tumors establish in the omentum, ovaries, liver, spleen, uterus, and pancreas. Tumor growth is initially very slow and progressive within the peritoneal cavity with an ultimate development of tumor ascites, spontaneous metastasis to the lung, increasing serum and ascites levels of CA125, and the retention of tumor-associated human fibroblasts and lymphocytes that remain functional and responsive to cytokines for prolonged periods. With this model one will be able to determine how fibroblasts and lymphocytes within the tumor microenvironment may contribute to tumor growth and metastasis, and will make it possible to evaluate the efficacy of therapies that are designed to target these cells in the tumor stroma.

  4. Characterization of Poly(A)-Protein Complexes Isolated from Free and Membrane-Bound Polyribosomes of Ehrlich Ascites Tumor Cells

    NARCIS (Netherlands)

    Janssen, Dick B.; Counotte-Potman, Anda D.; Venrooij, Walther J. van

    1976-01-01

    Proteins present in messenger ribonucleoprotein particles were labeled with [35S]-methionine in Ehrlich ascites tumor cells in which synthesis of new ribosomes was inhibited. Poly(A)-protein complexes were isolated from free and membrane-bound polyribosomes by sucrose gradient centrifugation and

  5. Mean platelet volume as a novel predictor of systemic inflammatory response in cirrhotic patients with culture-negative neutrocytic ascites.

    Science.gov (United States)

    Gálvez-Martínez, Marisol; Servín-Caamaño, Alfredo I; Pérez-Torres, Eduardo; Salas-Gordillo, Francisco; Rivera-Gutiérrez, Xaira; Higuera-de la Tijera, Fátima

    2015-05-08

    To identify a mean platelet volume (MPV) cutoff value which should be able to predict the presence of bacterial infection. An observational, analytic, retrospective study. We evaluated medical records of cirrhotic patients who were hospitalized from January 2012 to January 2014 at the Gastroenterology Department of "Hospital General de México Dr. Eduardo Liceaga", we included 51 cirrhotic patients with ascites fluid infection (AFI), and 50 non-infected cirrhotic patients as control group. Receiver operator characteristic curves were used to identify the best cutoff value of several parameters from hematic cytometry, including MPV, to predict the presence of ascites fluid infection. Of the 51 cases with AFI, 48 patients (94.1%) had culture-negative neutrocytic ascites (CNNA), 2 (3.9%) had bacterial ascites, and one (2%) had spontaneous bacterial peritonitis. Infected patients had greater count of leucocytes and polymorphonuclear cells, greater levels of MPV and cardiac frequency (P 0.80). A cutoff MPV value of 8.3 fl was the best to discriminate between cirrhotic patients with AFI and those without infection. Our results support that MPV can be an useful predictor of systemic inflammatory response syndrome in cirrhotic patients with AFI, particularly CNNA.

  6. The Angiogenic Activity of Ascites in the Course of Ovarian Cancer as a Marker of Disease Progression

    Directory of Open Access Journals (Sweden)

    Krzysztof Gawrychowski

    2014-01-01

    Full Text Available Ovarian cancer cells are able to create invasive implants in the peritoneum and their growth is directly associated with the angiogenetic potential. This effect is probably stimulated by vascular endothelial growth factor (VEGF and interleukin-8 (IL-8, which are both found in ascites. The aim of this study was to assess the influence of ascites produced by ovarian cancer on the angiogenesis. Peritoneal fluid was collected from patients with advanced ovarian cancer; cancer cells were separated from CD45+ leukocytes. Angiogenesis was assessed in mice, after intradermal injection of full cellular suspension together with supernatant or phosphate buffered saline, purified cancer cells suspension, or CD45+ leukocytes suspension. The angiogenesis index (AI was assessed after 72 hours. VEGF and Il-8 were measured in the supernatant and cellular suspension. AI was the highest in the isolated cancer cells suspensions as well in the group stimulated with supernatant. Both VEGF and IL-8 were high in supernatants from ascites rich in cancer cells (>45%. A significant correlation was revealed between IL-8 concentration and AI. We conclude that ascites in patients with advanced ovarian cancer stimulates angiogenesis and this mechanism is dependent mostly on cancer cells activity and enhanced by cooperation with infiltrating leukocytes.

  7. Evolution of sarcoma 180 (ascitic tumor in mice infected with Schistosoma mansoni

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    Fausto Edmundo Lima Pereira

    1986-03-01

    Full Text Available Mice infected with 60 cercariae of Schistosoma mansoni were more resistant to the sarcoma 180 ascites tumor. Tumor inoculation was performed 50 days after schistosoma infection and the animals were observed and weighed at 48 hours intervals for development and progression of malignancy. In infected mice the weight gain (ascites formation started later and was shorter than in uninfected Controls. Also, the number of tumor cells into the peritoneal cavity 72h after tumor implantation was shorter in infected group than incontrols. This in creased resistance against a transplantable tumor probably is related to the effect of endotoxin on tumoricidal activity of macrophages activated by the infection. The immunodepression induced by Schistosoma mansoni infection enhances the proliferation of endogenous bacteria increasing the amount of endotoxin absorbed from the gut.Camundongos infectados com 60 cercárias de Schistosoma mansoni tomaram-se mais resistentes ao sarcoma 180 na forma de tumor ascítico. A inoculação das células tumorais foi feita no 50º dia de infecção e a evolução do tumor foi acompanhada através dapesagem dos animais com intervalos de 48 horas. Nos camundongos infectados o ganho de peso (formação da ascite começou mais tarde e foi menor do que nos controles não infectados. Também o número de células tumorais na cavidade peritoneal 72 horas após a implantação do tumor foi menor no grupo infectado. Este aumento de resistência a um tumor transplantávelpossivelmente está relacionado ao efeito de endotoxinas sobre a atividade tumoricida dos macrofagos ativados pela infecção. A imunossupressão induzida pela infecção favorece a proliferação de bactérias da flora endógena aumentando a quantidade de endotoxinas absorvidas pelo intestino.

  8. Acute Viral Hepatitis in Pediatric Age Groups

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    Sudhamshu KC

    2014-03-01

    Full Text Available Introduction: Our clinical experience showed that there has been no decrease in pediatric cases of acute viral hepatitis in Kathmandu. The objective of the study was to analyze the etiology, clinical features, laboratory parameters, sonological findings and other to determine the probable prognostic factors of Acute Viral Hepatitis in pediatric population. Methods: Consecutive patients of suspected Acute Viral Hepatitis, below the age of 15 years, attending the liver clinic between January 2006 and December2010were studied. After clinical examination they were subjected to blood tests and ultrasound examination of abdomen. The patients were divided in 3 age groups; 0–5, 5–10 and 5–15 years. Clinical features, laboratory parameters, ultrasound findings were compared in three age groups. Results: Etiology of Acute Viral Hepatitis was Hepatitis A virus 266 (85%, Hepatitis E virus in 24 (8%, Hepatitis B virus in 15 (5%. In 7(2% patients etiology was unknown. Three patients went to acute liver failure but improved with conservative treatment. There was no statistical difference in most of the parameters studied in different age groups. Ascites was more common in 5-10 years age group. Patients with secondary bacterial infection, ultrasound evidence of prominent biliary tree and ascites were associated with increased duration of illness. Patients with history of herbal medications had prolonged cholestasis. Conclusions: Hepatitis A is most common cause of Acute Viral Hepatitis in pediatric population. Improper use of herbal medications, secondary bacterial infection and faulty dietary intake was associated with prolonged illness. Patients with prominent biliary radicals should be treated with antibiotics even with normal blood counts for earlier recovery. Keywords: Acute viral hepatitis; hepatitis A; hepatitis E; herbal medications.

  9. Severe de novo Hepatitis B Recovered from Late-Onset Liver Insufficiency with Prolonged Ascites and Hypoalbuminemia due to Hepatitis B Virus Genotype Bj with Precore Mutation

    Directory of Open Access Journals (Sweden)

    Akira Sato

    2016-10-01

    Full Text Available De novo hepatitis B is associated with a high risk of hepatic failure often resulting in fatal fulminant hepatitis even when nucleotide analogues are administered. A 77-year-old female developed de novo hepatitis B after R-CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisolone treatment for diffuse large B-cell lymphoma. Hepatitis B virus (HBV isolated from the patient was of genotype Bj, with a precore mutation (G1896A exhibiting an extremely high viral load at the onset of hepatitis. She showed markedly high levels of transaminase with mild jaundice on admission and rapid decrease of prothrombin activity after admission. Although acute liver failure was averted by the administration of entecavir and corticosteroid pulse therapy, liver volume decreased to 860 ml, and marked hypoalbuminemia accompanying massive ascites occurred 2 months after the onset of hepatitis and persisted for 3 months with high levels of HBV DNA and mild abnormal alanine aminotransferase levels. Frequent infusions of albumin solution, nutrition support, and alleviation therapy showed limited effect. However, overall improvement along with HBV DNA reduction was observed after increasing the dose of entecavir and completion of prednisolone that was administered with a minimum dose for adrenal insufficiency. An immediate and sufficient suppression of virus replication with potent antiviral therapy is critical, particularly in patients infected with HBV precore mutation (G1896A and/or Bj genotype, which may have a high viral replication and direct hepatocellular damage.

  10. In vitro NMR proton http://ej.iop.org/images/0031-9155/41/3/014/img1.gif"/> measurements in peritoneal ascites

    Science.gov (United States)

    Yilmaz, A.; Tez, M.; Göral, V.; Boylu, S.; Kaplan, A.; Kavak, G.

    1996-03-01

    The proton spin - lattice relaxation rate http://ej.iop.org/images/0031-9155/41/3/014/img10.gif" ALIGN="TOP"/> in malignant and non-malignant ascites was measured with an FT NMR spectrometer operating at 60 MHz. The mean relaxation rate in non-malignant ascites was significantly smaller than that of malignant ascites. However, the http://ej.iop.org/images/0031-9155/41/3/014/img11.gif" ALIGN="TOP"/> of malignant ascites overlaps with that of non-malignant ascites over all concentrations of total protein (TP) in samples. The http://ej.iop.org/images/0031-9155/41/3/014/img11.gif" ALIGN="TOP"/> in non-malignant ascites correlates strongly with TP, whilst the http://ej.iop.org/images/0031-9155/41/3/014/img11.gif" ALIGN="TOP"/> in malignant ascites shows only a moderate correlation. http://ej.iop.org/images/0031-9155/41/3/014/img14.gif" ALIGN="TOP"/> measurements before and after addition of ascorbic acid (reductant) suggest that there is a small paramagnetic contribution of ions to the http://ej.iop.org/images/0031-9155/41/3/014/img11.gif" ALIGN="TOP"/> in malignant ascites. The least-squares fitting of http://ej.iop.org/images/0031-9155/41/3/014/img11.gif" ALIGN="TOP"/> versus TP for non-malignant data gives a linear relationship, and suggests that the http://ej.iop.org/images/0031-9155/41/3/014/img14.gif" ALIGN="TOP"/> mechanism in non-malignant ascites is caused by a fast chemical exchange of water molecules between protein-bound water and free water.

  11. Immunological changes in the ascites of cancer patients after intraperitoneal administration of the bispecific antibody catumaxomab (anti-EpCAM×anti-CD3).

    Science.gov (United States)

    Fossati, Marco; Buzzonetti, Alexia; Monego, Giovanni; Catzola, Valentina; Scambia, Giovanni; Fattorossi, Andrea; Battaglia, Alessandra

    2015-08-01

    To explore the effects of intraperitoneal (i.p.) infusion of catumaxomab, a bispecific monoclonal antibody (anti-EpCAM×anti-CD3), on T cells, NK cells and macrophages in ascites of cancer patients and to understand how ascitic immune cells can be activated despite the pervasive immunosuppressive ability of ascites microenvironment. Six patients with malignant ascites received i.p. catumaxomab infusion. Ascitic immune cells were profiled by flow cytometry and gene expression at baseline and after i.p. catumaxomab infusion. In vitro experiments enabled investigations on the adverse effect of ascites microenvironment on catumaxomab-stimulated immune cells. I.p. catumaxomab infusion enhanced the expression of the CD69 and CD38 activation molecules in CD4(+) and CD8(+) T cells, NK cells and macrophages, and favoured CD8(+) T cell accumulation into the peritoneal cavity. An analogous immune cell activation as well as IFN-γ and IL-2 production were induced by catumaxomab in vitro. In vitro experiments showed that the immunosuppressive milieu of ascites abrogated all the immunostimulatory activities of catumaxomab. Adding EpCAM(+) tumour cells to the culture permitted both catumaxomab Fab regions to engage cognate antigens and restored immunostimulatory catumaxomab activity. This is the first demonstration in a clinical setting that i.p. catumaxomab infusion activates NK cells and macrophages in addition to T cells in ascites and favours CD8(+) T cell accumulation into the peritoneal cavity. Moreover, our findings indicate that the concomitant binding of both catumaxomab Fab regions delivers an activation signal that is strong enough to activate immune cells despite the prevailing immunosuppressive environment of malignant ascites. Copyright © 2015 Elsevier Inc. All rights reserved.

  12. Downregulation of taurine uptake in multidrug resistant Ehrlich ascites tumor cells

    DEFF Research Database (Denmark)

    Poulsen, K A; Litman, Thomas; Eriksen, J

    2002-01-01

    In daunorubicin resistant Ehrlich ascites tumor cells (DNR), the initial taurine uptake was reduced by 56% as compared to the parental, drug sensitive Ehrlich cells. Kinetic experiments indicated that taurine uptake in Ehrlich cells occurs via both high- and low-affinity transporters. The maximal...... rate constant for the initial taurine uptake was reduced by 45% (high-affinity system) and 49% (low affinity system) in the resistant subline whereas the affinity of the transporters to taurine was unchanged. By immunoblotting we identified 3 TauT protein bands in the 50-70 kDa region. A visible...... reduction in the intensity of the band with the lowest molecular weight was observed in resistant cells. Quantitative RT-PCR indicated a significant reduction in the amount of taurine transporter mRNA in the resistant cells. Drug resistance in DNR Ehrlich cells is associated with overexpression of the mdr1...

  13. Benzodiazepines and risk for hepatic encephalopathy in patients with cirrhosis and ascites

    DEFF Research Database (Denmark)

    Grønbæk, Lisbet; Watson, Hugh; Vilstrup, Hendrik

    2017-01-01

    Background: There is limited evidence to support the belief that benzodiazepines increase cirrhosis patients’ risk of hepatic encephalopathy (HE). Objective: We aimed to examine the association between benzodiazepine use and HE development in cirrhosis patients. Methods: We used data on 865...... cirrhosis patients with ascites from three trials to study the effect of benzodiazepine use on development of first-time HE. For each patient, we classified periods of benzodiazepine use by the numbers of days since initiation. We used Cox regression to compare the risk of HE in current benzodiazepine users...... vs. non-users adjusting for confounders. Results: Cirrhosis patients were not at increased risk of HE for the first 2 days of benzodiazepine use, but then faced a five-fold increased risk of HE during days 3 to 10 of benzodiazepine use. The risk of HE was not increased for those who had been using...

  14. Effect of cytochalasins on F-actin and morphology of Ehrlich ascites tumor cells

    DEFF Research Database (Denmark)

    Mills, J W; Falsig Pedersen, S; Walmod, P S

    2000-01-01

    that, in intact cells, different cytochalasins can have varying effects on cell morphology and F-actin content and organization. To examine this problem in more detail, we analyzed the effects of cytochalasins on the cell morphology of and F-actin content and organization in Ehrlich ascites tumor (EAT......) cells. After a 3-min exposure to 0.5 microM cytochalasin D, B, or E, F-actin content was equally reduced in all cases and this correlated with a reduction in the amount of cortical F-actin associated with the EAT cell membrane. However, only with CE was cell morphology markedly altered......, with the appearance of numerous blebs. At 10 microM, blebbing was present in all conditions and the organization of cortical F-actin was disrupted. F-actin content, however, was not further reduced by this higher concentration and in CD it was identical to control levels. Exposure of EAT cells to similar...

  15. Regulation of Caspase-3 and Bcl-2 Expression in Dalton's Lymphoma Ascites Cells by Abrin

    Directory of Open Access Journals (Sweden)

    V. Ramnath

    2009-01-01

    Full Text Available The role of abrin, a toxic lectin isolated from seeds of Abrus precatorius Linn in inducing apoptosis in murine Dalton's Lymphoma Ascites (DLA cells was evaluated. Abrin when incubated at the concentration of 10 ng per million DLA cells could bring about cell death as typical morphological changes with apoptosis. However, necrotic cell death dominated when a higher dose of abrin was used. DNA samples, isolated from DLA cells treated with abrin showed fragmentation. Abrin brought about induction of apoptosis by stimulating the expression of pro-apoptotic Caspase-3, at the same time blocking the expression of Bcl-2, which is an anti apoptotic gene. However, the expression of tumor suppressor gene p53 has not been observed in control and abrin-treated DLA cells. Results suggested that abrin effectively induced apoptotic changes in the tumor cells that led to cellular death.

  16. Antitumour and antioxidant activity of some Red Sea seaweeds in Ehrlich ascites carcinoma in vivo.

    Science.gov (United States)

    Ahmed, Hanaa H; Hegazi, Muhammad M; Abd-Alla, Howaida I; Eskander, Emad F; Ellithey, Mona S

    2011-01-01

    The antitumour activities of extracts from the Red Sea seaweeds Jania rubens, Sargassum subrepandum, and Ulva lactuca were investigated in an in vivo mice model based on intramuscular injection of Ehrlich ascites tumour cells. In parallel, antioxidant activities were measured. Tumour marker levels, liver biochemical parameters, and hepatic oxidant/antioxidant status were measured to prove the anticancer and antioxidant nature of the algal extracts. Significant decreases in carcinoembryonic antigen (CEA) and a-fetoprotein (AFP) levels, activities of liver enzymes, levels of nitric oxide (NO) and malondialdehyde (MDA), and an increase in total antioxidant capacity (TAC) were recorded in groups treated with the algal extracts. Jania rubens was selected for phytochemical screening of its phytoconstituents. In addition, carotenoids, halides, minerals, lipoidal matters, proteins, and carbohydrates were studied. Furthermore, 7-oxo-cholest-5(6)-en-3-ol (1) and cholesterol (2) were isolated from the dichloromethane fraction.

  17. The effect of magnesium on glycolysis of permeabilized Ehrlich ascites tumor cells.

    Science.gov (United States)

    Wolf, F I; Bossi, D; Cittadini, A

    1991-09-16

    We have previously observed that extracellular Mg2+ influences the phosphofructokinase (PFK) activity of intact Ehrlich Ascites tumour cells (EATC). In this study we have investigated the mechanism by which Mg2+ modulates this key glycolytic enzyme in EATC made permeable to the cation by either digitonin or dextran sulphate. Results showed that when Mg2+ is freely permeable to the cytosol, the in vivo PFK activity, calculated as FDP/G6P ratio, is not increased as it is in intact cells. We also observed that in permeabilized cells Mg2+ determines the increase of glucose 6 phosphate (G6P), fructose 1,6 bisphosphate (FDP) and lactate production. We hypothesize that extracellular Mg2+ regulates PFK and glycolysis in these neoplastic cells not by entering the cytosol but by a specific interaction with the plasma membrane.

  18. Lack of therapeutic improvement of liver fibrosis in rats by dexamethasone in spite of ascites amelioration.

    Science.gov (United States)

    Ki, Sung Hwan; Choi, Dal Woong; Kim, Choon Won; Kim, Sang Geon

    2005-02-28

    Pathophysiology of liver fibrosis (LF) includes hepatic parenchymal cell destruction and connective tissue formation. Although dexamethasone has been used in the liver diseases, there is controversy over the beneficial effects of dexamethasone on LF. Previous studies showed that CCAAT/enhancer binding protein-beta (C/EBPbeta) activation contributes to hepatocyte regeneration and dissolution of fibrosis and that dexamethasone activates C/EBPbeta whereas C/EBPbeta-mediated gene induction by dexamethasone is antagonized by a corepressor. The present study investigated the possible therapeutic effect of dexamethasone for the treatment of LF in rats. We injected rats with multiple doses of dimethylnitrosamine (DMN) for 4 weeks and then used the LF rats to determine whether dexamethasone treatment therapeutically improved liver functions and resolved fibers accumulated in the liver. Dexamethasone (100 microg/kg, po, three times per week for 4 weeks) failed to restore the body weight gain and liver weight decreased by LF. The body weight gain reduced during LF was further decreased by dexamethasone treatment. Animals were subjected to blood biochemical, liver histopathological and immunochemical analyses. Although dexamethasone treatment significantly reduced ascites in LF rats, the plasma albumin and total protein levels decreased in fibrotic rats were not restored. Impaired liver functions during LF including elevated plasma aminotransferases and bilirubin levels along with GSTA2 repression were not recovered by dexamethasone. Dexamethasone failed to decrease the fibrosis score and to eliminate the extracellular matrix and alpha-smooth muscle actin accumulated in the fibrotic liver. The results of the present study showed that dexamethasone ameliorated ascites in LF rats but failed to improve the liver functions and fiber accumulation, and that the possible beneficial effect of dexamethasone might result from anti-inflammatory effect but not from liver improvement.

  19. Response to tolvaptan and its effect on prognosis in cirrhotic patients with ascites.

    Science.gov (United States)

    Kogiso, Tomomi; Yamamoto, Kuniko; Kobayashi, Mutsuki; Ikarashi, Yuichi; Kodama, Kazuhisa; Taniai, Makiko; Torii, Nobuyuki; Hashimoto, Etsuko; Tokushige, Katsutoshi

    2017-08-01

    The vasopressin V2 receptor antagonist tolvaptan has been used for the treatment of cirrhotic patients with ascites; however, no predictor of efficacy and prognosis has been developed. We evaluated candidate predictors of response to tolvaptan treatment. This was a single-center retrospective study. Overall, 97 Japanese cirrhotic patients (60 men, median age 63 years), who were hospitalized for ascites treatment including oral tolvaptan coupled with conventional diuretics, were enrolled. The efficacy of tolvaptan was defined as a urination increase of ≥500 mL or a urine volume ≥2000 mL/day on the day following treatment. The prognosis of tolvaptan treatment was evaluated by the post-treatment survival time by Kaplan-Meier analysis. Tolvaptan therapy was effective in 67% of cirrhotic patients. Patients showed -1.5 (-17.2 to +6.2) kg change in body weight and 40% achieved ≥2.0 kg reduction in body weight after 1 week of treatment. Platelet counts, urine sodium (Na) level, and urine Na/potassium (Na/K) ratio were higher, and the blood urea nitrogen (BUN)/creatinine (Cr) ratio was lower, in cases showing a response to tolvaptan. The combination of a BUN/Cr ratio ≥17.5 and urine Na/K ratio tolvaptan, and the response rate in these patients was only 39% (P tolvaptan therapy. Urinary BUN and Na excretion were predictive of a response to tolvaptan, and tolvaptan treatment may improve the prognosis of cirrhotic patients. © 2016 The Japan Society of Hepatology.

  20. Treatment with non-selective beta blockers is associated with reduced severity of systemic inflammation and improved survival of patients with acute-on-chronic liver failure

    DEFF Research Database (Denmark)

    Mookerjee, Rajeshwar P; Pavesi, Marco; Thomsen, Karen Louise

    2016-01-01

    BACKGROUND & AIMS: Non-selective beta blockers (NSBBs) have been shown to have deleterious outcomes in patients with refractory ascites, alcoholic hepatitis and spontaneous bacterial peritonitis leading many physicians to stop the drug in these cases. Acute-on-chronic liver failure (ACLF) is char...

  1. Effect of the selective vasopressin V2 receptor antagonists in hepatic cirrhosis patients with ascites: a meta-analysis

    Directory of Open Access Journals (Sweden)

    Shao-hui TANG

    2013-07-01

    Full Text Available Objective To evaluate the efficacy and safety of selective vasopressin V2 receptor antagonists in the treatment of hepatic cirrhosis patients with ascites. Methods PubMed, EMBASE, Web of Science, The Cochrane Central Register of Controlled Trials, Database for Chinese Technical Periodical (VIP, Chinese Journal Full-Text Database (CNKI, and Wan Fang Digital Journal Full-text Database were retrieved to collect clinical randomized controlled trials of hepatic cirrhosis with ascites treated by selective vasopressin V2 receptor antagonists. Meta analysis was performed by using Review Manager 5.0. Results Nine randomized controlled trials including 1884 patients met the inclusion criteria. Meta-analysis showed that: 1 The selective vasopressin V2 receptor antagonists were associated with a significant reduction in body weight compared with placebo (WMD=–1.98kg, 95%CI:–3.24-–0.72kg, P=0.002. Treatment with selective vasopressin V2 receptor antagonists was associated with an improvement of low serum sodium concentration compared to placebo (WMD=3.74mmol/L, 95%CI: 0.91-6.58mmol/L, P=0.01. The percentage of patients with worsening ascites was higher in the group of patients treated with placebo (RR=0.51, 95%CI: 0.34-0.77, P=0.001. 2 The amplitude of increased urine volume was obviously higher in selective vasopressin V2 receptor antagonists group than in placebo group (WMD=1437.65ml, 95%CI: 649.01-2226.30ml, P=0.0004. The difference of serum creatinine in the selective vasopressin V2 receptor antagonists group was not statistically significant compared with the control group (WMD=–3.49μmol/L, 95%CI: –12.54¬5.56μmol/L, P=0.45. 3 There was no statistical significance between the two groups in the heart rate, systolic pressure, diastolic pressure and mortality (P>0.05. The rate of other adverse reactions was higher in the selective vasopressin V2 receptor antagonists group compared with that of placebo group (P=0.003. Conclusion

  2. Protein markers of cancer-associated fibroblasts and tumor-initiating cells reveal subpopulations in freshly isolated ovarian cancer ascites

    Directory of Open Access Journals (Sweden)

    Wintzell My

    2012-08-01

    Full Text Available Abstract Background In ovarian cancer, massive intraperitoneal dissemination is due to exfoliated tumor cells in ascites. Tumor-initiating cells (TICs or cancer stem cells and cells showing epithelial-mesenchymal-transition (EMT are particularly implicated. Spontaneous spherical cell aggregates are sometimes observed, but although similar to those formed by TICs in vitro, their significance is unclear. Methods Cells freshly isolated from malignant ascites were separated into sphere samples (S-type samples, n=9 and monolayer-forming single-cell suspensions (M-type, n=18. Using western blot, these were then compared for expression of protein markers of EMT, TIC, and of cancer-associated fibroblasts (CAFs. Results S-type cells differed significantly from M-type by expressing high levels of E-cadherin and no or little vimentin, integrin-β3 or stem cell transcription factor Oct-4A. By contrast, M-type samples were enriched for CD44, Oct-4A and for CAF markers. Independently of M- and S-type, there was a strong correlation between TIC markers Nanog and EpCAM. The CAF marker α-SMA correlated with clinical stage IV. This is the first report on CAF markers in malignant ascites and on SUMOylation of Oct-4A in ovarian cancer. Conclusions In addition to demonstrating potentially high levels of TICs in ascites, the results suggest that the S-type population is the less tumorigenic one. Nanoghigh/EpCAMhigh samples represent a TIC subset which may be either M- or S-type, and which is separate from the CD44high/Oct-4Ahigh subset observed only in M-type samples. This demonstrates a heterogeneity in TIC populations in vivo which has practical implications for TIC isolation based on cell sorting. The biological heterogeneity will need to be addressed in future therapeutical strategies.

  3. Combinatory Evaluation of Transcriptome and Metabolome Profiles of Low Temperature-induced Resistant Ascites Syndrome in Broiler Chickens

    OpenAIRE

    Shourong Shi; Yiru Shen; Shan Zhang; Zhenhua Zhao; Zhuocheng Hou; Huaijun Zhou; Jianmin Zou; Yuming Guo

    2017-01-01

    To select metabolic biomarkers and differentially expressed genes (DEGs) associated with resistant-ascites syndrome (resistant-AS), we used innovative techniques such as metabolomics and transcriptomics to comparatively examine resistant-AS chickens and AS controls. Metabolomic evaluation of chicken serum using ultra-performance liquid chromatography-quadruple time-of-flight high-sensitivity mass spectrometry (UPLC-QTOF/HSMS) showed significantly altered lysoPC(18:1), PE(18:3/16:0), PC(20:1/1...

  4. Disregarded Effect of Biological Fluids in siRNA Delivery: Human Ascites Fluid Severely Restricts Cellular Uptake of Nanoparticles.

    Science.gov (United States)

    Dakwar, George R; Braeckmans, Kevin; Demeester, Joseph; Ceelen, Wim; De Smedt, Stefaan C; Remaut, Katrien

    2015-11-04

    Small interfering RNA (siRNA) offers a great potential for the treatment of various diseases and disorders. Nevertheless, inefficient in vivo siRNA delivery hampers its translation into the clinic. While numerous successful in vitro siRNA delivery stories exist in reduced-protein conditions, most studies so far overlook the influence of the biological fluids present in the in vivo environment. In this study, we compared the transfection efficiency of liposomal formulations in Opti-MEM (low protein content, routinely used for in vitro screening) and human undiluted ascites fluid obtained from a peritoneal carcinomatosis patient (high protein content, representing the in vivo situation). In Opti-MEM, all formulations are biologically active. In ascites fluid, however, the biological activity of all lipoplexes is lost except for lipofectamine RNAiMAX. The drop in transfection efficiency was not correlated to the physicochemical properties of the nanoparticles, such as premature siRNA release and aggregation of the nanoparticles in the human ascites fluid. Remarkably, however, all of the formulations except for lipofectamine RNAiMAX lost their ability to be taken up by cells following incubation in ascites fluid. To take into account the possible effects of a protein corona formed around the nanoparticles, we recommend always using undiluted biological fluids for the in vitro optimization of nanosized siRNA formulations next to conventional screening in low-protein content media. This should tighten the gap between in vitro and in vivo performance of nanoparticles and ensure the optimal selection of nanoparticles for further in vivo studies.

  5. Preservation of nutritional-status in patients with refractory ascites due to hepatic cirrhosis who are undergoing repeated paracentesis.

    Science.gov (United States)

    Sorrentino, Paolo; Castaldo, Giuseppe; Tarantino, Luciano; Bracigliano, Alessandra; Perrella, Alessandro; Perrella, Oreste; Fiorentino, Francesco; Vecchione, Raffaela; D' Angelo, Salvatore

    2012-04-01

    Refractory ascites in liver-cirrhosis is associated with a poor prognosis. We performed a prospective study to investigate whether aggressive nutritional-support could improve outcomes in cirrhotic patients. Cirrhotic patients undergoing serial large-volume paracentesis for refractory-ascites were enrolled and randomized into three groups. Group A received post-paracentesis intravenous nutritional-support in addition to a balanced oral diet and a late-evening protein snack, group B received the same oral nutritional-protocol as the first group but without parenteral support, and group C (the control group) received a low-sodium or sodium-free diet. Clinical, anthropometric and laboratory nutritional parameters and biochemical tests of liver and renal function were reported for 12 months of follow-up. We enrolled 120 patients, who were randomized into three groups of equal size. Patients on the nutritional-protocol showed better preservation of clinical, anthropometric and laboratory nutritional parameters that were associated with decreased deterioration of liver function compared with patients on the low-sodium or sodium-free diet (group C). Groups A and B had lower morbidity and mortality rates than the control group (C). Mortality rates were significantly better in patients who were treated with parenteral-nutritional-support than for the other two groups. In patients who were on the nutritional-protocol, there was a reduction in the requirement of taps for the treatment of refractory ascites. Post-paracentesis parenteral-nutritional-support with a balanced oral diet and an evening protein snack appears to be the best care protocol for patients with liver-cirrhosis that has been complicated by refractory-ascites. © 2011 Journal of Gastroenterology and Hepatology Foundation and Blackwell Publishing Asia Pty Ltd.

  6. A survey of treatment approaches of malignant ascites in Germany and Austria.

    Science.gov (United States)

    Jehn, C F; Küpferling, S; Oskay-Özcelik, G; Lüftner, D

    2015-07-01

    Malignant ascites (MA) is a common manifestation of advanced cancer. Currently, there are no evidence-based guidelines for the management of MA. We conducted a survey with physicians throughout Germany and Austria, to get an overview of current approaches and opinions in the treatment of MA. One hundred and twenty-eight medical oncologists (MO), gastroenterologists (GE), and gynecologists (GYN) completed an electronic questionnaire consisting of 33 questions. Ninety percent of the physicians were from Germany and 10% from Austria; 48% of those were MO, 30% were GYN, and 14% were GE. Most physicians treated an average of 34 patients (pts)/year with MA. Twenty-six percent of these pts suffered from ovarian, 20% from pancreatic, 17% from gastric, and 14% from colorectal cancer. The majority of the physicians associated MA with poor prognosis (92%) and significant reduction in quality of life (87%). One third felt that MA was a contraindication for full dosing of systemic chemotherapy. Paracentesis (PC) was performed in 70% of pts with symptom relieve and quality of life being the main reasons. Almost half of the pts required 3-5 PC, 50% even more than 5 PC during the course of their disease. Only 15% of pts needed multiple PC per week; the majority (79%) needed the procedure either once a week or every 14 days. In 61% of pts, 3-5 L of ascites fluid was drained. Only in 8%, 5 L and more were removed. Volume substitution with IV albumin was performed in 40% of pts. Most pts (55%) had to stay 1-3 h in a healthcare facility for the procedure. However, 21% had to stay ≥1 day. While almost all physicians (89%) performed a PC at some point in the treatment of MA, 75% felt that a systemic chemotherapy and 55% thought a concomitant diuretic therapy were a necessary adjunct. Seven percent of the pts received a targeted treatment with catumaxomab. Repeated PC is the main pillar of treatment of MA; its effect is only temporary and requires significant hospital resources

  7. Redox signaling in acute pancreatitis

    Science.gov (United States)

    Pérez, Salvador; Pereda, Javier; Sabater, Luis; Sastre, Juan

    2015-01-01

    Acute pancreatitis is an inflammatory process of the pancreatic gland that eventually may lead to a severe systemic inflammatory response. A key event in pancreatic damage is the intracellular activation of NF-κB and zymogens, involving also calcium, cathepsins, pH disorders, autophagy, and cell death, particularly necrosis. This review focuses on the new role of redox signaling in acute pancreatitis. Oxidative stress and redox status are involved in the onset of acute pancreatitis and also in the development of the systemic inflammatory response, being glutathione depletion, xanthine oxidase activation, and thiol oxidation in proteins critical features of the disease in the pancreas. On the other hand, the release of extracellular hemoglobin into the circulation from the ascitic fluid in severe necrotizing pancreatitis enhances lipid peroxidation in plasma and the inflammatory infiltrate into the lung and up-regulates the HIF–VEGF pathway, contributing to the systemic inflammatory response. Therefore, redox signaling and oxidative stress contribute to the local and systemic inflammatory response during acute pancreatitis. PMID:25778551

  8. Treatment of cancerous ascites and radical gastrectomy with intraperitoneal hyperthermic double-distilled water and cis-diaminodichloro-platinum perfusion

    Science.gov (United States)

    Chen, Zhi-Xing; Chen, Jia-Ping; Chen, Zhong; Peng, De-Shu; Zhen, Ji-Xiang; Tan, Jian-San

    1997-01-01

    AIM: To study the therapeutic effect of intraperitoneal hyperthermic double-distilled water and cis-diaminodichloro-platinum (DDP) perfusion for cancerous ascites and radical gastrectomy. METHODS: LACA mice were injected peritoneally with H22 cancer cells (2 × 107 tumor cells). Five days later, the mice received treatments with either intraperitoneal perfusion of 37 °C isotonic fluid (group I), or 43 °C simple hyperthermic double-distilled water (group II), isotonic fluid (group III), DDP (group IV) or a combination of the hyperthermic double-distilled water with DDP (group V). A clinical experiment with intraperitoneal hyperthermic double-distilled water perfusion with DDP was carried out from September 1991 through September 1993 with 32 advanced gastric cancer patients who had undergone radical gastrectomy. RESULTS: In comparison with the untreated control group of cancer cell-bearing LACA mice, the mice in all treatment groups showed near complete obliteration of cancer cells in the peritoneal cavity, markedly reduced ascites, prolonged survival times, and reduced growth of peritoneal cancerous nodes. In the clinical experiment, all 32 patients with advanced carcinoma had achieved satisfactory results at the 1-year follow-up, but had unsatisfactory results at the 2-year follow-up. CONCLUSION: The intraperitoneal hyperthermic double-distilled water perfusion with DDP inhibited the occurrence of ascites in LACA mice bearing cancer cells, and prolonged the lifetime of patients with gastric cancer who had undergone radical gastrectomy. PMID:27053879

  9. [Disorders of water and electrolyte metabolism and changes in acid-base balance in patients with ascitic liver cirrhosis].

    Science.gov (United States)

    Gottfriedová, Halima; Horáčková, Miroslava; Čáslavská, Milena; Špičák, Julius; Schück, Otto

    2017-01-01

    In patients with advanced cirrhosis with ascites disorders of water and electrolyte metabolism are often present and they are associated with changes in acid-base balance. These changes can be very complicated, their diagnosis and treatment difficult. Dilutional hyponatremia is the most common disorder. Hyponatremia in these patients is associated with increased morbidity and mortality before and after liver transplantation. Other common disorders include hyperchloremic acidosis, hypokalemia, metabolic alkalosis, lactic acidosis, respiratory alkalosis. If renal impairment occurs (for example hepatorenal syndrome), metabolic acidosis and retention of acid metabolites may develop. The pathogenesis of these conditions applies primarily hemodynamic changes. Activation of renin-angiotensin-aldosterone system and non-osmotic stimulation of antidiuretic hormone trigger serious changes in water and natrium-chloride metabolism. This activation is clinically expressed like oedema, ascites, hydrothorax, low to zero natrium concentration in urine and increased urinary osmolality, which is higher than serum osmolality. In practice, the evaluation can be significantly modified by the ongoing diuretic therapy. Closer monitoring of water and electrolyte metabolism together with acid-base balance in patients with ascitic liver cirrhosis is important, not only in terms of diagnosis but especially in terms of therapy.

  10. Tissue Xpert™ MTB/Rif assay is of limited use in diagnosing peritoneal tuberculosis in patients with exudative ascites.

    Science.gov (United States)

    Bera, Chinmay; Michael, Joy Sarojini; Burad, Deepak; Shirly, Suzana B; Gibikote, Sridhar; Ramakrishna, Banumathi; Goel, Ashish; Eapen, C E

    2015-09-01

    Xpert™ MTB/Rif is a multiplex hemi-nested real-time PCR-based assay to detect presence of M. tuberculosis within 2 hours of sample collection. The present study aimed at assessing efficacy of Xpert™ MTB/Rif assay for diagnosing peritoneal tuberculosis. Patients with exudative ascites, fluid negative for acid-fast bacilli on auramine O fluorescence staining and unyielding fluid cytology for malignant cells, were included. Ultrasound-guided omental biopsy samples were obtained in all. Xpert™ MTB/Rif assay on tissue samples was assessed against a composite "reference" standard for diagnosis of peritoneal tuberculosis, defined as presence of any of the three-culture showing M tuberculosis, granulomatous inflammation on histology or resolution of ascites with 2 months of antitubercular therapy. During January 2012-July 2013, 28 patients (age:43 ± 15 years; mean ± SD; male:20) were recruited. Serum ascitic albumin gradient was MTB/Rif assay was positive in 4/21 patients with peritoneal tuberculosis and in none of the 7 patients with alternative diagnosis. Thus, sensitivity, specificity, positive, and negative predictive values for tissue Xpert™ MTB/Rif assay in diagnosing peritoneal tuberculosis were 19% (95% C.I: 6% to 42%), 100% (95% C.I: 59% to 100%), 100% (40% to 100%), and 29% (95% C.I: 13% to 51%), respectively. Tissue Xpert™ MTB/Rif assay was of limited use in diagnosing peritoneal tuberculosis.

  11. Better Clinical Efficiency of TILs for Malignant Pleural Effusion and Ascites than Cisplatin Through Intrapleural and Intraperitoneal Infusion.

    Science.gov (United States)

    Chu, Hongjin; Du, Fengcai; Gong, Zhaohua; Lian, Peiwen; Wang, Zhixin; Li, Peng; Hu, Baohong; Chi, Cheng; Chen, Jian

    2017-08-01

    To evaluate the clinical efficiency of tumor-infiltrating lymphocytes (TILs) compared to cisplatin for malignant pleural effusion and ascites through intrapleural and intraperitoneal infusion. Thirteen patients with malignant pleural effusion and ascites were divided into a TIL-treated group and a cisplatin-treated group. Patients were given TILs or cisplatin, through intrapleural and intraperitoneal infusion respectively, after drainage of the malignant serous effusion by thoracentesis or abdominocentesis. The overall response rate and disease control rate of the TIL-treated group (33.33% and 83.33%) were higher than that of the cisplatin-treated group (28.57% and 71.43%). The progression-free survival for the TIL-treated group was significantly longer (p=0.002) and better than that of the cisplatin-treated group (66.67% vs. 28.57%). Quality of life apparently improved in the TIL-treated group and was clearly higher than that in the cisplatin-treated group. The use of TILs has a better clinical efficiency for malignant pleural effusion and ascites than cisplatin through intrapleural and intraperitoneal infusion without severe adverse effects. Copyright© 2017, International Institute of Anticancer Research (Dr. George J. Delinasios), All rights reserved.

  12. Acute necrotizing pancreatitis with pancreatic abscess due to Prevotella species in a diabetic

    Directory of Open Access Journals (Sweden)

    Sonavane A

    2010-01-01

    Full Text Available Acute pancreatitis occasionally presents as pancreatic abscess with complications like pleural effusion and ascites. There are several pre-disposing factors, the most common being cholelithiaisis, alcohol abuse, infective causes, trauma, and metabolic causes such as diabetic ketoacidosis, while some cases are idiopathic. Here, we report a rare case of acute necrotizing pancreatitis in a 40-year-old male who presented with pain in the abdomen, ascites and left basal pleural effusion. A computerized tomography (CT scan showed findings suggestive of pancreatic necrosis, with abscess formation and free-fluid surrounding area. The aspirated pus sample was processed for Gram staining and culture, which yielded growth of Prevotella species in an anaerobic culture. Exploratory laparotomy was performed and intra-abdominal collection drained. Necrosectomy of the distal tail and body of the pancreas was performed. The patient was started on antibiotics and along with supportive treatment, responded well.

  13. Characterisation of multidrug-resistant Ehrlich ascites tumour cells selected in vivo for resistance to etoposide

    DEFF Research Database (Denmark)

    Nielsen, D; Maare, C; Eriksen, J

    2000-01-01

    -extractable immunoreactive topoisomerase IIalpha and beta in EHR2/VP16 was reduced by 30-40% relative to that in EHR2. The multidrug resistance-associated protein (MRP) mRNA was increased 20-fold in EHR2/VP16 as compared with EHR2, whereas the expression of P-glycoprotein was unchanged. In EHR2/VP16, the steady......M. ATPase activity was slightly stimulated by daunorubicin, whereas vinblastine, verapamil, and cyclosporin A had no effect. In conclusion, development of resistance to VP16 in EHR2 is accompanied by a significant reduction in topoisomerase II (alpha and beta) and by increased expression of MRP mRNA (20......An Ehrlich ascites tumour cell line (EHR2) was selected for resistance to etoposide (VP16) by in vivo exposure to this agent. The resulting cell line (EHR2/VP16) was 114.3-, 5.7-, and 4.0-fold resistant to VP16, daunorubicin, and vincristine, respectively. The amount of salt...

  14. Antitumor activity and antioxidant status of Caesalpinia bonducella against Ehrlich ascites carcinoma in Swiss albino mice.

    Science.gov (United States)

    Gupta, Malaya; Mazumder, Upal Kanti; Kumar, Ramanathan Sambath; Sivakumar, Thangavel; Vamsi, Madgula Lakshmi Mohan

    2004-02-01

    The methanol extract of Caesalpinia bonducella FLEMING (Caesalpiniaceae) leaves (MECB) were evaluated for antitumor activity against Ehrlich ascites carcinoma (EAC)-bearing Swiss albino mice. The extract was administered at the doses of 50, 100, and 200 mg/kg body weight per day for 14 days after 24 h of tumor inoculation. After the last dose and 18 h fasting, the mice were sacrificed. The present study deals with the effect of MECB on the growth of transplantable murine tumor, life span of EAC-bearing hosts, hematological profile, and biochemical parameters such as lipid peroxidation (LPO), glutathione content (GSH), superoxide dismutase (SOD), and catalase (CAT) activities. MECB caused significant (P<0.01) decrease in tumor volume, packed cell volume, and viable cell count; and it prolonged the life span of EAC-tumor bearing mice. Hematological profile converted to more or less normal levels in extract-treated mice. MECB significantly (P<0.05) decreased the levels of lipid peroxidation and significantly (P<0.05) increased the levels of GSH, SOD, and CAT. The MECB was found to be devoid of conspicuous short-term toxicity in the mice when administered daily (i.p.) for 14 days at the doses of 50, 100, 200, and 300 mg/kg. The treated mice showed conspicuous toxic symptoms only at 300 mg/kg. The results indicate that MECB exhibited significant antitumor and antioxidant activity in EAC-bearing mice.

  15. Effect of ascitic media formed by glycerin on the prevention of peritoneal adhesions.

    Science.gov (United States)

    Aksoy, F; Vatansev, C; Tekin, A; Pamukcu, A; Küçükkartallar, T; Yilmaz, H; Vatansev, H; Esen, H; Aksoy, N

    2009-01-01

    We aimed to investigate whether or not artificial ascites media formed using glycerin are effective in the prevention of intraperitoneal adhesions. Thirty-six Wistar albino male rats were used in the study. The rats were divided into 3 groups as follows. Group I: control group; group II (isotonic group): 3 ml of 0.9% NaCl was injected into the peritoneal cavity, and group III (glycerin group): 0.5 ml of liquid glycerin and 3 ml of 0.9% NaCl was injected into the peritoneal cavity. There were serious adhesions in the control group. Adhesion rates were lower in the isotonic group compared with the control group, but the difference was not statistically significant (p > 0.05). When adhesion rates of the glycerin group were compared with the control and isotonic groups, significant differences were found, especially between the glycerin and control groups (p glycerin decreases postoperative adhesions. We suggest that glycerin was more effective as it has the chemical ability to draw water to its media. As such, the formation of adhesions may be decreased by increasing the amount of physiological liquid inside the abdomen. Copyright (c) 2009 S. Karger AG, Basel.

  16. Cellular uptake of {sup 212}BiOCl by Ehrlich ascites cells: A dosimetric analysis

    Energy Technology Data Exchange (ETDEWEB)

    Roeske, J.C.; Whitlock, J.L.; Harper, P.V.; Rotmensch, J. [Univ. of Chicago, IL (United States); Stinchcomb, T.G. [DePaul Univ., Chicago, IL (United States). Dept. of Physics; Schwartz, J.L. [Univ. of Washington, Seattle, WA (United States). Dept. of Radiation Oncology; Hines, J.J. [Argonne National Lab., IL (United States). Chemistry Div.

    1999-01-01

    Bi-212 is an alpha-emitting radionuclide being investigated as a therapeutic agent in the intraperitoneal treatment of micrometastatic ovarian carcinoma. In evaluating a new therapeutic modality, cell-survival studies are often used as a means of quantifying the biological effects of radiation. In this analysis, Ehrlich ascites cells were irradiated under conditions similar to therapy in various concentrations of Bi-212. Immediately following irradiation, a cell survival assay was performed in which cells were plated and colonies were counted after 10--14 days. Both a macrodosimetric and a microdosimetric approach were used in analyzing these data. These models used as input the fraction of activity within the cell and in solution, the distribution of cell sizes, and the variation of LET along individual alpha-particle tracks. The results indicate that the energy deposited within the nucleus varies significantly among individual cells. There is a small fraction of cell nuclei which receive no hits, while the remaining cells receive energy depositions which can differ significantly from the mean value. These dosimetric parameters are correlated with measured cell survival and will be a useful predictor of outcome for therapeutic doses.

  17. Magnetic resonance elastography in the detection of hepatorenal syndrome in patients with cirrhosis and ascites

    Energy Technology Data Exchange (ETDEWEB)

    Low, Gavin [Cambridge University Hospitals NHS Foundation Trust Hospital, Department of Radiology, Addenbrooke' s Hospital, England (United Kingdom); University of Alberta, Edmonton, Alberta (Canada); University of Cambridge School of Clinical Medicine, Department of Radiology, Cambridge (United Kingdom); Owen, Nicola E.; Alexander, Graeme J.M. [Cambridge University Hospitals NHS Foundation Trust Hospital, Division of Gastroenterology and Hepatology, Addenbrooke' s Hospital, England (United Kingdom); Joubert, Ilse; Patterson, Andrew J.; Graves, Martin J. [Cambridge University Hospitals NHS Foundation Trust Hospital, Department of Radiology, Addenbrooke' s Hospital, England (United Kingdom); Lomas, David J. [Cambridge University Hospitals NHS Foundation Trust Hospital, Department of Radiology, Addenbrooke' s Hospital, England (United Kingdom); University of Cambridge School of Clinical Medicine, Department of Radiology, Cambridge (United Kingdom)

    2015-10-15

    Hepatorenal syndrome (HRS) is the most lethal cause of renal impairment in cirrhosis. Magnetic resonance elastography (MRE) is a diagnostic test that characterises tissues based on their biomechanical properties. The aim of this study was to assess the feasibility of MRE for detecting HRS in cirrhotic patients. A prospective diagnostic investigation was performed. Renal MRE was performed on 21 hospitalised patients with cirrhosis and ascites. Six patients had HRS, one patient had non-HRS renal impairment, and 14 patients had normal renal function. The MRE-measured renal stiffness was compared against the clinical diagnosis as determined by clinical review alongside laboratory and radiologic results. The MRE-measured renal stiffness was significantly lower in patients with HRS (median stiffness of 3.30 kPa at 90 Hz and 2.62 kPa at 60 Hz) compared with patients with normal renal function (median stiffness of 5.08 kPa at 90 Hz and 3.41 kPa at 60 Hz) (P ≤ 0.014). For the detection of HRS, MRE had an area under the receiver operating characteristic curve of 0.94 at 90 Hz and 0.89 at 60 Hz. MRE had excellent inter-rater agreement, as assessed by Bland-Altman and intraclass correlation coefficient (> 0.9). MRE shows potential in the detection of HRS. (orig.)

  18. Ascites with right heart failure in a dog: diagnosis and management

    Directory of Open Access Journals (Sweden)

    Karlapudi Satish Kumar

    2014-09-01

    Full Text Available A female Labrador dog presented with a history of distended abdomen was subjected for clinical, physical, hemato-biochemical, eletrocardiographic, and ultrasonographic evaluations. Respiratory distress, weakness, fluid thrill on palpation of abdomen, cough, cyanotic tongue, and syncope were the significant manifestations. Elevated levels of creatine kinase, lactate dehydrogenase, alanine amino transferase, and alkaline phosphatase with normal blood urea nitrogen and creatinine were the common serum chemistry findings. Low voltage QRS complexes were the electrocardiographic abnormalities. Classical ground glass appearance of abdomen, and enlarged heart with increased sternal contact were the radiographic findings of abdomen and thorax. Ultrasonography of abdomen revealed floating viscera in the anechoic effusion with engorged and distended hepatic vasculature. 2-dimensional echocardiography revealed dilated right ventricle both on B- and M-mode. Further, insufficiency in mitral and tricuspid valves were recorded on pulsed and color flow Doppler. Hence, right heart failure due to ascites was confirmed, and the condition was successfully managed with losartas, spiranolactone, co-enzyme Q10 and tricholine citrate, and sorbitol.

  19. Mechanism of growth inhibitory effect of cape aloe extract in ehrlich ascites tumor cells.

    Science.gov (United States)

    Kametani, Saeda; Oikawa, Tomoko; Kojima-Yuasa, Akiko; Kennedy, David Opare; Norikura, Toshio; Honzawa, Mayumi; Matsui-Yuasa, Isao

    2007-12-01

    Cape aloe (Aloe ferox Miller) has been a herb well known for its cathartic properties and has also been used popularly as a health drink (juice, tea and tonic) in the United States and in Europe. Cape aloe extract also has been reported to possess several pharmacological effects, such as anti-inflammatory, anti-bacterial, anti-fungal and protective effect against liver injury. However, the investigations on an anti-tumor activity in cape aloe extract are very few and subsequent mechanisms have not been well elucidated. In this study, we examined the effect of the selective growth inhibitory activity of cape aloe extract and found that the cape aloe extract, especially the dichloromethane (CH(2)Cl(2)) extract, caused a dose-dependent growth inhibitory effect in Ehrlich ascites tumor cells (EATC), but not in mouse embryo fibroblast (NIH3T3) cells, which was used as a normal cell model. Furthermore, the CH(2)Cl(2) extract caused an accumulation of cells in the G1 phase and a decrease of cells in the S and G2/M phase of the cell cycle and inhibited DNA synthesis in a dose-dependent manner. In addition, other results suggest that cell cycle arrest and inhibition of proliferation in EATC by the CH(2)Cl(2 )extract are associated with decreased retinoblastoma protein (Rb) phosphorylation.

  20. Antitumor activity and antioxidant property of Curcuma caesia against Ehrlich's ascites carcinoma bearing mice.

    Science.gov (United States)

    Karmakar, Indrajit; Dolai, Narayan; Suresh Kumar, R B; Kar, Biswakanth; Roy, Sudipendra Nath; Haldar, Pallab Kanti

    2013-06-01

    Curcuma caesia Roxb. (Zingiberaceae), commonly known as "Kala Haldi" in Bengali, has been traditionally used for the treatment of cancer, bruises, inflammation and as an aphrodisiac. To evaluate the antitumor activity and antioxidant status of the methanol extract of Curcuma caesia (MECC) rhizomes on Ehrlich's ascites carcinoma (EAC)-treated mice. In vitro cytotoxicity assay of MECC was evaluated by using Trypan blue method. Determination of in vivo antitumor activity was performed after 24 h of EAC cells (2 × 10(6) cells/mouse) inoculation; MECC (50 and 100 mg/kg i.p.) was administered daily for nine consecutive days. On day 10, half of the mice were sacrificed and the rest were kept alive for assessment of increase in lifespan. Antitumor effect of MECC was assessed by the study of tumor volume, tumor weight, viable and non-viable cell count, hematological parameters and biochemical estimations. Furthermore, antioxidant parameters were assayed by estimating liver and kidney tissue enzymes. MECC showed direct cytotoxicity (IC50 90.70 ± 8.37 μg/mL) on EAC cell line. MECC exhibited significant (p antioxidant assay significantly (p antioxidant properties. Further research is in progress to find out the active principle(s) of MECC for its antitumor activity.

  1. Protective Effect of Zingiber officinale Against Dalton's Lymphoma Ascites Tumour by Regulating Inflammatory Mediator and Cytokines.

    Science.gov (United States)

    Rubila, Sundararaj; Ranganathan, Thottiam Vasudevan; Sakthivel, Kunnathur Murugesan

    2016-12-01

    The aim of the present investigation was to evaluate Zingiber officinale paste against Dalton's lymphoma ascites (DLA)-induced tumours in Swiss albino mice. Experimental animals received Z. officinale paste (low dose 100 mg/kg bw and high dose 500 mg/kg bw) orally for eight alternative days. Treatment with Z. officinale paste showed significant increase in haemoglobin level and decrease in aspartate amino transferase (AST), alanine aminotransferase (ALT), alkaline phosphatase (ALP) and gamma glutamyl transferase (γ-GT) level. Z. officinale paste reduced the inflammatory mediators and cytokine levels, such as inducible nitric oxide (iNOS), tumour necrosis factor level (TNF-α) and interleukin-1β (IL-1β). Treatment with Z. officinale paste also significantly increased the antioxidant enzyme level, such as superoxide dismutase (SOD), catalase (CAT), reduced glutathione (GSH) and glutathione transferase (GST), and decreased the lipid peroxidation. Treatment also increased the vitamin C and E levels in treated animals compared with the DLA-bearing host. Histopathological studies also confirmed the protective influence of Z. officinale paste against DLA. The present study suggested that Z. officinale paste could be used as natural spice and a potent antitumour agent.

  2. External validation of a prognostic model for predicting survival of cirrhotic patients with refractory ascites.

    Science.gov (United States)

    Guardiola, Jordi; Baliellas, Carme; Xiol, Xavier; Fernandez Esparrach, Glòria; Ginès, Pere; Ventura, Pere; Vazquez, Santiago

    2002-09-01

    Cirrhotic patients with refractory ascites (RA) have a poor prognosis, although individual survival varies greatly. A model that could predict survival for patients with RA would be helpful in planning treatment. Moreover, in cases of potential liver transplantation, a model of these characteristics would provide the bases for establishing priorities of organ allocation and the selection of patients for a living donor graft. Recently, we developed a model to predict survival of patients with RA. The aim of this study was to establish its generalizability for predicting the survival of patients with RA. The model was validated by assessing its performance in an external cohort of patients with RA included in a multicenter, randomized, controlled trial that compared large-volume paracentesis and peritoneovenous shunt. The values for actual and model-predicted survival of three risk groups of patients, established according to the model, were compared graphically and by means of the one-sample log-rank test. The model provided a very good fit to the survival data of the three risk groups in the validation cohort. We also found good agreement between the survival predicted from the model and the observed survival when patients treated with peritoneovenous shunt and with paracentesis were considered separately. Our survival model can be used to predict the survival of patients with RA and may be a useful tool in clinical decision making, especially in deciding priority for liver transplantation.

  3. Inhibition of glutathione synthesis eliminates the adaptive response of ascitic hepatoma 22 cells to nedaplatin that targets thioredoxin reductase

    Energy Technology Data Exchange (ETDEWEB)

    Wang, Yijun [School of Tea and Food Science, Anhui Agricultural University, Hefei 230036, Anhui (China); Lu, Hongjuan [Productivity Center of Jiangsu Province, Nanjing 210042, Jiangsu (China); Wang, Dongxu; Li, Shengrong; Sun, Kang; Wan, Xiaochun [School of Tea and Food Science, Anhui Agricultural University, Hefei 230036, Anhui (China); Taylor, Ethan Will [Department of Nanoscience, Joint School of Nanoscience and Nanoengineering, University of North Carolina at Greensboro, Greensboro, NC 27402 (United States); Zhang, Jinsong, E-mail: zjs@ahau.edu.cn [School of Tea and Food Science, Anhui Agricultural University, Hefei 230036, Anhui (China)

    2012-12-15

    Thioredoxin reductase (TrxR) is a target for cancer therapy and the anticancer mechanism of cisplatin involves TrxR inhibition. We hypothesize that the anticancer drug nedaplatin (NDP), an analogue of cisplatin and a second-generation platinum complex, also targets TrxR. Furthermore, we investigate whether the therapeutic efficacy of NDP can be enhanced by simultaneous modulation of 1) TrxR, via NDP, and 2) glutathione (GSH), via the GSH synthesis inhibitor buthionine sulfoximine (BSO). Mice bearing ascitic hepatoma 22 (H22) cells were treated with NDP alone or NDP plus BSO. TrxR activity of H22 cells was inhibited by NDP in a dose-dependent manner. A high correlation between the inhibition of TrxR activity at 6 h and the inhibition of ascitic fluid volume at 72 h was established (r = 0.978, p < 0.01). As an adaptive response, the viable ascitic cancer cells after NDP treatment displayed an enlarged cell phenotype, assembled with several-fold more antioxidant enzymes and GSH-predominant non-protein free thiols. This adaptive response was largely eliminated when BSO was co-administered with NDP, leading to the decimation of the H22 cell population without enhancing renal toxicity, since at this dose, NDP did not inhibit renal TrxR activity. In conclusion, the pharmacological effect of NDP involves TrxR inhibition, and the adaptive response of NDP-treated ascitic H22 cells can be efficiently counteracted by BSO. Simultaneous modulation of TrxR and GSH on ascitic H22 cells using NDP plus BSO greatly enhances therapeutic efficacy as compared with the single modulation of TrxR using NDP alone. -- Highlights: ► Nedaplatin at a pharmacological dose inhibits TrxR in cancer cells but not in kidney. ► The nedaplatin-treated cancer cells exhibit adaptive response. ► Buthionine sulfoximine inhibits glutathione in both cancer cells and kidney. ► Buthionine sulfoximine counteracts the adaptive response to the nedaplatin treatment. ► Buthionine sulfoximine does not

  4. Validation of Tikhonov adaptively regularized gamma variate fitting with 24-h plasma clearance in cirrhotic patients with ascites

    Energy Technology Data Exchange (ETDEWEB)

    Wesolowski, Carl Adam [Memorial University of Newfoundland, Radiology, St. John' s, NL (Canada); General Hospital, Nuclear Medicine, St. John' s, Newfoundland (Canada); Ling, Lin [Memorial University of Newfoundland, Radiology, St. John' s, NL (Canada); Xirouchakis, Elias; Giamalis, Ioannis G.; Burroughs, Andrew K. [Royal Free Hospital, The Royal Free Sheila Sherlock Liver Centre, London (United Kingdom); Burniston, Maria T. [Royal Free Hampstead NHS Trust, Department of Medical Physics, London (United Kingdom); Puetter, Richard C. [University of California, San Diego, Center for Astrophysics and Space Sciences, La Jolla, CA (United States); Babyn, Paul S. [University of Saskatchewan, Radiology, Saskatoon, SK (Canada)

    2011-12-15

    The aim was to compare late-time extrapolation of plasma clearance (CL) from Tikhonov adaptively regularized gamma variate fitting (Tk-GV) and from mono-exponential (E1) fitting. Ten {sup 51}Cr-ethylenediaminetetraacetic acid bolus IV studies in adults - 8 with ascites - assessed for liver transplantation, with 12-16 plasma samples drawn from 5-min to 24-h, were fit with Tk-GV and E1 models and CL results were compared using Passing-Bablok fitting. The 24-h CL(Tk-GV) values ranged from 11.4 to 79.7 ml/min. Linear regression of 4- versus 24-h CL(Tk-GV) yielded no significant departure from a slope of 1, whereas the 4- versus 24-h CL(E1) slope, 1.56, was significantly increased. For CL(Tk-GV-24-h) versus CL(E1-24-h), there was a biased slope and intercept (0.85, 5.97 ml/min). Moreover, the quality of fitting of 24-h data was significantly better for Tk-GV than for E1, as follows. For 10 logarithm of concentration curves, higher r values were obtained for each Tk-GV fit (median 0.998) than for its corresponding E1 fit (median 0.965), with p < 0.0001 (paired t-test of z-statistics from Fisher r-z transformations). The E1 fit quality degraded with increasing V/W [volume of distribution (l) per kg body weight, p=0.003]. However, Tk-GV fit quality versus V/W was uncorrelated (p=0.8). CL(E1) values were dependent on sample time and the quality of fit was poor and degraded with increasing ascites, consistent with current opinion that CL(E1) is contraindicated in ascitic patients. CL(Tk-GV) was relatively more accurate and the good quality of fit was unaffected by ascites. CL(Tk-GV) was the preferred method for the accurate calculation of CL and was useful despite liver failure and ascites. (orig.)

  5. Percutaneous radiofrequency ablation for hepatic tumors abutting the diaphragm: clinical assessment of the heat-sink effect of artificial ascites.

    Science.gov (United States)

    Nam, Sang Yu; Rhim, Hyunchul; Kang, Tae Wook; Lee, Min Woo; Kim, Young-Sun; Choi, Dongil; Lee, Won Jae; Park, Yulri; Chang, Ilsoo; Lim, Hyo K

    2010-02-01

    This study was designed to assess whether artificial ascites has a heat-sink effect on the ablation zone for percutaneous radiofrequency ablation (RFA) of hepatic tumors abutting the diaphragm. We retrospectively assessed 28 patients who underwent percutaneous RFA for the treatment of a single nodular hepatic tumor that abutted the diaphragm from July 2000 to December 2006. All patients underwent ultrasound-guided RFA using internally cooled electrodes. A single ablation for 12 minutes was applied using 3-cm active-tip electrodes. We divided patients into two groups on the basis of whether artificial ascites was introduced before RFA: Group A consisted of patients who received artificial ascites with a mean of 760 mL of a 5% dextrose in water solution (n = 15) and group B consisted of patients who did not receive artificial ascites (n = 13). The volume of the ablation zone was measured on CT images obtained immediately after the ablation procedure, and imaging findings were compared for both groups using the Student's t test. We also compared the local tumor progression rate between both groups using the chi-square test (mean follow-up, 37.4 months). There was no significant difference between the two patient groups with regard to age, sex, Child-Pugh class, or tumor location (p > 0.05). The tumors were significantly smaller in group A patients (mean +/- SD, 1.6 +/- 0.5 cm) than in group B patients (2.1 +/- 0.7 cm) (p = 0.019). The mean volume of the RFA zone was 31.6 +/- 11.9 cm(3) in group A patients and 30.9 +/- 11.0 cm(3) in group B patients. There was no significant difference between the groups in the ablation volume (p = 0.871). Local tumor progression was noted in four patients (26.7%) in group A and in three patients (23.1%) in group B. There was no significant difference in the local tumor progression rate between the two groups (p = 0.83). Artificial ascites did not show a heat-sink effect on the volume of the ablation zone after percutaneous RFA for the

  6. Metastatic gastric signet-ring cell carcinoma: A rare cause of acute appendicitis

    OpenAIRE

    Erçetin, Candaş; Dural, Ahmet Cem; Özdenkaya, Yaşar; Dural, Özlem; Dada, Huriye Gözde Muhafız; Yeğen, Gülçin; Kapran, Yersu; Erbil, Yeşim

    2015-01-01

    We report a 32-year-old patient who underwent laparoscopy with classical symptoms and signs of acute appendicitis. An inflamed, edematous and non-perforated appendix, also a large amount gelatinous ascites, omental and peritoneal implants were seen. Appendectomy was performed and multiple biopsies were taken from omentum and peritoneum for definitive diagnosis. Histopathologic diagnosis was a metastatic gastric signet-ring cell carcinoma (GSRCC) involving appendix and other specimens. A flat ...

  7. Severe hypertriglyceridemia induced pancreatitis in pregnancy.

    Science.gov (United States)

    Gupta, Natasha; Ahmed, Seema; Shaffer, Lemuel; Cavens, Paula; Blankstein, Josef

    2014-01-01

    Acute pancreatitis caused by severe gestational hypertriglyceridemia is a rare complication of pregnancy. Acute pancreatitis has been well associated with gallstone disease, alcoholism, or drug abuse but rarely seen in association with severe hypertriglyceridemia. Hypertriglyceridemia may occur in pregnancy due to normal physiological changes leading to abnormalities in lipid metabolism. We report a case of severe gestational hypertriglyceridemia that caused acute pancreatitis at full term and was successfully treated with postpartum therapeutic plasma exchange. Patient also developed several other complications related to her substantial hypertriglyceridemia including preeclampsia, chylous ascites, retinal detachment, pleural effusion, and chronic pericarditis. This patient had no previous family or personal history of lipid abnormality and had four successful prior pregnancies without developing gestational hypertriglyceridemia. Such a severe hypertriglyceridemia is usually seen in patients with familial chylomicronemia syndromes where hypertriglyceridemia is exacerbated by the pregnancy, leading to fatal complications such as acute pancreatitis.

  8. Severe Hypertriglyceridemia Induced Pancreatitis in Pregnancy

    Directory of Open Access Journals (Sweden)

    Natasha Gupta

    2014-01-01

    Full Text Available Acute pancreatitis caused by severe gestational hypertriglyceridemia is a rare complication of pregnancy. Acute pancreatitis has been well associated with gallstone disease, alcoholism, or drug abuse but rarely seen in association with severe hypertriglyceridemia. Hypertriglyceridemia may occur in pregnancy due to normal physiological changes leading to abnormalities in lipid metabolism. We report a case of severe gestational hypertriglyceridemia that caused acute pancreatitis at full term and was successfully treated with postpartum therapeutic plasma exchange. Patient also developed several other complications related to her substantial hypertriglyceridemia including preeclampsia, chylous ascites, retinal detachment, pleural effusion, and chronic pericarditis. This patient had no previous family or personal history of lipid abnormality and had four successful prior pregnancies without developing gestational hypertriglyceridemia. Such a severe hypertriglyceridemia is usually seen in patients with familial chylomicronemia syndromes where hypertriglyceridemia is exacerbated by the pregnancy, leading to fatal complications such as acute pancreatitis.

  9. Chyloperitoneum after laparoscopic Roux-en-Y gastric bypass (LRYGB).

    Science.gov (United States)

    Hidalgo, Jesús E; Ramirez, Alexander; Patel, Sheetal; Acholonu, Emeka; Eckstein, Jeremy; Abu-Jaish, Wasef; Szomstein, Samuel; Rosenthal, Raul J

    2010-02-01

    A true chylous effusion is defined as the presence of ascitic fluid with high fat (triglyceride) content, usually higher than 110 mg/dl. We report a case of chyloperitoneum following laparoscopic Roux-en-Y gastric bypass (LRYGB) in a 40-year-old patient who was admitted for surgery on May 31, 2007. On August 2008 an abdominal CT with contrast was ordered for chronic abdominal pain showing diffuse ascites as well as mesenteric adenitis. On September 2008, the patient was admitted to the hospital. An elective diagnostic laparoscopy was scheduled. A large amount of chylous fluid was found. Microscopic analysis came back negative. The patient made an uneventful recovery after surgery. To our knowledge, this is the first reported case of chylous ascites following LRYGB. Chyloperitoneum should be considered as a possible cause of ascites in patients with chronic small bowel obstruction following a LRYGB.

  10. A Randomized Clinical Trial of Preoperative Administration of Branched-Chain Amino Acids to Prevent Postoperative Ascites in Patients with Liver Resection for Hepatocellular Carcinoma.

    Science.gov (United States)

    Kikuchi, Yutaro; Hiroshima, Yukihiko; Matsuo, Kenichi; Kawaguchi, Daisuke; Murakami, Takashi; Yabushita, Yasuhiro; Endo, Itaru; Taguri, Masataka; Koda, Keiji; Tanaka, Kuniya

    2016-10-01

    Massive postoperative ascites remains a major threat that can lead to liver failure and other fatal complications, especially in patients with poor liver function. Branched-chain amino acid (BCAA) administration increases biosynthesis and secretion of albumin by hepatocytes and increases oncotic pressure by elevating blood albumin concentration, thereby decreasing peripheral edema, ascites, and pleural effusion. We randomly allocated consecutive patients undergoing major liver resection for hepatocellular carcinoma to either a group where oral BCAA administration was initiated 3 weeks before liver resection, or a non-BCAA group. The primary study endpoint was development of postoperative ascites. Overall, 39 patients were allocated to the BCAA group, while 38 were assigned to the non-BCAA group. No significant difference in the rate of refractory ascites, considered alone, was evident between the BCAA (5.1 %) and non-BCAA groups (13.2 %; p = 0.263). However, the occurrence of refractory ascites and/or pleural effusion was significantly less frequent in the BCAA group (5.1 %) than in the non-BCAA group (21.1 %; p = 0.047). Furthermore, the postoperative serum concentration of reduced-state albumin was greater immediately after liver resection in the BCAA group than in the non-BCAA group. Preoperative administration of BCAA did not significantly improve prevention of refractory ascites, but significant effectiveness in preventing ascites, pleural effusion, or both, as well as improving metabolism of albumin, was demonstrated [University Hospital Medical Information Network (UMIN) reference number 000004244].

  11. Medical ozone and radiotherapy in a peritoneal, Erlich-ascites, tumor-cell model.

    Science.gov (United States)

    Kızıltan, Huriye Şenay; Bayir, Ayşe Güneş; Yucesan, Gul; Eris, Ali Hikmet; İdin, Kadir; Karatoprak, Cumali; Aydin, Teoman; Akcakaya, Adem; Mayadagli, Alpaslan

    2015-01-01

    Medical ozone therapy is used for treatment of inflammation in alternative and complementary medicine. It has been reported that the beneficial effects of radiotherapy increased with the addition of medical ozone therapy. This study intended to investigate the antitumor and antiedema effects of ozone therapy when applied in different concentrations in mice with peritoneal carcinomatosis (PC) and to evaluate the contribution of medical ozone therapy to the outcomes for radiotherapy in vivo. Ehrlich ascites carcinoma (EAC) cells were inoculated intraperitoneally (IP) to develop peritoneal carcinomatosis in 60 adult male Swiss albino mice. The animals were divided into 5 groups. Groups 1 and 2 were treated IP for a period of 10 d with daily medical ozone therapy. Group 3 received radiotherapy into the abdomen for 5 d. Groups 4 and 5 were treated with medical ozone therapy for 10 d and radiotherapy for 5 d. Groups 1 and 4 received a 20 mg/L concentration of ozone and groups 2 and 5 received a 40 mg/L concentration. A sixth group acted as controls, and serum physiologic was given to them IP. Changes in body weight and abdominal circumference were measured daily for each mouse. Survival rates of the groups of mice were also determined. The results were compared between groups and were statistically analyzed. Changes in body weights and abdominal circumferences in the different groups were statistically different. The longest survival rates were found for groups 3 and 5, and survival rates for the 5 experimental groups were significantly higher than for the control group. Medical ozone therapy or radiotherapy was found to be effective when administered alone or concurrently to mice with PC, suggesting that medical ozone therapy might serve as a method of obtaining antiedema and antitumor effects, providing a longer survival time.

  12. Binding studies of the antitumoral radiopharmaceutical 125I-Crotoxin to Ehrlich ascites tumor cells

    Energy Technology Data Exchange (ETDEWEB)

    Silveira, Marina B.; Santos, Raquel G. dos [Centro de Desenvolvimento da Tecnologia Nuclear (CDTN/CNEN-MG), Belo Horizonte, MG (Brazil); Dias, Consuelo L. Fortes [Fundacao Ezequiel Dias (FUNED), Belo Horizonte, MG (Brazil)], e-mail: consuelo@pq.cnpq.br; Cassali, Geovanni D. [Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG (Brazil). Lab. de Patologia Comparada], e-mail: cassalig@icb.ufmg.br

    2009-07-01

    The development of tools for functional diagnostic imaging is mainly based on radiopharmaceuticals that specifically target membrane receptors. Crotoxin (Crtx), a polypeptide isolated from Crotalus durissus terrificus venom, has been shown to have an antitumoral activity and is a promising bioactive tracer for tumor detection. More specific radiopharmaceuticals are being studied to complement the techniques applied in the conventional medicine against breast cancer, the most frequent cause of death from malignant disease in women. Crtx's effect has been shown to be related with the overexpression of epidermal growth factor receptor (EGFR), present in high levels in 30 to 60% of breast tumor cells. Our objective was to evaluate Crtx as a tracer for cancer diagnosis, investigating its properties as an EGFR-targeting agent. Ehrlich ascites tumor cells (EAT cells) were used due to its origin and similar characteristics to breast tumor cells, specially the presence of EGFR. Crtx was labeled with 125I and binding experiments were performed. To evaluate the specific binding in vitro of Crtx, competition binding assay was carried out in the presence of increasing concentrations of non-labelled crotoxin and epidermal growth factor (EGF). Specific binding of 125I-Crtx to EAT cells was determined and the binding was considered saturable, with approximately 70% of specificity, high affinity (Kd = 19.7 nM) and IC50 = 1.6 x 10-11 M. Our results indicate that Crtx's interaction with EAT cells is partially related with EGFR and increases the biotechnological potential of Crtx as a template for radiopharmaceutical design for cancer diagnosis. (author)

  13. Transcriptome Analysis and Gene Identification in the Pulmonary Artery of Broilers with Ascites Syndrome.

    Directory of Open Access Journals (Sweden)

    Fei Yang

    Full Text Available Pulmonary arterial hypertension, also known as Ascites syndrome (AS, remains a clinically challenging disease with a large impact on both humans and broiler chickens. Pulmonary arterial remodeling presents a key step in the development of AS. The precise molecular mechanism of pulmonary artery remodeling regulating AS progression remains unclear.We obtained pulmonary arteries from two positive AS and two normal broilers for RNA sequencing (RNA-seq analysis and pathological observation. RNA-seq analysis revealed a total of 895 significantly differentially expressed genes (DEGs with 437 up-regulated and 458 down-regulated genes, which were significantly enriched to 12 GO (Gene Ontology terms and 4 KEGG (Kyoto Encyclopedia of Genes and Genomes pathways (Padj<0.05 regulating pulmonary artery remodeling and consequently occurrence of AS. These GO terms and pathways include ribosome, Jak-STAT and NOD-like receptor signaling pathways which regulate pulmonary artery remodeling through vascular smooth cell proliferation, inflammation and vascular smooth cell proliferation together. Some notable DEGs within these pathways included downregulation of genes like RPL 5, 7, 8, 9, 14; upregulation of genes such as IL-6, K60, STAT3, STAT5 Pim1 and SOCS3; IKKα, IkB, P38, five cytokines IL-6, IL8, IL-1β, IL-18, and MIP-1β. Six important regulators of pulmonary artery vascular remodeling and construction like CYP1B1, ALDH7A1, MYLK, CAMK4, BMP7 and INOS were upregulated in the pulmonary artery of AS broilers. The pathology results showed that the pulmonary artery had remodeled and become thicker in the disease group.Our present data suggested some specific components of the complex molecular circuitry regulating pulmonary arterial remodeling underlying AS progression in broilers. We revealed some valuable candidate genes and pathways that involved in pulmonary artery remodeling further contributing to the AS progression.

  14. Probiotics improve survival of septic rats by suppressing conditioned pathogens in ascites.

    Science.gov (United States)

    Liu, Da-Quan; Gao, Qiao-Ying; Liu, Hong-Bin; Li, Dong-Hua; Wu, Shang-Wei

    2013-07-07

    To investigate the benefits of probiotics treatment in septic rats. The septic rats were induced by cecal ligation and puncture. The animals of control, septic model and probiotics treated groups were treated with vehicle and mixed probiotics, respectively. The mixture of probiotics included Bifidobacterium longum, Lactobacillus bulgaricus and Streptococcus thermophilus. We observed the survival of septic rats using different amounts of mixed probiotics. We also detected the bacterial population in ascites and blood of experimental sepsis using cultivation and real-time polymerase chain reaction. The severity of mucosal inflammation in colonic tissues was determined. Probiotics treatment improved survival of the rats significantly and this effect was dose dependent. The survival rate was 30% for vehicle-treated septic model group. However, 1 and 1/4 doses of probiotics treatment increased survival rate significantly compared with septic model group (80% and 55% vs 30%, P probiotics treated group compared with septic model group (5.20 ± 0.57 vs 9.81 ± 0.67, P probiotics treated group compared with septic model group (33.3% vs 100.0%, P probiotics treated group were decreased significantly compared with that of septic model group (3.93 ± 0.73 vs 8.80 ± 0.83, P probiotics treatment, there was a decrease in the scores of inflammatory cell infiltration into the intestinal mucosa in septic animals (1.50 ± 0.25 vs 2.88 ± 0.14, P Probiotics improve survival of septic rats by suppressing these conditioned pathogens.

  15. Probiotics improve survival of septic rats by suppressing conditioned pathogens in ascites

    Science.gov (United States)

    Liu, Da-Quan; Gao, Qiao-Ying; Liu, Hong-Bin; Li, Dong-Hua; Wu, Shang-Wei

    2013-01-01

    AIM: To investigate the benefits of probiotics treatment in septic rats. METHODS: The septic rats were induced by cecal ligation and puncture. The animals of control, septic model and probiotics treated groups were treated with vehicle and mixed probiotics, respectively. The mixture of probiotics included Bifidobacterium longum, Lactobacillus bulgaricus and Streptococcus thermophilus. We observed the survival of septic rats using different amounts of mixed probiotics. We also detected the bacterial population in ascites and blood of experimental sepsis using cultivation and real-time polymerase chain reaction. The severity of mucosal inflammation in colonic tissues was determined. RESULTS: Probiotics treatment improved survival of the rats significantly and this effect was dose dependent. The survival rate was 30% for vehicle-treated septic model group. However, 1 and 1/4 doses of probiotics treatment increased survival rate significantly compared with septic model group (80% and 55% vs 30%, P probiotics treated group compared with septic model group (5.20 ± 0.57 vs 9.81 ± 0.67, P probiotics treated group compared with septic model group (33.3% vs 100.0%, P probiotics treated group were decreased significantly compared with that of septic model group (3.93 ± 0.73 vs 8.80 ± 0.83, P probiotics treatment, there was a decrease in the scores of inflammatory cell infiltration into the intestinal mucosa in septic animals (1.50 ± 0.25 vs 2.88 ± 0.14, P Probiotics improve survival of septic rats by suppressing these conditioned pathogens. PMID:23840152

  16. [Two cases of advanced gastric cancer with peritonitis carcinomatosa that showed disappearance of ascites and obtained a good quality of life by using DIF and paclitaxel].

    Science.gov (United States)

    Okumura, Kenji; Tani, Souichiro; Shiogai, Youji; Kodama, Masashi; Mekata, Eiji; Tan, Tohru

    2012-04-01

    We report two cases of advanced gastric cancer. The first was a 77-year-old man who had experienced distal gastrectomy about 35 years ago. He complained of abdominal bloating, and a gastrointestinal scope showed that he had advanced gastric cancer. CT scan revealed massive ascites. Dissemination of the peritoneum was suspected, and chemotherapy using S-1 (80mg/m², biweekly)plus paclitaxel (50mg/m², on days 1 and 8) was selected, He had no major side effects and the ascites disappeared. He was able to receive 18 courses on an outpatient basis. The second case was a 79-year-old man who had total gastrectomy performed 1 year ago. Invasion to the diaphragm and lymph node metastasis were detected. We selected S-1 (80 mg/m²)as adjuvant chemotherapy but that caused severe fatigue. Eventually he refused the drug. Six month later, he had abdominal bloating and CT scan revealed that he had massive ascites. UFT-E (1. 5 g/body) was administered and paclitaxe (l 50 mg/m²) was added. The ascites disappeared and he has had a stable life. DIF (S-1, UFT) plus paclitaxel is considered to be a useful chemotherapy combination against advanced gastric cancer that has peritoneal dissemination or ascites, even for older patients.

  17. Human epididymis protein 4 immunostaining of malignant ascites differentiates cancer of Müllerian origin from gastrointestinal cancer.

    Science.gov (United States)

    Stiekema, Anna; Van de Vijver, Koen K; Boot, Henk; Broeks, Annegien; Korse, Catharina M; van Driel, Willemien J; Kenter, Gemma G; Lok, Christianne A R

    2017-03-01

    An accurate diagnosis of cancer of Müllerian origin is required before the initiation of treatment. An overlap in clinical presentation and cytological, histological, or imaging studies with other nongynecological tumors does occur. Therefore, immunocytochemistry markers are used to determine tumor origin. Human epididymis protein 4 (HE4) is overexpressed in tissue of epithelial ovarian cancer (EOC). It has shown to be a sensitive and specific serum marker for EOC and to be of value for the differentiation between EOC and ovarian metastases of gastrointestinal origin. The objective of the current study was to evaluate HE4 immunocytochemistry in malignant ascites for differentiation between cancer of Müllerian origin, including EOC, and adenocarcinomas of the gastrointestinal tract. Cytological specimens of 115 different adenocarcinomas (45 EOCs, 46 cases of gastric cancer, and 24 cases of colorectal cancer) were stained for HE4, paired box 8 (PAX8), and other specific markers. 91% of the ascites samples from patients with EOC stained for both HE4 and PAX8. The 4 samples without HE4 staining were a clear cell carcinoma, a low-grade serous adenocarcinoma, an undifferentiated adenocarcinoma, and a neuroendocrine carcinoma. All high-grade serous adenocarcinomas (n = 37, 100%) stained with HE4, compared with 94% that stained positively for PAX8. In cases of gastric or colorectal cancer, 25% and 21% of cases, respectively, stained positive for HE4. No PAX8 staining was observed in colorectal or gastric adenocarcinomas. HE4 staining in ascites is feasible and appears to have a high sensitivity for high-grade serous ovarian cancer. HE4 is a useful addition to the current panel of immunocytochemistry markers for the diagnosis of EOC and for differentiation with gastrointestinal adenocarcinomas. Cancer Cytopathol 2017;125:197-204. © 2016 American Cancer Society. © 2017 American Cancer Society.

  18. Dorsal acoustic windows may ameliorate liver ultrasound in patients with chronic liver disease and meteorism/obesity/ascites.

    Science.gov (United States)

    Domenicali, Marco; Tufoni, Manuel; Bevilacqua, Vittoria; Benazzi, Barbara; Ricci, Carmen Serena; Tovoli, Alessandra; Napoli, Lucia; Caraceni, Paolo; Bernardi, Mauro

    2013-10-01

    To identify dorsal acoustic windows (DAWs) for the study of the liver and to investigate whether they could improve the visualization of the liver in patients with chronic liver disease and ascites, meteorism, and/or obesity. The study was based on a single ultrasound examination and divided into three successive stages. Firstly, we performed a preliminary study involving 10 cirrhotic patients to identify new DAWs. Inter-observer reproducibility of measurements obtained through the DAWs was then assessed in another 29 cirrhotic patients. Finally, in 50 patients with chronic hepatitis/cirrhosis, we employed the DAWs when ascites, meteorism or obesity hampered the conventional ultrasound examination. With patients sitting, we found three new DAWs, by the combined use of which it was possible to explore the liver, spleen, and their vascular structures, and which provided reproducible measurements. In the clinical setting, we found 11 of 50 patients in whom the addition of the new DAWs led to better results in terms of successful visualization/Doppler measurements for portal vein (ratio = 100 % vs 27 %, p = 0.001), hepatic artery (ratio = 90 % vs 27 %, p = 0.004), and hepatic veins (mean number = 2.4 ± 0.2 vs 1.0 ± 0.2, p = 0.01). Among these 11 patients, in one case the addition of DAWs led to visualization of hepatic focal lesions in the right lobe, not previously displayed through conventional ultrasound. These DAWs may be an additional tool that improves the accuracy of ultrasound examinations in patients with meteorism, ascites, or obesity.

  19. Characterisation of non-P-glycoprotein multidrug-resistant Ehrlich ascites tumour cells selected for resistance to mitoxantrone

    DEFF Research Database (Denmark)

    Nielsen, D; Eriksen, J; Maare, C

    2000-01-01

    An Ehrlich ascites tumour cell line (EHR2) was selected in vivo for resistance to mitoxantrone (MITOX). The resistant cell line (EHR2/MITOX) was 6123-, 33-, and 30-fold-resistant to mitoxantrone, daunorubicin, and etoposide, respectively, but retained sensitivity to vincristine. The resistant cel...... to be associated with: 1) a quantitative reduction in topoisomerase IIalpha and beta protein; 2) reduced drug accumulation, probably as a result of increased expression of a novel transport protein with ATPase activity; and 3) increased expression of MRP mRNA....

  20. Removal of ascites up to 7.5 liters on one occasion and 45 liters in total may be safe in patients with severe ovarian hyperstimulation syndrome.

    Science.gov (United States)

    Ozgun, Mahmut T; Batukan, Cem; Oner, Gokalp; Uludag, Semih; Aygen, Ercan M; Sahin, Yilmaz

    2008-11-01

    Ovarian hyperstimulation syndrome (OHSS) is a serious and potentially lethal complication of ovulation induction. We report herein a case with OHSS treated by serial vaginal paracentesis. A 31-year-old patient was hospitalized due to severe OHSS after in vitro fertilization (IVF)-embryo transfer. Transvaginal drainage was performed with a standard 17-gauge IVF needle connected to a vacuum pump through a drainage set in nine courses. We removed 45 liters of ascitic fluid in total and 7.5 liters of ascitic fluid in one course, leading to improvement of the patient's condition and laboratory parameters. In conclusion, removal of ascites up to 7.5 liters on one occasion and 45 liters in total by serial vaginal paracentesis may be performed in patients with severe OHSS.

  1. Characterisation of ribosomal proteins from HeLa and Krebs II mouse ascites tumor cells by different two-dimensional polyacrylamide gel electrophoresis techniques

    DEFF Research Database (Denmark)

    Issinger, O G; Beier, H

    1978-01-01

    Electrophoresis of ribosomal proteins according to Kaltschmidt and Wittmann, 1970a, b (pH 8.6/pH 4.5 urea system) yielded 29 proteins for the small subunits and 35 and 37 proteins for the large subunits of Krebs II ascites and HeLa ribosomes, respectively. Analysis of the proteins according...... to a modified technique by Mets and Bogorad (1974) (pH 4.5/pH 8.6 SDS system) revealed 28 and 29 proteins in the small subunits and 37 and 38 proteins in the large subunits of Krebs II ascites and HeLa ribosomes. The molecular weights of the individual proteins were determined by: 1. "three-dimensional" gel...... using the pH 4.5/pH 8.6 SDS system. The molecular weights Krebs II ascites and HeLa ribosomal proteins are compared with those obtained by other authors for different mammalian species....

  2. The trifunctional antibody catumaxomab for the treatment of malignant ascites due to epithelial cancer: Results of a prospective randomized phase II/III trial

    Science.gov (United States)

    Heiss, Markus M; Murawa, Pawel; Koralewski, Piotr; Kutarska, Elzbieta; Kolesnik, Olena O; Ivanchenko, Vladimir V; Dudnichenko, Alexander S; Aleknaviciene, Birute; Razbadauskas, Arturas; Gore, Martin; Ganea-Motan, Elena; Ciuleanu, Tudor; Wimberger, Pauline; Schmittel, Alexander; Schmalfeldt, Barbara; Burges, Alexander; Bokemeyer, Carsten; Lindhofer, Horst; Lahr, Angelika; Parsons, Simon L

    2010-01-01

    Malignant ascites is a common manifestation of advanced cancers, and treatment options are limited. The trifunctional antibody catumaxomab (anti-epithelial cell-adhesion molecule x anti-CD3) represents a targeted immunotherapy for the intraperitoneal (i.p.) treatment of malignant ascites secondary to epithelial cancers. In this phase II/III trial (EudraCT 2004-000723-15; NCT00836654), cancer patients (n = 258) with recurrent symptomatic malignant ascites resistant to conventional chemotherapy were randomized to paracentesis plus catumaxomab (catumaxomab) or paracentesis alone (control) and stratified by cancer type (129 ovarian and 129 nonovarian). Catumaxomab was administered as an i.p. infusion on Days 0, 3, 7 and 10 at doses of 10, 20, 50 and 150 μg, respectively. The primary efficacy endpoint was puncture-free survival. Secondary efficacy parameters included time to next paracentesis, ascites signs and symptoms and overall survival (OS). Puncture-free survival was significantly longer in the catumaxomab group (median 46 days) than the control group (median 11 days) (hazard ratio = 0.254: p < 0.0001) as was median time to next paracentesis (77 versus 13 days; p < 0.0001). In addition, catumaxomab patients had fewer signs and symptoms of ascites than control patients. OS showed a positive trend for the catumaxomab group and, in a prospectively planned analysis, was significantly prolonged in patients with gastric cancer (n = 66; 71 versus 44 days; p = 0.0313). Although adverse events associated with catumaxomab were frequent, they were manageable, generally reversible and mainly related to its immunologic mode of action. Catumaxomab showed a clear clinical benefit in patients with malignant ascites secondary to epithelial cancers, especially gastric cancer, with an acceptable safety profile. PMID:20473913

  3. Therapeutic effects of Euphorbia Pekinensis and Glycyrrhiza glabra on Hepatocellular Carcinoma Ascites Partially Via Regulating the Frk-Arhgdib-Inpp5d-Avpr2-Aqp4 Signal Axis

    Science.gov (United States)

    Zhang, Yanqiong; Yan, Chen; Li, Yuting; Mao, Xia; Tao, Weiwei; Tang, Yuping; Lin, Ya; Guo, Qiuyan; Duan, Jingao; Lin, Na

    2017-02-01

    To clarify unknown rationalities of herbaceous compatibility of Euphorbia Pekinensis (DJ) and Glycyrrhiza glabra (GC) acting on hepatocellular carcinoma (HCC) ascites, peritoneum transcriptomics profiling of 15 subjects, including normal control (Con), HCC ascites mouse model (Mod), DJ-alone, DJ/GC-synergy and DJ/GC-antagonism treatment groups were performed on OneArray platform, followed by differentially expressed genes (DEGs) screening. DEGs between Mod and Con groups were considered as HCC ascites-related genes, and those among different drug treatment and Mod groups were identified as DJ/GC-combination-related genes. Then, an interaction network of HCC ascites-related gene-DJ/GC combination-related gene-known therapeutic target gene for ascites was constructed. Based on nodes’ degree, closeness, betweenness and k-coreness, the Frk-Arhgdib-Inpp5d-Avpr2-Aqp4 axis with highly network topological importance was demonstrated to be a candidate target of DJ/GC combination acting on HCC ascites. Importantly, both qPCR and western blot analyses verified this regulatory effects based on HCC ascites mice in vivo and M-1 collecting duct cells in vitro. Collectively, different combination designs of DJ and GC may lead to synergistic or antagonistic effects on HCC ascites partially via regulating the Frk-Arhgdib-Inpp5d-Avpr2-Aqp4 axis, implying that global gene expression profiling combined with network analysis can offer an effective way to understand pharmacological mechanisms of traditional Chinese medicine prescriptions.

  4. Partial Trisomy 16p (16p12.2→pter and Partial Monosomy 22q (22q13.31 →qter Presenting With Fetal Ascites and Ventriculomegaly: Prenatal Diagnosis and Array Comparative Genomic Hybridization Characterization

    Directory of Open Access Journals (Sweden)

    Chih-Ping Chen

    2010-12-01

    Conclusion: Partial trisomy 16p can be associated with fetal ascites and ventriculomegaly in the second trimester. Prenatal sonographic detection of fetal ascites in association with ventriculomegaly should alert chromosomal abnormalities and prompt cytogenetic investigation, which may lead to the identification of an unexpected parental translocation involving chromosomal segments associated with cerebral and vascular abnormalities.

  5. ANTIGENIC RELATEDNESS OF SELECTED FLAVIVIRUSES: STUDY WITH HOMOLOGOUS AND HETEROLOGOUS IMMUNE MOUSE ASCITIC FLUIDS

    Directory of Open Access Journals (Sweden)

    S.S. BABA

    1998-11-01

    Full Text Available The antigenic relationship of 9 flaviviruses, Yellow fever (YF , Wesselsbron (WSL , Uganda S (UGS , Potiskum (POT, West Nile (WN , Banzi (BAN , Zika (ZK , Dengue type 1 (DEN-1 and Dengue type 2 (DEN-2, was assessed by cross-haemagglutination-inhibition (Cross-HI and cross-complement fixation (Cross-CF reactions between each of the viruses and their homologous immune mouse ascitic fluids. Titre ratios were calculated using the heterologous and homologous titres. Cross-CF reactions revealed wider antigenic variations among viruses than Cross-HI reactions. There was no significant antigenic variation between WSL, POT and YF viruses using either of those methods. However, definite differences in antigenicity were observed between them and UGS, BAN and ZK viruses. There were no significant differences between UGS, BAN and ZK or between DEN-1 and DEN-2. The serological relationship among flaviviruses is important in establishing diagnosis and epidemiology of these infections in Africa.A relação antigênica de 9 Flavivirus, Febre amarela (YF, Wesselsbron (WSL, Uganda S (UGS, Potiskum (POT, West Nile (WN, Banzi (BAN, Zika (ZK, Dengue tipo 1 (DEN-1 e Dengue tipo2 (DEN-2, foi avaliada por reação de inibição da hemaglutinação cruzada (cross-HI e reação de fixação do complemento cruzada (Cross-CF entre cada um dos virus e seu fluido ascítico homólogo em camundongos. Médias de títulos foram calculadas usando os títulos heterólogos e homólogos. Reações cruzadas CF revelaram maiores variações antigênicas entre virus do que reações cruzadas HI. Não houve variação antigênica significativa entre virus WSL, POT e YF usando cada um dos métodos. Todavia, diferenças definidas da antigenicidade foram observadas entre eles e os vírus UGS, BAN e ZK. Não existiram diferenças significativas entre UGS, BAN e ZK ou entre DEN-1 e DEN-2. A relação sorológica entre Flavivirus é importante para se estabelecer o diagnóstico e a

  6. Does artificial ascites induce the heat-sink phenomenon during percutaneous radiofrequency ablation of the hepatic subcapsular area?: an in vivo experimental study using a rabbit model.

    Science.gov (United States)

    Kim, Young Sun; Rhim, Hyunchul; Choi, Dongil; Lim, Hyo K

    2009-01-01

    To evaluate the effect of the heat-sink phenomenon induced by artificial ascites on the size of the ablation zone during percutaneous radiofrequency (RF) ablation of the hepatic subcapsular area in an in vivo rabbit model. A total of 21 percutaneous rabbit liver RF ablations were performed with and without artificial ascites (5% dextrose aqueous solution). The rabbits were divided into three groups: a) control group (C, n = 7); b) room temperature ascites group (R, n = 7); and c) warmed ascites group (W, n = 7). The tip of a 1 cm, internally cooled electrode was placed on the subcapsular region of the hepatic dome via ultrasound guidance, and ablation was continued for 6 min. Changes in temperature of the ascites were monitored during the ablation. The size of the ablation zones of the excised livers and immediate complications rates were compared statistically between the groups (Mann-Whitney U test, Kruskal-Wallis test, linear-by-linear association, p = 0.05). One rabbit from the "W" group expired during the procedure. In all groups, the ascites temperatures approached their respective body temperatures as the ablations continued; however, a significant difference in ascites temperature was found between groups "W" and "R" throughout the procedures (39.2+/-0.4 degrees C in group W and 33.4+/-4.3 degrees C in group R at 6 min, p = 0.003). No significant difference was found between the size of the ablation zones (782.4+/-237.3 mL in group C, 1,172.0+/-468.9 mL in group R, and 1,030.6+/-665.1 mL in group W, p = 0.170) for the excised liver specimens. Diaphragmatic injury was identified in three of seven cases (42.9%) upon visual inspection of group "C" rabbits (p = 0.030). Artificial ascites are not likely to cause a significant heat-sink phenomenon in the percutaneous RF ablation of the hepatic subcapsular region.

  7. Anticancer Potential of Aqueous Ethanol Seed Extract of Ziziphus mauritiana against Cancer Cell Lines and Ehrlich Ascites Carcinoma

    Directory of Open Access Journals (Sweden)

    Tulika Mishra

    2011-01-01

    Full Text Available Ziziphus mauritiana (Lamk. is a fruit tree that has folkloric implications against many ailments and diseases. In the present study, anticancer potential of seed extract of Ziziphus mauritiana in vitro against different cell lines (HL-60, Molt-4, HeLa, and normal cell line HGF by MTT assay as well as in vivo against Ehrich ascites carcinoma bearing Swiss albino mice was investigated. The extract was found to markedly inhibit the proliferation of HL-60 cells. Annexin and PI binding of treated HL-60 cells indicated apoptosis induction by extract in a dose-dependent manner. The cell cycle analysis revealed a prominent increase in sub Go population at concentration of 20 μg/ml and above. Agarose gel electrophoresis confirmed DNA fragmentation in HL-60 cells after 3 h incubation with extract. The extract also exhibited potent anticancer potential in vivo. Treatment of Ehrlich ascites carcinoma bearing Swiss albino mice with varied doses (100–800 mg/kg b.wt. of plant extract significantly reduced tumor volume and viable tumor cell count and improved haemoglobin content, RBC count, mean survival time, tumor inhibition, and percentage life span. The enhanced antioxidant status in extract-treated animals was evident from decline in levels of lipid peroxidation and increased levels of glutathione, catalase, and superoxide dismutase.

  8. Flow-systems analysis and characterization of protein contents and proliferating kinetics in ascites and solid tumors

    Energy Technology Data Exchange (ETDEWEB)

    Crissman, H.A.; Kissane, R.J.; Wanek, P.L.; Oka, M.S.; Steinkamp, J.A.

    1976-01-01

    Flow microfluorometric analysis of the DNA and protein content of mouse ascites and solid tumor cell populations grown in vivo has provided information on protein distribution of cells in various phases of the cell cycle, as well as age-associated changes in proliferation kinetics of these tumor systems. L1210 ascites cells and solid Lewis lung carcinomas were dispersed, fixed, and stained for both DNA and protein, respectively, using the fluorochromes propidium iodide (red) and fluorescein isothiocyanate (green). Simultaneous DNA and protein determinations were performed using a flow system in which rapid two-color analysis of stained cells was achieved at approximately 10/sup 3/ cells/second. Analysis of the DNA distributions of L1210 cells on days three, four, six, and seven following implantation of 10/sup 5/ cells revealed changes in cycle kinetic patterns concomitant with increased cell density or tumor age. DNA distribution patterns for Lewis lung tumors showed a 2C peak and a cell proliferation pattern extending between the 4C and 8C peaks. Cells sorted electronically from the 2C and 4C-8C contents of the DNA spectrum were identified morphologically as normal and tumor cells, respectively. Tumor cells exhibited elevated protein distributions compared to normal cells; however, tumor cells were quite heterogeneous in cell size and morphology.

  9. Evaluation of reagent strips for ascitic fluid leukocyte determination: is it a possible alternative for spontaneous bacterial peritonitis rapid diagnosis?

    Directory of Open Access Journals (Sweden)

    Tarsila C.R. Ribeiro

    Full Text Available In order to evaluate the accuracy of a urine reagent dipstick (Multistix 10SG® to determine ascitic fluid leukocyte count, we prospectively studied 106 cirrhotic patients from April 2003 to December 2004, in two different centers (Federal University of São Paulo - UNIFESP-EPM and Federal University of Juiz de Fora - HU-UFJF for the rapid bedside diagnosis of spontaneous bacterial peritonitis. The mean age 54 ± 12 years, there was a predominance of males (eighty-two patients, 77%, and alcohol was the most frequent etiology (43%. Forty-four percent of patients were classified as Child B and fifty-one as Child C (51%. Abdominal paracentesis was performed both in outpatient and inpatient settings and the Multistix 10SG® was tested. Eleven cases of spontaneous bacterial peritonitis were identified by means of polymorphonuclear count. If we considered the positive Multistix 10SG® result of 3 or more, the sensitivity, specificity, positive and negative predictive value were respectively 71%, 99%, 91% and 98%. With a positive reagent strip result taken as grade 2 (traces or more, sensitivity was 86% and specificity was 96% with positive and negative predictive values of 60% and 99%, respectively. Diagnostic accuracy was 95%. We concluded that the use of a urine reagent dipstick (Multistix 10SG® could be considered a quick, easy and cheap method for ascitic fluid cellularity determination in SBP diagnosis.

  10. Therapeutic effects of short- and intermediate-term tolvaptan administration for refractory ascites in patients with advanced liver cirrhosis.

    Science.gov (United States)

    Akiyama, Shintaro; Ikeda, Kenji; Sezaki, Hitomi; Fukushima, Taito; Sorin, Yushi; Kawamura, Yusuke; Saitoh, Satoshi; Hosaka, Tetsuya; Akuta, Norio; Kobayashi, Masahiro; Suzuki, Fumitaka; Suzuki, Yoshiyuki; Arase, Yasuji; Kumada, Hiromitsu

    2015-11-01

    Tolvaptan, an oral arginine vasopressin V2 receptor antagonist, became available for hepatic ascites. We evaluated the therapeutic efficacy and safety of tolvaptan administration to treat refractory ascites. Data were collected from 15 hospitalized patients with cirrhosis (hepatitis C, 10; alcoholism, five) after adding tolvaptan (3.75-11.25 mg/day) to conventional diuretics. Bodyweights and serum sodium and creatinine concentrations were measured. Tolvaptan was continued for 4 weeks or longer for a median follow-up period of 42 days (range, 28-56). In the first week (introduction phase), tolvaptan significantly reduced median weight (66.6, 65.9 and 63.1 kg on days 0, 1 and 7, respectively; P tolvaptan for 2 weeks or longer and six (40%, three good responders and three responders) were treated for a median of 42 days without additional intervention. During this intermediate-term administration of tolvaptan, the median weight reduction was statistically significant (65.4, 61.9 and 56.9 kg on days 0, 7 and 42, respectively; P Tolvaptan safely alleviated fluid retention caused by hepatic cirrhosis. Intermediate-term administration of tolvaptan apparently helped maintain weight reduction achieved during the introduction phase. © 2014 The Japan Society of Hepatology.

  11. Current limits and future challenges in the management of renal dysfunction in patients with cirrhosis: report from the International Club of Ascites

    DEFF Research Database (Denmark)

    Angeli, Paolo; Sanyal, Arun; Møller, Søren

    2013-01-01

    is based either on the more recent knowledge on renal dysfunction in advanced cirrhosis or current opinions among the members of the International Club of Ascites (ICA) on the management of this complication, obtained through a survey and discussed during the EASL-ICA Joint Meeting in Berlin in March 2011...

  12. Treatment of ovarian cancer ascites by intra-peritoneal injection of diphtheria toxin A chain-H19 vector: a case report

    Directory of Open Access Journals (Sweden)

    Abu-lail Rasha

    2010-07-01

    Full Text Available Abstract Introduction Ovarian cancer ascitic fluid, which contains malignant cells, is usually present in women with an advanced stage disease. There are currently no effective therapies for the treatment of ovarian cancer ascitic fluid. We developed a new therapeutic strategy to target expression of the diphtheria toxin fragment A gene in ovarian tumor cells under the control of H19 regulatory sequences. Case presentation A 64-year-old Caucasian woman was diagnosed with a stage IIIc epithelial ovarian cancer. She suffered from progressive disease, accumulation of malignant ascites that needed to be drained weekly, abdominal pain, vomiting, anorexia and severe weakness. Infusion of the diphtheria toxin A chain-H19 plasmid into the peritoneum of our patient resulted in complete resolution of the ascites with minimum adverse events. Conclusion On the basis of this preliminary experience, we are currently conducting an extensive Phase I study on a larger number of patients in order to assess the safety and preliminary efficacy of this novel patient-oriented treatment approach.

  13. Cholesterol modulates the volume-regulated anion current in Ehrlich-Lettre ascites cells via effects on Rho and F-actin

    DEFF Research Database (Denmark)

    Klausen, Thomas Kjaer; Hougaard, Charlotte; Hoffmann, Else K

    2006-01-01

    )] in this process. In Ehrlich-Lettre ascites (ELA) cells, a current with biophysical and pharmacological properties characteristic of VRAC was activated by hypotonic swelling. A 44% increase in cellular cholesterol content had no detectable effects on F-actin organization or VRAC activity. A 47% reduction...... by preventing the hypotonicity-induced decrease in Rho activity and eliciting actin polymerization....

  14. Low ascitic fluid total protein levels is not associated to the development of spontaneous bacterial peritonitis in a cohort of 274 patients with cirrhosis

    DEFF Research Database (Denmark)

    Mo, Silje; Bendtsen, Flemming; Wiese, Signe Skovgaard

    2018-01-01

    Background: Spontaneous bacterial peritonitis (SBP) is a complication to decompensated cirrhosis. Fluoroquinolones may prevent SBP. However, predictive markers for SBP are wanted. Guidelines suggest that patients with ascitic fluid protein below 15 g/l receive fluoroquinolones to prevent SBP...

  15. A novel neutralizing antibody targeting pregnancy-associated plasma protein-a inhibits ovarian cancer growth and ascites accumulation in patient mouse tumorgrafts.

    Science.gov (United States)

    Becker, Marc A; Haluska, Paul; Bale, Laurie K; Oxvig, Claus; Conover, Cheryl A

    2015-04-01

    The majority of ovarian cancer patients acquire resistance to standard platinum chemotherapy and novel therapies to reduce tumor burden and ascites accumulation are needed. Pregnancy-associated plasma protein-A (PAPP-A) plays a key role in promoting insulin-like growth factor (IGF) pathway activity, which directly correlates to ovarian cancer cell transformation, growth, and invasiveness. Herein, we evaluate PAPP-A expression in tumors and ascites of women with ovarian cancer, and determine the antitumor efficacy of a neutralizing monoclonal PAPP-A antibody (mAb-PA) in ovarian cancer using primary patient ovarian tumorgrafts ("Ovatars"). PAPP-A mRNA expression in patient ovarian tumors correlated with poor outcome and was validated as a prognostic surrogate in Ovatar tumors. Following confirmation of mAb-PA bioavailability and target efficacy in vivo, the antitumor efficacy of mAb-PA in multiple Ovatar tumor models was examined and the response was found to depend on PAPP-A expression. Strikingly, the addition of mAb-PA to standard platinum chemotherapy effectively sensitized platinum-resistant Ovatar tumors. PAPP-A protein in ascites was also assessed in a large cohort of patients and very high levels were evident across the entire sample set. Therefore, we evaluated targeted PAPP-A inhibition as a novel approach to managing ovarian ascites, and found that mAb-PA inhibited the development, attenuated the progression, and induced the regression of Ovatar ascites. Together, these data indicate PAPP-A as a potential palliative and adjunct therapeutic target for women with ovarian cancer. ©2015 American Association for Cancer Research.

  16. Acute Bronchitis

    Science.gov (United States)

    ... of bronchitis: acute and chronic. Most cases of acute bronchitis get better within several days. But your cough ... that cause colds and the flu often cause acute bronchitis. These viruses spread through the air when people ...

  17. Occult ureteropelvic junction obstruction presenting as anuria and urinary ascites in an infant with antenatal, unilateral hydronephrosis.

    Science.gov (United States)

    Hirselj, Daniel A; Zmaj, Paul M; Firlit, Casimir F

    2009-10-01

    To discuss an unusual case of occult ureteropelvic junction obstruction. A premature male infant with severe, unilateral hydronephrosis presented to the emergency room with 20 h of dry diapers. Placement of urethral catheter did not return urine. Imaging revealed persistent hydronephrosis on the previously affected side and new-onset hydronephrosis with perirenal fluid on the contralateral side. Patient was taken to the operating room and forniceal rupture from occult ureteropelvic junction obstruction with urinary ascites was identified. The obstruction was surgically repaired at that time and his postoperative course was uncomplicated. While most agree on postnatal evaluation for some children with antenatal hydronephrosis, there is no consensus as to the timing and frequency of evaluation. The risk of significant obstruction in children with low grades of hydronephrosis is very low, and many are not followed. This is a rare case in which low-grade postnatal hydronephrosis resulted in significant clinical obstruction.

  18. Cell cycle-dependent activity of the volume- and Ca2+-activated anion currents in Ehrlich lettre ascites cells

    DEFF Research Database (Denmark)

    Klausen, Thomas Kjaer; Bergdahl, Andreas; Christophersen, Palle

    2007-01-01

    Recent evidence implicates the volume-regulated anion current (VRAC) and other anion currents in control or modulation of cell cycle progression; however, the precise involvement of anion channels in this process is unclear. Here, Cl- currents in Ehrlich Lettre Ascites (ELA) cells were monitored......+ in the pipette), was unaltered from G0 to G1, but decreased in early S phase. A novel high-affinity anion channel inhibitor, the acidic di-aryl-urea NS3728, which inhibited both VRAC and CaCC, attenuated ELA cell growth, suggesting a possible mechanistic link between cell cycle progression and cell cycle......-dependent changes in the capacity for conductive Cl- transport. It is suggested that in ELA cells, entrance into the S phase requires an increase in VRAC activity and/or an increased potential for regulatory volume decrease (RVD), and at the same time a decrease in CaCC magnitude....

  19. Expression of P-glycoprotein and multidrug resistance associated protein in Ehrlich ascites tumor cells after fractionated irradiation

    DEFF Research Database (Denmark)

    Nielsen, D; Maare, C; Eriksen, J

    2001-01-01

    PURPOSE: To characterize irradiated murine tumor cells with respect to drug resistance, drug kinetics, and ATPase activity, and to evaluate the possible role of P-glycoprotein (PGP) and murine multidrug resistance associated protein (Mrp1) in the drug-resistant phenotype of these cells. METHODS...... AND MATERIALS: Sensitive Ehrlich ascites tumor cells (EHR2) were in vitro exposed to fractionated irradiation (60 Gy). Western blot analysis was performed for determination of PGP and Mrp1, reverse transcriptase-polymerase chain reaction (RT-PCR) for determination of mdr1a + b mRNA, and semiquantitative RT......-PCR for Mrp1 mRNA. The clonogenic assay was applied to investigate sensitivity, whereas the steady-state drug accumulation of daunorubicin (DNR), 3H-vincristine (VCR), and 3H-etoposide (VP16) was measured by spectrofluorometry and scintillation counting, respectively. For determining of ATPase activity...

  20. Protective effect of pantothenic acid and related compounds against permeabilization of Ehrlich ascites tumour cells by digitonin

    Energy Technology Data Exchange (ETDEWEB)

    Slyshenkov, Vyacheslav S.; Rakowska, Mariola; Wojtczak, Lech [Polska Akademia Nauk, Warsaw (Poland). Inst. Biologii Doswiadczalnej

    1996-12-31

    Preincubation of Ehrlich ascites tumour cells with millimolar concentrations of pantothenic acid, pantothenol or panthethine, but not with homopantothenic acid, at 22 C or 32 C, but not at 0 C, makes the plasma membrane more resistant to the damaging effect of submillimolar concentrations of digitonin. It is proposed that this increased resistance is due to the increased rate of cholesterol biosynthesis. In fact, incorporation of [{sup 14}C]acetate into cholesterol is by 45% increased in the cells preincubated with pantothenic acid; this probably reflects elevation of the content of CoA in such cells [Slyshenkov, V.S., Rakowska, M., Moiseenok, A.G and Wojtczak, L. (1995) Free Radical Biol. Med. 19, 767-772]. (author). 9 refs, 2 figs, 1 tab.

  1. The Performance and Incidence of Ascites in Broiler Chickens in Response to Feed Restriction and Meal Feeding Programs

    Directory of Open Access Journals (Sweden)

    Behrouz Dastar

    2014-04-01

    Full Text Available An experiment was conducted to evaluate the effect of feed restriction (FR and meal feeding (MF on performance, carcass characteristics and related parameters to ascites in Ross 308 male broiler chickens. Five dietary treatments were 1 the control (ad libo. feeding, 2 feed restriction from 7 to 14 days (FR14, 3 feed restriction from 7 to 21 days (FR21, 4 meal feeding from 7 to 14 days (MF14 and 5 meal feeding from 7 to 21days (MF21. All birds were fed adlibitum for the first week post hatch and after 21 days of age. Four replicate of 12 birds were allocated to each treatment. The results indicated FR and MF21 groups had significantly (p

  2. Antineoplastic Activities of MT81 and Its Structural Analogue in Ehrlich Ascites Carcinoma-Bearing Swiss Albino Mice

    Directory of Open Access Journals (Sweden)

    Sujata Maiti Choudhury

    2010-01-01

    Full Text Available Many fungal toxins exhibit in vitro and in vivo antineoplastic effects on various cancer cell types. Luteoskyrin, a hydroxyanthraquinone has been proved to be a potent inhibitor against Ehrlich ascites tumor cells. The comparative antitumor activity and antioxidant status of MT81 and its structural analogue [Acetic acid-MT81 (Aa-MT81] having polyhydroxyanthraquinone structure were assessed against Ehrlich ascites carcinoma (EAC tumor in mice. The in vitro cytotoxicity was measured by the viability of EAC cells after direct treatment of the said compounds. In in vivo study, MT81 and its structural analogue were administered (i.p. at the two different doses (5, 7 mg MT81; 8.93, 11.48 mg Aa-MT81/kg body weight for 7 days after 24 hrs. of tumor inoculation. The activities were assessed using mean survival time (MST, increased life span (ILS, tumor volume, viable tumor cell count, peritoneal cell count, protein percentage and hematological parameters. Antioxidant status was determined by malondialdehyde (MDA and reduced glutathione (GSH content, and by the activity of superoxide dismutase (SOD and catalase (CA T. MT81 and its structural analogues increased the mean survival time, normal peritoneal cell count. They decreased the tumor volume, viable tumor cell count, hemoglobin percentage and packed cell volume. Differential counts of WBC, total counts of RBC & WBC that altered by EAC inoculation, were restored in a dose-dependent manner. Increased MDA and decreased GSH content and reduced activity of SOD, and catalase in EAC bearing mice were returned towards normal after the treatment of MT81 and its structural analogue. Being less toxic than parent toxin MT81, the structural analogue showed more prominent antineoplastic activities against EAC cells compared to MT81. At the same time, both compounds exhibit to some extent antioxidant potential for the EAC-bearing mice.

  3. The Development of an Angiogenic Protein "Signature" in Ovarian Cancer Ascites as a Tool for Biologic and Prognostic Profiling.

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    Sofia-Paraskevi Trachana

    Full Text Available Advanced ovarian cancer (AOC is one of the leading lethal gynecological cancers in developed countries. Based on the important role of angiogenesis in ovarian cancer oncogenesis and expansion, we hypothesized that the development of an "angiogenic signature" might be helpful in prediction of prognosis and efficacy of anti-angiogenic therapies in this disease. Sixty-nine samples of ascitic fluid- 35 from platinum sensitive and 34 from platinum resistant patients managed with cytoreductive surgery and 1st-line carboplatin-based chemotherapy- were analyzed using the Proteome ProfilerTM Human Angiogenesis Array Kit, screening for the presence of 55 soluble angiogenesis-related factors. A protein profile based on the expression of a subset of 25 factors could accurately separate resistant from sensitive patients with a success rate of approximately 90%. The protein profile corresponding to the "sensitive" subset was associated with significantly longer PFS (8 [95% Confidence Interval {CI}: 8-9] vs. 20 months [95% CI: 15-28]; Hazard ratio {HR}: 8.3, p<0.001 and OS (20.5 months [95% CI: 13.5-30] vs. 74 months [95% CI: 36-not reached]; HR: 5.6 [95% CI: 2.8-11.2]; p<0.001. This prognostic performance was superior to that of stage, histology and residual disease after cytoreductive surgery and the levels of vascular endothelial growth factor (VEGF in ascites. In conclusion, we developed an "angiogenic signature" for patients with AOC, which can be used, after appropriate validation, as a prognostic marker and a tool for selection for anti-angiogenic therapies.

  4. Characteristics of the accumulation of methotrexate polyglutamate derivatives in Ehrlich ascites tumor cells and isolated rat hepatocytes

    Energy Technology Data Exchange (ETDEWEB)

    Fry, D.W.; Gewirtz, D.A.; Yalowich, J.C.; Goldman, I.D.

    1983-01-01

    The intracellular synthesis and retention of polygammaglutamyl derivatives of methotrexate and their interactions with H/sub 2/ folate reductase was evaluated. Methotrexate polyglutamates were detected within 15 minutes in hepatocytes exposed to 1 microM methotrexate, and continued to accumulate for at least 60 minutes producing a large transmembrane gradient. These derivatives appeared to be preferentially retained within the cell. In studies with the Ehrlich ascites tumor accumulation of methotrexate polyglutamates was increased over 5-fold by the addition of 5 mM L-glutamine or L-glutamate and exhibited a positive correlation with the extracellular concentration of methotrexate. When Ehrlich ascites tumor cells were exposed to 10 microM methotrexate and 5 mM L-glutamine intracellular polyglutamates were detected within 10 minutes and their levels increased linearly over 4 hours. As these derivatives accumulated, there was a decline in intracellular methotrexate due at least in part to a replacement of methotrexate on H/sub 2/ folate reductase by polyglutamates and subsequent efflux of the previously bound methotrexate from the cell. When polyglutamate derivatives were in excess of the H/sub 2/ folate reductase binding capacity and extracellular methotrexate removed, methotrexate rapidly exited the cell whereas the majority of its metabolites were retained and eventually saturated the major portion of the enzyme. These studies indicate that (1) intracellular methotrexate is rapidly converted to polygammaglutamyl derivatives, (2) these metabolites effectively compete with methotrexate for binding sites on H/sub 2/ folate reductase, (3) these derivatives are retained within the cell more effectively than methotrexate, and (4) vincristine and probenecid may be potentially useful for selectively increasing methotrexate polyglutamates in tumor cells.

  5. ROS activate KCl cotransport in nonadherent Ehrlich ascites cells but K+ and Cl- channels in adherent Ehrlich Lettré and NIH3T3 cells

    DEFF Research Database (Denmark)

    Lambert, Ian Henry; Klausen, Thomas Kjær; Bergdahl, Andreas

    2009-01-01

    KCl cotransport in Ehrlich ascites tumor cells and not K(+) and Cl(-) channels. Addition of H2O2 to hypotonically exposed cells accelerates the regulatory volume decrease and the concomitant net loss of K(+), whereas no additional increase in the K(+) and Cl(-) conductance was observed. The effect...... ascites cells, a subtype of the Ehrlich ascites tumor cells, and NIH3T3 mouse fibroblasts increased the K(+) and Cl(-) conductances after hypotonic cell swelling. Hence, H2O2 induces KCl cotransport or K(+) and Cl(-) channels in non-adherent and adherent cells, respectively. Key words: Reactive oxygen...

  6. Acute-on-chronic Liver Failure.

    Science.gov (United States)

    Sarin, Shiv Kumar; Choudhury, Ashok

    2016-12-01

    Acute-on-chronic liver failure (ACLF) is a distinct entity that differs from acute liver failure and decompensated cirrhosis in timing, presence of treatable acute precipitant, and course of disease, with a potential for self-recovery. The core concept is acute deterioration of existing liver function in a patient of chronic liver disease with or without cirrhosis in response to an acute insult. The insult should be a hepatic one and presentation in the form of liver failure (jaundice, encephalopathy, coagulopathy, ascites) with or without extrahepatic organ failure in a defined time frame. ACLF is characterized by a state of deregulated inflammation. Initial cytokine burst presenting as SIRS, progression to CARS and associated immunoparalysis leads to sepsis and multi-organ failure. Early identification of the acute insult and mitigation of the same, use of nucleoside analogue in HBV-ACLF, steroid in severe alcoholic hepatitis, steroid in severe autoimmune hepatitis and/or bridging therapy lead to recovery, with a 90-day transplant-free survival rate of up to 50 %. First-week presentation is crucial concerning SIRS/sepsis, development, multiorgan failure and consideration of transplant. A protocol-based multi-disciplinary approach including critical care hepatology, early liver transplant before multi-organ involvement, or priority for organ allocation may improve the outcome. Presentation with extrahepatic organ involvement or inclusion of sepsis as an acute insult in definition restricts the therapy, i.e., liver transplant or bridging therapy, and needs serious consideration. Augmentation of regeneration, cell-based therapy, immunotherapy, and gut microbiota modulation are the emerging areas and need further research.

  7. Overview on acute-on-chronic liver failure.

    Science.gov (United States)

    Zhang, Jing; Gao, Shan; Duan, Zhongping; Hu, Ke-Qin

    2016-03-01

    Liver failure (LF) is defined as severe dysfunction in hepatic synthesis, detoxification, and metabolism induced by various etiologies. Clinical presentation of LF typically includes severe jaundice, coagulation disorder, hepatic encephalopathy, and ascites. LF can be classified into acute LF, acute-on-chronic LF (ACLF), and chronic LF. ACLF has been demonstrated as a distinct syndrome with unique clinical presentation and outcomes. The severity, curability, and reversibility of ACLF have attracted considerable attention. Remarkable developments in ACLF-related conception, diagnostic criteria, pathogenesis, and therapy have been achieved. However, this disease, especially its diagnostic criteria, remains controversial. In this paper, we systemically reviewed the current understanding of ACLF from its definition, etiology, pathophysiology, pathology, and clinical presentation to management by thoroughly comparing important findings between east and west countries, as well as those from other regions. We also discussed the controversies, challenges, and needs for future studies to promote the standardization and optimization of the diagnosis and treatment for ACLF.

  8. Microscopy and polymerase chain reaction detection of Leishmania chagasi in the pleural and ascitic fluid of a patient with AIDS: Case report and review of diagnosis and therapy of visceral leishmaniasis

    OpenAIRE

    Ada RS Diehl; dos Santos, Rodrigo P; Ricardo Zimmerman; Luz, Letícia P; Tanara Weiss; Pedro Jacobson; Goldani, Luciano Z.

    2004-01-01

    Atypical visceral leishmaniasis is increasingly reported in immunocompromised patients, including patients with AIDS. A case of visceral leishmaniasis in an HIV-infected Brazilian patient with pulmonary and peritoneal involvement is reported. Histological evaluation of pleural fluid and ascites aspirate revealed macrophages with intracellular Leishmania. Polymerase chain reaction analysis was positive for Leishmania in the pleural and ascitic fluid with use of primers specific for Leishmania ...

  9. Massive Ascites as the Only Sign of Ovarian Juvenile Granulosa Cell Tumor in an Adolescent: A Case Report and a Review of the Literature

    Directory of Open Access Journals (Sweden)

    Azin Ashnagar

    2013-01-01

    Full Text Available Ovarian neoplasms are relatively rare in childhood and adolescence; only 5% to 8% of the cases are of sex cord stromal origin. Granulosa cell tumors are a group of estrogen producing sex cord stromal tumors of the ovary. They occur in 95% of the cases in adults, and only about 5% of the cases, which differ in histologic characteristics, are of juvenile type. A 13-year-old girl is reported who presented with massive abdominal distention and ascites. An abdominopelvic computed tomography scan showed a predominantly cystic mass lesion with septations arising from the left ovary. All tumor markers were normal, but serum inhibin level was increased. The patient underwent mass resection with salpingoophorectomy. Histopathology was compatible with the juvenile granulosa cell tumor. Interestingly, menarche was started in the patient soon after the surgery. To the best of our knowledge, massive ascites as the only clinical manifestation in the juvenile granulosa cell tumor has not reported as yet.

  10. Combined Gene Therapy Using AdsVEGFR2 and AdsTie2 With Chemotherapy Reduces the Growth of Human Ovarian Cancer and Formation of Ascites in Mice.

    Science.gov (United States)

    Tuppurainen, Laura; Sallinen, Hanna; Karvonen, Anni; Valkonen, Elina; Laakso, Hanne; Liimatainen, Timo; Hytönen, Elisa; Hämäläinen, Kirsi; Kosma, Veli-Matti; Anttila, Maarit; Ylä-Herttuala, Seppo

    2017-06-01

    Ovarian cancer is highly dependent on tumor microvessels and angiogenesis regulated by vascular endothelial growth factors (VEGFs) and their receptors (VEGFRs) and angiopoietins (Ang) and their Tie receptors. We studied the efficacy of adenoviral (Ad) gene therapy with soluble VEGFR2 and Tie2 combined with paclitaxel and carboplatin for the treatment of ovarian cancer. An intraperitoneal human ovarian cancer xenograft model in nude mice (n = 44) was used in this study. Gene therapy was given intravenously when the presence of sizable tumors was confirmed in magnetic resonance imaging. The study groups were as follows: AdCMV as a control (group I), AdCMV with chemotherapy (group II), AdsVEGFR2 and AdsTie2 (group III), and AdsVEGFR2 and AdsTie2 with chemotherapy (group IV). Antitumor effectiveness was assessed by overall tumor growth, ascites, immunohistochemistry, microvessel density, and sequential magnetic resonance imaging analyses. AdsVEGFR2 and AdsTie2 gene therapy (group III) significantly reduced tumor weights as compared with group II (P = 0.007). Accumulation of ascites was significantly reduced when the mice were treated with AdsVEGFR2 and AdsTie2 gene therapy or with combined gene therapy and chemotherapy as compared with controls (P = 0.029 and P = 0.010, respectively). Vascular endothelial growth factor and Ang2 levels in ascites fluid were elevated after the gene therapy. Combined inhibition of VEGF/VEGFR2 and Ang/Tie2 pathways provided efficient therapy for ovarian cancer in mice. In addition, antiangiogenic gene therapy has potential as a treatment for the accumulation of ascites.

  11. Myxoma virus-mediated oncolysis of ascites-derived human ovarian cancer cells and spheroids is impacted by differential AKT activity.

    Science.gov (United States)

    Correa, Rohann J M; Komar, Monica; Tong, Jessica G K; Sivapragasam, Milani; Rahman, Masmudur M; McFadden, Grant; Dimattia, Gabriel E; Shepherd, Trevor G

    2012-05-01

    We propose that metastatic epithelial ovarian cancer (EOC) is a potential therapeutic target for the oncolytic agent, Myxoma virus (MYXV). Primary EOC cells were isolated from patient ascites and cultured as adherent cells or in suspension using Ultra Low-Attachment dishes. MYXV expressing green fluorescent protein was used to infect cells and spheroids. Infection was monitored by fluorescence microscopy, viral titering and immunoblotting for M-T7 and M130 virus protein expression, and cell viability by alamarBlue assay. Akti-1/2 (5 μM) and rapamycin (20 nM) were used to assay the role of PI3K-AKT signaling in mediating MYXV infection. Ascites-derived EOC cells grown in adherent culture are effectively killed by MYXV infection. EOC cells grown in suspension to form three-dimensional EOC spheroids readily permit MYXV entry into cells, yet are protected from the cytopathic effects of late MYXV infection. Upon reattachment (to model secondary metastasis), EOC spheroids are re-sensitized to MYXV-mediated oncolysis. The critical determinant that facilitates efficient MYXV infection is the presence of an activated PI3K-AKT signaling pathway. Treatment with the specific AKT inhibitor Akti-1/2 reduces infection of monolayer EOC cells and spheroids. Direct infection of freshly-collected ascites demonstrated that 54.5% of patient samples were sensitive to MYXV-mediated oncolytic cell killing. We also demonstrate that factor(s) present in ascites may negatively impact MYXV infection and oncolysis of EOC cells, which may be due to a down-regulation in endogenous AKT activity. Differential activity of AKT serves as the mechanistic basis for regulating MYXV-mediated oncolysis of EOC spheroids during key steps of the metastatic program. In addition, we provide the first evidence that MYXV oncolytic therapy may be efficacious for a significant proportion of ovarian cancer patients with metastatic disease. Copyright © 2012 Elsevier Inc. All rights reserved.

  12. Efficacy and safety of alternating norfloxacin and rifaximin as primary prophylaxis for spontaneous bacterial peritonitis in cirrhotic ascites: a prospective randomized open-label comparative multicenter study.

    Science.gov (United States)

    Assem, M; Elsabaawy, M; Abdelrashed, M; Elemam, S; Khodeer, S; Hamed, W; Abdelaziz, A; El-Azab, G

    2016-03-01

    Primary prevention of spontaneous bacterial peritonitis (SBP) is an important strategy to reduce morbidity and mortality in cirrhotic patients with ascites. Efficacy and safety of alternating rifaximin and norfloxacin as primary prophylaxis is questionable. Three hundred thirty-four cirrhotic patients with high SAAG (≥1.1) ascites, protein level in ascitic fluid less than 1.5 g/dL with advanced liver disease (Child-Pugh score >9 points with serum bilirubin level >3 mg/dL) or renal impairment (serum creatinine level >1.2 mg/dL, blood urea nitrogen level >25 mg/dL, or serum sodium level <130 mEq/L) were included in an open-label, randomized study aimed at comparing alternating use of norfloxacin and rifaximin vs. norfloxacin or rifaximin alone as primary prophylaxis for SBP. Both intention-to-treat and per-protocol efficacy analyses were done after 6 months of treatment by assessment of ascitic fluid neutrophil count. Safety analysis was done for all intention-to-treat populations. Alternating norfloxacin and rifaximin showed superior prophylaxis by intention-to-treat (74.7 vs. 56.4% vs. 68.3%, p < 0.048). Pairwise analysis showed that alternating regimen had lower probability to develop SBP when compared to a norfloxacin-based regimen in intention-to-treat (p = 0.016) and per protocol analysis (p = 0.039). There was no difference among the studied groups regarding the incidence and severity of adverse events reported. Alternating norfloxacin- and rifaximin-based primary prophylaxis for SBP showed higher efficacy with the same safety profile when compared with monotherapy of norfloxacin.

  13. Changes in the structure and functions of membranes in erythrocytes and Ehrlich ascites carcinoma cells under the influence of a new generation hybrid antioxidant IKhFAN-10.

    Science.gov (United States)

    Vekshina, O M; Fatkullina, L D; Kim, Yu A; Burlakova, E B

    2007-04-01

    We studied the effect of a new generation hybrid antioxidant IKhFAN-10 on the structure and function of cell membranes (organization of the lipid bilayer and proteins and activity of ion channels). The test preparation proposed for the therapy of neurodegenerative diseases modified properties of membranes in erythrocytes and Ehrlich ascites carcinoma cells and affected functional activity of cells. We determined the doses of this antioxidant, which did not cause side effects.

  14. The construction of cDNA library and the screening of related antigen of ascitic tumor cells of ovarian cancer.

    Science.gov (United States)

    Hou, Q; Chen, K; Shan, Z

    2015-01-01

    To construct the cDNA library of the ascites tumor cells of ovarian cancer, which can be used to screen the related antigen for the early diagnosis of ovarian cancer and therapeutic targets of immune treatment. Four cases of ovarian serous cystadenocarcinoma, two cases of ovarian mucinous cystadenocarcinoma, and two cases of ovarian endometrial carcinoma in patients with ascitic tumor cells which were used to construct the cDNA library. To screen the ovarian cancer antigen gene, evaluate the enzyme, and analyze nucleotide sequence, serological analysis of recombinant tumor cDNA expression libraries (SEREX) and suppression subtractive hybridization technique (SSH) techniques were utilized. The detection method of recombinant expression-based serological mini-arrays (SMARTA) was used to detect the ovarian cancer antigen and the positive reaction of 105 cases of ovarian cancer patients and 105 normal women's autoantibodies correspondingly in serum. After two rounds of serologic screening and glycosides sequencing analysis, 59 candidates of ovarian cancer antigen gene fragments were finally identified, which corresponded to 50 genes. They were then divided into six categories: (1) the homologous genes which related to the known ovarian cancer genes, such as BARD 1 gene, etc; (2) the homologous genes which were associated with other tumors, such as TM4SFI gene, etc; (3) the genes which were expressed in a special organization, such as ILF3, FXR1 gene, etc; (4) the genes which were the same with some protein genes of special function, such as TIZ, ClD gene; (5) the homologous genes which possessed the same source with embryonic genes, such as PKHD1 gene, etc; (6) the remaining genes were the unknown genes without the homologous sequence in the gene pool, such as OV-189 genes. SEREX technology combined with SSH method is an effective research strategy which can filter tumor antigen with high specific character; the corresponding autoantibodies of TM4SFl, ClD, TIZ, BARDI

  15. Benefits of artificially induced pleural effusion and/or ascites for percutaneous radiofrequency ablation of hepatocellular carcinoma located on the liver surface and in the hepatic dome.

    Science.gov (United States)

    Iwai, Shuji; Sakaguchi, Hiroki; Fujii, Hideki; Kobayashi, Sawako; Morikawa, Hiroyasu; Enomoto, Masaru; Tamori, Akihiro; Kawada, Norifumi

    2012-01-01

    Radiofrequency ablation (RFA) with artificial pleural effusion and/or artificial ascites has recently been recognized as a useful device for the treatment of hepatocellular carcinoma (HCC). However, the indication of this technique is unclear and its therapeutic efficacy is undetermined. We decided the precise indication for the use of artificial infusion. Artificial pleural effusion was indicated for tumors located on the dorsal side of the liver surface in the right lobe. Artificial ascites were indicated for (i) tumors located on the ventral side of the liver surface in the right lobe; (ii) tumors that could not be completely visualized but located near the liver surface in the right lobe; and (iii) tumors on the liver surface and adjacent to organs. The total local recurrence rates at 1 and 2 years were 4% and 22%, respectively. The estimated survival rates of 32 naïve patients at 1 and 3 years were 90% and 78%, respectively. The local recurrence rates of a tumor size of 3 cm at 2 years were 22% and 17%, respectively. RFA with artificial pleural effusion and/or ascites is effective for tumors located on the liver surface and in the hepatic dome.

  16. O-Linked glycome and proteome of high-molecular-mass proteins in human ovarian cancer ascites: Identification of sulfation, disialic acid and O-linked fucose.

    Science.gov (United States)

    Karlsson, Niclas G; McGuckin, Michael A

    2012-07-01

    The O-linked glycosylation of the main acidic high-molecular-weight glycoprotein from ascites fluid from patients with ovarian cancer were analyzed. The O-linked oligosaccharides were shown to consist of mainly highly sialylated core 1 and 2 structures with a smaller amount of sulfated core 2 structures. These structures were shown to be able to be further extended into small keratan sulfate (KS)-type oligosaccharides with up to four N-acetyllactosamine units. Proteomic studies of the acidic fraction of ascites fluid from patients with ovarian cancer showed that this fraction was enriched in proteoglycans. Among them, lumican, agrin, versican and dystroglycans were potential candidates, with threonine- and serine-rich domains that could carry a significant amount of O-linked glycosylation, including also the O-linked KS. Glycomic analysis using liquid chromatography (LC)-tandem mass spectrometry (MS/MS) also showed that the disialic acid NeuAc-NeuAc- was frequently found as the terminating structure on the O-linked core 1 and 2 oligosaccharides from one ascites sample. Also, a small amount of the epidermal growth factor (EGF)-associated O-linked fucose structure Gal-GlcNAc-Fucitol was detected with and without sialic acid in the LC-MS/MS analysis. Candidate proteins containing O-linked fucose were suggested to be proteoglycan-type molecules containing the O-linked fucose EGF consensus domain.

  17. Acute respiratory failure following ovarian hyperstimulation syndrome

    Directory of Open Access Journals (Sweden)

    Antonello Nicolini

    2013-03-01

    Full Text Available Ovarian hyperstimulation syndrome is a serious and potentially life-threatening physiological complication that may be encountered in patients who undergo controlled ovarian hyperstimulation cycles. The syndrome is typically associated with regimes of exogenous gonadotropins, but it can be seen, albeit rarely, when clomiphene is administered during the induction phase. Although this syndrome is widely described in scientific literature and is well known by obstetricians, the knowledge of this pathological and potentially life-threatening condition is generally less than satisfactory among physicians. The dramatic increase in therapeutic strategies to treat infertility has pushed this condition into the realm of acute care therapy. The potential complications of this syndrome, including pulmonary involvement, should be considered and identified so as to allow a more appropriate diagnosis and management. We describe a case of a woman with an extremely severe (Stage 6 ovarian hyperstimulation syndrome who presented ascites, bilateral pleural effusion and severe respiratory failure treated with non-invasive ventilation. The patient was admitted to the intensive care unit because of severe respiratory failure, ascites, and bilateral pleural effusion due to ovarian hyperstimulation syndrome. Treatment included non-invasive ventilation and three thoracentesis procedures, plus the administration of albumin, colloid solutions and high-dose furosemid. Severe form of ovarian hyperstimulation syndrome is observed in 0.5-5% of the women treated, and intensive care may be required for management of thromboembolic complications, renal failure and severe respiratory failure. Pulmonary intensive care may involve thoracentesis, oxygen supplementation and, in more severe cases, assisted ventilation. To our knowledge, there have been only two studies in English language medical literature that describe severe respiratory failure treated with non

  18. Bronchitis - acute

    Science.gov (United States)

    ... sharing features on this page, please enable JavaScript. Acute bronchitis is swelling and inflamed tissue in the main ... present only for a short time. Causes When acute bronchitis occurs, it almost always comes after having a ...

  19. Acute cholecystitis

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/article/000264.htm Acute cholecystitis To use the sharing features on this page, please enable JavaScript. Acute cholecystitis is sudden swelling and irritation of the gallbladder. ...

  20. Ultrastructural changes produced in Ehrlich ascites carcinoma cells by ultraviolet-visible radiation in the presence of melanins

    Energy Technology Data Exchange (ETDEWEB)

    Lea, P.J.; Pawlowski, A.; Persad, S.D.; Menon, I.A.; Haberman, H.F.

    1988-01-01

    Irradiation of Ehrlich ascites carcinoma (EAC) cells in the presence of pheomelanin, i.e., red hair melanin (RHM), has been reported to produce extensive cell lysis. Irradiation in the presence of eumelanin, i.e., black hair melanin (BHM), or irradiation in the absence of either type of melanin did not produce this effect. We observed that RHM particles penetrated the cell membrane without apparent structural damage to the cell or the cell membrane. Irradiation of the cells in the absence of melanin did not produce any changes in the ultrastructure of the cells. Incubation of the cells in the dark in the presence of RHM produced only minor structural, mainly cytoplasmic changes. Irradiation of the cells in the presence of RHM produced extensive ultrastructural changes prior to complete cell lysis; these changes were more severe than the effects of incubation of the cells in the dark in the presence of RHM. When the cells incubated in the dark or irradiated in the presence of latex particles or either one of the eumelanins particles, viz. BHM or synthetic dopa melanin, these particles did not penetrate into the cells or produce any ultrastructural changes. These particles were in fact not even ingested by the cells.

  1. Inhibitory effect of cyclophosphamide on the biosynthesis of a perchloro-soluble protein fraction of ehrlich ascites carcinoma cells

    Directory of Open Access Journals (Sweden)

    R. Raposo Abreu

    1973-01-01

    Full Text Available The perchloro-soluble mucroptotein fraction was determined in the cells of Ehrlich ascites carcinoma on the 10th and 12th days post-inoculation of the tumor. After 3 days of a single subcutaneous dose of cyclophosphamide (200 mg/kg the mucoprotein levels were found considerable lower. This difference was highly significant statistically.Foi determinada a fração mucoproteica percloro-solúvel nas células do carcinoma ascítico de Ehrlich, no 10º e 12º dias após a inoculação do tumor. Nos camundongos injetados com uma única dose subcutânea de ciclofosfamida (200 mg/kg os níveis desta fração foram encontrados consideravelmente mais baixos. A análise estatística demonstrou que as diferenças observadas entre os animais controles e os tratados com ciclofosfamida foram altamente significativas.

  2. Conversion therapy of gastric cancer with massive malignant ascites and ovarian metastases by systemic and intraperitoneal chemotherapy.

    Science.gov (United States)

    Kondo, Tomohiro; Kitayama, Hiromitsu; Sugiyama, Junko; Hirayama, Michiaki; Suzuki, Yoshinori; Oyamada, Yumiko; Tsuji, Yasushi

    2016-12-01

    Intravenous and intraperitoneal paclitaxel with S-1 is showing promising results in gastric cancer with peritoneal metastases. We herein report a successful conversion of unresectable to resectable disease using combination chemotherapy with trastuzumab. The patient was a 39-year-old woman with human epidermal growth factor receptor 2-positive gastric cancer with peritoneal, pulmonary and bilateral ovarian metastases. After 6 cycles of S-1 plus cisplatin with trastuzumab, followed by 15 cycles of intravenous and intraperitoneal paclitaxel with S-1 and trastuzumab, the pulmonary and peritoneal metastases exhibited complete response and no evidence of malignancy was found on diagnostic laparoscopy. We performed metastasectomy of the bilateral sizeable ovaries, followed by total gastrectomy. The patient had no recurrence for 16 months after the gastrectomy. Therefore, satisfactory response to systemic and intraperitoneal chemotherapy may convert unresectable to resectable disease, and primary tumor resection with ovarian metastasectomy may prolong survival. This combination chemotherapy has the potential of becoming a conversion therapy for gastric cancer with peritoneal metastases, even if ascites and ovarian metastases are extensive.

  3. Mechanisms of activation of NHE by cell shrinkage and by calyculin A in Ehrlich ascites tumor cells

    DEFF Research Database (Denmark)

    Pedersen, Stine Helene Falsig; Varming, Camilla; Hoffmann, E K

    2002-01-01

    The Na+/H+ exchanger isoforms NHE1, NHE2, and NHE3 were all found to be expressed in Ehrlich ascites tumor cells, as evaluated by Western blotting and confocal microscopy. Under unstimulated conditions, NHE1 was found predominantly in the plasma membrane, NHE3 intracellularly, and NHE2 in both...... compartments. Osmotic cell shrinkage elicited a rapid intracellular alkalinization, the sensitivity of which to EIPA (IC50 0.19 microM) and HOE 642 (IC50 0.85 microM) indicated that it predominantly reflected activation of NHE1. NHE activation by osmotic shrinkage was inhibited by the protein kinase C...... inhibitors chelerythrine (IC50 12.5 microM), Gö 6850 (5 microM), and Gö 6976 (1 microM), and by the p38 MAPK inhibitor SB 203580 (10 microM). Furthermore, hypertonic cell shrinkage elicited a biphasic increase in p38 MAPK phosphorylation, with the first significant increase detectable 2 minutes after...

  4. Antitumor efficacy and amelioration of oxidative stress by Trichosanthes dioica root against Ehrlich ascites carcinoma in mice.

    Science.gov (United States)

    Bhattacharya, Sanjib; Prasanna, Angelene; Majumdar, Piyali; Kumar, R B Suresh; Haldar, Pallab K

    2011-09-01

    Trichosanthes dioica Roxb. (Cucurbitaceae) is a dioecious climber, traditionally used in India for several medicinal purposes. The present study assessed the hydroalcoholic extract of T. dioica root (TDA) for antitumor effect and antioxidant influence against Ehrlich ascites carcinoma (EAC) in Swiss albino mice. Twenty four hours after intraperitoneal inoculation of tumor (EAC) cells in mice, TDA was administered at 5 and 10 mg/kg body weight daily for 9 consecutive days. On the 10th day, half of the mice were sacrificed for estimation of tumor proliferation, hematological, and liver antioxidant parameters viz. lipid peroxidation, reduced glutathione (GSH), glutathione S-transferase (GST), superoxide dismutase (SOD) and catalase (CAT); and the rest were kept alive for assessment of increase in life span. The antitumor effect of TDA was assessed by evaluating tumor weight, tumor volume, packed cell volume, viable and non-viable tumor cell counts, median survival time and percentage increase in life span of EAC bearing mice. TDA exhibited dose dependent and significant (p TDA treated mice as compared to EAC control. TDA treatment significantly (p TDA possessed promising antitumor efficacy in mice, plausibly mediated by amelioration of oxidative stress by multiple mechanisms.

  5. Purification of, and generation of antibodies against an actin-binding cell surface glycoprotein from ascites tumor cell microvilli

    Energy Technology Data Exchange (ETDEWEB)

    Metcalf, T.N. III; Carraway, C.A.C.; Carraway, K.L.

    1987-05-01

    Isolated microvilli from 13762 ascites tumor cells contain a transmembrane, cell surface glycoprotein (CAG - cytoskeleton associated glycoprotein) which binds to microfilaments. The authors have purified this protein from Triton X-100 extracts of microvilli by two consecutive sucrose density gradient centrifugation steps in the presence of sodium dodecyl sulfate (SDS). Under non-reducing conditions, CAG behaves as a 20 S species, and has a molecular weight of 1-2 x 10/sup 6/. The molecular weight of the reduced, SDS subunit is 80,000. The authors have demonstrated that the purified, non-reduced CAG molecule can bind /sup 125/I actin. Antibodies against CAG were raised in rabbits by injecting CAG which was eluted from preparative SDS gels run under reducing conditions. Interestingly, this antibody also reacts with the heavy chain of soluble rat IgM, another mulitmeric glycoprotein of similar molecular weight. This antibody will be useful for the localization of cross-reactive molecules in other cells and tissues.

  6. Effects of Dietary L-carnitine Supplementation on Growth Performance, Organ Weight, Biochemical Parameters and Ascites Susceptibility in Broilers Reared Under Low-temperature Environment

    Directory of Open Access Journals (Sweden)

    Y. W. Wang

    2013-02-01

    Full Text Available The objective of this study was to investigate the effects of L-carnitine on growth performance, organ weight, biochemical parameters of blood, heart and liver, and ascites susceptibility of broilers at different ages reared under a low-temperature environment. A total of 420 1-d-old male Ross 308 broilers were randomly assigned to two dietary treatments with fifteen replicates of fourteen broilers each. Treatment diets consisted of L-carnitine supplementation at levels of 0 and 100 mg/kg. At 11-d of age, low temperature stress was used to increase ascites susceptibility. Blood, heart and liver samples were collected at different ages for analysis of boichemical parameters. The results showed that, there was no significant difference in growth performance with L-carnitine supplementation, but the mortality due to ascites was significantly decreased. Dietary L-carnitine supplementation significantly reduced heart index (HI and ascites heart index (AHI on d 21, lung index (LUI on d 35 and liver index (LI on d 42. The broilers fed diets containing L-carnitine had significantly lower red blood cell counts (RBC, hemoglobin (HGB concentration and hematocrit (HCT on d 42. Dietary L-carnitine supplementation significantly reduced malondialdehyde (MDA content of heart tissue on d 21 and 35, and significantly increased total superoxide dismutase (T-SOD and Glutathione peroxidase (GSH-Px activity of the heart on d 21 and 42. L-carnitine supplementation significantly reduced serum triglyceride (TG content on d 28 and 35 and serum glucose (GLU on d 35 and 42, and significantly increased serum total protein (TP and globulin (GLO content on d 42. L-carnitine supplementation significantly enhanced liver succinodehydrogenase (SDH, malic dehydrogenase (MDH and Na+-K+-ATPase activity on d 28, and tended to reduce the lactic acid (LD level of liver on d 35 (p = 0.06. L-carnitine supplementation significantly reduced serum uric acid (UA content on d 28, 35 and 42

  7. Acute Porphyrias.

    Science.gov (United States)

    Besur, Siddesh; Schmeltzer, Paul; Bonkovsky, Herbert L

    2015-09-01

    Porphyrias are a group of eight metabolic disorders characterized by defects in heme biosynthesis. Porphyrias are classified into two major categories: 1) the acute or inducible porphyrias and 2) the chronic cutaneous porphyrias. The acute hepatic porphyrias are further classified into acute intermittent porphyria (AIP), hereditary coproporphyria, variegate porphyria, and porphyria due to severe deficiency of delta-aminolevulinic acid (ALA) dehydratase (ALADP). AIP is the most common, and ALADP is the least common acute porphyria. The clinical presentations of acute porphyrias are nonspecific. There are no pathognomonic signs or symptoms. The most frequent presenting symptom is abdominal pain, but pain in the chest, back, or lower extremities may also occur. Hyponatremia is the most common electrolyte abnormality during acute attacks, and hypomagnesemia is also common. Both are risk factors for development of seizures, which occur in ∼ 20-30% of acute attacks. Once suspected, the diagnosis of porphyria can be rapidly established by checking random urinary porphobilinogen. Initial management of acute porphyria includes discontinuation of all potentially harmful drugs and management of symptoms. Acute attacks should be treated emergently with intravenous heme and glucose to avoid considerable morbidity and mortality. Acute attacks last a few days, and the majority of patients are asymptomatic between attacks. Prognosis is good if the condition is recognized early and treated aggressively. Copyright © 2015 Elsevier Inc. All rights reserved.

  8. Síndrome ascítica em frangos de corte: uma revisão sobre a fisiologia, avaliação e perspectivas Ascitic syndrome in broiler chickens: a review about physiology, evaluation and perspectives

    Directory of Open Access Journals (Sweden)

    Millor Fernandes do Rosário

    2004-12-01

    Full Text Available Os programas de melhoramento genético de frangos de corte que buscam máxima velocidade de ganho de peso, alta eficiência alimentar, alta viabilidade, maior rendimento de carcaça e menor deposição de gordura podem desencadear algumas síndromes fisiológicas, dentre as quais destacam-se o estresse calórico, a morte súbita e a ascite. A ascite se enquadra no conceito das síndromes multifatoriais, uma vez que sua manifestação ocorre quando certos fatores genéticos e ambientais atuam em conjunto determinando o processo. As limitações anatômica e fisiológica da circulação sanguínea nos pulmões provocam a síndrome de hipertensão pulmonar (PHS; esta pode provocar grande acúmulo de fluido na cavidade abdominal, quadro este denominado de ascite. Ocorre redução da eficiência da circulação sangüínea, levando as aves à morte por hipóxia, predominantemente no período entre 30 e 40 dias de idade. Uma vez desencadeado o processo ascítico, a ave dificilmente é aproveitada no abate já que a mesma restringe o consumo de alimento, ganhando menos peso. Adicionalmente, a carcaça apresenta aumento do volume da cavidade abdominal e conseqüente congestão dos órgãos internos. A descrição da fisiologia, medidas de avaliação e perspectivas são apresentadas neste trabalho.Poultry genetic breeding programs which look for maximum weight gain, improved feed conversion, high viability, high carcass yield and low fat deposition may cause some physiologic syndromes, for example caloric stress, sudden death and ascites. Ascites is framed in concept of the multifactorial syndromes, once its manifestation happens when certain genetic and environment factors act together, determining the process. Anatomical and physiological limitations in blood circulation in the lungs give rise to pulmonary hypertension syndrome (PHS, producing great fluid accumulation in abdominal cavity, which is denominated ascites. Ascites causes reduction of blood

  9. Integrative analysis of transcriptomic and metabolomic profiling of ascites syndrome in broiler chickens induced by low temperature.

    Science.gov (United States)

    Shi, Shourong; Shen, Yiru; Zhao, Zhenhua; Hou, Zhuocheng; Yang, Ying; Zhou, Huaijun; Zou, Jianmin; Guo, Yuming

    2014-11-01

    Ascites syndrome (AS) still has an unacceptably high incidence rate in both humans and animals although there have been many studies on AS. To continue our previous pathological and biochemical investigation on the underlying mechanisms of AS incidence in broiler chickens, cutting-edge technologies including RNA-seq and metabolimics were used by directly comparing AS chickens and healthy controls. The RNA-seq analysis in the liver identified 390 differentially expressed genes (DEGs), among which 212 genes were up-regulated and 178 genes were down-regulated in the AS group compared to the control. For the down-regulated DEGs, further gene ontology (GO) analysis suggested that lipid metabolism, cell differentiation, enzyme linked receptor protein signaling pathway and steroid biosynthesis pathway were significantly enriched. For up-regulated DEGs, the cholesterol metabolic process has the lowest p value (0.000966) of fold enrichment while the cholesterol biosynthetic process has the highest fold enrichment (46.67). The metabolomic analysis of serum revealed statistically significant changes in the concentrations of LysoPC(20 : 4), LysoPC(16 : 0), LysoPC(18 : 0), LysoPC(18 : 1), LysoPC(18 : 2), PC(14 : 1/20 : 1), PC(20 : 4/18 : 0), PC(14 : 1/22 : 1), dihydroxyacetone, indoleacrylic acid, ursodeoxycholic acid, l-valine, and l-tryptophan. The integrative analysis of transcriptome and metabolome indicated that two biological pathways of tryptophan biosynthesis and metabolism, and glycerophospholipid metabolism may contribute to the induction of AS in broilers. These findings have provided novel insights into our understanding of molecular mechanisms of AS incidence in broilers.

  10. Combinatory Evaluation of Transcriptome and Metabolome Profiles of Low Temperature-induced Resistant Ascites Syndrome in Broiler Chickens.

    Science.gov (United States)

    Shi, Shourong; Shen, Yiru; Zhang, Shan; Zhao, Zhenhua; Hou, Zhuocheng; Zhou, Huaijun; Zou, Jianmin; Guo, Yuming

    2017-05-24

    To select metabolic biomarkers and differentially expressed genes (DEGs) associated with resistant-ascites syndrome (resistant-AS), we used innovative techniques such as metabolomics and transcriptomics to comparatively examine resistant-AS chickens and AS controls. Metabolomic evaluation of chicken serum using ultra-performance liquid chromatography-quadruple time-of-flight high-sensitivity mass spectrometry (UPLC-QTOF/HSMS) showed significantly altered lysoPC(18:1), PE(18:3/16:0), PC(20:1/18:3), DG(24:1/22:6/0:0), PS(18:2/18:0), PI(16:0/16:0), PS(18:0/18:1), PS(14:1/14:0), dihydroxyacetone, ursodeoxycholic acid, tryptophan, L-valine, cycloserine, hypoxanthine, and 4-O-Methylmelleolide concentrations on day 21 and LysoPC(18:0), LysoPE(20:1/0:0), LysoPC(16:0), LysoPE(16:0/0:0), hypoxanthine, dihydroxyacetone, 4-O-Methylmelleolide, LysoPC(18:2), and PC(14:1/22:1) concentrations on day 35, between the susceptible and resistant groups. Compared to the susceptible group, transcriptomic analysis of liver samples using RNA-seq revealed 413 DEGs on day 21 and 214 DEGs on day 35 in the resistant group. Additional evaluations using gene ontology (GO) indicate that significant enrichment occurred in the oxygen transportation, defensive reactions, and protein modifications of the decreased DEGs as well as in the cell morphological formation, neural development, and transforming growth factor (TGF)-beta signalling of the increased DEGs on day 21. Oxygen transportation was also significantly enriched for downregulated DEGs on day 35. The combinatory evaluation of the metabolome and the transcriptome suggests the possible involvement of glycerophospholipid metabolism in the development of resistant-AS in broilers.

  11. Stimulation of glucose uptake by Musa sp. (cv. elakki bale) flower and pseudostem extracts in Ehrlich ascites tumor cells.

    Science.gov (United States)

    Bhaskar, Jamuna J; Salimath, Paramahans V; Nandini, Chilkunda D

    2011-06-01

    Glucose uptake study plays a major role in diabetes research. Impaired glucose uptake has been implicated in the development of hyperglycemia during diabetes. Banana plant is known for its anti-diabetic properties and our earlier report revealed that banana flower and pseudostem of Musa sp. cv. elakki bale is beneficial during diabetes in rat models. The present study was designed to evaluate the potential effect of banana flower and pseudostem extracts on glucose uptake in Ehrlich ascites tumor (EAT) cells using 2-[N-(7-nitrobenz-2-oxa-1,3-diazol-4-yl)amino]-2-deoxy-D-glucose (2-NBDG), a fluorescent analogue of 2-deoxyglucose. Methanol and aqueous extracts of banana flower and pseudostem were more potent in promoting glucose uptake in EAT cells, in comparison to acetone and ethanol extracts. At 20 µg dosage, highest net glucose uptake was observed in aqueous extracts of banana flower (18.17 ± 0.43 nmol L⁻¹) and pseudostem (19.69 ± 0.41 nmol L⁻¹). Total polyphenol content was higher in methanol (9.031 ± 0.036 g kg⁻¹) and aqueous (6.862 ± 0.024 g kg⁻¹) extracts of banana flower compared to pseudostem, which were 0.442 ± 0.006 and 0.811 ± 0.011 g kg⁻¹, respectively. Banana flower and pseudostem extracts are able to promote glucose uptake into the cells, presumably through glucose transporters 1 and 3, which could be beneficial in diabetes. Glucose uptake is likely promoted by phenolic acids besides other bioactives. It can be hypothesized that consumption of nutraceutical-rich extract of banana flower and pseudostem could replace some amount of insulin being taken for diabetes. Copyright © 2011 Society of Chemical Industry.

  12. Acute cholecystitis

    OpenAIRE

    Fialkowski, Elizabeth; Halpin, Valerie; Whinney, Robb R

    2008-01-01

    Acute cholecystitis causes unremitting right upper quadrant pain, anorexia, nausea, vomiting, and fever, and if untreated can lead to perforations, abscess formation, or fistulae. About 95% of people with acute cholecystitis have gallstones.It is thought that blockage of the bile duct by a gallstone or local inflammation can lead to acute cholecystitis, but we don't know whether bacterial infection is also necessary.

  13. Acute cholecystitis

    OpenAIRE

    Halpin, Valerie

    2014-01-01

    Acute cholecystitis causes unremitting right upper quadrant pain, anorexia, nausea, vomiting, and fever, and if untreated can lead to perforations, abscess formation, or fistulae. About 95% of people with acute cholecystitis have gallstones.It is thought that blockage of the cystic duct by a gallstone or local inflammation can lead to acute cholecystitis, but we don't know whether bacterial infection is also necessary.

  14. Acute cholecystitis

    OpenAIRE

    Halpin, Valerie; Gupta, Aditya

    2011-01-01

    Acute cholecystitis causes unremitting right upper quadrant pain, anorexia, nausea, vomiting, and fever, and if untreated can lead to perforations, abscess formation, or fistulae. About 95% of people with acute cholecystitis have gallstones.It is thought that blockage of the bile duct by a gallstone or local inflammation can lead to acute cholecystitis, but we don't know whether bacterial infection is also necessary.

  15. [A case of pleural effusion associated with acute hepatitis A].

    Science.gov (United States)

    Ko, Young Sun; Yoo, Ki Deok; Hyun, Yil Sik; Chung, Hae Ryoung; Park, Soo Yuk; Kim, Sun Min; Jeon, Yong Cheol

    2010-03-01

    Hepatitis A virus (HAV) infection is common in developing countries, including Korea. It can be accompanied by extrahepatic complications such as renal failure, arthritis, and vasculitis. Pleural effusion is a very rare complication of HAV infection, which has been reported usually in children, and has benign clinical courses. Here we report a case of pleural effusion with ascites which occurred in an adult hepatitis A patient. A 26-year-old-woman presented generalized myalgia and fever and was diagnosed as acute hepatitis A. Despite of the improvement of laboratory findings, fever and cough persisted. Pleural effusion newly appeared on the serial chest radiologic images. After the fever settled down, the pleural effusion resolved spontaneously at 13th day of admission.

  16. Risk factors for acute kidney injury after partial hepatectomy.

    Science.gov (United States)

    Bredt, Luis Cesar; Peres, Luis Alberto Batista

    2017-06-28

    To identify risk factors for the occurrence of acute kidney injury (AKI) in the postoperative period of partial hepatectomies. Retrospective analysis of 446 consecutive resections in 405 patients, analyzing clinical characteristics, preoperative laboratory data, intraoperative data, and postoperative laboratory data and clinical evolution. Adopting the International Club of Ascites criteria for the definition of AKI, potential predictors of AKI by logistic regression were identified. Of the total 446 partial liver resections, postoperative AKI occurred in 80 cases (17.9%). Identified predictors of AKI were: Non-dialytic chronic kidney injury (CKI), biliary obstruction, the Model for End-Stage Liver Disease (MELD) score, the extent of hepatic resection, the occurrence of intraoperative hemodynamic instability, post-hepatectomy haemorrhage, and postoperative sepsis. The MELD score, the presence of non-dialytic CKI and biliary obstruction in the preoperative period, and perioperative hemodynamics instability, bleeding, and sepsis are risk factors for the occurrence of AKI in patients that underwent partial hepatectomy.

  17. Macrophages Reprogrammed In Vitro Towards the M1 Phenotype and Activated with LPS Extend Lifespan of Mice with Ehrlich Ascites Carcinoma.

    Science.gov (United States)

    Kalish, Sergey V; Lyamina, Svetlana V; Usanova, Elena A; Manukhina, Eugenia B; Larionov, Nikolai P; Malyshev, Igor Y

    2015-10-16

    BACKGROUND The majority of tumors trigger macrophage reprogramming from an anti-tumor M1 phenotype towards a pro-tumor M2 phenotype. The M2 phenotype promotes tumor growth. We hypothesized that increasing the number of M1 macrophages in a tumor would limit carcinogenesis and extend the lifespan of the tumor host. The aim of this study was to verify this hypothesis in Ehrlich ascites carcinoma (EAC). The objectives were to evaluate effects of 1) EAC on a macrophage phenotype and NO-producing macrophage activity in vivo; 2) ascitic fluid from mice with EAC on a macrophage phenotype and NO-producing macrophage activity in vitro; and 3) in vitro reprogrammed M1 macrophages on lifespan of mice with EAC. MATERIAL AND METHODS The study was conducted using C57BL/6J mice. RESULTS Concentration of nitrite, a stable NO metabolite and an index of NO production, was measured spectrophotometrically. Shifts of macrophage phenotype were assessed by changes in NO production as well as by amounts of CD80, a marker of M1 phenotype, and CD206, a marker of M2 phenotype. The CD markers were measured by flow cytometry. Macrophages were reprogrammed towards the M1 phenotype using two reprogramming factors: 0% FBS and 20 ng/ml IFN-γ. The study results showed that 1) EAC inhibited the macrophage NO production in vivo and reprogrammed macrophages towards the M2 phenotype; 2) ascitic fluid of mice with EAC inhibited the macrophage NO production in vitro and reprogrammed macrophages towards the M2 phenotype; and 3) injection of in vitro reprogrammed M1 macrophages into mice with EAC significantly increased the lifespan of mice. CONCLUSIONS These findings suggest that promising biotechnologies for restriction of tumor growth could be developed based on the in vitro macrophage reprogramming.

  18. Immune-Inflammatory and Metabolic Effects of High Dose Furosemide plus Hypertonic Saline Solution (HSS) Treatment in Cirrhotic Subjects with Refractory Ascites

    Science.gov (United States)

    Bellia, Chiara; Clemente, Giuseppe; Pecoraro, Rosaria; Maida, Carlo; Simonetta, Irene; Vassallo, Valerio; Di Bona, Danilo; Gulotta, Eliana; Ciaccio, Marcello; Pinto, Antonio

    2016-01-01

    Introduction Patients with chronic liver diseases are usually thin as a result of hypermetabolism and malnutrition expressed by reduced levels of leptin and impairment of other adyponectins such as visfatin. Aims We evaluated the metabolic and inflammatory effects of intravenous high-dose furosemide plus hypertonic saline solutions (HSS) compared with repeated paracentesis and a standard oral diuretic schedule, in patients with cirrhosis and refractory ascites. Methods 59 consecutive cirrhotic patients with refractory ascites unresponsive to outpatient treatment. Enrolled subjects were randomized to treatment with intravenous infusion of furosemide (125–250mg⁄bid) plus small volumes of HSS from the first day after admission until 3 days before discharge (Group A, n:38), or repeated paracentesis from the first day after admission until 3 days before discharge (Group B, n: 21). Plasma levels of ANP, BNP, Leptin, visfatin, IL-1β, TNF-a, IL-6 were measured before and after the two type of treatment. Results Subjects in group A were observed to have a significant reduction of serum levels of TNF-α, IL-1β, IL-6, ANP, BNP, and visfatin, thus regarding primary efficacy endpoints, in Group A vs. Group B we observed higher Δ-TNF-α, Δ-IL-1β, Δ-IL-6, Δ-ANP, Δ-BNP, Δ-visfatin, Δ-Leptin at discharge. Discussion Our findings underline the possible inflammatory and metabolic effect of saline overload correction in treatment of cirrhosis complications such as refractory ascites, suggesting a possible role of inflammatory and metabolic-nutritional variables as severity markers in these patients. PMID:27941973

  19. Immune-Inflammatory and Metabolic Effects of High Dose Furosemide plus Hypertonic Saline Solution (HSS Treatment in Cirrhotic Subjects with Refractory Ascites.

    Directory of Open Access Journals (Sweden)

    Antonino Tuttolomondo

    Full Text Available Patients with chronic liver diseases are usually thin as a result of hypermetabolism and malnutrition expressed by reduced levels of leptin and impairment of other adyponectins such as visfatin.We evaluated the metabolic and inflammatory effects of intravenous high-dose furosemide plus hypertonic saline solutions (HSS compared with repeated paracentesis and a standard oral diuretic schedule, in patients with cirrhosis and refractory ascites.59 consecutive cirrhotic patients with refractory ascites unresponsive to outpatient treatment. Enrolled subjects were randomized to treatment with intravenous infusion of furosemide (125-250mg⁄bid plus small volumes of HSS from the first day after admission until 3 days before discharge (Group A, n:38, or repeated paracentesis from the first day after admission until 3 days before discharge (Group B, n: 21. Plasma levels of ANP, BNP, Leptin, visfatin, IL-1β, TNF-a, IL-6 were measured before and after the two type of treatment.Subjects in group A were observed to have a significant reduction of serum levels of TNF-α, IL-1β, IL-6, ANP, BNP, and visfatin, thus regarding primary efficacy endpoints, in Group A vs. Group B we observed higher Δ-TNF-α, Δ-IL-1β, Δ-IL-6, Δ-ANP, Δ-BNP, Δ-visfatin, Δ-Leptin at discharge.Our findings underline the possible inflammatory and metabolic effect of saline overload correction in treatment of cirrhosis complications such as refractory ascites, suggesting a possible role of inflammatory and metabolic-nutritional variables as severity markers in these patients.

  20. Efficacy and safety of ultrasound-guided continuous hyperthermic intraperitoneal perfusion chemotherapy for the treatment of malignant ascites: a midterm study of 36 patients

    Directory of Open Access Journals (Sweden)

    Wu YB

    2016-01-01

    Full Text Available Yinbing Wu,1,2 Mingxin Pan,1 Shuzhong Cui,2 Mingchen Ba,2 Zulong Chen,2 Qiang Ruan2 1Second Department of Hepatobiliary Surgery, Zhujiang Hospital, Southern Medical University, 2Treatment Center of Body Cavitary Thermo-Perfusion, Cancer Hospital of Guangzhou Medical University, Guangzhou Medical University, Guangzhou, People’s Republic of China Background: This study aimed to evaluate the efficacy and safety of ultrasound-guided continuous hyperthermic intraperitoneal perfusion chemotherapy (CHIPC for the treatment of malignant ascites (MA. Methods: Between July 2011 and June 2013, 36 MA patients were prospectively and consecutively hospitalized for three cycles of elective CHIPC under ultrasound guidance, maintained at a constant flow rate of 400–600 mL/min normal saline containing 5-fluorouracil plus mitomycin or carboplatin and at a constant temperature of 43°C±0.2°C, for 90 minutes. Main outcome measures were ascites resolution, Karnofsky performance status (KPS, and serum tumor biomarkers at 2 weeks after the last cycle of CHIPC. All the patients underwent uneventful CHIPC as scheduled, and vital signs remained stable over CHIPC. Results: At 2 weeks after the last cycle of CHIPC, MA completely and partially resolved in 26 (72.2% patients and eight (22.2% patients, respectively; mean KPS score increased from pretreatment 61±9 to posttreatment 76±9 (P<0.001, and serum carcinoembryonic antigen and carbohydrate antigens 12-5 and 19-9 significantly decreased (all P<0.01. Conclusion: The current study indicated that ultrasound-guided CHIPC is an effective and safe palliative treatment modality for MA with respect to MA resolution, patient’s general well-being, and systemic disease control. The long-term benefit of CHIPC on overall survival remains to be investigated in MA patients. Keywords: continuous hyperthermic intraperitoneal perfusion chemotherapy, malignant ascites, peritoneal carcinomatosis, ultrasound guidance, safety

  1. Mid-infrared spectroscopy of serum, a promising non-invasive method to assess prognosis in patients with ascites and cirrhosis

    Science.gov (United States)

    Le Corvec, Maëna; Jezequel, Caroline; Monbet, Valérie; Fatih, Nadia; Charpentier, Frédéric; Tariel, Hugues; Boussard-Plédel, Catherine; Bureau, Bruno; Loréal, Olivier; Sire, Olivier

    2017-01-01

    Background & aims Prognostic tests are critical in the management of patients with cirrhosis and ascites. Biological tests or scores perform poorly in that situation. Mid-infrared fibre evanescent wave spectroscopy (MIR-FEWS) which allows for global serum metabolic profiling may provide more relevant information by measuring a wider range of metabolic parameters in serum. Here we present the accuracy of a MIR-FEWS based predictive model for the prognosis of 6 months survival in patients with ascites and cirrhosis. Methods Patients with ascites were prospectively included and followed up for 6 months. MIR-FEWS spectra were measured in serum samples. The most informative spectral variables obtained by MIR-FEWS were selected by FADA algorithm and then used to build the MIR model. Accuracy of this model was assessed by ROC curves and 90%/10% Monte Carlo cross-validation. MIR model accuracy for 6 months survival was compared to that of the Child-Pugh and MELD scores. Results 119 patients were included. The mean age was 57.36±13.70, the MELD score was 16.32±6.26, and the Child-Pugh score was 9.5±1.83. During follow-up, 23 patients died (20%). The MIR model had an AUROC for 6 months mortality of 0.90 (CI95: 0.88–0.91), the MELD 0.77 (CI95: 0.66–0.89) and Child-Pugh 0.76 (CI95: 0.66–0.88). MELD and Child-Pugh AUROCs were significantly lower than that of the MIR model (p = 0.02 and p = 0.02 respectively). Multivariate logistic regression analysis showed that MELD (pinfrared spectroscopy could be helpful in the management of these patients. PMID:29020046

  2. Phosphorylation in vivo of non-ribosomal proteins from native 40 S ribosomal particles of Krebs II mouse ascites-tumour cells

    DEFF Research Database (Denmark)

    Schuck, J; Reichert, G; Issinger, O G

    1981-01-01

    Four non-ribosomal proteins from native 40 S ribosomal subunits with mol.wts. of 110 000, 84 000, 68 000 and 26 000 were phosphorylated in vivo when ascites cells were incubated in the presence of [32P]Pi. The 110 000-, 84 000- and 26 000-dalton proteins are identical with phosphorylated products...... from native 40 S subunits after phosphorylation in vitro by a cyclic nucleotide-independent protein kinase. Phosphoserine was the major phosphorylated amino acid of the proteins phosphorylated in vivo and in vitro....

  3. Influence of genetic variations in the SOD1 gene on the development of ascites and spontaneous bacterial peritonitis in decompensated liver cirrhosis

    DEFF Research Database (Denmark)

    Schwab, Sebastian; Lehmann, Jennifer; Lutz, Philipp

    2017-01-01

    from pathogens. As both processes are involved in the development of liver cirrhosis and its complications, genetic variation of the SOD1 gene was investigated. PATIENTS AND METHODS: Two SOD1 single nucleotide polymorphisms (rs1041740 and rs3844942) were analyzed in 49 cirrhotic patients undergoing...... liver transplantation. In addition, 344 cirrhotic patients with ascites were analyzed in a cohort of 521 individuals in terms of the relationship of these polymorphisms with spontaneous bacterial peritonitis (SBP). RESULTS: Although rs3844942 showed no associations with complications of cirrhosis, we...

  4. Inducible Protective Processes in Animal Systems XIII: Comparative Analysis of Induction of Adaptive Response by EMS and MMS in Ehrlich Ascites Carcinoma Cells

    OpenAIRE

    Periyapatna Vishwaprakash Mahadimane; Venkateshaiah Vasudev

    2014-01-01

    In order to investigate the presence of adaptive response in cancerous cells, two monofunctional alkylating agents, namely, ethyl methanesulfonate (EMS) and methyl methanesulfonate (MMS), were employed to treat Ehrlich ascites carcinoma (EAC) cells in vivo. Conditioning dose of 80 mg/kg body weight of EMS or 50 mg/kg body weight of MMS and challenging dose of 240 mg/kg body weight of EMS or 150 mg/kg body weight of MMS were selected by pilot toxicity studies. Conditioned EAC cells when challe...

  5. Characterization of native 40 S particles from Krebs II mouse ascites tumor cells: resolution, nomenclature and molecular weights of the nonribosomal proteins

    DEFF Research Database (Denmark)

    Reichert, G; Issinger, O G

    1981-01-01

    Native 40 S particles from Krebs II mouse ascites tumor cells were isolated on a large scale. A nonribosomal protein moiety of about 30 proteins could be removed from the ribosomal particles by treatment with 250 mM KCl. These proteins were analysed by two-dimensional polyacrylamide gel...... spots were excised from two-dimensional gels and transferred directly or after electrodialysis onto the third dimension gel. The proteins fell into a molecular weight range from about 20,000 to 300,000....

  6. Spontaneous Perforation of Common Bile Duct in a Child with a Clinical Manifestation of Acute Abdominal Distension: A Case Report

    Energy Technology Data Exchange (ETDEWEB)

    Jeong, Hee Rok; Namkyung Sook; Kim, Heung Cheol; Hong, Myung Sun [Dept. of Radiology, Chuncheon Sacred Heart Hospital, Hallym University College of Medicine, Chuncheon (Korea, Republic of)

    2011-09-15

    Spontaneous perforation of common bile duct (CBD) is extremely rare in children, but potentially a fatal disorder that requires an emergency laparotomy. Most of the patients present with insidious symptoms including slowly progressive abdominal distension with accumulation of the ascites, fluctuating mild jaundice, and clay-colored stools. We report a case of surgically confirmed spontaneous perforation of the CBD in a 3-year-old girl who presented with acute abdominal distension with no biliary symptoms or signs, and who showed imaging findings consistent with anomalous pancreaticobiliary ductal union with a focal stenosis in the CBD.

  7. Bronchitis (acute)

    OpenAIRE

    Wark, Peter

    2015-01-01

    Acute bronchitis affects more than 40 in 1000 adults per year in the UK. The causes are usually considered to be infective, but only around half of people have identifiable pathogens.The role of smoking or environmental tobacco smoke inhalation in predisposing to acute bronchitis is unclear.One third of people may have longer-term symptoms or recurrence.

  8. Acute nierschade

    NARCIS (Netherlands)

    Hageman, D.; Kooman, J.P.; Lance, M.D.; van Heurn, L.W.E.; Snoeijs, M.G.

    2012-01-01

    - 'Acute kidney injury' is modern terminology for a sudden decline in kidney function, and is defined by the RIFLE classification (RIFLE is an acronym for Risk, Injury, Failure, Loss and End-stage kidney disease).- Acute kidney injury occurs as a result of the combination of reduced perfusion in the

  9. Inhibition of ascitic ehrlich tumor cell growth by intraperitoneal injection of Pfaffia paniculata (Brazilian ginseng butanolic residue

    Directory of Open Access Journals (Sweden)

    Juliana Vieira

    2010-06-01

    Full Text Available This study aimed to investigate the effects of the administration of butanolic residue (BR of Pfaffia paniculata by intraperitoneal route to Ehrlich ascitis tumor bearing mice. Initially, a toxicity study of P. paniculata BR was performed in which doses of 12.5; 25 and 50mg/Kg were administered by intraperitoneal injection for seven days to Swiss mice. The treatment did not show toxicity. Then, Swiss male mice received, by intraperitoneal injection, once a day, 12.5; 25 or 50mg/Kg of P. paniculata BR for seven days. This protocol started in the same day of tumor inoculation with 5X10(6 cells i.p. The treatment with butanolic residue of P.paniculata i.p caused a significant increase in the ascitic volume; however, a significant decrease in tumor cells number per ml (pNeste estudo, foi avaliado o efeito do tratamento intraperitoneal com Resíduo Butanólico de Pfaffia paniculata, sobre o crescimento do Tumor de Ehrlich, forma ascítica. Foram utilizados dois grupos de 15 camundongos cada, sendo um grupo controle e o outro grupo tratado com RB 50mg/Kg. Todos os animais foram inoculados intraperitonealmente, com 5X10(6 células tumorais O tratamento iniciou-se no mesmo dia da inoculação do tumor. Assim, os animais receberam diariamente, por via intraperitoneal, 0,1 ml de RB na concentrações 50 mg/Kg, ou PBS como controle. Após 7 dias da inoculação do tumor, os animais foram eutanasiados e foi colhido o fluído ascítico total, para a contagem do número de células tumorais presentes neste fluído e estudo da morfologia destas células . Neste experimento observou-se aumento significante da quantidade de fluido ascítico nos animais tratados com RB, e diminuição significativa em relação ao número de células tumorais/ml e células tumorais totais, presentes no fluído ascítico, comparativamente com os animais controle. Estes resultados sugerem efeito inibitório tópico do RB levando à morte as células neoplásicas.

  10. Some genetic profiles in liver of Ehrlich ascites tumor-bearing mice under the stress of irradiation

    Directory of Open Access Journals (Sweden)

    Amal I. Hassan

    2014-04-01

    Full Text Available Radiation therapy aims to kill cancer cells with a minimum of normal tissue exposure. In an attempt to define the molecular and biochemical changes associated with exposure to radiotherapy, the objective of the present study is to explore the effect of gamma (γ irradiation on nuclear factor, erythroid 2 (NFE2, P53, stromelysin-1 (matrix metalloproteinase-3 (MMP3, BCL-2 and BAX genes expression in Ehrlich ascites carcinoma (EAC bearing mice. Various biochemical parameters such as liver function, H2O2, B% and T% lymphocytes, total antioxidants and MDA were investigated to evaluate their usefulness as possible during cancer treatment with radiotherapy. Rats were irradiated with a single whole body Cobalt 60-gamma radiation dose of 0.5 Gy. Sixty-four female mice, weighing 20–25 g were used in this study and divided into three main groups. The first group served as control group, while the second were injected intraperitoneally with EAC then was subdivided into two groups, II A and II B. The latter one (group II B, the animals were exposed to a single dose of 0.5 Gy whole body γ irradiation. The third main group, were irradiated with a single dose of 0.5 Gy whole body γ irradiation. Blood and liver tissue samples were collected at 4, 24 and 96 h post-irradiation. The gene expression levels in the livers of animals from each exposure group were compared individually with that of pooled sham-irradiated animals. MMP3 and NFE2 were overexpressed in liver samples of EAC group post 4, 24 and 96 h of γ irradiation (IIB. On the other hand, P53 and BCL-2 genes were downregulated by using RT-PCR analysis post 4, 24 and 96 h of γ irradiation (IIB. As well as, liver function and MDA were increased significantly in the γ - irradiation group (3rd group when compared to control mice (1st group. Gamma irradiation 3rd group revealed increase in the level of T% and B% lymphocytes. According to the obtained results, both γ rays and time period alter

  11. Effect of early feed restriction on physiological responses, performance and ascites incidence in broiler chickens raised in normal or cold environment.

    Science.gov (United States)

    Mohammadalipour, R; Rahmani, H R; Jahanian, R; Riasi, A; Mohammadalipour, M; Nili, N

    2017-02-01

    Intensive selection of broilers for faster growth and better feed efficiency resulted in greater susceptibility to metabolic disorders such as ascites syndrome, which is one of the major causes of mortality and economic loss in broiler industry. Whereas cool temperature is one of the primary triggers for ascites, early feed restriction (FDR) significantly alleviates its incidence and mortality. However, little is known about effects of FDR, cold environmental temperature and their interaction on physiological responses in broiler chickens. For this purpose, 320 one-day-old male broilers were divided into two treatment groups of Ad libitum (Ad) and feed restricted (FR) with eight pen replicates each. Chickens in FR group underwent feed access limitation from days 7 to 14 of age. On day 21 half of the birds (four pens) in each group exposed to the cold temperature (CT) and the other half (four pens) continued at normal temperature (NT). Average daily feed intake, average daily weight gain and feed conversion ratio (FCR) were measured at days 7, 14, 21, 28 and 42. At 39 and 46 days of age two chicks with a BW around the pen average were selected from each pen and slaughtered after collecting blood samples. Then, relative weight of internal organs and right ventricle weight per total ventricle weight (RV : TV) ratio were calculated. Compared with NT group, CT birds had higher daily feed intake and FCR (Pcold stress conditions, FDR reduced activity of alanine aminotransferase and aspartate aminotransferase (Pdamage.

  12. Quantitation of branched-chain amino acids in ascites by capillary electrophoresis with light-emitting diode-induced fluorescence detection.

    Science.gov (United States)

    Chang, Po-Ling; Chiu, Tai-Chia; Wang, Tsang-En; Hu, Kuang-Chun; Tsai, Yu-Hsien; Hu, Cho-Chun; Bair, Ming-Jong; Chang, Huan-Tsung

    2011-04-01

    Branched-chain amino acids (BCAAs) are one of the important biomarkers for monitoring liver disease such as hepatitis or hepatoma. In this communication, we present the determination of the concentrations of BCAA in ascites by CE light-emitted diode-induced fluorescence (LEDIF) using 1.5% m/v poly(ethylene oxide) (average M(v) : ~8 000 000 g/mol) that was prepared in 10 mM sodium tetraborate solution (pH 9.3). Naphthalene-2,3-dicarboxaldehyde was used to derivatize 15 amino acids (AAs) to form naphthalene-2,3-dicarboxaldehyde (NDA)-AA derivatives prior to CE analysis. The separation of 15 NDA-AA derivatives was accomplished within 15 min, with RSD values of gold standard method using an AA analyzer. We have found that the concentrations of the three BCAAs in ascites obtained from patients suffering from liver diseases were lower than those from healthy individuals. Our approach is highly efficient, sensitive, and cost-effective, which holds great potential for the diagnosis of liver diseases. Copyright © 2011 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

  13. Acute Pancreatitis and Pregnancy

    Science.gov (United States)

    ... Pancreatitis Acute Pancreatitis and Pregnancy Acute Pancreatitis and Pregnancy Timothy Gardner, MD Acute pancreatitis is defined as ... pancreatitis in pregnancy. Reasons for Acute Pancreatitis and Pregnancy While acute pancreatitis is responsible for almost 1 ...

  14. Acute Cholecystitis

    National Research Council Canada - National Science Library

    Schuld, Jochen; Glanemann, Matthias

    2015-01-01

    The treatment of acute cholecystitis has been controversially discussed in the literature as there are no high-evidence-level data yet for determining the optimal point in time for surgical intervention...

  15. Bronchitis (acute)

    OpenAIRE

    Wark, Peter

    2008-01-01

    Acute bronchitis, with transient inflammation of the trachea and major bronchi, affects over 40/1000 adults a year in the UK. The causes are usually considered to be infective, but only around half of people have identifiable pathogens.The role of smoking or environmental tobacco smoke inhalation in predisposing to acute bronchitis is unclear.A third of people may have longer-term symptoms or recurrence.

  16. Comparison of phosphorylation of ribosomal proteins from HeLa and Krebs II ascites-tumour cells by cyclic AMP-dependent and cyclic GMP-dependent protein kinases

    DEFF Research Database (Denmark)

    Issinger, O G; Beier, H; Speichermann, N

    1980-01-01

    identified by two-dimensional gel electrophoresis. Almost identical results were obtained when ribosomal subunits from HeLa or ascites-tumour cells were used. About 50-60% of the total radioactive phosphate incorporated into small-subunit ribosomal proteins by either kinase was associated with protein S6...

  17. Distribution of 3H within purine nucleotides of Ehrlich mouse ascites tumour cells after intraabdominal injection of myo-[2-3H]inositol

    DEFF Research Database (Denmark)

    Christensen, Søren; Klenow, H.; Overgaard-Hansen, Kay

    2000-01-01

    In Ehrlich mouse ascites tumour cells, exposed intra-abdominally to [2-3H]inositol, ATP and GTP presented enough aberrant 3H-label to cause potential interference in the chromatographic analysis of inositol phosphates involved in signal transduction. After acid extraction and charcoal adsorption...

  18. The effect of 3'-deoxyadenosine N(1)-oxide on growth in vitro and in vivo on Ehrlich ascites tumor and on a human squamous lung cell carcinoma xenograft in nude mice

    DEFF Research Database (Denmark)

    Svendsen, K R; Overgaard-Hansen, K; Frederiksen, S

    1996-01-01

    The effect of 3'-deoxyadenosine N(1)-oxide (3'-dANO) on Ehrlich ascites tumor and a human squamous lung cell carcinoma was investigated. The 3'-dANO concentration that inhibited the cell growth 50% (IC(50)) in Ehrlich ascites tumor cells in vitro was 0.15 mM, and the killing efficiency concentrat......The effect of 3'-deoxyadenosine N(1)-oxide (3'-dANO) on Ehrlich ascites tumor and a human squamous lung cell carcinoma was investigated. The 3'-dANO concentration that inhibited the cell growth 50% (IC(50)) in Ehrlich ascites tumor cells in vitro was 0.15 mM, and the killing efficiency...... concentration (concentration of the drug that kills all cells) was 1 mM. By simultaneous administration of 3'-dANO and the adenosine deaminase inhibitor erythro-9-(2-hydroxyl-3-nonyl) adenine (EHNA), the IC(50) of 3'-dANO was unchanged, but the killing efficiency concentration of 3'dANO was reduced to 0.3 m...

  19. Effect of time duration of digestion/decontamination technique on yield of mycobacteria and contamination rates from sterile body fluids (pleural and ascitic fluid) and pus specimens.

    Science.gov (United States)

    Shafiq, Samreen; Saleem, Faryal; Jabeen, Kauser; Farooqi, Joveria; Alam, Warda; Hanif, Sadia; Ali, Shazia; Shakoor, Sadia; Hasan, Rumina

    2016-12-01

    Duration of digestion/decontamination has a considerable impact on yield of mycobacteria especially from sterile body fluids and pus specimens. Additionally, duration of digestion/decontamination affects the contamination rates. This study evaluates the effect of digestion/decontamination protocol for 15 and 20min versus inoculation of media directly from the sample on contamination rates as well as the yield of mycobacteria from pus and sterile fluids other than cerebrospinal fluids. Pleural fluid (n=60), pus (n=48) and ascitic fluid (n=12) specimens were cultured for mycobacteria and evaluated for contamination and mycobacterial yield using three different processing methodologies: without digestion/decontamination with 5% NaOH-NALC (D/D), D/D for 15min and D/D for 20min. All samples >3mL in volume were spun at 3000 RCF for 15min, whereas those less than 3mL were used as is. They were simultaneously processed using the three different methods as mentioned above, and inoculated on LJ media and MGIT. Smear was made from samples treated for 20min and stained with fluorescent stain. Kinyoun staining was done on smears with dubious findings. Mycobacterial culture yield and contamination rates were recorded at 6weeks as recommended by the Global Laboratory Initiative (GLI) laboratory manual 2014. Pleural fluid and pus contamination rates were substantially lowered by increasing decontamination time from 15 to 20min, but it did not have any effect for ascitic fluid (Table 1). The 5-min difference in the decontamination procedure improved mycobacterial culture yield for pus samples by 10%, but there was no substantial effect on pleural and ascitic fluids. Prolonged decontamination did not compromise the culture yield in any of the mentioned specimens. In areas where specimen delay is common and sterility of collection procedure cannot be ensured, digestion/decontamination with NaOH-NALC for up to 20min can reduce contamination rates without considerably compromising

  20. Association of the G-protein and α2-adrenergic receptor gene and plasma norepinephrine level with clonidine improvement of the effects of diuretics in patients with cirrhosis with refractory ascites: a randomised clinical trial.

    Science.gov (United States)

    Yang, Y Y; Lin, H C; Lee, W P; Chu, C J; Lin, M W; Lee, F Y; Hou, M C; Jap, J S; Lee, S D

    2010-11-01

    Clonidine is an α(2)-adrenoceptor agonist which, by coupling with G-protein, has been proposed as an alternative treatment for refractory ascites of patients with cirrhosis for several years. Genetic polymorphisms of β-adrenoceptor and angiotensin II type 1 receptor blockers have been reported to affect drug response in patients with cirrhosis. This study evaluated the clonidine-diuretic response rate, favourable predictors and genetic components of the clonidine-diuretic response in patients with cirrhosis with refractory ascites. 270 patients with cirrhosis with refractory ascites were randomised equally into two treatment groups to receive diuretics alone or the clonidine-diuretics association. The primary end point was clonidine-diuretic response rate. Secondary end points were mean daily dose of diuretics, times of paracentesis, ascites-related readmission and 1-year survival rate. Good clonidine responders had better natriuresis and diuresis as well as a significant decrease in abdominal circumference, plasma renin, aldosterone and norepinephrine levels. The overall clonidine-diuretics response rate was 55-60%. In patients with cirrhosis, the prevalence of ARDA(2)C WD/DD and GNB3 CT/TT genotypes was 71% and 77%, respectively. Among the responders, 71% of patients with cirrhosis had the ARDA(2)C WD/DD genotype and 67% has the GNB3 CT/TT genotype. Besides higher baseline norepinephrine levels, the presence of both ARDA(2)C WD/DD and GNB3 CT/TT genotypes showed a positive predictive value of 82% and a negative predictive value of 79% for good clonidine response. These results suggest that neurohormonal and genetic testing may be used as predictive factors for the additive effects of clonidine on the diuresis and natriuresis effects of diuretics in patients with cirrhosis with refractory ascites.

  1. A cell shrinkage-induced non-selective cation conductance with a novel pharmacology in Ehrlich-Lettre-ascites tumour cells

    DEFF Research Database (Denmark)

    Lawonn, Peter; Hoffmann, Else K; Hougaard, Charlotte

    2003-01-01

    In whole-cell recordings on Ehrlich-Lettre-ascites tumour (ELA) cells, the shrinkage-induced activation of a cation conductance with a selectivity ratio P(Na):P(Li):P(K):P(choline):P(NMDG) of 1.00:0.97:0.88:0.03:0.01 was observed. In order of potency, this conductance was blocked by Gd(3+)=benzamil......>amiloride>ethyl-isopropyl-amiloride (EIPA). In patch-clamp studies using the cell-attached configuration, a 14 pS channel became detectable that was reversibly activated upon hypertonic cell shrinkage. It is concluded that ELA cells express a shrinkage-induced cation channel that may reflect a molecular link between amiloride...

  2. Current limits and future challenges in the management of renal dysfunction in patients with cirrhosis: report from the International Club of Ascites

    DEFF Research Database (Denmark)

    Angeli, Paolo; Sanyal, Arun; Møller, Søren

    2013-01-01

    Advanced cirrhosis is often complicated by a multi organ failure syndrome which involves many different organs besides the liver. The high morbidity and mortality secondary to this clinical setting is often related to renal dysfunction, either alone or, more frequently, in combination with other...... organ dysfunction. A clear defintion of renal dysfunction, an accurate differential diagnostic process of its different phenotypes as well as of full understanding of its pathophysiological mechanisms are crucial to the development of strategies for the management of this complication. This article...... is based either on the more recent knowledge on renal dysfunction in advanced cirrhosis or current opinions among the members of the International Club of Ascites (ICA) on the management of this complication, obtained through a survey and discussed during the EASL-ICA Joint Meeting in Berlin in March 2011...

  3. Interactions between three subpopulations of Ehrlich ascites tumor and a P388 murine leukemia in mixed solid tumors in immune competent mice

    DEFF Research Database (Denmark)

    Aabo, K; Vindeløv, L L; Christensen, I B

    1989-01-01

    Cellular interactions between three subpopulations of Ehrlich ascites tumor and between these and the P388 murine leukemia were studied during growth of solid tumors obtained by mixtures of the cells in immune competent N/D mice. An immunogenic Ehrlich cell line (E1.15) induced an immunologically...... based growth inhibition of the two other Ehrlich cell lines (E1.80 and E1.95) which themselves were non-immunogenic. E1.15 was, however, unable to induce an immunological response against the P388 cell line. It is therefore suggested that when in close contact, immunologically induced cellular responses...... of interaction required close cellular contact of viable cells, and no cellular immune response was elicited by the host animals. A third finding was that a faster growing Ehrlich cell line E1.95 dominated the tumors when inoculated in mixture with a slower growing subpopulation E1.80. This could be explained...

  4. Possible interrelationship between changes in F-actin and myosin II, protein phosphorylation, and cell volume regulation in Ehrlich ascites tumor cells

    DEFF Research Database (Denmark)

    Pedersen, S F; Hoffmann, E K

    2002-01-01

    Osmotic shrinkage of Ehrlich ascites tumor cells (EATC) elicited translocation of myosin II from the cytosol to the cortical region, and swelling elicits concentration of myosin II in the Golgi region. Rho kinase and p38 both appeared to be involved in shrinkage-induced myosin II reorganization....... In contrast, the previously reported shrinkage-induced actin polymerization [Pedersen et al. (1999) Exp. Cell Res. 252, 63-74] was independent of Rho kinase, p38, myosin light chain kinase (MLCK), and protein kinase C (PKC), which thus do not exert their effects on the shrinkage-activated transporters via...... by osmotic shrinkage and by the serine/threonine phosphatase inhibitor Calyculin A (CL-A). Both stimuli caused Rho kinase-dependent myosin II relocation to the cortical cytoplasm, but in contrast to the shrinkage-induced F-actin polymerization, CL-A treatment elicited a slight F-actin depolymerization...

  5. VALIDITY OF CONTRAST ENHANCED CT IN THE ASSESSMENT OF ACUTE PANCREATITIS AND ITS RELATED COMPLICATIONS

    Directory of Open Access Journals (Sweden)

    Mannivanan

    2016-03-01

    Full Text Available BACKGROUND In the earlier days, ultrasonogram was considered as one of the most important investigation for pancreatitis, later the clinicians started using cholangiography in acute pancreatitis, but today CT is considered as a gold standard test in the diagnosis of acute pancreatitis. Though the sensitivity of CT in diagnosing acute pancreatitis was not studied much particularly in a mild case, but a good-quality contrast enhanced CT demonstrates distinct pancreatic and peri-pancreatic abnormalities. AIM To assess the importance of computed tomography in diagnosing acute pancreatitis and its related complications. MATERIALS AND METHODS A prospective study was conducted on 150 patients with clinically suspected pancreatitis. CT was performed on all the patients with Siemens Spiral CT scanner Sensation 16 slice. Oral contrast of was 1000 mL given one hour prior to the scan in the form of taking 250 mL every 15 mins. The CT severity index (CTSI and the necrosis point scoring was used to assess the severity of acute pancreatitis. All the complications related to acute pancreatitis were also assessed. RESULTS The CT analysis in the detection of acute pancreatitis showed the sensitivity of 100% and the positive predictive value of 97.3%. The severity index of acute pancreatitis based on the CT imaging had shown that majority of the patients are with moderate (60.6% level of acute pancreatitis. The necrosis point scoring showed that 54.6% of the patients had necrosis involving less than 30% of the pancreas. Among the various complications detected by CECT the commonest were pleural effusion and ascites. CONCLUSION CECT is the most important gold standard technique both for diagnosis as well as for predicting the prognosis in acute pancreatitis. The clinicians should routinely send the patient for the CT imaging whenever there is a suspicion of pancreatitis clinically.

  6. Acute Pancreatitis

    DEFF Research Database (Denmark)

    Bertilsson, Sara; Håkansson, Anders; Kalaitzakis, Evangelos

    2017-01-01

    Aims: We aimed to evaluate the potential relation between the incidence of (alcoholic and non-alcoholic) acute pancreatitis (AP) and alcohol consumption in the general population, and whether the occurrence of AP shows any seasonal variation, particularly in relation to periods with expected...... consumption in the general population do not appear to be related to changes in the incidence of AP and there are no significant seasonal differences in the occurrence of AP in Sweden. Short summary: The incidence of acute pancreatitis (AP) is increasing, and alcohol is still recognized as one of the most...

  7. Lower-extremity lymphedema following neck dissection--an uncommon complication after cervical ligation of the thoracic duct.

    Science.gov (United States)

    Raguse, Jan D; Pfitzmann, Robert; Bier, Jürgen; Klein, Martin

    2007-09-01

    Thoracic duct injuries and chylous fistula are well-known complications of neck dissection, occurring in 1-2% of cases. Management of these injuries can be conservative or operative. Conservative treatment consists of fat restricted diet or total parenteral nutrition reducing the volume of chyle production. Operative management includes exploration of the neck or if necessary open thoracotomy to ligate the thoracic duct. Following cervical thoracic duct ligation only few complications like chylothorax or chylous ascites are described in the literature. To the best authors knowledge, this is the first report in the english literature describing lower-extremity lymphedema following cervical thoracic duct ligation.

  8. Role of isothiocyanate conjugate of pterostilbene on the inhibition of MCF-7 cell proliferation and tumor growth in Ehrlich ascitic cell induced tumor bearing mice

    Energy Technology Data Exchange (ETDEWEB)

    Nikhil, Kumar; Sharan, Shruti; Chakraborty, Ajanta [Molecular Endocrinology Laboratory, Department of Biotechnology, Indian Institute of Technology Roorkee, Roorkee 247 667, Uttarakhand (India); Bodipati, Naganjaneyulu; Krishna Peddinti, Rama [Department of Chemistry, Indian Institute of Technology Roorkee, Roorkee 247 667, Uttarakhand (India); Roy, Partha, E-mail: paroyfbs@iitr.ernet.in [Molecular Endocrinology Laboratory, Department of Biotechnology, Indian Institute of Technology Roorkee, Roorkee 247 667, Uttarakhand (India)

    2014-01-15

    Naturally occurring pterostilbene (PTER) and isothiocyanate (ITC) attract great attention due to their wide range of biological properties, including anti-cancer, anti-leukemic, anti-bacterial and anti-inflammatory activities. A novel class of hybrid compound synthesized by introducing an ITC moiety on PTER backbone was evaluated for its anti-cancer efficacy in hormone-dependent breast cancer cell line (MCF-7) in vitro and Ehrlich ascitic tumor bearing mice model in vivo. The novel hybrid molecule showed significant in vitro anti-cancer activity (IC{sub 50}=25±0.38) when compared to reference compound PTER (IC{sub 50}=65±0.42). The conjugate molecule induced both S and G2/M phase cell cycle arrest as indicated by flow cytometry analysis. In addition, the conjugate induced cell death was characterized by changes in cell morphology, DNA fragmentation, activation of caspase-9, release of cytochrome-c into cytosol and increased Bax: Bcl-2 ratio. The conjugate also suppressed the phosphorylation of Akt and ERK. The conjugate induced cell death was significantly increased in presence of A6730 (a potent Akt1/2 kinase inhibitor) and PD98059 (a specific ERK inhibitor). Moreover, the conjugated PTER inhibited tumor growth in Ehrlich ascitic cell induced tumor bearing mice as observed by reduction in tumor volume compared to untreated animals. Collectively, the pro-apoptotic effect of conjugate is mediated through the activation of caspases, and is correlated with the blockade of the Akt and ERK signaling pathways in MCF-7 cells. - Highlights: • Conjugate was prepared by appending isothiocyanate moiety on pterostilbene backbone. • Conjugate showed anticancer effects at comparatively lower dose than pterostilbene. • Conjugate caused blockage of the Akt and ERK signaling pathways in MCF-7 cells. • Conjugate significantly reduced solid tumor volume as compared to pterostilbene.

  9. Aquaporin 5 expression is altered in ovarian tumors and ascites-derived ovarian tumor cells in the chicken model of ovarian tumor.

    Science.gov (United States)

    Tiwari, Anupama; Hadley, Jill A; Ramachandran, Ramesh

    2014-10-25

    Aquaporin 5 (AQP5), a member of the aquaporin family of transmembrane channel proteins, is involved in water transport and cellular proliferation in various tumors. The objective of this study was to determine cellular localization of aquaporin 5 (AQP5) in the ovarian tumors of chicken, a preclinical model for human ovarian tumor and to determine if AQP5 mRNA and protein expression levels in cancerous chicken ovaries and in ascites-derived chicken ovarian cancer (COVCAR) cell lines are different from normal ovaries and normal ovarian surface epithelial (NOSE) cells, respectively. Immunohistochemical staining was performed to determine the localization of AQP5-immunoreactive (ir) cells in normal and cancerous ovaries. To determine AQP5 mRNA and protein concentrations in cancerous ovaries and COVCAR cell lines, quantitative real time PCR and Western blotting analysis were performed, respectively. Student's t-test was performed to compare the levels of AQP5 mRNA or protein in cancerous ovaries and COVCAR cell lines with that of normal ovaries and NOSE cells, respectively. AQP5-ir cells were localized in granulosa and theca layers of normal ovarian follicles whereas cancerous ovaries showed AQP5 immunostaining in the surface epithelium, fibroblast cells of the stroma, and in the cells lining tumor cysts and acini. AQP5 mRNA concentration were significantly lesser while AQP5 protein concentrations were significantly greater in cancerous ovaries compared to that in normal ovaries (P cell lines compared with that in NOSE cells. AQP5 is differentially expressed in ovarian tumor and in COVCAR cell lines suggesting a potential involvement of AQP5 in ovarian tumorigenesis, metastasis, and survival of ovarian tumor cells in ascites.

  10. Peritonitis bacteriana espontánea: estudio en pacientes cirróticos descompensados con ascitis Spontaneous bacterial peritonitis in decompensated cirrhotic patients with ascites

    Directory of Open Access Journals (Sweden)

    Fernando Montoya Maya

    1995-02-01

    . coli y estreptococos del grupo viridans debe tenerse en cuenta para la adecuada selección de la terapia empírica antibacteriana.

    Between February 1993 and March 1994 a prospective descriptive study was carried out in 25 cirrhotic patients (three of them on two occasions with clinical or ultrasonographic ascites; they were hospitalized in the Internal Medicine ward of San Vicente de Paúl Hospital, in Medellín, Colombia, because of decompensation. All of them went through diagnostic paracentesis with cytologic, bacteriologic and chemical studies. Average age was 43.9 years (13 to 77 years, 13 were women (52% and 12 men (48%. Infection of the ascitic fluid was found in 11 cases (39.3%, namely: Bacterascites 6 cases (monomicrobial 3 cases (27.3%, polymicrobial 3 cases (27.3%», spontaneous bacterial peritonitis 3 cases (polymicrobial 2 cases (18.2% and monomicrobial1 case (9.1 %» and neutrocytic ascites 2 cases (18.2%. Seventy two percent of the infectious episodes caused fever (p < 0.01 and in 46% there was abdominal pain (p < 0.1. AII patients with infected ascites belonged to Child's classification C. Serum albumin levellower than 2 g/dl was a risk factor for developing infection. Escherichia coli was cultivated on 5 occasions (45.5%, viridans group of Streptococci in 5 (45.5%, anaerobes in 3 (27.3% and other bacteria in 3 (27.3%. Mortality due to infected ascites was 27.3% (3 cases, comparable to that produced by other causes that was 29.4% (5/17. We conclude that ascitic fluid infection is a common complication in decompensated cirrhotic patients. Thecardinal clinical signs are fever and abdominal pain. The frequent isolation of E. coli and viridans group Streptococci has to be taken into account for the initiation of antibiotic therapy in cases with clinical suspicion.

  11. [Biochemical and functional changes in experimental acute pancreatitis in the rat].

    Science.gov (United States)

    Díez Miralles, M; Pardo Correcher, J M; González Santos, J; Graells Ferrer, M L; Ferrando Marco, J; Regalado Pareja, R I; Medrano Heredia, J

    1989-10-01

    To discover the biochemical alterations occurring in the first 24 hours of acute pancreatitis (PA), we made an experimental study using rats. We used 90 animals in which necrosis and hemorrhage were induced by closing the choledochus. Animals underwent evolutive periods of 1, 2, 3, 4, 5, 6, 12, 18 and 24 hours. They were sacrificed and plasma (to determine amylase, lipase, creatinine and calcium), urine (amylase and creatinine), ascitic and pleural liquid (amylase and lipase) were obtained from 6 animals of each evolutive period. We made a post-mortem study of the pancreas of three animals of each subgroup. There was a significant increase in the amylasemia from the third hour (p less than 0.005) and of plasmatic lipase from the first hour (p less than 0.0001). Creatinine values remained in normal range and calcemia fell after the sixth hour (p less than 0.001). There was an increase in amylase concentration in urine and in ascitic and pleural liquids, and of the lipase in the last two. These changes correlated with the duration of the disease and with the histologic changes of the gland, which consist in edema, acinar necrosis, vasculitis and hemorrhage, which are present from the first hour and increase as time passes.

  12. Respiratory impact of paracentesis in cirrhotic patients with acute lung injury.

    Science.gov (United States)

    Levesque, Eric; Hoti, Emir; Jiabin, Jin; Dellamonica, Jean; Ichai, Philippe; Saliba, Faouzi; Azoulay, Daniel; Samuel, Didier

    2011-06-01

    Ascites may contribute to the loss of lung volume and alter the gas exchange in cirrhotic patients with acute lung injury (ALI). The aim of the study was to evaluate the effects of paracentesis on respiratory parameters in ventilated cirrhotic patients with ALI. This was a prospective trial in an intensive care unit of a university hospital. Thirty-one cirrhotic patients on mechanical ventilation (with ALI) requiring paracentesis were included in this study. Arterial blood gases, intraabdominal pressures, ventilator parameters, and lung volumes were measured before and after the ascitic drainage. Following paracentesis, the intraabdominal pressure decreased (24.1 ± 7.0 vs 12.3 ± 8.9 mm Hg, P < .0001) and the Pao(2)/Fio(2) improved significantly (190.0 ± 65.2 vs 284.9 ± 76.1 mm Hg, P < .0001), without hemodynamic disturbances. End-expiratory lung volume, markedly reduced before drainage, increased significantly following paracentesis (Δ end-expiratory lung volume: +463 ± 249 mL, P = .0009). No adverse effects related to the paracentesis were encountered. In contrast to ventilatory recruitment maneuvers, paracentesis is a simple and well-tolerated technique able to improve oxygenation and alveolar recruitment without the risk of the lung overdistension in severely hypoxemic cirrhotic patients. Copyright © 2011 Elsevier Inc. All rights reserved.

  13. Acute Sinusitis

    Science.gov (United States)

    ... Acute sinusitis is mostly caused by the common cold. Unless a bacterial infection develops, most cases resolve within a week to 10 days. In ... sinusitis is most often caused by the common cold, which is a viral infection. In some cases, a bacterial infection develops. Risk factors You may ...

  14. Acute pancreatitis.

    Science.gov (United States)

    Munsell, Melissa A; Buscaglia, Jonathan M

    2010-04-01

    Acute pancreatitis is a common disease most frequently caused by gallstone disease or excess alcohol ingestion. Diagnosis is usually based on characteristic symptoms, often in conjunction with elevated serum pancreatic enzymes. Imaging is not always necessary, but may be performed for many reasons, such as to confirm a diagnosis of pancreatitis, rule out other causes of abdominal pain, elucidate the cause of pancreatitis, or to evaluate for complications such as necrosis or pseudocysts. Though the majority of patients will have mild, self-limiting disease, some will develop severe disease associated with organ failure. These patients are at risk to develop complications from ongoing pancreatic inflammation such as pancreatic necrosis, fluid collections, pseudocysts, and pancreatic duct disruption. Validated scoring systems can help predict the severity of pancreatitis, and thus, guide monitoring and intervention.Treatment of acute pancreatitis involves supportive care with fluid replacement, pain control, and controlled initiation of regular food intake. Prophylactic antibiotics are not recommended in acute pancreatitis if there is no evidence of pancreatic infection. In patients who fail to improve, further evaluation is necessary to assess for complications that require intervention such as pseudocysts or pancreatic necrosis. Endoscopy, including ERCP and EUS, and/or cholecystectomy may be indicated in the appropriate clinical setting. Ultimately, the management of the patient with severe acute pancreatitis will require a multidisciplinary approach. (c) 2010 Society of Hospital Medicine.

  15. Acute Bronchitis.

    Science.gov (United States)

    Kinkade, Scott; Long, Natalie A

    2016-10-01

    Cough is the most common illness-related reason for ambulatory care visits in the United States. Acute bronchitis is a clinical diagnosis characterized by cough due to acute inflammation of the trachea and large airways without evidence of pneumonia. Pneumonia should be suspected in patients with tachypnea, tachycardia, dyspnea, or lung findings suggestive of pneumonia, and radiography is warranted. Pertussis should be suspected in patients with cough persisting for more than two weeks that is accompanied by symptoms such as paroxysmal cough, whooping cough, and post-tussive emesis, or recent pertussis exposure. The cough associated with acute bronchitis typically lasts about two to three weeks, and this should be emphasized with patients. Acute bronchitis is usually caused by viruses, and antibiotics are not indicated in patients without chronic lung disease. Antibiotics have been shown to provide only minimal benefit, reducing the cough or illness by about half a day, and have adverse effects, including allergic reactions, nausea and vomiting, and Clostridium difficile infection. Evaluation and treatment of bronchitis include ruling out secondary causes for cough, such as pneumonia; educating patients about the natural course of the disease; and recommending symptomatic treatment and avoidance of unnecessary antibiotic use. Strategies to reduce inappropriate antibiotic use include delayed prescriptions, patient education, and calling the infection a chest cold.

  16. Acute abdomen

    Directory of Open Access Journals (Sweden)

    Wig J

    1978-01-01

    Full Text Available 550 cases of acute abdomen have been analysed in detail includ-ing their clinical presentation and operative findings. Males are more frequently affected than females in a ratio of 3: 1. More than 45% of patients presented after 48 hours of onset of symptoms. Intestinal obstruction was the commonest cause of acute abdomen (47.6%. External hernia was responsible for 26% of cases of intestinal obstruction. Perforated peptic ulcer was the commonest cause of peritonitis in the present series (31.7% while incidence of biliary peritonitis was only 2.4%.. The clinical accuracy rate was 87%. The mortality in operated cases was high (10% while the over-all mortality rate was 7.5%.

  17. [Acute cholangiocholecystitis].

    Science.gov (United States)

    Gavrilescu, S; Rădulescu, D

    1991-01-01

    In analysis of a group of 48 patients, the authors describe an entity they call acute cholangio-cholecystitis (or acute cholecystitis of choledochal origin) and define it by 4 obligatory criteria: 1. vesicular lesion of acute cholecystitis type; 2. the obstruction of the main bile duct in the direction of its junction with the cystic duct; 3. free duct communication between the gallbladder and the main bile ducts; 4. fluid content (purulent gallbladder) found identical over the whole biliary territory (the gallbladder the main bile ducts the intrahepatic bile ducts). This entity represents 7.6% of the total of acute cholecystitis and was met in 2.8% of the total of the interventions for the main bile ducts obstruction. The deficient biological background of the patients (60% over 60 years old), and other seriousness factors--vesicular destructive lesions associated with biliary peritonitis (7/48), the existence of the duct obstruction, usually calculous (42/48), but also hydatic (3/48) or tumoural (3/48), the multitude and seriousness of the associated lesions are emphasized. The surgery, performed in over 80% emergent cases, was directed to the decomprimation of the main biliary axis to which the increase of the gangrenous cholecyst, treatment of the duct obstructive factor, repair of the internal biliary fistulas, treatment of the consequent peritonitis were added. The results, very often good (71%), were shadowed by a series of complications (29%) which ended in deaths (14.5%). The paper pleads for the early surgery of the lithiasic biliary disease, before the appearance of the inevitable complications.

  18. Sinusitis (acute)

    Science.gov (United States)

    2008-01-01

    Introduction Acute sinusitis is defined pathologically, by transient inflammation of the mucosal lining of the paranasal sinuses lasting less than 4 weeks. Clinically, it is characterised by nasal congestion, rhinorrhoea, facial pain, hyposmia, sneezing, and, if more severe, additional malaise and fever. It affects 1−5% of the adult population each year in Europe. Methods and outcomes We conducted a systematic review and aimed to answer the following clinical questions: What are the effects of treatments in people with clinically diagnosed acute sinusitis, and with radiologically or bacteriologically confirmed acute sinusitis? We searched: Medline, Embase, The Cochrane Library and other important databases up to August 2007 (BMJ Clinical Evidence reviews are updated periodically; please check our website for the most up-to-date version of this review). We included harms alerts from relevant organisations such as the US Food and Drug Administration (FDA) and the UK Medicines and Healthcare products Regulatory Agency (MHRA). Results We found 19 systematic reviews, RCTs, or observational studies that met our inclusion criteria. We performed a GRADE evaluation of the quality of evidence for interventions. Conclusions In this systematic review we present information relating to the effectiveness and safety of the following interventions: antibiotics (amoxicillin, co-amoxiclav, doxycycline, cephalosporins, macrolides, different doses [amoxicillin, co-amoxiclav, doxycycline, cephalosporins, macrolides], long-course regimens), antihistamines, cephalosporins or macrolides, decongestants (xylometazoline, phenylephrine, pseudoephedrine), doxycycline, saline nasal washes, steam inhalation, and topical corticosteroids (intra-nasal). PMID:19450327

  19. Bronchitis (acute).

    Science.gov (United States)

    Wark, Peter

    2011-06-20

    Acute bronchitis affects over 40/1000 adults a year in the UK. The causes are usually considered to be infective, but only around half of people have identifiable pathogens. The role of smoking or of environmental tobacco smoke inhalation in predisposing to acute bronchitis is unclear. One third of people may have longer-term symptoms or recurrence. We conducted a systematic review and aimed to answer the following clinical question: What are the effects of treatments for acute bronchitis in people without chronic respiratory disease? We searched: Medline, Embase, The Cochrane Library, and other important databases up to March 2010 (Clinical Evidence reviews are updated periodically; please check our website for the most up-to-date version of this review). We included harms alerts from relevant organisations such as the US Food and Drug Administration (FDA) and the UK Medicines and Healthcare products Regulatory Agency (MHRA). We found 21 systematic reviews, RCTs, or observational studies that met our inclusion criteria. We performed a GRADE evaluation of the quality of evidence for interventions. In this systematic review we present information relating to the effectiveness and safety of the following interventions: analgesics, antibiotics (macrolides, tetracyclines, cephalosporins, penicillins, or trimethoprim-sulfamethoxazole [co-trimoxazole]), antihistamines, antitussives, beta(2) agonists (inhaled or oral), and expectorants/mucolytics.

  20. Acute leukemia.

    Science.gov (United States)

    Rose-Inman, Hayley; Kuehl, Damon

    2014-08-01

    Although great progress has been made in the understanding and treatment of acute leukemia, this disease has not been conquered. For emergency providers (EPs), the presentation of these patients to an emergency department presents a host of challenges. A patient may present with a new diagnosis of leukemia or with complications of the disease process or associated chemotherapy. It is incumbent on EPs to be familiar with the manifestations of leukemia in its various stages and maintain some suspicion for this diagnosis, given the nebulous and insidious manner in which leukemia can present. Copyright © 2014 Elsevier Inc. All rights reserved.

  1. Hyperoncotic colloids and acute kidney injury: a meta-analysis of randomized trials

    Science.gov (United States)

    2010-01-01

    Introduction It has been hypothesized that hyperoncotic colloids might contribute to acute kidney injury (AKI). However, the validity of this hypothesis remains unclear. Methods A meta-analysis was conducted of randomized controlled trials evaluating AKI after infusion of hyperoncotic albumin and hydroxyethyl starch (HES) solutions. Mortality was a secondary endpoint. Eligible trials were sought by multiple methods, and the pooled odds ratios (OR) for AKI and death and 95% confidence intervals (CI) were computed under a random effects model. Results Eleven randomized trials with a total of 1220 patients were included: 7 evaluating hyperoncotic albumin and 4 hyperoncotic HES. Clinical indications were ascites, surgery, sepsis and spontaneous bacterial peritonitis. Hyperoncotic albumin decreased the odds of AKI by 76% (OR, 0.24; CI, 0.12-0.48; P colloid solutions per se injure the kidney. Renal effects appear instead to be colloid-specific, with albumin displaying renoprotection and HES showing nephrotoxicity. PMID:21029460

  2. Chylous leak following left anterior spine decompression: Case report

    African Journals Online (AJOL)

    East African Orthopaedic Journal. Journal Home · ABOUT · Advanced Search · Current Issue · Archives · Journal Home > Vol 7, No 1 (2013) >. Log in or Register to get access to full text downloads.

  3. The efficiency of apparent diffusion coefficient quantification in diagnosis of acute cholecystitis and in differentiation of cholecystitis from extrinsic benign gallbladder wall thickening.

    Science.gov (United States)

    Beyazal, Mehmet; Avcu, Serhat; Celiker, Fatma Beyazal; Yavuz, Alpaslan; Toktaş, Osman

    2014-09-01

    The aim of the current study was to assess the efficiency of the apparent diffusion coefficient (ADC) measurement in diagnosis of acute cholecystitis and in differentiation of cholecystitis from extrinsic benign gallbladder wall thickening. Forty patients who were diagnosed to have acute cholecystitis by ultrasonographic examination were included in this study. The control group consisted of 18 patients without symptoms of gallstones and cholecystitis whose gallbladder walls were thickened due to cirrhotic ascites. Both groups were examined using diffusion weighted imaging, and the mean ADC values were compared using Student's t-test. The diagnoses of the 40 patients were proven by histopathological examination. The mean ADC values of patients diagnosed with cholecystitis (1.68 ± 0.36 × 10(-3) mm(2)/s) were significantly lower than the mean ADC values of the control group (2.35 ± 0.24 × 10(-3) mm(2)/s) (p cholecystitis, with a sensitivity of 94% and a specificity of 89.7%. ADC value quantification may be an efficient method for making a diagnosis of cholecystitis and in differential diagnosis of cholecystitis from the extrinsic benign gallbladder wall thickening that can be seen during the course of cirrhotic ascites.

  4. Acute cerebellar ataxia

    Science.gov (United States)

    Cerebellar ataxia; Ataxia - acute cerebellar; Cerebellitis; Post-varicella acute cerebellar ataxia; PVACA ... Acute cerebellar ataxia in children, particularly younger than age 3, may occur several weeks after an illness caused by a virus. ...

  5. Acute Liver Failure

    Science.gov (United States)

    Acute liver failure Overview Acute liver failure is loss of liver function that occurs rapidly — in days or weeks — usually in a person who has no pre-existing liver disease. Acute liver failure is less common than ...

  6. Immunostimulatory activities of a low molecular weight antitumoral polysaccharide isolated from Agaricus blazei Murill (LMPAB) in Sarcoma 180 ascitic tumor-bearing mice.

    Science.gov (United States)

    Niu, Ying-Cai; Liu, Ji-Cheng; Zhao, Xue-Mei; Su, Fu-Qin; Cui, Hong-Xia

    2009-07-01

    LMPAB is a linear beta-(1-3)-glucan we isolated from polysaccharide extract of Agaricus blazei Murill (AbM). Effects of LMPAB on splenic natural killer (NK) cell activity, splenocyte proliferation, index of spleen and thymus, IFN-gamma expression in spleen and the concentration of IL-12, IL-18 and TNF-alpha in serum of S180 ascitic tumor-bearing mice were detected. The results showed that intraperitoneal injection of LMPAB (100 mg x kg(-1) x d(-1)) significantly increased the thymus index. LMPAB augmented splenic NK cell activity in a dose-dependent manner (50-200 mg x kg(-1) x d(-1)). The concanavalin A (3 microg/ ml) stimulated splenocyte proliferation was significantly enhanced by LMPAB at dosages of 50, 100 or 200 mg x kg(-1) x d(-1). Further studies showed that LMPAB (50, 100 or 200 mg x kg(-1) x d(-1), 14d) significantly increased the production of IL-12, TNF-alpha, IL-18 and the expression IFN-gamma as determined by ELISA and immunohistochemistry, respectively. These results clearly indicate that the anti-tumor effects of LMPAB are closely associated with up-regulation of activity of NK cells, expression of IFN-gamma in spleen and the systemic level of IL-12, IL-18 and TNF-alpha in tumor-bearing mice.

  7. Inducible Protective Processes in Animal Systems XIII: Comparative Analysis of Induction of Adaptive Response by EMS and MMS in Ehrlich Ascites Carcinoma Cells.

    Science.gov (United States)

    Mahadimane, Periyapatna Vishwaprakash; Vasudev, Venkateshaiah

    2014-01-01

    In order to investigate the presence of adaptive response in cancerous cells, two monofunctional alkylating agents, namely, ethyl methanesulfonate (EMS) and methyl methanesulfonate (MMS), were employed to treat Ehrlich ascites carcinoma (EAC) cells in vivo. Conditioning dose of 80 mg/kg body weight of EMS or 50 mg/kg body weight of MMS and challenging dose of 240 mg/kg body weight of EMS or 150 mg/kg body weight of MMS were selected by pilot toxicity studies. Conditioned EAC cells when challenged after 8 h time lag resulted in significant reduction in chromosomal aberrations compared to challenging dose of respective agents. As has been proved in earlier studies with normal organisms, even in cancerous cells (EAC), there is presence of adaptive response to methylating and ethylating agents. Furthermore, it is also interesting to note in the present studies that the methylating agent, MMS, is a stronger inducer of the adaptive response than the ethylating agent, EMS.

  8. Congenital urethrovaginal fistula associated with imperforate hymen causing fetal urinary ascites and abdominal cystic lesions: A case report and literature review

    Directory of Open Access Journals (Sweden)

    Koichi Ohno

    2015-02-01

    Full Text Available A primipara presented to our hospital due to fetal ascites, bilateral hydronephrosis and hydrometrocolpos. The female baby had two giant abdominal cysts, a single atrium and foot polydactyly. Absence of the vaginal orifice was noticed, and the hymen was broken through; the left cyst collapsed after fluid drainage. The right cyst was punctured and drained, which improved the hydronephrosis. Contrast imaging showed medium pouring into the abdominal cavity via the uterine tube; the right cyst was a 6 × 5 cm closed cavity. Vaginal uroplania persisted even after hospital discharge. At the age of 4 years, cystoscopy showed a fistulous opening on the urethra 5 mm distal from the internal urethral orifice. A catheter inserted via the opening was found in the vagina. In our case, urine poured into the abdominal cavity through the fistula and uterine tube; following obstruction of the uterine tube, giant hydrometrocolpos and hydrosalpinx appeared. Three cases of congenital urethrovaginal fistula (CUVF with imperforate hymen have been reported. A remnant of communication between the uterovaginal primordium and urogenital sinus may be responsible for CUVF.

  9. Inducible Protective Processes in Animal Systems XIII: Comparative Analysis of Induction of Adaptive Response by EMS and MMS in Ehrlich Ascites Carcinoma Cells

    Directory of Open Access Journals (Sweden)

    Periyapatna Vishwaprakash Mahadimane

    2014-01-01

    Full Text Available In order to investigate the presence of adaptive response in cancerous cells, two monofunctional alkylating agents, namely, ethyl methanesulfonate (EMS and methyl methanesulfonate (MMS, were employed to treat Ehrlich ascites carcinoma (EAC cells in vivo. Conditioning dose of 80 mg/kg body weight of EMS or 50 mg/kg body weight of MMS and challenging dose of 240 mg/kg body weight of EMS or 150 mg/kg body weight of MMS were selected by pilot toxicity studies. Conditioned EAC cells when challenged after 8 h time lag resulted in significant reduction in chromosomal aberrations compared to challenging dose of respective agents. As has been proved in earlier studies with normal organisms, even in cancerous cells (EAC, there is presence of adaptive response to methylating and ethylating agents. Furthermore, it is also interesting to note in the present studies that the methylating agent, MMS, is a stronger inducer of the adaptive response than the ethylating agent, EMS.

  10. Research of ALA combined with HpD-PDT which induced s180 ascitic tumor cells, death or apoptosis on cytology

    Science.gov (United States)

    Zhu, Jing; Yan, Min; Zhang, Hui-Guo; Li, Enling; Luo, Hongyu

    2005-07-01

    To ascertain the adequate dosage of ALA combined with HpD-PDT which induced tumor cell death or apoptosis on cytology. And to study the different effect of ALA-PDT and HPD-PDT used only. Rat ascitic tumor cells(S180) were randomly divided into several groups and incubated with ALA(20μg/ml 、40μg/ml、80μg/ml 、160μg/ml)、HPD(2.5μg/ml、5μg/ml、10μg/ml)and their combination dosages. 630nm light (total output 2W) was delivered to tumor cells at a constant fluence rate: 200mw/cm2 and a constant irradiated time period: 20 minutes. We set 3 groups (no photosensitizers or no irradiation or neither) to be the control groups. We used inversion microscopy to observe the morphological change of tumor cells and flow cytometry technology to detect the death or apoptosis of tumor cells during the experiment. ..

  11. Cytotoxic and antioxidant property of a purified fraction (NN-32) of Indian Naja naja venom on Ehrlich ascites carcinoma in BALB/c mice.

    Science.gov (United States)

    Das, Tanaya; Bhattacharya, Shamik; Halder, Babli; Biswas, Archita; Das Gupta, Shubho; Gomes, Antony; Gomes, Aparna

    2011-06-01

    A cytotoxic and antioxidant protein (NN-32) from the Indian spectacled cobra Naja naja venom was identified and its probable mode of action on murine Ehrlich ascites carcinoma (EAC) was established. The venom purified through ion exchange chromatography produced several peaks, among which fraction 32 produced cytotoxic-cardiotoxic properties. This fraction (NN-32) showed a single peak (retention time 38.3 min) by HPLC using C4 column. The molecular mass determined by MALDI-MS, found to be 6.7 kDa and the first ten N-terminal sequence was determined (LKCNKLVPLF) by Edmann degradation method using applied Biosystem procise sequencer. It was observed that the sequence shared 100% homology with other cytotoxin cardiotoxin identified from the venom of Naja species. NN-32 showed cytotoxicity on EAC cells, increased survival time of inoculated EAC mice, reduced solid tumor volume and weight. NN-32 increased proapoptotic protein caspase 3 and 9 activity and Bax-Bcl2 ratio. It also increased the antioxidant markers glutathione, glutathione peroxidase, glutathione transferase, superoxide dismutase and catalase activity. NN-32 increased serum IL-10 level and decreased murine keratinocyte-derived chemokine level. The cardiotoxicity of NN-32 was established on isolated guinea pig auricle, where 100% irreversible blockade of auricular contraction was observed. Thus, it may be concluded that, NN-32 induced anticancer activity in EAC mice was partly mediated through its apoptogenic - antioxidant property. Copyright © 2011 Elsevier Ltd. All rights reserved.

  12. Acute Appendicitis

    DEFF Research Database (Denmark)

    Tind, Sofie; Qvist, Niels

    2017-01-01

    BACKGROUND: The classification of acute appendicitis (AA) into various grades is not consistent, partly because it is not clear whether the perioperative or the histological findings should be the foundation of the classification. When comparing results from the literature on the frequency...... patients were included. In 116 (89 %) of these cases, appendicitis was confirmed histological. There was low concordance between the perioperative and histological diagnoses, varying from 16 to 76 % depending on grade of AA. Only 44 % of the patients receiving antibiotics postoperatively had a positive...... peritoneal fluid cultivation. CONCLUSION: There was a low concordance in clinical and histopathological diagnoses of the different grades of appendicitis. Perioperative cultivation of the peritoneal fluid as a standard should be further examined. The potential could be a reduced postoperative antibiotic use...

  13. Acute kidney failure

    Science.gov (United States)

    ... kidney injury. Alternative Names Kidney failure; Renal failure; Renal failure - acute; ARF; Kidney injury - acute Images Kidney anatomy References Devarajan P. Biomarkers for assessment of renal ...

  14. Management of Pediatric Acute Liver Failure in a Region With Insufficient Deceased Donor Support: A Single-Center Experience.

    Science.gov (United States)

    Yankol, Yucel; Ertugrul, Mustafa; Kanmaz, Turan; Mecit, Nesimi; Ocak, Ilhan; Durmaz, Ozlem; Acarli, Koray; Kalayoglu, Munci

    2016-10-01

    Acute liver failure is a rapidly progressive and life-threatening disease in children, whose clinical features differ from those of adults. This is a review of a single center's experience with pediatric acute liver failure in a region with insufficient deceased donor support. The study is a retrospective review and analysis of 22 pediatric patients with acute liver failure between January 2007 and May 2013. The cause of acute liver failure was indeterminate in 45.4% of cases. Listing for liver transplant was required in 72.7% of patients, whereas 27.3% developed spontaneous remission. In the patients placed on the liver transplant wait list, 75% underwent liver transplant and 25% died before undergoing liver transplant. The presence of ascites, high-grade encephalopathy, and laboratory findings including high lactate dehydrogenase and phosphorous levels and international normalized ratio were significant parameters in selecting patients needing liver transplants. All liver transplants were from living donors. One- and 3-year patient survival rates after liver transplant were 75% and 75%. No serious donor complications occurred. Living-donor liver transplant may be the only option to save the lives of pediatric patients with acute liver failure, especially in regions with insufficient deceased-donor support. Timely referral to a multidisciplinary transplant center, expedient evaluation of living donors, and appropriate timing of transplant are crucial for a successful outcome.

  15. Diagnosing and Treating Acute Bronchitis

    Science.gov (United States)

    ... Lung Disease Lookup > Acute Bronchitis Diagnosing and Treating Acute Bronchitis Questions to Ask Your Doctor about Acute Bronchitis ... Symptoms that last a few weeks How Is Acute Bronchitis Diagnosed? Healthcare providers diagnose acute bronchitis by asking ...

  16. CT in acute mesenteric ischaemia

    Energy Technology Data Exchange (ETDEWEB)

    Lee, R.; Tung, H.K.S.; Tung, P.H.M.; Cheung, S.C.W.; Chan, F.L

    2003-04-01

    Enhanced computed tomography (CT) is frequently performed for possible bowel ischaemia. It has the distinct advantage of possible detection of the causes of ischaemia. Radiologists therefore need to be familiar with the spectrum of diagnostic CT signs. We present the CT imaging findings in surgically proven cases of small bowel ischaemia. In addition to signs pertaining to the underlying aetiological pathology, bowel dilatation, bowel wall thickening, mural gas, occlusion of mesenteric vessels, ascites and infarct of other abdominal organs were observed.

  17. Acute lower extremity ischaemia

    African Journals Online (AJOL)

    In a nutshell. • A patient with sudden onset of a cold, weak, numb and painful foot has acute lower extremity ischaemia (ALEXI) until proven otherwise. Labelling patients as acute gout, acute phlegmasia (deep vein thrombosis), acute sciatica, etc. may result in unnecessary delays in treatment, with tragic consequences.

  18. Gastrodin stimulates anticancer immune response and represses transplanted H22 hepatic ascitic tumor cell growth: Involvement of NF-κB signaling activation in CD4 + T cells

    Energy Technology Data Exchange (ETDEWEB)

    Shu, Guangwen; Yang, Tianming [College of Pharmacy, South-Central University for Nationalities, Wuhan (China); Wang, Chaoyuan [College of Life Science, South-Central University for Nationalities, Wuhan (China); Su, Hanwen, E-mail: suhanwen-1@163.com [Renmin Hospital of Wuhan University, Wuhan (China); Xiang, Meixian, E-mail: xiangmeixian99@163.com [College of Pharmacy, South-Central University for Nationalities, Wuhan (China)

    2013-06-15

    Gastrodia elata Blume (G. elata) is a famous restorative food in East Asia. It can be used as an auxiliary reagent in hepatocellular carcinoma (HCC) treatment. Previous studies unveiled that G. elata exhibited immunomodulatory activities. To explore the active ingredients contributing to its immunomodulatory activities, gastrodin, vanillin, and parishin B were purified from G. elata and their anti-HCC effects were assessed in vivo. Among these compounds, only gastrodin was capable of repressing transplanted H22 ascitic hepatic tumor cell growth in vivo with low toxicity. Further investigations were designed to explore the effects of gastrodin on the immune system of tumor-bearing mice and potential molecular mechanisms underlying these effects. Our data showed that gastrodin ameliorated tumor cell transplantation-induced activation of endogenous pro-apoptotic pathway in CD4 + T cells and abnormalities in serum cytokine profiles in host animals. These events enhanced cytotoxic activities of natural killer and CD8 + T cells against H22 hepatic cancer cells. Gastrodin administration specifically upregulated mRNA levels of several nuclear factor κB (NF-κB) responsive genes in CD4 + T cells but not in CD8 + T cells. Chromatin immunoprecipitation assay showed that gastrodin increased the association of NF-κB p65 subunit to the promoter regions of IL-2 and Bcl-2 encoding genes in CD4 + T cells. Our investigations demonstrated that gastrodin is the main active ingredient contributing to the anticancer immunomodulatory properties of G. elata. Promoting NF-κB-mediated gene transcription in CD4 + T cells is implicated in its immunomodulatory activity. - Highlights: • Gastrodin stimulates anticancer immune response. • Gastrodin represses tumor transplantation-induced CD4 + T cell apoptosis. • Gastrodin activates NF-κB activity in CD4 + T cells.

  19. CHANGES IN THE ELECTRICAL SURFACE CHARGE AND TRANSPLANTATION PROPERTIES OF TA3 ASCITES TUMOR CELLS DURING SHORT-TERM MAINTENANCE IN AN ISOTONIC SALT SOLUTION

    Energy Technology Data Exchange (ETDEWEB)

    Tenforde, T. S.; Richards, W. R.; Kelly, L. S.

    1980-12-01

    TA3 ascites tumor cells maintained in vitro as a dilute suspension in 0.9% NaCl solution (physiological saline) were found to undergo time-dependent degenerative processes leading to alterations in both membrane characteristics and tumor transplantation properties. A 30% decrease in the negative cellular surface charge density occurred within 2 hr. when TA3 cells were incubated in a 0.9% NaCl solution at 23 °C. A similar reduction in negative surface charge density occurred within 0.5 hr. when the medium was maintained at 37 °C. This time-dependent reduction in surface charge was prevented when cellular metabolism was blocked either by maintaining the medium at 4 °C. or by adding 1 mM cyanide ion to a 23 °C medium. TA3 cells incubated as a dilute suspension in 0.9% NaCl solution at 23 °C also exhibited a large 9 time-dependent reduction in proliferative capacity in isogeneic LAF1/J hosts, as indicated by an increase in the tumor dose for 50% mortality (TD50). Lowering the temperature of the medium to 4 °C was observed to slow the onset of the degenerative processes that lead to a decreased transplantability of TA3 cells. The modification in growth properties of TA3 cells maintained in vitro was found to be attributable in part to an alteration in tumor histocompatibility. This effect was demonstrated by comparing the tumor growth kinetics and TD50 values in normal hosts versus hosts that had been immunosuppressed by whole-body irradiation. Following the in vitro maintenance of TA3 cells, nigrosin dye exclusion tests were performed as a means of assessing cell viability. Evidence obtained in this series of experiments indicated that vital staining is an inadequate criterion for judging either the extent of cell membrane damage or the loss of cellular proliferative capacity.

  20. N-ω-chloroacetyl-L-ornithine has in-vitro activity against cancer cell lines and in-vivo activity against ascitic and solid tumors.

    Science.gov (United States)

    Vargas-Ramírez, Alba L; Medina-Enríquez, Miriam M; Cordero-Rodríguez, Neira I; Ruiz-Cuello, Tatiana; Aguilar-Faisal, Leopoldo; Trujillo-Ferrara, José G; Alcántara-Farfán, Verónica; Rodríguez-Páez, Lorena

    2016-07-01

    N-ω-chloroacetyl-L-ornithine (NCAO) is an ornithine decarboxylase (ODC) inhibitor that is known to exert cytotoxic and antiproliferative effects on three neoplastic human cancer cell lines (HeLa, MCF-7, and HepG2). Here, we show that NCAO has antiproliferative activity in 13 cancer cell lines, of diverse tissue origin from human and mice, and in a mouse cancer model in vivo. All cell lines were sensitive to NCAO after 72 h of treatment (the EC50 ranged from 1 to 50.6 µmol/l). The Ca Ski cell line was the most sensitive (EC50=1.18±0.07 µmol/l) and MDA-MB-231 was the least sensitive (EC50=50.6±0.3 µmol/l). This ODC inhibitor showed selectivity for cancer cells, exerting almost no cytotoxic effect on the normal Vero cell line (EC50>1000 µmol/l). NCAO induced apoptosis and inhibited tumor cell migration in vitro. Furthermore, in vivo, this compound (at 50 and 100 mg/kg, daily intraperitoneal injection for 7 days) exerted potent antitumor activity against both solid and ascitic tumors in a mouse model using the myeloma (Ag8) cell line. At these same two doses, the toxicological evaluation showed that NCAO has no obvious systemic toxicity. The current results suggest that the antitumor activity is exerted by apoptosis related not only to a local but also a systemic cytotoxic effect exerted by NCAO on tumor cells. The applications for NCAO as an antitumor agent may be extensive; however, further studies are needed to ascertain the antitumor activity on other types of tumor in vivo and to determine the precise molecular mechanism of its activity.

  1. Effects of ultraviolet-visible irradiation in the presence of melanin isolated from human black or red hair upon Ehrlich ascites carcinoma cells

    Energy Technology Data Exchange (ETDEWEB)

    Menon, I.A.; Persad, S.; Ranadive, N.S.; Haberman, H.F.

    1983-07-01

    The present study is an attempt to investigate the possibility that ultraviolet irradiation in the presence of pheomelanin may be more harmful to cells than the irradiation in the presence of eumelanin. The effects of UV-visible irradiation upon Ehrlich ascites carcinoma cells in the presence of the melanin isolated from human black hair (eumelanin) or from red hair (pheomelanin) were investigated. Irradiation of these cells was found to produce cell lysis, as observed by leakage of 51Cr from labeled cells and intracellular lactic dehydrogenase from the cells and decrease in cell viability demonstrated by the trypan blue exclusion test. The three parameters were quantitatively parallel to one another under various experimental conditions, namely different periods of irradiation and irradiation in the presence of different concentrations of melanin. The above effects were more pronounced when the irradiation was carried out in the presence of melanin from red hair than in the presence of black-hair melanin. In the absence of either melanin, the irradiation did not produce any significant effect in cell viability or cell lysis. Irradiation of the cells in the presence of red-hair melanin also decreased the transplantability of these cells. These observations clearly show that irradiation of cells in the presence of pheomelanin could produce cytotoxic effects. The present experimental design may have application in the development of in vitro models for the study of UV radiation-induced cutaneous carcinogenesis. The reactions of pheomelanin may be related to the susceptibility of ''Celtic'' skin to UV radiation-induced skin damage and carcinogenesis.

  2. Pea lectin inhibits growth of Ehrlich ascites carcinoma cells by inducing apoptosis and G2/M cell cycle arrest in vivo in mice.

    Science.gov (United States)

    Kabir, Syed Rashel; Nabi, Md Mahamodun; Haque, Ariful; Rokon Uz Zaman; Mahmud, Zahid Hayat; Reza, Md Abu

    2013-11-15

    Pea (Pisum sativum L.) lectin is known to have interesting pharmacological activities and of great interest on biomedical research. In the current research pea lectin was purified followed by ion exchange chromatography on DEAE column and affinity chromatography on glucose-sepharose column. The lectin shown 11.7-84% inhibitory effect against Ehrlich ascites carcinoma (EAC) cells at the concentration range of 8-120 μg/ml in RPMI 1640 medium as determined by MTT assay. Pea lectin was also shown 63% and 44% growth inhibition against EAC cells in vivo in mice when administered 2.8 mg/kg/day and 1.4 mg/kg/day (i.p.) respectively for five consequent days. When Pea lectin injected into the EAC bearing mice for 10 days its significantly increased the hemoglobin and RBC with the decreased of WBC levels toward the normal. Apoptotic cell morphological change of the treated EAC cells of mice was determined by fluorescence and optical microscope. Interestingly, cell growth inhibition of the lectin was significantly reduced in the presence of caspase inhibitors. Treatment with the lectin caused the cell cycle arrest at G2/M phase of EAC cells which was determined by flow cytometry. The expression of apoptosis-related genes, Bcl-2, Bcl-X and Bax was evaluated by reverse transcriptase polymerase chain reaction (RT-PCR). Intensive increase of Bax gene expression and totally despaired of Bcl-2 and Bcl-X gene expression were observed in the cells treated with Pea lectin for five consecutive days. Copyright © 2013 Elsevier GmbH. All rights reserved.

  3. Synthesis, structure, electrochemistry, and spectral characterization of bis-isatin thiocarbohydrazone metal complexes and their antitumor activity against ehrlich ascites carcinoma in swiss albino mice.

    Science.gov (United States)

    Sathisha, M P; Revankar, V K; Pai, K S R

    2008-01-01

    The synthesis, structure, electrochemistry, and biological studies of Co(II), Ni(II), Cu(II), and Zn(II) complexes of thiocarbohydrazone ligand are described. The ligand is synthesized starting from thiocarbohydrazide and isatin. It is evident from the IR data that in all the complexes, only one part of the ligand is coordinated to the metal ion resulting mononuclear complexes. The ligand coordinates essentially through the carbonyl oxygen of the isatin fragment, the nitrogen atom of the azomethine group, and sulfur atom after deprotonation to give five membered rings. H1 NMR spectrum of the ligand shows only one set of signals for the aromatic protons, while the NH of isatin and NH of hydrazone give rise to two different singlets in the 11-14 ppm range. The formulations, [Cu(L)Cl].2H2O, [Cu(L)(CH3COO)].2H2O, [Ni(L)Cl], [Ni(L)(CH3COO)], [Co(L2)], and [Zn(L2)].2H2O are in accordance with elemental analyses, physical, and spectroscopic measurements. The complexes are soluble in organic solvents. Molar conductance values in DMF indicate the nonelectrolytic nature of the complexes. Copper complex displays quasireversible cyclic voltametric responses with Ep near -0.659 v and 0.504 v Vs Ag/AgCl at the scan rate of 0.1 V/s. Copper(II) complexes show a single line EPR signals. For the observed magnetic moment and electronic spectral data possible explanation has been discussed. From all the available data, the probable structures for the complexes have been proposed. The compounds synthesized in present study have shown promising cytotoxic activity when screened using the in vitro method and at the same time were shown to have good activity when tested using the Ehrlich ascites carcinoma (EAC) model. The antimicrobial screening showed that the cobalt complex possesses enhanced antimicrobial activity towards fungi.

  4. Studies on the cytotoxic, biochemical and anti-carcinogenic potentials of ninhydrin on Ehrlich ascites carcinoma cell-bearing Swiss albino mice.

    Science.gov (United States)

    Qureshi, S; Al-Shabanah, O A; Al-Bekairi, A M; Al-Harbi, M M; Al-Gharably, N M; Raza, M

    2000-08-01

    Ninhydrin (2,2-dihydroxy-1,3-indane dione) was evaluated for its antitumor and cytotoxic properties in Ehrlich ascites carcinoma cell (EAC Cell)-bearing mice. The rationale behind this study has been mainly the literature reports of its characteristic interference with DNA synthesis and calcium homeostasis. Antitumor activity was evaluated from the total count and viability of EAC cells in addition to their nucleic acid, protein, non-protein sulfhydryls (NP-SH) and malondialdehyde (MDA) contents. The EAC cell-bearing animals were also observed for the effect on their survival and body weight variations. In addition, the tumors grown at the site of injection were evaluated for histopathological changes. Ninhydrin treatments (5, 10 and 20 mg/kg/day) abate the increase in body weight and advanced the duration of survival in EAC cell-bearing mice. The results on histopathological investigations show retardation in tumor growth, decreased frequency of mitotic figures and hair follicles and an increased necrosis in the tumor by ninhydrin treatment. Our results on cytotoxicity, which demonstrated compression in the number of EAC cells and their viability substantiate these data. The results of biochemical studies on EAC cells exhibit a reduction in the levels of DNA, RNA, proteins and NP-SH with a subsequent increase in the concentrations of MDA after ninhydrin treatment. Inhibition in tumor growth was dose dependently significant with the same dose regimen. The observed cytotoxic and antitumor activity of ninhydrin was comparable to cyclophosphamide. The possible mode of action of ninhydrin-induced cytotoxic and antitumor activity appear to be due to its interference with mitochondrial function resulting in inhibition of DNA synthesis, an effect that is being investigated further.

  5. Chronic Dietary Administration of the Glycolytic Inhibitor 2-Deoxy-D-Glucose (2-DG Inhibits the Growth of Implanted Ehrlich's Ascites Tumor in Mice.

    Directory of Open Access Journals (Sweden)

    Saurabh Singh

    Full Text Available Dietary energy restriction (DER has been well established as a potent anticancer strategy. Non-adoption of restricted diet for an extended period has limited its practical implementation in humans with a compelling need to develop agents that mimic effects similar to DER, without reduction in actual dietary intake. Glycolytic inhibitor, 2-deoxy-D-glucose (2-DG, has recently been shown to possess potential as an energy restriction mimetic agent (ERMA. In the present study we evaluated the effect of dietary 2-DG administration on a mouse tumor model, with a focus on several potential mechanisms that may account for the inhibition of tumorigenesis.Swiss albino strain 'A' mice were administered with 0.2% and 0.4% w/v 2-DG in drinking water for 3 months prior to tumor implantation (Ehrlich's ascites carcinoma; EAC and continued till the termination of the study with no adverse effects on general physiology and animal growth. Dietary 2-DG significantly reduced the tumor incidence, delayed the onset, and compromised the tumor growth along with enhanced survival. We observed reduced blood glucose and serum insulin levels along with decreased proliferating cell nuclear antigen (PCNA and bromodeoxyuridine positive (BrdU+ tumor cells in 2-DG fed mice. Also, reduced levels of certain key players of metabolic pathways such as phosphatidylinositol 3-kinase (PI3K, phosphorylated-Akt and hypoxia inducible factor-1 alpha (HIF-1α were also noted in tumors of 2-DG fed mice. Further, decrease in CD4+/CD8+ ratio and T-regulatory cells observed in 2-DG fed mice suggested enhanced antitumor immunity and T cell effector function.These results strongly suggest that dietary 2-DG administration in mice, at doses easily achievable in humans, suitably modulates several pleotrophic factors mimicking DER and inhibits tumorigenesis, emphasizing the use of ERMAs as a promising cancer preventive strategy.

  6. Hyaluronic acid-grafted PLGA nanoparticles for the sustained delivery of berberine chloride for an efficient suppression of Ehrlich ascites tumors.

    Science.gov (United States)

    Bhatnagar, Priyanka; Kumari, Manisha; Pahuja, Richa; Pant, A B; Shukla, Y; Kumar, Pradeep; Gupta, K C

    2018-02-13

    To promote the specific targeting and elimination of CD44-positive cancer cells, berberine chloride (BRB)-encapsulated hyaluronic acid-grafted poly(lactic-co-glycolic acid) copolymer (BRB-d(HA)-g-PLGA) nanoparticles (NPs) were prepared. The targeted action of these NPs was compared to non-targeted BRB-loaded PLGA NPs and bulk BRB. The in vitro studies demonstrated faster release of BRB and increased cytotoxicity of BRB-d(HA)-g-PLGA NPs in Hela and MCF-7 cells in comparison to BRB-PLGA NPs and bulk BRB. The uptake of BRB-d(HA)-g-PLGA NPs was increased in case of MCF-7 cells as compared to HeLa cells owing to the higher expression of CD44 receptors on MCF-7 cells. The CD44 receptor-mediated uptake of these NPs was confirmed through competitive inhibition experiments. The in vitro results were further validated in vivo in Ehrlich Ascites Carcinoma (EAC)-bearing mice. EAC-bearing mice were injected intravenously with these NPs and the results obtained were compared with that of BRB-PLGA NPs and bulk BRB. BRB-d(HA)-g-PLGA NPs were found to significantly enhance apoptosis, sub-G1 content, life span, mean survival time, and ROS levels in EAC cells with subsequent decrease in mitochondrial membrane potential and tumor burden ion tumor-bearing mice. Taking into account the findings of in vitro and in vivo studies, the enhanced and targeted anti-tumor activity of HA-grafted PLGA copolymer-encapsulated NPs of BRB cannot be negated. Therefore, HA-grafted nanoparticle-based delivery of BRB may offer a promising and improved alternative for anti-tumor therapy.

  7. Acute otitis externa

    OpenAIRE

    Hui, Charles PS

    2013-01-01

    Acute otitis externa, also known as ‘swimmer’s ear’, is a common disease of children, adolescents and adults. While chronic suppurative otitis media or acute otitis media with tympanostomy tubes or a perforation can cause acute otitis externa, both the infecting organisms and management protocol are different. This practice point focuses solely on managing acute otitis externa, without acute otitis media, tympanostomy tubes or a perforation being present.

  8. Case Report: Detection and quantification of tumor cells in peripheral blood and ascitic fluid from a metastatic esophageal cancer patient using the CellSearch® technology [v1; ref status: indexed, http://f1000r.es/2hr

    Directory of Open Access Journals (Sweden)

    Qian Tu

    2014-01-01

    Full Text Available Analysis of ascitic fluid should help to identify and characterize malignant cells in gastrointestinal cancer. However, despite a high specificity, the sensitivity of traditional ascitic fluid cytology remains insufficient, at around 60%. Since 2004 the CellSearch® technology has shown its advantages in the detection of circulating tumor cells (CTCs in peripheral blood, which can perform an accurate diagnosis and molecular analysis at the same time. To our knowledge, no previous study has explored the potential utility of this technology for the detection and quantification of tumor cells in ascitic fluid samples. Herein we report a case of metastatic esophageal adenocarcinoma in a 70-year-old man presenting with dysphagia and a large amount of fluid in the peritoneal cavity. Analysis of a peripheral blood sample and ascites sample with the CellSearch® technology both revealed the presence of putative tumor cells that were positive for epithelial cell adhesion molecule (EpCAM and cytokeratin (CK expression. This study confirmed the hematogenous dissemination of esophageal cancer by the detection of circulating tumor cells in the peripheral blood, and is the first to demonstrate that tumor cells can be identified in ascitic fluid by using CellSearch® technology.

  9. Acute Fatty Liver of Pregnancy: A Clinical-Paraclinical Survey

    Directory of Open Access Journals (Sweden)

    Mohammad Jafari

    2015-02-01

    Full Text Available Background Acute Fatty Liver of Pregnancy (AFLP is one of the serious complications of the pregnancy period. Surveying the laboratory and clinical signs is effective in timely prognosis and fast treatment of this illness. Objectives The current study aimed to evaluate AFLP among the hospitalized subjects. Patients and Methods This retrospective study was conducted on clinical and preclinical records of 25 females with AFLP for maternal and perinatal prognosis from 2000 to 2009. The data was analyzed using SPSS ver. 19. Results The patients aged 16 - 45 years old with one to four pregnancies (pregnancy; they were 24 to 39 weeks pregnant with the mean of 33.56 weeks, and 56% were multifarious. The most prevalent clinical symptoms were nausea, vomiting, abdominal pain, headache, pruritus, and icterus. The laboratory signs included disorders of liver, coagulation, kidney, and hypoglycemia. Nausea and vomiting in the first and second age groups (Group 1, patients were 35 years. were the most prevalent symptoms. No patient had fever, ascites, and polydipsia. There was one case of mother and fetal death. Conclusions In the current study, the clinical and paraclinical signs of AFLP were mostly - liver, coagulation, kidney, and hypoglycemia disorders. Considering that patients mostly refer in three phases of clinical, laboratory, and complications, it is essential to evaluate the suspected ones who present clinical symptoms especially nausea, vomiting and abdominal pain.

  10. Acute fatty liver of pregnancy with hypoglycaemia, diabetes insipidus and pancreatitis, preceded by intrahepatic cholestasis of pregnancy.

    Science.gov (United States)

    English, Nicola; Rao, Jegajeeva

    2015-04-15

    We present the case of a 33-year-old woman in her first pregnancy. She presented with pruritus at 34 weeks gestation. A diagnosis of intrahepatic cholestasis of pregnancy was made based on elevated bile acids and elevated liver transaminases. She re-presented 4 days later, jaundiced with abdominal pain and nausea, and was hypertensive. Her bilirubin was now elevated and her creatinine had doubled. The differential diagnosis-included pre-eclampsia and Hemolysis Elevated Liver enzymes Low Platelet count (HELLP) syndrome, and delivery was expedited. Postnatally, the patient became coagulopathic, though not thrombocytopaenic; she had persistent hypoglycaemia, hyponatraemia, developed acute pancreatitis and had profound ascites and peripheral oedema. Management was supportive with multidisciplinary care and over a period of 3 weeks she made a full clinical and biochemical recovery. 2015 BMJ Publishing Group Ltd.

  11. Surveillance for infectious complications in pediatric acute liver failure - a prospective study.

    Science.gov (United States)

    Mekala, Suresh; Jagadisan, Barath; Parija, Subhash Chandra; Lakshminarayanan, Subitha

    2015-03-01

    To prospectively evaluate infectious complications (IC) in pediatric acute liver failure (PALF) by employing surveillance cultures. From 2011 to 2013, children with PALF in a tertiary care centre received a standard protocolised management. Prophylactic parenteral antibiotics were used without antifungals. Surveillance cultures of blood, urine, ascites and tracheal aspirates were sent. Biochemical and clinical parameters and outcomes were compared between children with and without IC. Of the 29 children with PALF admitted during the study period (median age 36 mo, range 12-90 mo), 13.8 % had blood stream infections (BSI) at admission. Organisms were isolated in 8.8 % (12/136) of the blood cultures, 13.7 % (11/80) of the urine cultures, 30.8 % (8/26) of the tracheal aspirates and 7.1 % (1/14) of the ascitic fluid cultures. Gram negative bacteriae (n = 17) were the commonest, followed by fungi (n = 13) and gram positive bacteriae (n = 2). Klebsiella pneumoniae and Candida nonalbicans group were the commonest bacteria and fungi respectively. After admission, fungal BSI and urinary tract infections were diagnosed at a median time of 4 d (range 3-8 d) and 3.5 d (range 3-6 d) respectively. ICs were not associated with other complications and increased mortality but with longer hospital and pediatric intensive care unit (PICU) stay. In this study BSI was a common finding at admission in PALF. Inspite of prophylactic antibiotics, break through gram negative bacterial and fungal ICs were common. Empirical treatment of IC should include broad spectrum antibiotics. Fungal IC occurred beyond 48 h. Prophylactic antifungals at admission may be considered to decrease their frequency. IC prolongs PICU and hospital stay.

  12. Embelia ribes ameliorates lipopolysaccharide-induced acute respiratory distress syndrome.

    Science.gov (United States)

    Shirole, R L; Shirole, N L; Saraf, M N

    2015-06-20

    Embelia ribes Burm. f. (Fam. Myrsinaceae) locally known as Vidanga have been used for treating tumors, ascites, bronchitis, jaundice, diseases of the heart and brain in traditional Indian medicine. However, no scientific studies providing new insights in its pharmacological properties with respect to acute respiratory distress syndrome have been investigated. The present investigation aimed to elucidate the effectiveness of Embelin isolated from Embelia ribes seeds on attenuation of LPS-induced acute respiratory distress syndrome in murine models. Embelin (5, 10 and 20 mg/kg/day, i.p.) and Roflumilast (1 mg/kg/day, p.o.) were administered for four days and prior to LPS in rats (i.t.). Four hour after LPS challenge animals were anesthesized and bronchoalveolar lavage was done with ice-cold phosphate buffer. Assessment of BAL fluid was done for albumin, total protein, total cell and neutrophil count, TNF-α levels, nitrosoative stress. Superior lobe of right lung was used for histopathologic evaluation. Inferior lobe of right lung was used to obtain lung edema. Left lung was used for myeloperoxidase estimation. Arterial blood was collected immediately and analyzed for pH, pO2 and pCO2 were estimated. Pretreatment with embelin (5, 10 and 20 mg/kg, i.p.) decreased lung edema, mononucleated cellular infiltration, nitrate/nitrite, total protein, albumin concentrations, TNF-α in the bronchoalveolar lavage fluid and myeloperoxidase activity in lung homogenate. Embelin markedly prevented pO2 down-regulation and pCO2 augmentation. Additionally, it attenuated lung histopathological changes in acute respiratory distress syndrome model. The study demonstrates the effectiveness of Embelia ribes Burm. f. (Fam. Myrsinaceae) seeds in acute respiratory distress syndrome possibly related to its anti-inflammatory and protective effect against LPS induced airway inflammation by reducing nitrosative stress, reducing physiological parameters of blood gas change, TNF-α and mononucleated

  13. Effects of Baicalin on inflammatory mediators and pancreatic acinar cell apoptosis in rats with sever acute pancreatitis

    Directory of Open Access Journals (Sweden)

    zhang xiping

    2009-02-01

    Full Text Available

    • BACKGROUND: To investigate the effects of Baicalin and Octreotide on inflammatory mediators and pancreatic acinar cells apoptosis of rats with severe acute pancreatitis (SAP.
    • METHODS: SD rats were randomly divided into sham operated group (I group, model control group (II group, Baicalin treated group (III group and Octreotide treated group (IV group. Each group was also divided into subgroup of 3, 6 and 12 h (n = 15. The mortality rate, ascites/body weight ratio as well as the level of endotoxin, NO and ET-1 in blood were measured. The pathological severity score of pancreas, apoptotic indexes, and expression levels of Bax and Bcl-2 proteins in each group were investigated.
    • RESULTS: The survival rate of III and IV group has a significant difference compared with II group (P12 h < 0.05. The ascites volume, contents of inflammatory mediators in blood and pathological severity score of pancreas of III and IV group declined at different degrees compared to II group (P < 0.05, P < 0.01 or P < 0.001. Apoptotic index in III group was significantly higher than that in II group at 3 and 6 h (P3, 6 h < 0.05. Apoptotic index in IV group was significantly higher than that in II group at pancreatic tail at 6 h (P6 h < 0.05. Expression level of Bax in III group was significantly higher than that in II group (pancreatic head P3 h,6 h < 0.01, pancreatic tail P3 h < 0.001.
    • CONCLUSIONS: Compared with Octreotide in the treatment of SAP, the protective mechanisms of Baicalin include reducing the excessive inflammatory mediators’ release, inducing the pancreatic acinar cells apoptosis.
    • KEY WORDS: Severe acute pancreatitis, baicalin, octreotide, inflammatory mediators, apoptosis, tissue microarrays.

  14. Pentoxifylline Treatment in Acute Pancreatitis (AP)

    Science.gov (United States)

    2016-09-14

    Acute Pancreatitis (AP); Gallstone Pancreatitis; Alcoholic Pancreatitis; Post-ERCP/Post-procedural Pancreatitis; Trauma Acute Pancreatitis; Hypertriglyceridemia Acute Pancreatitis; Idiopathic (Unknown) Acute Pancreatitis; Medication Induced Acute Pancreatitis; Cancer Acute Pancreatitis; Miscellaneous (i.e. Acute on Chronic Pancreatitis)

  15. Chylaskos as a presentation of serous papillary adenocarcinoma of the endometrium: a case report

    Directory of Open Access Journals (Sweden)

    Maria Inês Sequeira

    2017-06-01

    Full Text Available A 77-year-old female was presented to the emergency department with intense anorexia, weight loss despite progressive abdominal distension, and dyspnea. Abdomen imagiology workup reveled moderate-volume ascites and a hepatic occupying lesion. Diagnostic paracentesis allowed the drainage of a chylous effusion and cytology analysis identified adenocarcinoma cells. Hepatic metastasis of papillary serous adenocarcinoma of the endometrium was confirmed after tomography-guided biopsy. Endometrial carcinoma is the most common malignant gynecological neoplasm in developed countries and is often classified in types I with endometrioid histology (estrogen-dependent and non endometrioid types II (non-estrogen-dependent. Chylous ascites or chylaskos is a rare presentation on hospital admission. Several etiologies have been described. In adults, solid malignancy is expected to be identified in less than 20% of the cases. A systematic review has found only one case of endometrial carcinoma presenting with chylous ascite. As far as we know, this is the first case report of a serous papillary adenocarcinoma of the endometrium presenting with chylaskos.

  16. Acute respiratory distress syndrome

    Science.gov (United States)

    ... page: //medlineplus.gov/ency/article/000103.htm Acute respiratory distress syndrome To use the sharing features on this page, please enable JavaScript. Acute respiratory distress syndrome (ARDS) is a life-threatening lung ...

  17. Acute Mesenteric Ischemia

    Science.gov (United States)

    ... of Celiac Disease Additional Content Medical News Acute Mesenteric Ischemia By Parswa Ansari, MD, Assistant Professor and Program ... Abdominal Abscesses Abdominal Wall Hernias Inguinal Hernia Acute Mesenteric Ischemia Appendicitis Ileus Intestinal Obstruction Ischemic Colitis Perforation of ...

  18. Acute Bronchitis - Multiple Languages

    Science.gov (United States)

    ... Are Here: Home → Multiple Languages → All Health Topics → Acute Bronchitis URL of this page: https://medlineplus.gov/languages/ ... V W XYZ List of All Topics All Acute Bronchitis - Multiple Languages To use the sharing features on ...

  19. Weight Loss & Acute Porphyria

    Science.gov (United States)

    ... APF You are here Home Diet and Nutrition Weight loss & acute Porphyria Being overweight is a particular problem ... of carbohydrate and energy in an effort to lose weight can worsen these diseases. Severe acute attacks have ...

  20. Radiology of acute phlebothrombosis

    Energy Technology Data Exchange (ETDEWEB)

    Richter, E.I.; Zeitler, E.

    1980-09-01

    The difference in technique of phlebography in acute phlebothrombosis and that in chronic venous insufficiency is demonstrated. Since acute phlebothrombosis can be cured with good results by thrombectomy and fibrinolysis in the first few days of the disease, phlebography should be performed early, preferably the day on which the presence of acute thrombosis is suspected.

  1. Radiopharmaceuticals in Acute Porphyria

    NARCIS (Netherlands)

    Schreuder, Nanno; Mamedova, Ilahä; Jansman, Frank G A

    2016-01-01

    PURPOSE: The acute porphyrias are a group of rare metabolic disorders of the heme biosynthetic pathway. Carriers of the acute porphyria gene are prone to potentially fatal acute attacks, which can be precipitated by drug exposure. It is therefore important to know whether a drug is safe for carriers

  2. Acute mastoiditis in children

    DEFF Research Database (Denmark)

    Anthonsen, Kristian; Høstmark, Karianne; Hansen, Søren

    2013-01-01

    Conservative treatment of acute otitis media may lead to more complications. This study evaluates changes in incidence, the clinical and microbiological findings, the complications and the outcome of acute mastoiditis in children in a country employing conservative guidelines in treating acute...

  3. Hyperosmotic stress strongly potentiates serum response factor (SRF)-dependent transcriptional activity in ehrlich lettré ascites cells through a mechanism involving p38 mitogen-activated protein kinase

    DEFF Research Database (Denmark)

    Gorbatenko, Andrej; Wiwel, Maria; Klingberg, Henrik

    2011-01-01

    Long-term osmotic stress results in altered gene transcription, however, with the exception of the TonE/TonEBP system, the underlying mechanisms are poorly understood. We previously showed that upon osmotic shrinkage of Ehrlich Lettré Ascites (ELA) fibroblasts, the MEK1-ERK1/2 pathway is transien......Long-term osmotic stress results in altered gene transcription, however, with the exception of the TonE/TonEBP system, the underlying mechanisms are poorly understood. We previously showed that upon osmotic shrinkage of Ehrlich Lettré Ascites (ELA) fibroblasts, the MEK1-ERK1/2 pathway......) and cAMP response element-binding protein (CREB) are differentially regulated in ELA cells. SRF Ser103 phosphorylation and SRF-dependent transcriptional activity were strongly augmented 5–30¿min and 24¿h, respectively, after hyperosmotic stress (50% increase in extracellular ionic strength), in a p38...... dephosphorylated within 5¿min of shrinkage. MSK1 phosphorylation recovered within 30¿min in a p38-MAPK-dependent manner. CREB was transiently dephosphorylated after shrinkage in a manner exacerbated by p38 MAPK inhibition or MSK1 knockdown, but unaffected by inhibition of RSK. In conclusion, in ELA cells...

  4. Investigation of Combined Action of Food Supplement's and Ionizing Radiation on the Cytogenetic Damage Induction and Ehrlich Ascite Carcinoma Growth on Mice in Vivo

    Science.gov (United States)

    Sorokina, Svetlana; Zaichkina, Svetlana; Dyukina, Alsu; Rozanova, Olga; Balakin, Vladimir; Peleshko, Vladimir; Romanchenko, Sergey; Smirnova, Helena; Aptikaeva, Gella; Shemyakov, Alexander

    In recent ten years one of the major problems of modern radiobiology is the study of radiation protective mechanisms with the help of different substances as well as activation of internal resources of the organism. Internal resources mean such phenomena as hormesis and adaptive response which represent cell or body reaction on low doses of inducing factors and predetermine their further high dose effect resistance. At present special interest is attracted by studies of biological effects of low-dose-rate high-LET radiation because of searching for new types of radiation for more effective cancer therapy and searching for new methods of radiation protection. Since natural biologically active substances have low toxicity and are capable of affecting physiological processes taking place in human’s organism and increasing organism’s natural defense system, the interest to protective means of vegetal origin and search of special food supplements intensifies every year. The purpose of this study is to investigate the combined influence of food supplement, low dose rate high-LET radiation simulating high-altitude flight conditions and X-ray radiations on radiosensitivity, induction of radiation adaptive response (RAR) and growth of Ehrlich ascite carcinoma as well. Experiments were performed with males of SHK mice at the age of two months. The animals were being irradiated with low-dose-rate high-LET radiation with the dose of 11,6 cGy (0,5 cGy/day) behind the concrete shield of the 70 GeV protons accelerator (Protvino). The X-ray irradiation was carried out on the RTH device with a voltage of 200 kV (1 Gy/min; Pushchino). The diet composition included products containing big amount of biologically active substances, such as: soybeam meat, buckwheat, lettuce leaves and drug of cod-liver oil. Four groups of mice were fed with selected products mentioned above during the whole irradiation period of 22 days. The control groups received the same food without irradiation

  5. Acute luchtweginfecties en acute coronaire syndromen

    NARCIS (Netherlands)

    Keller, T. T.; Mairuhu, A. T. A.; Gerdes, V. E. A.; Brandjes, D. P. M.; Peters, R. J. G.; van Gorp, E. C. M.

    2005-01-01

    Epidemiological research indicates a correlation between respiratory-tract infections and acute cardiovascular events. Chronic infections have been linked to the development of atherosclerosis. As a result of chronic infections a prolonged and elevated inflammatory activity arises. Inflammation and

  6. Interventional Treatment of Abdominal Compartment Syndrome during Severe Acute Pancreatitis: Current Status and Historical Perspective

    Directory of Open Access Journals (Sweden)

    Dejan V. Radenkovic

    2016-01-01

    Full Text Available Abdominal compartment syndrome (ACS in patients with severe acute pancreatitis (SAP is a marker of severe disease. It occurs as combination of inflammation of retroperitoneum, visceral edema, ascites, acute peripancreatic fluid collections, paralytic ileus, and aggressive fluid resuscitation. The frequency of ACS in SAP may be rising due to more aggressive fluid resuscitation, a trend towards conservative treatment, and attempts to use a minimally invasive approach. There remains uncertainty about the most appropriate surgical technique for the treatment of ACS in SAP. Some unresolved questions remain including medical treatment, indications, timing, and interventional techniques. This review will focus on interventional treatment of this serious condition. First line therapy is conservative treatment aiming to decrease IAP and to restore organ dysfunction. If nonoperative measures are not effective, early abdominal decompression is mandatory. Midline laparostomy seems to be method of choice. Since it carries significant morbidity we need randomized studies to establish firm advantages over other described techniques. After ACS resolves efforts should be made to achieve early primary fascia closure. Additional data are necessary to resolve uncertainties regarding ideal timing and indication for operative treatment.

  7. Decitabine in Treating Children With Relapsed or Refractory Acute Myeloid Leukemia or Acute Lymphoblastic Leukemia

    Science.gov (United States)

    2013-01-22

    Childhood Acute Myeloblastic Leukemia With Maturation (M2); Childhood Acute Promyelocytic Leukemia (M3); Recurrent Childhood Acute Lymphoblastic Leukemia; Recurrent Childhood Acute Myeloid Leukemia; Secondary Acute Myeloid Leukemia

  8. Acute Q Fever Presenting as Fever of Unknown Origin with Rapidly Progressive Hepatic Failure in a Patient with Alcoholism

    Directory of Open Access Journals (Sweden)

    Po-Han Lin

    2008-11-01

    Full Text Available We report a case of fulminant acute Q fever presenting as fever of unknown origin with rapidly progressive hepatic failure in a patient with alcoholism. A 51-year-old electrician, who was a habitual drinker, presented with a 2-week history of intermittent high fever, acute hepatomegaly and rapidly progressive jaundice after being accidentally exposed to dust from bird nests when he was repairing electrical equipment and circuitry at an abandoned factory in Taipei County. Ascites and prolonged prothrombin time were noted at admission. Transjugular liver biopsy and bone marrow biopsy found multiple small fibrinoid-ring granulomas in liver parenchyma and bone marrow. Doxycycline therapy was empirically started. The fever gradually subsided over a 2-week period, along with the recovery of liver function. The diagnosis of acute Q fever was confirmed by high titers of antibodies against Coxiella burnetii (phase I IgM 1:160 and IgG 1:2560, phase II IgM > 1:320 and IgG 1:5120 and a four-fold elevation of phase II IgG titer in the paired serum. The experience of this case shows that the possibility of Q fever should not be overlooked in patients who have an unexplained febrile illness and severe liver function impairment following exposure to a contaminated environment in Taiwan.

  9. Acute renal failure associated with nonfulminant acute viral hepatitis A

    OpenAIRE

    Sarawgi, S.; Gupta, A K; Arora, D S; Jasuja, S.

    2008-01-01

    Hepatitis A runs a benign course in children, but may have atypical presentations in adults. Very rarely acute renal failure complicates nonfulminant hepatitis A. We report a patient with nonfulminant acute viral hepatitis A with multiorgan involvement. Patient had biopsy proven acute interstitial nephritis, acute pancreatitis, acute myocarditis and required hemodialysis for 6 weeks.

  10. Acute Idiopathic Scrotal Edema

    Directory of Open Access Journals (Sweden)

    Micheál Breen

    2013-01-01

    Full Text Available We report a case of acute idiopathic scrotal edema (AISE in a 4-year-old boy who presented with acute scrotal pain and erythema. The clinical features, ultrasound appearance, and natural history of this rare diagnosis are reviewed. In this report, we highlight the importance of good ultrasound technique in differentiating the etiology of the acute scrotum and demonstrate the color Doppler “Fountain Sign” that is highly suggestive of AISE.

  11. Acute recurrent polyhydramnios

    DEFF Research Database (Denmark)

    Rode, Line; Bundgaard, Anne; Skibsted, Lillian

    2007-01-01

    Acute recurrent polyhydramnios is a rare occurrence characterized by a poor fetal outcome. This is a case report describing a 34-year-old woman presenting with acute recurrent polyhydramnios. Treatment with non-steroidal anti-inflammatory drugs (NSAID) and therapeutic amniocenteses was initiated...... an enzyme-linked immunosorbent assay. As in normal pregnancies, amniotic prolactin levels decreased by 80% from highest to lowest value in this case of resolving acute recurrent polyhydramnios....

  12. Acute periodontal lesions

    OpenAIRE

    Herrera Gonzalez, David; Alonso Álvarez, Bettina; Arriba de la Fuente, Lorenzo; Santa- Cruz Astorqui, Isabel; Serrano, Cristina; Sanz Alonso, Mariano

    2014-01-01

    This is a review and update on acute conditions affecting the gingival tissues, including abscesses in the periodontium, necrotizing periodontal diseases, and other acute conditions that cause gingival lesions with acute presentation, such as infectious process not associated with oral bacterial biofilms, muco-cutanenous disorders, and traumatic and allergic lesions. A periodontal abscess is clinically important since it is a relatively frequent dental emergency, it can compromise the periodo...

  13. Acute rhinosinusitis in adults.

    Science.gov (United States)

    Aring, Ann M; Chan, Miriam M

    2011-05-01

    Rhinosinusitis is one of the most common conditions for which patients seek medical care. Subtypes of rhinosinusitis include acute, subacute, recurrent acute, and chronic. Acute rhinosinusitis is further specified as bacterial or viral. Most cases of acute rhinosinusitis are caused by viral infections associated with the common cold. Symptomatic treatment with analgesics, decongestants, and saline nasal irrigation is appropriate in patients who present with nonsevere symptoms (e.g., mild pain, temperature less than 101°F [38.3°C]). Narrow-spectrum antibiotics, such as amoxicillin or trimethoprim/sulfamethoxazole, are recommended in patients with symptoms or signs of acute rhinosinusitis that do not improve after seven days, or that worsen at any time. Limited evidence supports the use of intranasal corticosteroids in patients with acute rhinosinusitis. Radiographic imaging is not recommended in the evaluation of uncomplicated acute rhinosinusitis. Computed tomography of the sinuses should not be used for routine evaluation, although it may be used to define anatomic abnormalities and evaluate patients with suspected complications of acute bacterial rhinosinusitis. Rare complications of acute bacterial rhinosinusitis include orbital, intracranial, and bony involvement. If symptoms persist or progress after maximal medical therapy, and if computed tomography shows evidence of sinus disease, referral to an otolaryngologist is warranted.

  14. Fulminant Acute Disseminated Encephalomyelitis

    National Research Council Canada - National Science Library

    Hassan A Alayafi; Faisal R Jahangiri; Mukki Almuntashri

    2014-01-01

      Acute disseminated encephalomyelitis, or post infectious encephalomyelitis is an immunologically mediated demyelinating disorder affecting the central nervous system after infection or vaccination...

  15. Fat-free muscle mass in magnetic resonance imaging predicts acute-on-chronic liver failure and survival in decompensated cirrhosis

    DEFF Research Database (Denmark)

    Praktiknjo, Michael; Book, Marius; Luetkens, Julian

    2018-01-01

    of sarcopenia using magnetic resonance imaging (MRI) in decompensated cirrhotic patients with transjugular intrahepatic portosystemic shunt (TIPS). METHODS: The total erector spinae muscle area and the intramuscular fat tissue area were measured and subtracted to calculate the fat-free muscle area (FFMA) in 116...... in a validation cohort of 45 patients. RESULTS: FFMA correlated with follistatin and TPMT and showed slightly better association with survival than TPMT. Gender-specific cut-off values for FFMA were determined for sarcopenia. Decompensation (ascites, overt hepatic encephalopathy) persisted after TIPS...... in the sarcopenia group but resolved in the non-sarcopenia group. Sarcopenic patients showed no clinical improvement after TIPS as well as higher mortality, mainly due to development of acute-on-chronic liver failure (ACLF). FFMA was an independent predictor of survival in these patients. CONCLUSION: This study...

  16. Ascitis en ausencia de edema: forma rara de inicio de la linfangiectasia intestinal congénita Ascites in absence of edema: a rare form of onset of congenital intestinal lymphangiectasis

    Directory of Open Access Journals (Sweden)

    Luis Francisco Martínez Cardet

    2005-06-01

    Full Text Available La linfangiectasia intestinal congénita, enteropatía perdedora de proteínas de aparición esporádica que afecta fundamentalmente a niños y adultos jóvenes, se inicia por lo general con edemas y diarreas. Mostramos el caso de un lactante que presentó ascitis en ausencia de edemas, así como los hallazgos clínicos, de laboratorio e histológicos y la respuesta al tratamiento con triglicéridos de cadena mediaCongenital intestinal lymphangiectasis, a protein-losing enteropathy that appears sporadically and affects mainly children and young adults, begins generally with edemas and diarrheas. The case of an infant that presented ascites in absence of edemas is presented. The clinical, laboratory and histological findings, as well as the response to the treatment with mean chain triglycerides are included in this paper

  17. A comparison of Simplified Acute Physiology Score II, Acute ...

    African Journals Online (AJOL)

    A comparison of Simplified Acute Physiology Score II, Acute Physiology and Chronic Health Evaluation II and Acute Physiology and Chronic Health Evaluation III scoring system in predicting mortality and length of stay at surgical intensive care unit.

  18. Logistic regression analysis of prognostic factors in 106 acute-on-chronic liver failure patients with hepatic encephalopathy

    Directory of Open Access Journals (Sweden)

    CUI Yanping

    2014-10-01

    Full Text Available ObjectiveTo analyze the prognostic factors in acute-on-chronic liver failure (ACLF patients with hepatic encephalopathy (HE and to explore the risk factors for prognosis. MethodsA retrospective analysis was performed on 106 ACLF patients with HE who were hospitalized in our hospital from January 2010 to July 2013. The patients were divided into improved group and deteriorated group. The univariate indicators including age, sex, laboratory indicators [total bilirubin (TBil, albumin (Alb, alanine aminotransferase (ALT, aspartate amino-transferase (AST, and prothrombin time activity (PTA], the stage of HE, complications [persistent hyponatremia, digestive tract bleeding, hepatorenal syndrome (HRS, ascites, infection, and spontaneous bacterial peritonitis (SBP], and plasma exchange were analyzed by chi-square test or t-test. Indicators with statistical significance were subsequently analyzed by binary logistic regression. ResultsUnivariate analysis showed that ALT (P=0.009, PTA (P=0.043, the stage of HE (P=0.000, and HRS (P=0.003 were significantly different between the two groups, whereas differences in age, sex, TBil, Alb, AST, persistent hyponatremia, digestive tract bleeding, ascites, infection, SBP, and plasma exchange were not statistically significant (P>0.05. Binary logistic regression demonstrated that PTA (b=-0097, P=0.025, OR=0.908, HRS (b=2.279, P=0.007, OR=9.764, and the stage of HE (b=1873, P=0.000, OR=6.510 were prognostic factors in ACLF patients with HE. ConclusionThe stage of HE, HRS, and PTA are independent influential factors for the prognosis in ACLF patients with HE. Reduced PTA, advanced HE stage, and the presence of HRS indicate worse prognosis.

  19. Acute disseminated encephalomyelitis mimicking acute meningoencephalitis.

    Science.gov (United States)

    Ashrafi, Mahmoud Reza; Amirkashani, Davood; Hirbod-Mobarakeh, Armin; Yaghmaei, Bahareh; Tavassoli, Alireza; Manafi, Farzad; Rezaei, Nima

    2013-12-01

    Acute disseminated encephalomyelitis is an inflammatory demyelinating disease of the central nervous system that usually occurs following an antecedent infection or vaccination. Children and young adults are predominantly affected, but it has low incidence in children younger than 3 years. The disease manifests with a wide range of neurological abnormalities and a variable combination of fever, headache, meningism, convulsion and cranial nerve palsies, and there are no pathognomonic clinical or laboratory findings. So, establishment of definitive diagnosis is challenging in infants. This challenge may result in delayed diagnosis and consequently delayed treatment of acute disseminated encephalomyelitis, which may cause permanent neurological disability. Herein, we report an infant with acute disseminated encephalomyelitis, who mimicked the symptoms of meningoencephalitis and the correct diagnosis and treatment were delayed till the development of a severe phase of the disease.

  20. ACUTE KIDNEY INJURY IN PATIENTS WITH CIRRHOSIS- CAUSES AND OUTCOME

    Directory of Open Access Journals (Sweden)

    Amit Hanmant Shejal

    2017-06-01

    Full Text Available BACKGROUND Acute Kidney Injury (AKI is a common complication in patients with cirrhosis leading to high mortality. Creatinine-based criteria for defining AKI are validated in general hospitalised patients, but their application to cirrhotic patients is less certain. This study was undertaken to evaluate current definition of AKI by International Club of Ascites (ICA and assess clinical course of hospitalised cirrhosis patients with AKI and to study the impact of AKI on mortality. MATERIALS AND METHODS We prospectively studied patients with AKI and cirrhosis for a period of 1 year and assessed the association between AKI severity and progression with complications, including death. RESULTS 48 cirrhotic patients with AKI were enrolled in the study period. Mean age of patients was 56.81 ± 9.78 years. The aetiology of cirrhosis included alcohol (52.1%, HBV (2.2%, HCV (4.2%, NASH (27.1% and cryptogenic (14.6%. 13 patients (27.1% had mortality while 35 patients (72.9% survived. 39 patients (81.25% had AKI at admission while 9 patients (18.75% developed later after admission. Patients achieved a peak severity of AKI stage 1, 10.41%; stage 2, 60.41%; and stage 3, 37.5%. The incidence of mortality, increased with severity of AKI in stepwise manner with peak AKI stage 1 has no mortality; stage 2 has 4 (30.76%; stage 3, 9 (69.23%. SIRS was present in 17 patients (35.4% and was significantly associated with mortality. CONCLUSION AKI, as defined by new ICA criteria, in patients with cirrhosis is associated with mortality in a stage-dependent fashion. Early intervention and preventing progression by timely and specific treatment may improve outcomes.

  1. Leukocytosis in acute stroke

    DEFF Research Database (Denmark)

    Kammersgaard, L P; Jørgensen, H S; Nakayama, H

    1999-01-01

    Leukocytosis is a common finding in the acute phase of stroke. A detrimental effect of leukocytosis on stroke outcome has been suggested, and trials aiming at reducing the leukocyte response in acute stroke are currently being conducted. However, the influence of leukocytosis on stroke outcome has...

  2. [Acute kidney injury

    NARCIS (Netherlands)

    Hageman, D.; Kooman, J.P.; Lance, M.D.; Heurn, L.W. van; Snoeijs, M.G.

    2012-01-01

    - 'Acute kidney injury' is modern terminology for a sudden decline in kidney function, and is defined by the RIFLE classification (RIFLE is an acronym for Risk, Injury, Failure, Loss and End-stage kidney disease).- Acute kidney injury occurs as a result of the combination of reduced perfusion in the

  3. Pediatric acute lung injury

    NARCIS (Netherlands)

    Dahlem, P.; van Aalderen, W. M. C.; Bos, A. P.

    2007-01-01

    Among ventilated children, the incidence of acute lung injury (ALI) was 9%; of that latter group 80% developed the acute respiratory distress syndrome (ARDS). The population-based prevalence of pediatric ARDS was 5.5 cases/100.000 inhabitants. Underlying diseases in children were septic shock (34%),

  4. [Nonocclusive acute mesenteric ischemia].

    Science.gov (United States)

    Vasile, I; Meşină, C; Paşalega, M; Calotă, F; Vâlcea, I D

    2008-01-01

    The authors present one case of acute mesenteric ischemia appeared to the patient 70 years old, with HTA and coronary heart disease with heart arrhythmia treated with angiotensin-converting-enzyme inhibitor, anti arrhythmia agents and antithrombin therapy (trombostop). Acute mesenteric ischemia is not an isolated clinical entity, but a complex of diseases, including acute mesenteric arterial embolus and thrombus, mesenteric venous thrombus and nonocclusive mesenteric ischemia. These diseases have common clinical features caused by impaired blood perfusion of the intestine, bacterial translocation and systemic inflammatory response syndrome. Reperfusion injury is another important feature of nonocclusive mesenteric ischemia. We discuss about the nonocclusive mesenteric ischemia is the most lethal form of acute mesenteric ischemia because of the poor understanding of its pathophysiology and its nonspecific symptoms, which often delay its diagnosis. Although acute mesenteric ischemia is still lethal and in-hospital mortality rates have remained high over the last few decades, accumulated knowledge on this condition is expected to improve its prognosis.

  5. [Advances in acute pancreatitis].

    Science.gov (United States)

    Domínguez-Muñoz, J Enrique

    2008-10-01

    The present article reports the most recent evidence on the latest advances in the definition, diagnosis and treatment of acute pancreatitis. The concept of acute pancreatitis and its complications is changing and the presence of persistent organ failure is essential to classify a patient as having severe disease. In this context, increased intestinal permeability is seen as an early phenomenon with important prognostic repercussions. Endoscopic ultrasonography is confirmed as the investigation of choice in patients with idiopathic acute pancreatitis or suspected acute biliary pancreatitis. Aggressive water and electrolyte replacement in the first few hours after onset is the key to a favorable clinical course. Conservative treatment and the use of endoscopic necrosectomy are replacing surgery as the treatment of choice of infected pancreatic necrosis. Lastly, the present article discusses the latest evidence on the prevention of post-endoscopic retrograde cholangiopancreatography (ERCP) acute pancreatitis.

  6. Acute Hepatic Porphyria

    Science.gov (United States)

    Bissell, D. Montgomery; Wang, Bruce

    2015-01-01

    The porphyrias comprise a set of diseases, each representing an individual defect in one of the eight enzymes mediating the pathway of heme synthesis. The diseases are genetically distinct but have in common the overproduction of heme precursors. In the case of the acute (neurologic) porphyrias, the cause of symptoms appears to be overproduction of a neurotoxic precursor. For the cutaneous porphyrias, it is photosensitizing porphyrins. Some types have both acute and cutaneous manifestations. The clinical presentation of acute porphyria consists of abdominal pain, nausea, and occasionally seizures. Only a small minority of those who carry a mutation for acute porphyria have pain attacks. The triggers for an acute attack encompass certain medications and severely decreased caloric intake. The propensity of females to acute attacks has been linked to internal changes in ovarian physiology. Symptoms are accompanied by large increases in delta-aminolevulinic acid and porphobilinogen in plasma and urine. Treatment of an acute attack centers initially on pain relief and elimination of inducing factors such as medications; glucose is administered to reverse the fasting state. The only specific treatment is administration of intravenous hemin. An important goal of treatment is preventing progression of the symptoms to a neurological crisis. Patients who progress despite hemin administration have undergone liver transplantation with complete resolution of symptoms. A current issue is the unavailability of a rapid test for urine porphobilinogen in the urgent-care setting. PMID:26357631

  7. Acute oncological emergencies.

    LENUS (Irish Health Repository)

    Gabriel, J

    2012-01-01

    The number of people receiving systemic anti-cancer treatment and presenting at emergency departments with treatment-related problems is rising. Nurses will be the first point of contact for most patients and need to be able to recognise oncological emergencies to initiate urgent assessment of patients and referral to the acute oncology team so that the most appropriate care can be delivered promptly. This article discusses the role of acute oncology services, and provides an overview of the most common acute oncological emergencies.

  8. Acute acalculous cholecystitis complicating chemotherapy for acute myeloblastic leukemia

    Directory of Open Access Journals (Sweden)

    Olfa Kassar

    2015-01-01

    Full Text Available Acute acalculous cholecystitis is a rare complication in the treatment of acute myeloblastic leukemia. Diagnosis of acute acalculous cholecystitis remains difficult during neutropenic period. We present two acute myeloblastic leukemia patients that developed acute acalculous cholecystitis during chemotherapy-induced neutropenia. They suffered from fever, vomiting and acute pain in the epigastrium. Ultrasound demonstrated an acalculous gallbladder. Surgical management was required in one patient and conservative treatment was attempted in the other patient. None treatment measures were effective and two patients died. Acute acalculous cholecystitis is a serious complication in neutropenic patients. Earlier diagnosis could have expedited the management of these patients.

  9. Acute myocardial infarction.

    Science.gov (United States)

    Reed, Grant W; Rossi, Jeffrey E; Cannon, Christopher P

    2017-01-14

    Acute myocardial infarction has traditionally been divided into ST elevation or non-ST elevation myocardial infarction; however, therapies are similar between the two, and the overall management of acute myocardial infarction can be reviewed for simplicity. Acute myocardial infarction remains a leading cause of morbidity and mortality worldwide, despite substantial improvements in prognosis over the past decade. The progress is a result of several major trends, including improvements in risk stratification, more widespread use of an invasive strategy, implementation of care delivery systems prioritising immediate revascularisation through percutaneous coronary intervention (or fibrinolysis), advances in antiplatelet agents and anticoagulants, and greater use of secondary prevention strategies such as statins. This seminar discusses the important topics of the pathophysiology, epidemiological trends, and modern management of acute myocardial infarction, focusing on the recent advances in reperfusion strategies and pharmacological treatment approaches. Copyright © 2017 Elsevier Ltd. All rights reserved.

  10. Acute coronary syndrome

    Science.gov (United States)

    ... Have plenty of fruits, veggies, whole grains, and lean meats. Try to limit foods high in cholesterol ... et al. 2014 AHA/ACC guideline for the management of patients with non-ST-elevation acute coronary ...

  11. Acute Kidney Failure

    Science.gov (United States)

    ... breath Acute kidney failure Symptoms & causes Diagnosis & treatment Advertisement Mayo Clinic does not endorse companies or products. ... a Job Site Map About This Site Twitter Facebook Google YouTube Pinterest Mayo Clinic is a not- ...

  12. [Acute dyspnea in children].

    Science.gov (United States)

    Gerson, P; Orliaguet, G

    2003-07-01

    Diagnosis of an acute obstructive dyspnea in children is very difficult, especially in the prehospital setting, because there are many possible causes. However, some of them may rapidly become life-threatening and therefore require a rapid prehospital management by a team staffed by a physician. The main causes of acute dyspnea in children usually include: obstructive dyspnea (acute laryngitis, foreign body aspiration, bronchiolotis, acute asthma), pulmonary infections and cardiac dyspnea, as well as dyspnea from other origins (cardiovascular collapse, hyperthermia, acidosis, intoxication, deshydratation). Following the assessment of the severity of the illness, the prehospital management should aimed at restoring an optimal oxygenation, before initiating a treatment adapted to the cause of the disease.

  13. Acute Lymphocytic Leukemia

    Science.gov (United States)

    ... of radiation, such as survivors of a nuclear reactor accident, have an increased risk of developing acute ... 18, 2015. Mesa RA (expert opinion). Mayo Clinic, Phoenix/Scottsdale, Ariz. May 30, 2015. Cook AJ. Decision ...

  14. Acute Lymphocytic Leukemia

    Science.gov (United States)

    ... al. Clinical manifestations and treatment of acute lymphoblastic leukemia in children. In: Hematology: Basic Principles and Practice. 6th ed. ... National Cancer Institute. http://www.cancer.gov/types/leukemia/patient/child-all-treatment-pdq#section/all. Accessed June 5, ...

  15. Acute Disseminated Encephalomyelitis: Outcome

    Directory of Open Access Journals (Sweden)

    J Gordon Millichap

    2002-11-01

    Full Text Available The clinical and neuroimaging findings in 84 consecutive children with acute disseminated encephalomyelitis (ADEM were studied prospectively, between March 1988 and July 2000, in relation to outcome at the National Pediatric Hospital, Buenos Aires, Argentina.

  16. Acute Radiation Syndrome

    Science.gov (United States)

    ... Matters Information on Specific Types of Emergencies Acute Radiation Syndrome (ARS): A Fact Sheet for the Public ... is called the radiation dose. People exposed to radiation will get ARS only if: The radiation dose ...

  17. Acute management of stones

    DEFF Research Database (Denmark)

    Jung, Helene; Osther, Palle J S

    2015-01-01

    INTRODUCTION: Stone management is often conservative due to a high spontaneous stone passage rate or non-symptomatic calyceal stones that do not necessarily require active treatment. However, stone disease may cause symptoms and complications requiring urgent intervention. MATERIAL AND METHODS......: In this review, we update latest research and current recommendations regarding acute management of stones, with particular focus on imaging, pain management, active stone interventions, medical expulsive therapy, and urolithiasis in pregnancy and childhood. RESULTS: Acute stone management should be planned...

  18. Acute liver failure

    DEFF Research Database (Denmark)

    Larsen, Fin Stolze; Bjerring, Peter Nissen

    2011-01-01

    Acute liver failure (ALF) results in a multitude of serious complications that often lead to multi-organ failure. This brief review focuses on the pathophysiological processes in ALF and how to manage these.......Acute liver failure (ALF) results in a multitude of serious complications that often lead to multi-organ failure. This brief review focuses on the pathophysiological processes in ALF and how to manage these....

  19. Acute Leukemia in Children

    Directory of Open Access Journals (Sweden)

    K.V. Vilchevska

    2014-11-01

    Full Text Available The lecture presents current data on the etiology, pathogenesis, clinical manifestations, observation methods and principles of treatment of children with acute lymphoblastic leukemia. own clinical observation of development of the acute lymphoblastic leukemia clinical picture in a child aged 4 years old has been described. This case is characterized by late diagnosis and inappropriate prescription of steroids in combination with antipyretic agents that led to tumor resistance to the treatment.

  20. Mobilization of xanthine oxidase from the gastrointestinal tract in acute pancreatitis

    Directory of Open Access Journals (Sweden)

    Closa Daniel

    2004-01-01

    Full Text Available Abstract Background Xanthine oxidoreductase has been proposed to play a role in the development of local and systemic effects of acute pancreatitis. Under physiologic conditions, the enzyme exists mainly as xanthine dehydrogenase (XDH but can be converted by proteolytic cleavage to its superoxide-generating form xanthine oxidase (XOD. In addition to its intracellular location XDH/XOD is also associated to the polysaccharide chains of proteoglycans on the external endothelial cell membrane. In the early stages of acute pancreatitis, this enzyme seems to be arising from its mobilization from the gastrointestinal endothelial cell surface. Taking into account the ability of α-amylase to hydrolyze the internal α-1,4 linkages of polysaccharides, we wanted to elucidate the involvement of α-amylase in XDH/XOD mobilization from the gastrointestinal endothelial cell surface and the relevance of the ascitic fluid (AF as the source of α-amylase in experimental acute pancreatitis. Methods Acute pancreatitis was induced in male Wistar rats by intraductal administration of 5% sodium taurocholate. In another experimental group 3000 U/Kg α-amylase was i.v. administered. The concentrations of XDH, XOD and α-amylase in plasma and AF and myeloperoxidase (MPO in lung have been evaluated. In additional experiments, the effect of peritoneal lavage and the absorption of α-amylase present in the AF by an isolated intestine have been determined. Results Similar increase in XDH+XOD activity in plasma was observed after induction of acute pancreatitis and after i.v. administration of α-amylase. Nevertheless, the conversion from XDH to XOD was only observed in the pancreatitis group. Lung inflammation measured as MPO activity was observed only in the pancreatitis group. In addition peritoneal lavage prevented the increase in α-amylase and XDH+XOD in plasma after induction of pancreatitis. Finally, it was observed that α-amylase is absorbed from the AF by the

  1. Acute Myeloid Leukemia Presenting as Acute Appendicitis

    Directory of Open Access Journals (Sweden)

    Sherri Rauenzahn

    2013-01-01

    Full Text Available Appendicitis in leukemic patients is uncommon but associated with increased mortality. Additionally, leukemic cell infiltration of the appendix is extremely rare. While appendectomy is the treatment of choice for these patients, diagnosis and management of leukemia have a greater impact on remission and survival. A 59-year-old Caucasian female was admitted to the surgical service with acute right lower quadrant pain, nausea, and anorexia. She was noted to have leukocytosis, anemia, and thrombocytopenia. Abdominal imaging demonstrated appendicitis with retroperitoneal and mesenteric lymphadenopathy for which she underwent laparoscopic appendectomy. Peripheral smear, bone marrow biopsy, and surgical pathology of the appendix demonstrated acute myeloid leukemia (AML with nonsuppurative appendicitis. In the setting of AML, prior cases described the development of appendicitis with active chemotherapy. Of these cases, less than ten patients had leukemic infiltration of the appendix, leading to leukostasis and nonsuppurative appendicitis. Acute appendicitis with leukemic infiltration as the initial manifestation of AML has only been described in two other cases in the literature with an average associated morbidity of 32.6 days. The prompt management in this case of appendicitis and AML resulted in an overall survival of 185 days.

  2. Acute focal bacterial nephritis in a cohort of hospitalized adult patients with acute pyelonephritis. Assessment of risk factors and a predictive model.

    Science.gov (United States)

    Campos-Franco, Joaquin; Macia, Cristina; Huelga, Emilio; Diaz-Louzao, Carla; Gude, Francisco; Alende, Rosario; Gonzalez-Quintela, Arturo

    2017-04-01

    Acute focal bacterial nephritis (AFBN) is a complicated form of acute pyelonephritis (APN) characterized by single or multiple areas of localised infection in the kidney without liquefaction or abscess. Studies investigating AFBN in adults are scarce. The present study was aimed at evaluating the prevalence, associated factors, and presence of atypical clinical and radiological manifestations in adult AFBN patients. Also, we developed a clinical prediction model to evaluate the probability of AFBN in patients with APN. The clinical records of 377 patients (mean age 54years, 74.0% females) admitted to a hospital over a 5-year period with APN were reviewed. A total of 57 cases of AFBN were radiologically identified (prevalence, 15.1%). Patients with AFBN were younger and displayed atypical manifestations more frequently than patients without AFBN; these included both clinical and radiological (pleural effusion, gallbladder wall thickening, fluid around the gallbladder, perirenal fluid, and ascites) manifestations. Patients with AFBN showed lower systolic blood pressure and needed more days of therapy to become afebrile, longer total duration of antibiotic therapy, and longer hospital stay than patients without AFBN. Contraceptive use was more frequent in patients with AFBN. A model based on five clinical variables showed good discrimination performance for the diagnosis of AFBN (Area under the curve, 0.77 (95% CI, 0.69-0.89)). Patients with AFBN frequently present with atypical clinical and radiological manifestations. Clinical presentation by means of a predictive model may predict the presence of AFBN. Patients with AFBN need more intensive therapy, which is followed by a favourable outcome. Copyright © 2016 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.

  3. Computed tomographic evaluation of mesentery: diagnostic value in acute mesenteric ischemia.

    Science.gov (United States)

    Mazzei, Maria Antonietta; Mazzei, Francesco Giuseppe; Marrelli, Daniele; Imbriaco, Giusi; Guerrini, Susanna; Vindigni, Carla; Civitelli, Serenella; Roviello, Franco; Grassi, Roberto; Volterrani, Luca

    2012-01-01

    To evaluate the computed tomographic appearances of mesentery in acute mesenteric ischemia (AMI) to recognize characteristic features and their prognostic values. Computed tomographic examinations of 34 patients with a confirmed diagnosis of AMI were retrospectively reviewed to evaluate the number of mesenteric vessels, diameter of the superior mesenteric artery and superior mesenteric vein, mesenteric fat stranding, mesenteric vessel pneumatosis and ascites. Overall, at least one of these mesenteric signs was present in all but 1 patient. In all AMI of arterial occlusive type and in 68% of nonocclusive mesenteric ischemia, the number of arterial vessels was reduced (P = 0.067). Mesenteric vessel pneumatosis and reduced number of venous vessels were significantly associated with higher mortality (P = 0.027 and P = 0.042, respectively). Reperfusion signs were associated with a reduced mortality (28.7% vs 65.5%). Considering its characteristic features and its possible prognostic value, the evaluation of mesentery will supply additional information in the interpretation of computed tomography in AMI.

  4. Differentiating Acute Otitis Media and Acute Mastoiditis in Hospitalized Children.

    Science.gov (United States)

    Laulajainen-Hongisto, Anu; Aarnisalo, Antti A; Jero, Jussi

    2016-10-01

    Acute otitis media is a common infection in children. Most acute otitis media episodes can be treated at an outpatient setting with antimicrobials, or only expectant observation. Hospital treatment with parenteral medication, and myringotomy or tympanostomy, may be needed to treat those with severe, prolonged symptoms, or with complications. The most common intratemporal complication of acute otitis media is acute mastoiditis. If a child with acute mastoiditis does not respond to this treatment, or if complications develop, further examinations and other surgical procedures, including mastoidectomy, are considered. Since the treatment of complicated acute otitis media and complicated acute mastoiditis differs, it is important to differentiate these two conditions. This article focuses on the differential diagnostics of acute otitis media and acute mastoiditis in children.

  5. Acute cerebellar ataxia, acute cerebellitis, and opsoclonus-myoclonus syndrome.

    Science.gov (United States)

    Desai, Jay; Mitchell, Wendy G

    2012-11-01

    Acute cerebellar ataxia and acute cerebellitis represent a process characterized by parainfectious, postinfectious, or postvaccination cerebellar inflammation. There is considerable overlap between these entities. The mildest cases of acute cerebellar ataxia represent a benign condition that is characterized by acute truncal and gait ataxia, variably with appendicular ataxia, nystagmus, dysarthria, and hypotonia. It occurs mostly in young children, presents abruptly, and recovers over weeks. Neuroimaging is normal. Severe cases of cerebellitis represent the other end of the spectrum, presenting with acute cerebellar signs often overshadowed by alteration of consciousness, focal neurological deficits, raised intracranial pressure, hydrocephalus, and even herniation. Neuroimaging is abnormal and the prognosis is less favorable than in acute cerebellar ataxia. Acute disseminated encephalomyelitis may be confused with acute cerebellitis when the clinical findings are predominantly cerebellar, but lesions on neuroimaging are usually widespread. Paraneoplastic opsoclonus-myoclonus syndrome is often initially misdiagnosed as acute cerebellar ataxia, but has very specific features, course, and etiopathogensis.

  6. Neuronal transcription factor Brn-3a(l is over expressed in high-grade ovarian carcinomas and tumor cells from ascites of patients with advanced-stage ovarian cancer

    Directory of Open Access Journals (Sweden)

    Ahmed Nuzhat

    2010-07-01

    Full Text Available Abstract Objectives In view of the recent association of Brn-3 transcription factors with neuroblastomas, cervical, breast, and prostate cancers we examined the expression of Brn-3a(l in normal ovaries and in different histological grades of ovarian tumors. The expression of Brn-3a(l was also evaluated in normal ovarian and cancer cell lines and tumor cells isolated from the ascites of advanced-stage ovarian cancer patients. Methods Normal ovaries, benign, borderline, grades 1, 2 and 3 ovarian tumors were analyzed by immunohistochemistry for Brn-3a(l expression. A total of 46 ovarian specimens were included in the study. Immunofluorescence was used to investigate the expression of Brn-3a in normal ovarian and cancer cell lines. Brn-3a(l expression was also evaluated by Western blot in tumor cells isolated from ascites of advanced-stage ovarian cancer patients and also in ovarian cancer cell lines. Results Nearly 12% of normal and benign ovarian tissues and 57% of borderline ovarian tumors were positive for epithelial Brn-3a(l expression. Stromal staining was higher and it constituted 40% of normal non-cancerous ovaries compared to 50 and 86% in benign and borderline tumors. On the other hand, 85-100% of grades 1, 2 & 3 ovarian tumors demonstrated nuclear and cytoplasmic Brn-3a(l staining in the epithelium. Stromal staining in grades1, 2 and 3 tumors constituted 71-88% of total staining. Overall, immunoreactive Brn-3a was present in all grades of ovarian tumors. The extent of epithelial and stromal Brn-3a staining was significantly different between the normal and histological grades of tumors (epithelial-χ2 = 41.01, df = 20, P = 0.004, stromal-χ2 = 24.66. df = 15, P = 0.05. The extent of epithelial staining was significantly higher in grades 1 and 2 ovarian tumors compared to normal ovaries and benign ovarian tumors (p Conclusion These data suggest that like other cancers, Brn-3a(l expression is enhanced in ovarian tumors and its expression is

  7. Clinical features and predictors of outcome in acute hepatitis A and hepatitis E virus hepatitis on cirrhosis.

    Science.gov (United States)

    Radha Krishna, Yellapu; Saraswat, Vivek Anand; Das, Khaunish; Himanshu, Goel; Yachha, Surender Kumar; Aggarwal, Rakesh; Choudhuri, Gour

    2009-03-01

    Acute hepatitis A and E are recognized triggers of hepatic decompensation in patients with cirrhosis, particularly from the Indian subcontinent. However, the resulting acute-on-chronic liver failure (ACLF) has not been well characterized and no large studies are available. Our study aimed to evaluate the clinical profile and predictors of 3-month mortality in patients with this distinctive form of liver failure. ACLF was diagnosed in patients with acute hepatitis A or E [abrupt rise in serum bilirubin and/or alanine aminotransferase with positive immunoglobulin M anti-hepatitis A virus (HAV)/anti-hepatitis E virus (HEV)] presenting with clinical evidence of liver failure (significant ascites and/or hepatic encephalopathy) and clinical, biochemical, endoscopic (oesophageal varices at least grade II in size), ultrasonographical (presence of nodular irregular liver with porto-systemic collaterals) or histological evidence of cirrhosis. Clinical and laboratory profile were evaluated, predictors of 3-month mortality were determined using univariate and multivariate logistic regression and a prognostic model was constructed. Receiver-operating curves were plotted to measure performance of the present prognostic model, model for end-stage liver disease (MELD) score and Child-Turcotte-Pugh (CTP) score. ACLF occurred in 121 (3.75%) of 3220 patients (mean age 36.3+/-18.0 years; M:F 85:36) with liver cirrhosis admitted from January 2000 to June 2006. It was due to HEV in 80 (61.1%), HAV in 33 (27.2%) and both in 8 (6.1%). The underlying liver cirrhosis was due to HBV (37), alcohol (17), Wilson's disease (8), HCV (5), autoimmune (6), Budd-Chiari syndrome (2), haemochromatosis (2) and was cryptogenic in the rest (42). Common presentations were jaundice (100%), ascites (78%) and hepatic encephalopathy (55%). Mean (SD) CTP score was 11.4+/-1.6 and mean MELD score was 28.6+/-9.06. Three-month mortality was 54 (44.6%). Complications seen were sepsis in 42 (31.8%), renal failure in

  8. Gorham-Stout Disease Management during Pregnancy.

    Science.gov (United States)

    Bargagli, Elena; Piccioli, Caterina; Cavigli, Edoardo; Scola, Marianna; Rosi, Elisabetta; Lavorini, Federico; Novelli, Luca; Ugolini, Dario; Notaristefano, Tommaso; Filippo, Pieralli; Miele, Vittorio; Comin, Camilla E; Pistolesi, Massimo; Voltolini, Luca

    2017-10-01

    Gorham-Stout Disease (GSD) is a rare lymphatic disorder affecting children or young adults with no predilection of sex. It is generally associated with vanishing bone osteolytic lesions, thoracic and abdominal involvement, and diffuse pulmonary lymphangiomatosis. Chylous effusions and chylothorax, consequent to the abnormal proliferation of lymphatic vessels, may induce respiratory failure with a high mortality risk. Extrapulmonary alterations may include chylous ascites, lymphopenia, and destructing bone disease for overgrowth of lymphatic vessels. Here, we report the case of a young woman who developed a severe and recalcitrant GSD with persistent unilateral chylothorax during pregnancy. The complex management of this patient during and after pregnancy was discussed and compared with literature data to contribute to the definition of a correct diagnostic and therapeutic approach to this rare lymphatic disease.

  9. Radiopharmaceuticals in Acute Porphyria.

    Science.gov (United States)

    Schreuder, Nanno; Mamedova, Ilahä; Jansman, Frank G A

    2016-10-01

    The acute porphyrias are a group of rare metabolic disorders of the heme biosynthetic pathway. Carriers of the acute porphyria gene are prone to potentially fatal acute attacks, which can be precipitated by drug exposure. It is therefore important to know whether a drug is safe for carriers of the acute porphyria gene. In this study, radiopharmaceuticals were assessed on their porphyrogenicity (ie, the potential of a drug to induce an attack). The assessment was conducted by classifying the drugs according to the Thunell model. From 41 radiopharmaceuticals assessed, I-131 norcholesterol, Tc-99m mebrofenin, Tc-99m phytate, Tc-99m sestamibi, and Tl-201 chloride were classified as possibly porphyrogenic. I-131 norcholesterol, Tc-99m mebrofenin, Tc-99m phytate, Tc-99m sestamibi, and Tl-201 chloride should not be prescribed for patients experiencing acute porphyria unless an urgent indication is present and no safer alternative is available. In such cases, potential users should seek advice from a porphyria expert. Preventive measures may also be required. Copyright © 2016 Elsevier HS Journals, Inc. All rights reserved.

  10. Flavopiridol, Cytarabine, and Mitoxantrone in Treating Patients With Acute Leukemia

    Science.gov (United States)

    2013-10-07

    Recurrent Adult Acute Lymphoblastic Leukemia; Recurrent Adult Acute Myeloid Leukemia; Secondary Acute Myeloid Leukemia; Untreated Adult Acute Lymphoblastic Leukemia; Untreated Adult Acute Myeloid Leukemia

  11. Acute Toxicity of Vildagliptin.

    Science.gov (United States)

    Hoffmann, Peter; Martin, Lori; Keselica, Michael; Gunson, Diane; Skuba, Elizabeth; Lapadula, Dan; Hayes, Michael; Bentley, Phil; Busch, Steve

    2017-01-01

    This article describes acute toxicity data in cynomolgus monkeys following oral treatment with vildagliptin, a dipeptidyl peptidase-4 inhibitor. Acute toxicity symptoms in cynomolgus monkeys include edema formation of the extremities, tails, and face associated with skeletal muscle necrosis, and elevations of lactate dehydrogenase, creatine kinase, alanine transaminase, and aspartate aminotransferase activities in the serum; hypothermia; hypotension; tachycardia; moribundity; and death in a few isolated instances. In surviving animals, symptoms were reversible even if treatment was continued. Cynomolgus monkeys from Mauritius appear more sensitive than monkeys of Asian origin. The underlying mechanism(s) of these symptoms in cynomolgus monkeys is currently not well understood, although a vascular mechanism including initial vasoconstriction and subsequent vascular leakage in distal extremities may play a role. The monkey data are reviewed and discussed in the context of other preclinical and clinical data, and it is concluded that acute toxicity following vildagliptin treatment is a monkey-specific phenomenon without relevance for humans.

  12. Acute generalized exanthematous pustulosis.

    Science.gov (United States)

    Sidoroff, Alexis

    2012-01-01

    The key clinical features of acute generalized exanthematous pustulosis (AGEP) are the acute occurrence of numerous pinhead-sized nonfollicular sterile pustules on an edematous erythema accompanied by fever and leukocytosis. Histology shows mainly spongiform subcorneal and/or intraepidermal pustules, frequently a marked edema of the papillary dermis, neutrophils, and often eosinophils. AGEP is a reaction pattern mostly caused by drugs, the ones with the highest risk being antibacterial agents like ampicillin/amoxicillin, and quinolones, pristinamycin, anti-infective sulfonamides, the antimycotic drug terbinafine, (hydroxy)chloroquine, and diltiazem. In addition, a large number of other drugs as well as infections have been reported as triggers. AGEP is an acute and sometimes severe reaction. When the causative agent is withdrawn, it usually resolves quickly without specific treatment. Copyright © 2012 S. Karger AG, Basel.

  13. ACUTE STOMATITIS IN CHILDREN

    Directory of Open Access Journals (Sweden)

    L.N. Drobot’ko

    2010-01-01

    Full Text Available The problem of diseases of mucous membrane of oral cavity is one of the main ones in dentistry. Special attention in this problem should be given to the acute herpetic stomatitis. 80% of all cases of mucous membrane of oral cavity in children are herpetic stomatitis. Local immunity in children with acute stomatitis is closely related to the character of course of pathology. An administration of immunomodulatory treatment is pathogenetically grounded. Bacterial lysates mixture causes etiotropical and pathogenetical effect and increases the activity of immune system resulting in relapses prophylaxis.Key words: children, acute herpetic stomatitis, bacterial lysates mixture.(Voprosy sovremennoi pediatrii — Current Pediatrics. 2010;9(2:146-149

  14. Low back pain (acute).

    Science.gov (United States)

    McIntosh, Greg; Hall, Hamilton

    2011-05-09

    Low back pain affects about 70% of people in resource-rich countries at some point in their lives. Acute low back pain can be self-limiting; however, 1 year after an initial episode, as many as 33% of people still have moderate-intensity pain and 15% have severe pain. Acute low back pain has a high recurrence rate; 75% of those with a first episode have a recurrence. Although acute episodes may resolve completely, they may increase in severity and duration over time. We conducted a systematic review and aimed to answer the following clinical questions: What are the effects of oral drug treatments for acute low back pain? What are the effects of local injections for acute low back pain? What are the effects of non-drug treatments for acute low back pain? We searched: Medline, Embase, The Cochrane Library, and other important databases up to December 2009 (Clinical Evidence reviews are updated periodically, please check our website for the most up-to-date version of this review). We included harms alerts from relevant organisations such as the US Food and Drug Administration (FDA) and the UK Medicines and Healthcare products Regulatory Agency (MHRA). We found 49 systematic reviews, RCTs, or observational studies that met our inclusion criteria. We performed a GRADE evaluation of the quality of evidence for interventions. In this systematic review we present information relating to the effectiveness and safety of the following interventions: acupuncture, advice to stay active, analgesics (paracetamol, opioids), back exercises, back schools, bed rest, behavioural therapy, electromyographic biofeedback, epidural corticosteroid injections, lumbar supports, massage, multidisciplinary treatment programmes, muscle relaxants, non-steroidal anti-inflammatory drugs (NSAIDs), spinal manipulation, temperature treatments (short-wave diathermy, ultrasound, ice, heat), traction, and transcutaneous electrical nerve stimulation (TENS).

  15. Acute pulmoner embolism mimicking acute coronary syndrome

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    Fulya Avcı Demir

    2017-03-01

    Full Text Available Clinical and electocardiographic (ECG features in pulmonary embolism (PE lack of specificity and may mimic an acute coronary syndrom (ACS. We here report a case of a 56-year-old woman presenting with chest pain secondary to pulmonary artery embolism which was initially diagnosed as ACS due to electrocardiographic changes and raised troponin. PE presenting with negative T-wave inversion can mimic ACS and misdirect the diagnostic approach. Simultaneous T-wave inversions in anterior and inferior leads are important clues suggesting PE. Most common ECG findings in PE are anteroseptal T-wave inversion/ST-elevation or depression along with complete or incomplete right bundle branch block, sinus tachycardia, low QRS-complex voltage, an S1Q3T3 pattern, and right axis deviation. The reasons for the ECG changes that seem like ischemia are sudden RV strain, hypoxemia and the release of catecholamines. So we have to be aware that PE can present as acute coronary syndrome with ECG changes preoccupy ischemia

  16. Acute Prevertebral Calcific Tendinitis.

    Science.gov (United States)

    Tamm, Alexander; Jeffery, Caroline C; Ansari, Khalid; Naik, Sandeep

    2015-11-01

    We present a case of neck pain in a middle-aged woman, initially attributed to a retropharyngeal infection and treated with urgent intubation. With the help of computed tomography, the diagnosis was later revised to acute prevertebral calcific tendinitis, a self-limiting condition caused by abnormal calcium hydroxyapatite deposition in the longus colli muscles. It is critical to differentiate between these two disease entities due to dramatic differences in management. A discussion of acute prevertebral calcific tendinitis and its imaging findings is provided below.

  17. Acute dental pain II

    DEFF Research Database (Denmark)

    Jonasson, Peter; Kirkevang, Lise-Lotte; Rosen, Annika

    2016-01-01

    Acute dental pain most often occurs in relation to inflammatory conditions in the dental pulp or in the periradicular tissues surrounding a tooth, but it is not always easy to reach a diagnose and determine what treatment to perform. The anamnesis and the clinical examination provide valuable...... dental pain, they expect that the dentist starts treatment at once and that the treatment should provide pain relief. In this situation many patients are fragile, anxious and nervous. If the dentist is able to manage emergency treatment of acute dental pain this will build confidence and trust between...

  18. Acute Liver Failure.

    Science.gov (United States)

    Newland, Catherine D

    2016-12-01

    Pediatric acute liver failure (ALF) is a complex and rapidly progressive syndrome that results from a variety of age-dependent etiologies. It is defined by the acute onset of liver disease with no evidence of chronic liver disease. There must be biochemical or clinical evidence of severe liver dysfunction as defined by an international normalized ratio (INR) ≥2. If hepatic encephalopathy is present, INR should be ≥1.5. Unfortunately, due to the rarity of ALF in pediatric patients, there is a paucity of diagnostic and management algorithms and each patient must have an individualized approach. [Pediatr Ann. 2016;45(12):e433-e438.]. Copyright 2016, SLACK Incorporated.

  19. Acute disseminated encephalomyelitis

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    Panicker J

    2007-01-01

    Full Text Available Acute disseminated encephalomyelitis (ADEM presents as an acute-onset neurological dysfunction following a triggering event such as an infection or vaccination. Patients present with polysymptomatic neurological dysfunction, and imaging shows multifocal white matter lesions in the brain and spinal cord. Clinical evaluation, magnetic resonance imaging, and cerebrospinal fluid study are most useful in establishing the diagnosis and ruling out important differential diagnoses. Corticosteroids are the mainstay of treatment and the role of other modalities of treatment, such as plasma exchange and intravenous immunoglobulin, require further study. Prognosis is generally good. The recently proposed consensus definitions are likely to facilitate delineation of ADEM from other acquired demyelinating disorders.

  20. Acute bronchiolitis and croup.

    Science.gov (United States)

    Everard, Mark L

    2009-02-01

    Croup and acute bronchiolitis are common forms of virally induced respiratory disease in infancy and early childhood. There is good evidence that corticosteroids can ameliorate disease severity and alter the natural history of symptoms in patients who have croup and that temporary symptomatic benefit can be obtained from the use of nebulized adrenaline. The principle weakness when reviewing therapeutic interventions for acute bronchiolitis is the lack of a clear diagnostic test or definition. Current evidence suggests that oxygen is the only useful pharmacologic agent for correcting hypoxia.