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Sample records for ascites mimicking acute

  1. Acute chylous ascites mimicking acute appendicitis in a patient with pancreatitis

    Institute of Scientific and Technical Information of China (English)

    Emily K Smith; Edmund Ek; Daniel Croagh; Lavinia A Spain; Stephen Farrell

    2009-01-01

    We report a case of acute chylous peritonitis mimicking acute appendicitis in a man with acute on chronic pancreatitis. Pancreatitis, both acute and chronic, causing the development of acute chylous ascites and peritonitis has rarely been reported in the English literature. This is the fourth published case of acute chylous ascites mimicking acute appendicitis in the literature.

  2. [Ascites and acute kidney injury].

    Science.gov (United States)

    Piano, Salvatore; Tonon, Marta; Angeli, Paolo

    2016-07-01

    Ascites is the most common complication of cirrhosis. Ascites develops as a consequence of an abnormal splanchnic vasodilation with reduction of effecting circulating volume and activation of endogenous vasoconstrictors system causing salt and water retention. Patients with ascites have a high risk to develop further complications of cirrhosis such as hyponatremia, spontaneous bacterial peritonitis and acute kidney injury resulting in a poor survival. In recent years, new studies helped a better understanding of the pathophysiology of ascites and acute kidney injury in cirrhosis. Furthermore, new diagnostic criteria have been proposed for acute kidney injury and hepatorenal syndrome and a new algorithm for their management has been recommended with the aim of an early diagnosis and treatment. Herein we will review the current knowledge on the pathophysiology, diagnosis and treatment of ascites and acute kidney injury in patients with cirrhosis and we will identify the unmet needs that should be clarified in the next years.

  3. Chlamydia Peritonitis and Ascites Mimicking Ovarian Cancer

    Science.gov (United States)

    Macer, Matthew; Azodi, Masoud

    2016-01-01

    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. PMID:27747116

  4. Chylous ascites caused by acute pancreatitis with portal vein thrombosis

    OpenAIRE

    Park, Dong Eun; Chae, Kwon Mook

    2011-01-01

    Chylous ascites is defined as the accumulation of chyle in the peritoneum due to obstruction or rupture of the peritoneal or retroperitoneal lymphatic glands. Chylous ascites that arises from acute pancreatitis with portal vein thrombosis is very rare. We report here on a case of chylous ascite that was caused by acute pancreatitis with portal vein thrombosis, in which the patient showed an impressive response to conservative therapy with total parenteral nutrition and octerotide. We also rev...

  5. Chylous ascites caused by acute pancreatitis with portal vein thrombosis.

    Science.gov (United States)

    Park, Dong Eun; Chae, Kwon Mook

    2011-12-01

    Chylous ascites is defined as the accumulation of chyle in the peritoneum due to obstruction or rupture of the peritoneal or retroperitoneal lymphatic glands. Chylous ascites that arises from acute pancreatitis with portal vein thrombosis is very rare. We report here on a case of chylous ascite that was caused by acute pancreatitis with portal vein thrombosis, in which the patient showed an impressive response to conservative therapy with total parenteral nutrition and octerotide. We also review the relevant literature about chylous ascites with particular reference to the management of this rare disease.

  6. Acute Myopericarditis Mimicking Acute Myocardial Infarction

    Directory of Open Access Journals (Sweden)

    Seval İzdeş

    2011-08-01

    Full Text Available Acute coronary syndromes among young adults are relatively low when compared with older population in the intensive care unit. Electrocardiographic abnormalities mimicking acute coronary syndromes may be caused by non-coronary syndromes and the differential diagnosis requires a detailed evaluation. We are reporting a case of myopericarditis presenting with acute ST elevation and elevated cardiac enzymes simulating acute coronary syndrome. In this case report, the literature is reviewed to discuss the approach to distinguish an acute coronary syndrome from myopericarditis. (Journal of the Turkish Society Intensive Care 2011; 9:68-70

  7. Ascites

    DEFF Research Database (Denmark)

    Henriksen, Jens Henrik Sahl; Møller, Søren

    -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...... 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...

  8. Acute dystonia mimicking angioedema of the tongue

    DEFF Research Database (Denmark)

    Rasmussen, Eva Rye; Pallesen, Kristine A U; Bygum, Anette

    2013-01-01

    We report a case of acute dystonia of the face, jaw and tongue caused by metoclopramide and mimicking angioedema. The patient had attacks for several years before the correct diagnosis was made and we present the first ever published video footage of an attack. This adverse drug reaction is known...

  9. Abdominal actinomycosis mimicking acute appendicitis.

    Science.gov (United States)

    Conrad, Robert Joseph; Riela, Steven; Patel, Ravi; Misra, Subhasis

    2015-01-01

    A 52-year-old Hispanic woman presented to the emergency department, reporting worsening sharp lower right quadrant abdominal pain for 3 days. CT of the abdomen and pelvis showed evidence of inflammation in the peritoneal soft tissues adjacent to an enlarged and thick-walled appendix, an appendicolith, no abscess formation and a slightly thickened caecum consistent with acute appendicitis. During laparoscopic appendectomy, the caecum was noted to be firm, raising suspicion of malignancy. Surgical oncology team was consulted and open laparotomy with right hemicolectomy was performed. Pathology reported that the ileocaecal mass was not a malignancy but was, rather, actinomycosis. The patient was discharged after 10 days of intravenous antibiotics in the hospital, with the diagnosis of abdominal actinomycosis. Although the original clinical and radiological findings in this case were highly suggestive of acute appendicitis, abdominal actinomycosis should be in the differential for right lower quadrant pain as it may be treated non-operatively.

  10. Infant acute myocarditis mimicking acute myocardial infarction

    Science.gov (United States)

    Tilouche, Samia; Masmoudi, Tasnim; Sahnoun, Maha; Chkirbène, Youssef; Mestiri, Sarra; Boughamoura, Lamia; Ben Dhiab, Mohamed; Souguir, Mohamed Kamel

    2016-01-01

    Myocarditis is an inflammatory disease of the myocardium with heterogeneous clinical manifestations and progression. In clinical practice, although there are many methods of diagnosis of acute myocarditis, the diagnosis remains an embarrassing dilemma for clinicians. The authors report the case of 9-month-old infant who was brought to the Pediatric Emergency Department with sudden onset dyspnea. Examination disclosed heart failure and resuscitation was undertaken. The electrocardiogram showed an ST segment elevation in the anterolateral leads with a mirror image. Cardiac enzyme tests revealed a significant elevation of troponin and creatine phosphokinase levels. A diagnosis of acute myocardial infarction was made, and heparin therapy was prescribed. The infant died on the third day after admission with cardiogenic shock. The autopsy showed dilatation of the ventricles and massive edema of the lungs. Histological examinations of myocardium samples revealed the presence of a marked lymphocytic infiltrate dissociating myocardiocytes. Death was attributed to acute myocarditis. The authors call attention to the difficulties of differential diagnosis between acute myocarditis and acute myocardial infarction especially in children, and to the important therapeutic implications of a correct diagnosis. PMID:28210569

  11. Prolonged acute hepatitis A mimicking autoimmune hepatitis

    Institute of Scientific and Technical Information of China (English)

    Rintaro Mikata; Osamu Yokosuka; Fumio Imazeki; Kenichi Fukai; Tatsuo Kanda; Hiromitsu Saisho

    2005-01-01

    AIM: We report a case with a prolonged course of hepatitisA, with alanine aminotransferase (ALT) higher than 500 IU/Lfor more than 2 mo.METHODS: A middle-aged woman had an elevated IgG level of more than 2 000 mg/dL, positive arti-nudear antibodies (ANA) and anti-smooth muscle antibodies (ASMA), but no evidence of persistent hepatitis A virus (HAV) infection. Liver biopsy findings were compatible with prolonged acute hepatitis, although acute onset of autoimmune hepatitis could not be ruled out.RESULTS: It was assumed that she developed a course of hepatitis similar to autoimmune hepatitis triggered by HAV infection. Ursodeoxycholic acid (UDCA) treatment was initiated and a favorable outcome was obtained. CONCLUSION: We describe a case of a middle-aged woman who showed a prolonged course of acute hepatitis A mimicking autoimmune hepatitis. Treatment with UDCAproved to be effective.

  12. 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

  13. Acute Eosinophilic Ascites in a Middle-Aged Man

    Directory of Open Access Journals (Sweden)

    Fadi Bleibel

    2012-01-01

    Full Text Available Eosinophilic gastroenteritis is a rare condition characterized by recurrent eosinophilic infiltration of portions of the GI tract and presenting with nonspecific GI symptoms in association with peripheral eosinophilia. Its etiology and pathogenesis remain unclear and its symptoms overlap with many GI and systemic diseases. Thus, both gastroenterologists and general internists need to be aware of this rare condition. We present a case of a 55-year-old male with diffuse abdominal pain and distention for two weeks. His physical examination was significant for moderate ascites. Initial work-up demonstrated severe peripheral blood eosinophilia, normal liver function tests, thickening of the stomach and small bowel wall, and elevated serum IgE. Upper endoscopy and extensive testing for malignancy and parasitic infections failed to establish a diagnosis. Ascitic fluid analysis showed significant eosinophilia. Further, a full-thickness jejunal showed marked eosinophilic infiltration of the serosa and muscularis propria. Subsequent treatment with oral prednisone resulted in normalization of laboratory and radiologic abnormalities in a few week period.

  14. Acute Eosinophilic Ascites in a Middle-Aged Man

    Science.gov (United States)

    Bleibel, Fadi; Fragoza, Keith; Faller, Garrey T.

    2012-01-01

    Eosinophilic gastroenteritis is a rare condition characterized by recurrent eosinophilic infiltration of portions of the GI tract and presenting with nonspecific GI symptoms in association with peripheral eosinophilia. Its etiology and pathogenesis remain unclear and its symptoms overlap with many GI and systemic diseases. Thus, both gastroenterologists and general internists need to be aware of this rare condition. We present a case of a 55-year-old male with diffuse abdominal pain and distention for two weeks. His physical examination was significant for moderate ascites. Initial work-up demonstrated severe peripheral blood eosinophilia, normal liver function tests, thickening of the stomach and small bowel wall, and elevated serum IgE. Upper endoscopy and extensive testing for malignancy and parasitic infections failed to establish a diagnosis. Ascitic fluid analysis showed significant eosinophilia. Further, a full-thickness jejunal showed marked eosinophilic infiltration of the serosa and muscularis propria. Subsequent treatment with oral prednisone resulted in normalization of laboratory and radiologic abnormalities in a few week period. PMID:22649743

  15. Acutely calcified hematoma mimicking a displaced medial epicondyle fracture

    Directory of Open Access Journals (Sweden)

    Majed Addie

    2009-01-01

    Full Text Available We present an interesting and unusual case of an acutely calcified pin-site infection hematoma mimicking a displaced cartilaginous medial epicondyle, in a child with a Gartland type III fracture. The treatment of such pathology could be confusing and may interfere with the correct clinical decision-making process. To our knowledge, this is the first presentation of such a case.

  16. Solitary caecum diverticulitis mimicking acute appendicitis.

    Science.gov (United States)

    Hot, Semih; Eğin, Seracettin; Gökçek, Berk; Yeşiltaş, Metin; Alemdar, Ali; Akan, Arzu; Karahan, Servet Rüştü

    2015-12-01

    Solitary cecum diverticulum is a benign formation, but it can be complicated with inflammation, perforation and bleeding. Cecum diverticulitis (CD) is the most common complication of caecal diverticulum and it has the highest incidence among Asians, but it is a rare condition in the western world. The incidence of colonic diverticular disease can vary according to national origin, cultural structure and nutritional habits. CD is not common in our country, but it is an important situation because of its clinical similarity with the commonly seen acute right side abdominal diseases like acute appendicitis. Preoperative diagnosis is difficult, and hence, the actual frequency is not known. The treatment of CD can vary from medical therapy to right hemi colectomy. In this study, we presented ten CD cases on whom surgical resection was performed in our surgery unit during the last 8 years. Our purpose was to increase the awareness of surgeons about this situation, and so, make them pay attention for not having their first experience in the operating room.

  17. Pancreatitis with Electrocardiographic Changes Mimicking Acute Myocardial Infarction

    Directory of Open Access Journals (Sweden)

    Paul Khairy

    2001-01-01

    Full Text Available A 64-year-old woman with mild acute pancreatitis presented with epigastric pain, nausea and vomiting while undergoing hemodialysis for chronic renal insufficiency. Serial electrocardiograms revealed new onset ST segment elevations in leads V2 to V4 mimicking an anterior myocardial infarction, followed by diffusely inverted deep T waves. No cardiac pathology was demonstrated by echocardiography or coronary angiography. A review of the literature and possible pathophysiological mechanisms of electrocardiographic changes in acute pancreatitis, such as metabolic abnormalities, hemodynamic instability, vasopressors, pericarditis, myocarditis, a cardiobiliary reflex, exacerbation of underlying cardiac pathology, coagulopathy and coronary vasospasm, are discussed.

  18. Acute myocarditis triggering coronary spasm and mimicking acute myocardial infarction.

    Science.gov (United States)

    Kumar, Andreas; Bagur, Rodrigo; Béliveau, Patrick; Potvin, Jean-Michel; Levesque, Pierre; Fillion, Nancy; Tremblay, Benoit; Larose, Eric; Gaudreault, Valérie

    2014-09-26

    A 24-year-old healthy man consulted to our center because of typical on-and-off chest-pain and an electrocardiogram showing ST-segment elevation in inferior leads. An urgent coronary angiography showed angiographically normal coronary arteries. Cardiovascular magnetic resonance imaging confirmed acute myocarditis. Although acute myocarditis triggering coronary spasm is an uncommon association, it is important to recognize it, particularly for the management for those patients presenting with ST-segment elevation and suspect myocardial infarction and angiographically normal coronary arteries. The present report highlights the role of cardiovascular magnetic resonance imaging to identify acute myocarditis as the underlying cause.

  19. Acute myocarditis triggering coronary spasm and mimicking acute myocardial infarction

    Institute of Scientific and Technical Information of China (English)

    Andreas; Kumar; Rodrigo; Bagur; Patrick; Béliveau; Jean-Michel; Potvin; Pierre; Levesque; Nancy; Fillion; Benoit; Tremblay; éric; Larose; Valérie; Gaudreault

    2014-01-01

    A 24-year-old healthy man consulted to our center because of typical on-and-off chest-pain and an electrocardiogram showing ST-segment elevation in inferior leads. An urgent coronary angiography showed angiographically normal coronary arteries. Cardiovascular magnetic resonance imaging confirmed acute myocarditis. Although acute myocarditis triggering coronary spasm is an uncommon association, it is important to recognize it, particularly for the management for those patients presenting with ST-segment elevation and suspect myocardial infarction and angiographically normal coronary arteries. The present report highlights the role of cardiovascular magnetic resonance imaging to identify acute myocarditis as the underlying cause.

  20. Wernicke's Encephalopathy Mimicking Acute Onset Stroke Diagnosed by CT Perfusion

    Directory of Open Access Journals (Sweden)

    Alok Bhan

    2014-01-01

    Full Text Available Background. Metabolic syndromes such as Wernicke’s encephalopathy may present with a sudden neurological deficit, thus mimicking acute onset stroke. Due to current emphasis on rapid admission and treatment of acute stroke patients, there is a significant risk that these stroke mimics may end up being treated with thrombolysis. Rigorous clinical and radiological skills are necessary to correctly identify such metabolic stroke mimics, in order to avoid doing any harm to these patients due to the unnecessary use of thrombolysis. Patient. A 51-year-old Caucasian male was admitted to our hospital with suspicion of an acute stroke due to sudden onset dysarthria and unilateral facial nerve paresis. Clinical examination revealed confusion and dysconjugate gaze. Computed tomography (CT including a CT perfusion (CTP scan revealed bilateral thalamic hyperperfusion. The use of both clinical and radiological findings led to correctly diagnosing Wernicke’s encephalopathy. Conclusion. The application of CTP as a standard diagnostic tool in acute stroke patients can improve the detection of stroke mimics caused by metabolic syndromes as shown in our case report.

  1. Acute Abdomen Secondary to Incarcerated Umbilical Hernia after Treatment of Massive Cirrhotic Ascites

    Directory of Open Access Journals (Sweden)

    Hiang Keat Tan

    2013-01-01

    Full Text Available Umbilical herniation is common in patients with liver cirrhosis and ascites. Rarely, they suffer from incarceration and strangulation of the umbilical hernia after treatment of ascites. We report 3 cases of umbilical hernia incarceration following removal of massive ascites with different treatment modalities. Physicians managing this group of patients should be aware of this rare and potentially fatal complication.

  2. Acute Abdomen Secondary to Incarcerated Umbilical Hernia after Treatment of Massive Cirrhotic Ascites

    OpenAIRE

    2013-01-01

    Umbilical herniation is common in patients with liver cirrhosis and ascites. Rarely, they suffer from incarceration and strangulation of the umbilical hernia after treatment of ascites. We report 3 cases of umbilical hernia incarceration following removal of massive ascites with different treatment modalities. Physicians managing this group of patients should be aware of this rare and potentially fatal complication.

  3. Round ligament lipoma mimicking acute appendicitis in a 24-week pregnant female: a case report.

    Science.gov (United States)

    Miller, T J; Paulk, D G

    2013-04-01

    An exhaustive search of the literature using the Pub Med database revealed no reports of round ligament lipomas mimicking acute appendicitis in pregnant patients. There are relatively few articles on round ligament lipomas and even less on round ligament lipomas during pregnancy. This case report is on a 27-year-old 24-week pregnant female who presented with signs and symptoms similar to acute appendicitis who in fact had a large right pelvic round ligament lipoma that was causing her pain.

  4. Cholesterol granuloma of the right epididymis mimicking an acute scrotum

    Institute of Scientific and Technical Information of China (English)

    Borislav Spajic; Hrvoje Cupic; Goran Stimac; Ivica Brigic; Bozo Kruslin; Ognjen Kraus

    2006-01-01

    @@ Dear Sir, I am B. Spajic, the urologist from Clinical Department of Urology, Sestre Milosrdnice University Hospital,Zagreb, Croatia. Recently, we had a rare case of a cholesterol granuloma of the right epididymis at our department, showing clinical signs of acute scrotum. The case described here appears to be the second reporting cholesterol granuloma in the epididymis and the first one presenting with clinical signs of acute scrotum.

  5. Acute type II cryoglobulinaemic vasculitis mimicking atherosclerotic peripheral vascular disease.

    LENUS (Irish Health Repository)

    Saeed, A

    2012-01-31

    Atherosclerotic peripheral vascular disease is a common presenting cause for digital ischaemia in life long smokers. Acute severe Type II Cryoglobulinaemic vasculitis is a rare yet important cause, which may present with similar clinical features and which if undiagnosed may be rapidly fatal. Following the instigation of therapy with intravenous methylprednisolone and cyclophosphamide this patient made an excellent recovery.

  6. Cecal diverticulitis mimicking acute Appendicitis: a report of 4 cases

    Directory of Open Access Journals (Sweden)

    Kurtulus Idris

    2008-04-01

    Full Text Available Abstract Diverticulum of the cecum is a rare, benign, generally asymptomatic lesion that manifests itself only following inflammatory or hemorrhagic complications. Most patients with inflammation of a solitary diverticulum of the cecum present with abdominal pain that is indistinguishable from acute appendicitis. The optimal management of this condition is still controversial, ranging from conservative antibiotic treatment to aggressive resection. We describe four cases that presented with symptoms suggestive of appendicitis, but were found at operation to have an inflamed solitary diverticulum.

  7. Acute Aortic Dissection Mimicking STEMI in the Catheterization Laboratory: Early Recognition Is Mandatory

    Directory of Open Access Journals (Sweden)

    Alessio Arrivi

    2012-01-01

    Full Text Available Coronary malperfusion due to type A aortic dissection is a life-threatening condition where timely recognition and treatment are mandatory. A 77-year-old woman underwent an acute evolving type A aortic dissection mimicking acute myocardial infarction. Two pathophysiologic mechanisms are discussed: either thrombosis migrating from a previously treated giant aneurism of proximal left anterior descending or a local arterial complication due to left main stenting. Recognition of these occurrences in the catheterization laboratory is important to look immediately for surgery.

  8. Cholecystocolonic fistula mimicking acute cholecystitis diagnosed unequivocally by computed tomography.

    Science.gov (United States)

    Chick, Jeffrey Forris Beecham; Chauhan, Nikunj Rashmikant; Paulson, Vera Ashley; Adduci, Alexander J

    2013-12-01

    Cholecystocolonic fistula is an uncommon potential complication of cholecystitis found intraoperatively in 0.06-0.14 % of patients undergoing cholecystectomy and 0.1-0.5 % of autopsy series. Although cholecystocolonic fistula is the second most common cholecystoenteric fistula, second only to cholecystoduodenal fistula, it is diagnosed preoperatively in only 7.9 % of patients. Failure to preoperatively diagnose cholecystocolonic fistula places surgeons in precarious positions, as they may be forced to convert a seemingly routine cholecystectomy to a more sophisticated procedure coupled with adhesiolysis, colonic suturing, or colonic resection. We report a young patient who presented to the emergency department with complaints indicative of acute cholecystitis; however, preoperative ultrasound was suggestive of a cholecystoenteric fistula. Computed tomography and pathology were pathognomonic with clear visualization of the cholecystocolonic fistulous tract.

  9. Gastric perforation due to foreign body ingestion mimicking acute cholecystitis.

    Science.gov (United States)

    Henneman, Daniel; Bosman, Willem-Maarten; Ritchie, Ewan D; van den Bremer, Jephta

    2015-03-04

    An 82-year-old man presented with signs and symptoms that were suggestive of acute cholecystitis. He underwent a laparoscopic cholecystectomy. During the intervention, a wooden foreign body was removed from the infiltrated omentum, probably after it had perforated the gastric antrum. The gastric perforation had led to a secondary infection of the gallbladder. The presumed gastric perforation was treated conservatively, and the patient recovered well and was discharged after 7 days. Secondary inflamed gallbladders are rare; the current case is, to the best of our knowledge, the first case reporting a secondary infection of the gallbladder due to a gastric perforation. Clinicians should be aware of possible ingestion of foreign bodies in elderly patients wearing dental prosthetic devices.

  10. Chylous Ascites

    Directory of Open Access Journals (Sweden)

    Siva K Talluri

    2011-01-01

    Full Text Available Context: Chylous ascites is the accumulation of milky chyle in the peritoneal cavity. Chylous ascites has been reported after surgeries like abdominal aortic aneurysm repair, radical gastrectomy, duodenectomy, nephrectomy and Wilm′s tumor resection. Our literature search did not reveal any reports of chylous ascites after a gastric ulcer resection. We report about an elderly woman with a rare complication of chylous ascites after an emergent surgery for a perforated gastric ulcer. Case Report : A 70-year-old woman developed sudden respiratory distress on 5 th post-operative day after an elective C3-C7 cervical discectomy and fusion. Her past medical history was significant for cervical spondylosis. The Computed Tomography (CT scan of the chest revealed air under the diaphragm suspicious for hollow viscus perforation. She underwent an emergent surgery for drainage of hematoma in the neck along with an emergent laparotomy to repair a large perforated gastric ulcer distal to the gastro-esophageal junction. The patient had worsening of abdominal distention on 4 th post-operative day. The CT scan of abdomen showed fluid collection in the abdomen. The abdominal drain revealed large amount of serous milky fluid at the rate of 1500 ml per day. The fluid analysis showed that the triglyceride level was 170 mg/dl and cholesterol level was 15 mg/dl. The fluid cultures did not grow any organism. She responded to treatment with octreotide and a diet of medium chain triglyceride oil. Conclusion: Any obstruction or damage to the lymphatic channels results in chylous ascites. Lymphomas, metastatic malignancies, and abdominal surgeries commonly cause chylous ascites. Ascitic fluid triglyceride level greater than 110 mg/dl is diagnostic of chylous ascites. Chylous ascites is a rare complication of a peptic ulcer resection which can be managed effectively with octreotide.

  11. Acute calcific prevertebral tendonitis mimicking tension-type headache.

    Science.gov (United States)

    Wakabayashi, Yukihiro; Hori, Yuzo; Kondoh, Yayoi; Asano, Tomoshige; Yamada, Akira; Yamashita, Masanori; Nagatomi, Hirofumi

    2012-01-01

    A 74-year-old woman was admitted to our hospital due to severe nuchal pain and occipitalgia. Neurological examination found neck stiffness but no throat pain or dysphagia. Blood examination showed slight elevation of white blood cell count, but C-reactive protein level was normal. Cerebrospinal fluid examination found no abnormalities. Computed tomography (CT) and magnetic resonance (MR) imaging demonstrated no abnormalities in the brain. Cervical CT showed a small calcification in front of the C1 body. Cervical T(2)-weighted MR imaging showed a high intensity area in front of the upper cervical vertebral body from C1 to C4, suggesting inflammation of the longus colli muscles. We diagnosed acute calcific prevertebral tendonitis. She was administered nonsteroidal anti-inflammatory drugs. Her symptoms gradually improved and she was discharged without neurological deficit 8 days after admission. It is important to be aware of the possibility of this rare disease in a patient with severe occipitalgia but no sign of intracerebral lesion.

  12. Pulmonary Thromboembolism Complicating Acute Pancreatitis With Pancreatic Ascites: A Series of 4 cases

    OpenAIRE

    Ruchir Patel; Nirav Pipaliya; Prateik Poddar; Vikas Pandey; Meghraj Ingle; Prabha Sawant

    2016-01-01

    Acute pancreatitis is an inflammatory disease often associated with local and systemic complications. Portosplenic and splanchnic vascular complications of acute pancreatitis are common, but extrasplanchnic vessel thrombosis is less commonly seen. Among them, pulmonary thromboembolism is a very rare complication to be encountered with. We report four cases of acute pulmonary thromboembolism in patients with acute pancreatitis superimposed on chronic pancreatitis. All the patients had abdomina...

  13. Localized pseudomembranous colitis in the cecum and ascending colon mimicking acute appendicitis.

    Science.gov (United States)

    Chyung, Ju Won; Shin, Dong Gue

    2013-05-27

    A 61-year-old male was admitted to our hospital due to right lower abdominal pain and watery diarrhea for 3 d. Beginning 3 wk before he arrived in our hospital, he took 3(rd)-generation cephalosporin (cefixime) for 2 wk due to chronic left ear otitis media. Colonoscopic examination revealed yellowish patches of ulcerations and swelling covered with thick serosanguineous exudate in the cecum and ascending colon. After 7 d of oral metronidazole treatment, his symptoms completely disappeared. We report a case of localized pseudomembranous colitis in the cecum and ascending colon mimicking acute appendicitis associated with cefixime.

  14. Asymmetric Acute Motor Axonal Neuropathy With Unilateral Tongue Swelling Mimicking Stroke.

    Science.gov (United States)

    Chi, Man Sum; Ng, Shi Hon; Chan, Lok Yiu

    2016-11-01

    A 60-year-old man presented with acute onset of left hemiparesis and left hypoglossal nerve palsy with ipsilateral tongue swelling. He then progressed to tetraparesis in a few days. Cerebrospinal fluid showed cell protein dissociation. A nerve conduction study showed motor axonal neuropathy with sensory sparing. A subsequent blood test revealed anti-GD1b IgG antibody positivity. He was diagnosed to have acute motor axonal neuropathy (AMAN) and treated with a course of intravenous immunoglobulin with slow improvement. This is probably the first AMAN with asymmetrical presentation mimicking stroke reported in the literature in detail. The anti-GD1b IgG antibody is also not commonly associated with AMAN.

  15. Hypertrophic Cardiomyopathy Mimicking Acute Anterior Myocardial Infarction Associated with Sudden Cardiac Death

    Directory of Open Access Journals (Sweden)

    Y. Daralammouri

    2012-01-01

    Full Text Available Hypertrophic cardiomyopathy is the most common genetic disease of the heart. We report a rare case of hypertrophic obstructive cardiomyopathy mimicking an acute anterior myocardial infarction associated with sudden cardiac death. The patient presented with acute ST elevation myocardial infarction and significant elevation of cardiac enzymes. Cardiac catheterization showed some atherosclerotic coronary artery disease, without significant stenosis. Echocardiography showed left ventricular hypertrophy with a left ventricular outflow tract obstruction; the pressure gradient at rest was 20 mmHg and became severe with the Valsalva maneuver (100 mmHg. There was no family history of sudden cardiac death. Six days later, the patient suffered a syncope on his way to magnetic resonance imaging. He was successfully resuscitated by ventricular fibrillation.

  16. CT Findings of Foreign Body Reaction to a Retained Endoloop Ligature Plastic Tube Mimicking Acute Appendicitis: A Case Report

    Energy Technology Data Exchange (ETDEWEB)

    Ahn, Jae Hong; Kang, Chae Hoon; Choi, Soo-Jung; Park, Man Soo; Jung, Seung Mun; Ryu, Dae Shick; Shin, Dong Rock [Department of Radiology, Asan Foundation, GangNeung Asan Hospital, University of Ulsan College of Medicine, Gangneung 25440 (Korea, Republic of)

    2016-11-01

    Many hospitals experience one or more retained surgical instrument events with risk of patient morbidity and medicolegal problems. Identification of retained surgical instrument is important. The radiologists should be familiar with imaging finding of retained surgical instrument. In a 62-year-old female with a retained plastic tube, localized peritoneal infiltration around air-containing tubular structure mimicked acute appendicitis on abdomen computed tomography (CT), one year after laparoscopic cholecystectomy. We reported CT findings of foreign body reaction related to retained Endoloop ligature plastic tube mimicking acute appendicitis.

  17. CT findings of foreign body reaction to retained endoloop ligature plastic tube mimicking acute appendicitis: A case report

    Energy Technology Data Exchange (ETDEWEB)

    Ahn, Jae Hong; Kang, Chae Hoon; Choi, Soo Jung; Park, Man Soo; Jung, Seung Mun; Ryu, Dae Shick; Shin, Dong Rock [Dept. of Radiology, GangNeung Asan Hospital, University of Ulsan College of Medicine, Gangneung (Korea, Republic of)

    2016-07-15

    Many hospitals experience one or more retained surgical instrument events with risk of patient morbidity and medicolegal problems. Identification of retained surgical instrument is important. The radiologists should be familiar with imaging finding of retained surgical instrument. In a 62-year-old female with a retained plastic tube, localized peritoneal infiltration around air-containing tubular structure mimicked acute appendicitis on abdomen computed tomography (CT), one year after laparoscopic cholecystectomy. We reported CT findings of foreign body reaction related to retained Endoloop ligature plastic tube mimicking acute appendicitis.

  18. Acute post-infectious cerebellar ataxia due to co-infection of human herpesvirus-6 and adenovirus mimicking myositis.

    Science.gov (United States)

    Naselli, Aldo; Pala, Giovanna; Cresta, Federico; Finetti, Martina; Biancheri, Roberta; Renna, Salvatore

    2014-11-26

    Acute cerebellar ataxia (ACA) is a relatively common neurological disease in children. Most common types of ACA are acute post-infectious (APCA) and acute disseminated encephalomyelitis (ADEM). Less common but important causes include opsoclonus-myoclonus syndrome (OMS) and acute cerebellitis. Cerebellar neoplasms and acute hydrocephalus are additional causes of paediatric ataxia. APCA is the most common cause of ACA in children, comprising about 30-50% of total cases. This is a report about an immunocompetent 4-yrs-old male affected by APCA, due to co-infection by human herpesvirus-6 (HHV-6) and adenovirus, with symptoms mimicking myositis.

  19. Mediastino-abdominal lipomatosis: deep accumulation of fat mimicking a respiratory disease and ascites. Clinical aspects and metabolic studies in vitro.

    Science.gov (United States)

    Enzi, G; Digito, M; Marin, R; Carraro, R; Baritussio, A; Manzato, E

    1984-01-01

    We report on clinical and metabolic studies of a newly delineated lipomatosis, characterised by an abnormal mediastinal and abdominal accumulation of fat, without obesity. The clinical features, which occurred in all the patients studied, are: Exertional dyspnoea due to a space-occupying mediastinal accumulation of fat, without evidence of cardiac or pulmonary disease. A pseudo-ascitic abdominal enlargement, due to intra- and retroperitoneal accumulation of fatty tissue. Insulin-independent diabetes mellitus. Type IV hyperlipidaemia and elevated levels of plasma uric acid were observed in four patients. Intra-abdominal lipomatous tissue, obtained during laparoscopy from four patients, demonstrated a reduced lipolytic response to beta-adrenergic stimulation. Thus, fat deposition in the abdominal and mediastinal areas could be causally related to defective lipid mobilization in lipomatocytes. Lipoprotein lipase activity in abdominal adipose tissue were normal in two patients (10.0 and 10.6 nmol/g/min) and markedly elevated in another two patients (37.3 and 49.9 nmol/g/min), as compared with controls (12.7 +/- 2.1 nmol/g/min). When expressed on per cell basis, LPL activity in lipomatous tissue was significantly higher than in control tissue (3.21 +/- 1.1 nmol/10(5) cell/min vs 0.92 +/- 0.16 nmol/10(5) cell/min). Lipoprotein fractionation did not demonstrate consistent modification of the serum lipoprotein pattern. HDL and HDL2 cholesterol values were reduced, even in patients with elevated LPL activity in adipose tissue.

  20. (18)F-FDG PET/CT Findings in Acute Epstein-Barr Virus Infection Mimicking Malignant Lymphoma

    DEFF Research Database (Denmark)

    Ørbæk, Mathilde; Graff, Jesper; Markova, Elena;

    2016-01-01

    We present a case demonstrating the diagnostic work-up and follow-up of a patient with acute Epstein-Barr virus (EBV) infection in which the clinical picture and imaging on (18)F-FDG PET/CT mimicked malignant lymphoma. Follow-up (18)F-FDG PET/CT scan in the patient performed 7 weeks after...

  1. A Case of Acute Motor Axonal Neuropathy Mimicking Brain Death and Review of the Literature.

    Science.gov (United States)

    Ravikumar, Sandhya; Poysophon, Poysophon; Poblete, Roy; Kim-Tenser, May

    2016-01-01

    We describe a case report of fulminant Guillain-Barré syndrome (GBS) mimicking brain death. A previously healthy 60-year-old male was admitted to the neurointensive care unit after developing rapidly progressive weakness and respiratory failure. On presentation, the patient was found to have absent brainstem and spinal cord reflexes resembling that of brain death. Acute motor axonal neuropathy, a subtype of GBS, was diagnosed by cerebrospinal fluid and nerve conduction velocity testing. An electroencephalogram showed that the patient had normal, appropriately reactive brain function. Transcranial Doppler (TCD) ultrasound showed appropriate blood flow to the brain. GBS rarely presents with weakness so severe as to mimic brain death. This article provides a review of similar literature. This case demonstrates the importance of performing a proper brain death examination, which includes evaluation for irreversible cerebral injury, exclusion of any confounding conditions, and performance of tests such as electroencephalography and TCDs when uncertainty exists about the reliability of the clinical exam.

  2. Mycophenolate mofetil toxicity mimicking acute cellular rejection in a small intestinal transplant

    Science.gov (United States)

    Apostolov, Ross; Asadi, Khashayar; Lokan, Julie; Kam, Ning; Testro, Adam

    2017-01-01

    Mycophenolate mofetil (MMF) is an important medication used for maintenance immunosuppression in solid organ transplants. A common gastrointestinal (GI) side effect of MMF is enterocolitis, which has been associated with multiple histological features. There is little data in the literature describing the histological effects of MMF in small intestinal transplant (SIT) recipients. We present a case of MMF toxicity in a SIT recipient, with histological changes in the donor ileum mimicking persistent acute cellular rejection (ACR). Concurrent biopsies of the patient’s native colon showed similar changes to those from the donor small bowel, suggesting a non-graft specific process, raising suspicion for MMF toxicity. The MMF was discontinued and complete resolution of these changes occurred over three weeks. MMF toxicity should therefore be considered as a differential diagnosis for ACR and graft-versus-host disease in SITs. PMID:28280702

  3. Acute parietal lobe infarction presenting as Gerstmann's syndrome and cognitive decline mimicking senile dementia.

    Science.gov (United States)

    Chen, Tien-Yu; Chen, Chun-Yen; Yen, Che-Hung; Kuo, Shin-Chang; Yeh, Yi-Wei; Chang, Serena; Huang, San-Yuan

    2013-01-01

    Gerstmann's syndrome encompasses the tetrad of finger agnosia, agraphia, acalculia, and right-left confusion. An elderly man with a history of several cardiovascular diseases was initially brought to the psychiatric outpatient department by his family because of worsening of recent memory, executive function, and mixed anxious-depressive mood. Gerstmann's syndrome without obvious motor function impairment and dementia-like features could be observed at first. Emergent brain computed tomography scan revealed new left-middle cerebral artery infarction over the left posterior parietal lobe. This case reminds us that acute cerebral infarction involving the parietal lobe may present as Gerstmann's syndrome accompanied by cognitive decline mimicking dementia. As a result, emergent organic workups should be arranged, especially for elderly patients at high risk for cerebral vascular accident.

  4. 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.

  5. Acute parietal lobe infarction presenting as Gerstmann’s syndrome and cognitive decline mimicking senile dementia

    Directory of Open Access Journals (Sweden)

    Chen TY

    2013-07-01

    Full Text Available Tien-Yu Chen,1 Chun-Yen Chen,1,3 Che-Hung Yen,2,3 Shin-Chang Kuo,1,3 Yi-Wei Yeh,1,3 Serena Chang,1 San-Yuan Huang1,31Department of Psychiatry, 2Department of Neurology, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, 3Graduate Institute of Medical Sciences, National Defense Medical Center, Taipei, Taiwan, Republic of ChinaAbstract: Gerstmann’s syndrome encompasses the tetrad of finger agnosia, agraphia, acalculia, and right-left confusion. An elderly man with a history of several cardiovascular diseases was initially brought to the psychiatric outpatient department by his family because of worsening of recent memory, executive function, and mixed anxious-depressive mood. Gerstmann’s syndrome without obvious motor function impairment and dementia-like features could be observed at first. Emergent brain computed tomography scan revealed new left-middle cerebral artery infarction over the left posterior parietal lobe. This case reminds us that acute cerebral infarction involving the parietal lobe may present as Gerstmann’s syndrome accompanied by cognitive decline mimicking dementia. As a result, emergent organic workups should be arranged, especially for elderly patients at high risk for cerebral vascular accident.Keywords: Gerstmann’s syndrome, dementia, parietal lobe infarction

  6. Acute Inflammatory Bowel Disease Complicating Chronic Alcoholism and Mimicking Carcinoid Syndrome

    Directory of Open Access Journals (Sweden)

    Piercarlo Ballo

    2012-08-01

    Full Text Available We report the case of a woman with a history of chronic alcohol abuse who was hospitalized with diarrhea, severe hypokalemia refractory to potassium infusion, nausea, vomiting, abdominal pain, alternations of high blood pressure with phases of hypotension, irritability and increased urinary 5-hydroxyindoleacetic acid and cortisol. Although carcinoid syndrome was hypothesized, abdominal computed tomography and colonoscopy showed non-specific inflammatory bowel disease with severe colic wall thickening, and multiple colic biopsies confirmed non-specific inflammation with no evidence of carcinoid cells. During the following days diarrhea slowly decreased and the patient’s condition progressively improved. One year after stopping alcohol consumption, the patient was asymptomatic and serum potassium was normal. Chronic alcohol exposure is known to have several deleterious effects on the intestinal mucosa and can favor and sustain local inflammation. Chronic alcohol intake may also be associated with high blood pressure, behavior disorders, abnormalities in blood pressure regulation with episodes of hypotension during hospitalization due to impaired baroreflex sensitivity in the context of an alcohol withdrawal syndrome, increased urinary 5-hydroxyindoleacetic acid as a result of malabsorption syndrome, and increased urinary cortisol as a result of hypothalamic-pituitary-adrenal axis dysregulation. These considerations, together with the regression of symptoms and normalization of potassium levels after stopping alcohol consumption, suggest the intriguing possibility of a alcohol-related acute inflammatory bowel disease mimicking carcinoid syndrome.

  7. Acute inflammatory bowel disease complicating chronic alcoholism and mimicking carcinoid syndrome.

    Science.gov (United States)

    Ballo, Piercarlo; Dattolo, Pietro; Mangialavori, Giuseppe; Ferro, Giuseppe; Fusco, Francesca; Consalvo, Matteo; Chiodi, Leandro; Pizzarelli, Francesco; Zuppiroli, Alfredo

    2012-05-01

    We report the case of a woman with a history of chronic alcohol abuse who was hospitalized with diarrhea, severe hypokalemia refractory to potassium infusion, nausea, vomiting, abdominal pain, alternations of high blood pressure with phases of hypotension, irritability and increased urinary 5-hydroxyindoleacetic acid and cortisol. Although carcinoid syndrome was hypothesized, abdominal computed tomography and colonoscopy showed non-specific inflammatory bowel disease with severe colic wall thickening, and multiple colic biopsies confirmed non-specific inflammation with no evidence of carcinoid cells. During the following days diarrhea slowly decreased and the patient's condition progressively improved. One year after stopping alcohol consumption, the patient was asymptomatic and serum potassium was normal. Chronic alcohol exposure is known to have several deleterious effects on the intestinal mucosa and can favor and sustain local inflammation. Chronic alcohol intake may also be associated with high blood pressure, behavior disorders, abnormalities in blood pressure regulation with episodes of hypotension during hospitalization due to impaired baroreflex sensitivity in the context of an alcohol withdrawal syndrome, increased urinary 5-hydroxyindoleacetic acid as a result of malabsorption syndrome, and increased urinary cortisol as a result of hypothalamic-pituitary-adrenal axis dysregulation. These considerations, together with the regression of symptoms and normalization of potassium levels after stopping alcohol consumption, suggest the intriguing possibility of a alcohol-related acute inflammatory bowel disease mimicking carcinoid syndrome.

  8. A Case of Acute Motor Axonal Neuropathy Mimicking Brain Death and Review of the Literature

    Directory of Open Access Journals (Sweden)

    Sandhya eRavikumar

    2016-04-01

    Full Text Available We describe a case report of fulminant Guillain-Barré syndrome mimicking brain death. A previously healthy 60-year-old male was admitted to the neurointensive care unit after developing rapidly progressive weakness and respiratory failure. On presentation, the patient was found to have absent brainstem and spinal cord reflexes resembling that of brain death. Acute motor axonal neuropathy (AMAN, a subtype of Guillain-Barré syndrome, was diagnosed by cerebrospinal fluid and nerve conduction velocity testing. An electroencephalogram showed that the patient had normal, appropriately reactive brain function. Transcranial Doppler ultrasound showed appropriate blood flow to the brain. Guillain-Barré syndrome rarely presents with weakness so severe as to mimic brain death. This article provides a review of similar literature. This case demonstrates the importance of performing a proper brain death examination, which includes evaluation for irreversible cerebral injury, exclusion of any confounding conditions, and performance of tests such as electroencephalography and transcranial dopplers when uncertainty exists about the reliability of the clinical exam.

  9. Henoch-Schönlein purpura without systemic involvement beginning with acute scrotum and mimicking torsion of testis

    Directory of Open Access Journals (Sweden)

    Levent Verim

    2013-04-01

    Full Text Available Henoch-Schönlein purpura (HSP is the most common systemic vasculitis in children. Typical presentations of HSP are palpable purpura of the small vessels in the hips and lower limbs, abdominal pain, arthritis, and hematuria. Scrotal involvement manifested by the presence of scrotal pain and swelling during the course of the disease is rarely seen. HSP without systemic involvement with acute scrotum mimicking testicular torsion is even rare in the medical literature. In most cases, patients with this disease achieve complete recovery. Herein, we report an interesting HSP case with skin symptoms but without systemic involvement and then progression to acute scrotum resembling torsion of testis.

  10. CSF Ascites: Review of articles and a case presentation

    Directory of Open Access Journals (Sweden)

    R Pourkhalili

    2005-09-01

    Full Text Available Cerebrospinal fluid (CSF ascites is a rare complication after ventriculopritoneal (VP shunts. Most patients have gradual abdominal protrusion without any neurological sign or symptom of shunt malfunction. We presented a girl with posterior third ventricle glioblastoma and acute hydrocephalus who developed increasingly abdominal protrusion one month after VP shunt operation. Ascites fluid examination showed characteristic findings similar to CSF with no evidence of infection or malignant cells. Ventriculo-atrial shunt revision cured patient's ascites. Review articles of patients with CSF ascites after VP shunt were presented in details. Key words: Cerebrospinal fluid, Ascites, Ventriculopritoneal Shunt

  11. Ascitic fluid analysis in malignancy-related ascites.

    Science.gov (United States)

    Runyon, B A; Hoefs, J C; Morgan, T R

    1988-01-01

    A prospective study identified 45 patients with malignancy-related ascites among 448 ascites patients (10% of the total). Patients were categorized into five subgroups based on the pathophysiology of ascites formation. Each subgroup had a distinctive ascitic fluid analysis. Patients with peritoneal carcinomatosis but without massive liver metastases (53.3% of the patients with malignancy-related ascites) had a uniformly positive ascitic fluid cytology, high ascitic fluid protein concentration and low serum-ascites albumin gradient. Patients with massive liver metastases and no other cause for ascites formation (13.3% of the series) had a negative cytology, low ascitic fluid protein concentration, high serum-ascites albumin gradient and markedly elevated serum alkaline phosphatase. Those with peritoneal carcinomatosis and massive liver metastases (13.3% of the series) had a nearly uniformly positive ascitic fluid cytology, variable protein concentration, high serum-ascites albumin gradient and markedly elevated serum alkaline phosphatase. Chylous ascites (6.7%) was characterized by a milky appearance, negative cytology and an elevated ascitic fluid triglyceride concentration. Patients with hepatocellular carcinoma superimposed on cirrhosis (13.3%) had negative ascitic fluid cytology, low ascitic fluid protein concentration, high serum-ascites albumin gradient and elevated serum and ascitic fluid alpha-fetoprotein concentration. Two-thirds of patients with malignancy-related ascites had peritoneal carcinomatosis; 96.7% of patients with peritoneal carcinomatosis had positive ascitic fluid cytology. Ascitic fluid analysis is helpful in identifying and distinguishing the subgroups of malignancy-related ascites.

  12. Management of cirrhotic ascites

    DEFF Research Database (Denmark)

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

    2015-01-01

    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 in the na......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...... 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...

  13. Modulation of Cytokines Production by Indomethacin Acute Dose during the Evolution of Ehrlich Ascites Tumor in Mice

    Directory of Open Access Journals (Sweden)

    Luciana Boffoni Gentile

    2015-01-01

    Full Text Available The aim of the present study was to investigate the influence of a nonselective COX1/COX2 inhibitor (indomethacin on tumor growth of Ehrlich Ascites Tumor (EAT in mice, using as parameters the tumor growth and cytokine profile. Mice were inoculated with EAT cells and treated with indomethacin. After 1, 3, 6, 10, and 13 days the animals were evaluated for the secretion of TNFα, IL-1α, IL-2, IL-4, IL-6, IL-10, and IL-13 and PGE2 level in peritoneal cavity. The results have shown that EAT induces PGE2 production and increases tumor cells number from the 10th day. The cytokine profile showed EAT induces production of IL-6 from 10th day and of IL-2 on 13th day; the other studied cytokines were not affected in a significant way. The indomethacin treatment of EAT-bearing mice inhibited the tumor growth and PGE2 synthesis from the 10th day. In addition, the treatment of EAT-bearing mice with indomethacin has stimulated the IL-13 production and has significantly inhibited IL-6 in the 13th day of tumor growth. Taken together, the results have demonstrated that EAT growth is modulated by PGE2 and the inhibition of the tumor growth could be partly related to suppression of IL-6 and induction of IL-13.

  14. Modulation of Cytokines Production by Indomethacin Acute Dose during the Evolution of Ehrlich Ascites Tumor in Mice

    Science.gov (United States)

    Gentile, Luciana Boffoni; Queiroz-Hazarbassanov, Nicolle; Massoco, Cristina de Oliveira; Fecchio, Denise

    2015-01-01

    The aim of the present study was to investigate the influence of a nonselective COX1/COX2 inhibitor (indomethacin) on tumor growth of Ehrlich Ascites Tumor (EAT) in mice, using as parameters the tumor growth and cytokine profile. Mice were inoculated with EAT cells and treated with indomethacin. After 1, 3, 6, 10, and 13 days the animals were evaluated for the secretion of TNFα, IL-1α, IL-2, IL-4, IL-6, IL-10, and IL-13 and PGE2 level in peritoneal cavity. The results have shown that EAT induces PGE2 production and increases tumor cells number from the 10th day. The cytokine profile showed EAT induces production of IL-6 from 10th day and of IL-2 on 13th day; the other studied cytokines were not affected in a significant way. The indomethacin treatment of EAT-bearing mice inhibited the tumor growth and PGE2 synthesis from the 10th day. In addition, the treatment of EAT-bearing mice with indomethacin has stimulated the IL-13 production and has significantly inhibited IL-6 in the 13th day of tumor growth. Taken together, the results have demonstrated that EAT growth is modulated by PGE2 and the inhibition of the tumor growth could be partly related to suppression of IL-6 and induction of IL-13. PMID:26347589

  15. Sciatic Hernia Mimicking Perianal Abscess in a Cirrhotic Patient

    Directory of Open Access Journals (Sweden)

    Wellington Andraus

    2012-01-01

    Full Text Available Abdominal hernias are very frequent in cirrhotic patients with ascites. The hernias usually present as umbilical, inguinal, incisional, or femoral. However, these patients can also develop uncommon hernias such as pelvic hernias because of pelvic floor weakness and high abdominal pressure due to ascites. We present the first case of a cirrhotic patient with ascites that developed a giant sciatic hernia mimicking a perianal abscess.

  16. Acute primary haemorrhagic omental torsion mimicking perforated appendicitis: an unorthodox surgical paradox.

    Science.gov (United States)

    Rehman, Abdul

    2014-08-01

    Acute primary haemorrhagic omental torsion is an atypical and deceptive cause of acute abdomen that could closely mimic a myriad of intra-abdominal catastrophes, especially perforated appendicitis. The author reports a 30 years man who had presented with gradually worsening right-sided abdominal pain of 2 days duration. Laboratory work-up and abdominal radiographs were inconclusive. Abdominal sonography detected presence of free fluid in the pelvic cul-de-sac. Based on clinical and sonographic findings, presumptive diagnosis of perforated appendicitis was made and the patient was explored through extended Rockey-Davis incision. About 500 - 700 ml of dark-coloured blood (haemoperitoneum) was present in the peritoneal cavity and the pelvis secondary to acute haemorrhagic omental torsion. The appendix was grossly normal. Omentectomy and prophylactic appendicectomy resulted in uneventful recovery of the patient. Acute primary omental torsion is an uncommon pathology that must be kept in mind during differential diagnosis of acute abdomen, especially acute or perforated appendicitis.

  17. Isolated submucosal lipomatosis of appendix mimicking acute appendicitis: computed tomography findings

    Directory of Open Access Journals (Sweden)

    Şükrü Şanlı

    2014-03-01

    Full Text Available Acute appendicitis is one of the more common surgical emergencies, and it is one of the most common causes of acute abdominal pain. Intestinal lipomatosis is a rare condition particularly the isolated form of lipomatosis of the appendix which may mimic or present as an acute appendicitis, that frequently requires the surgical exploration.In this paper, we report computed tomography findings of a case wıth isolated form of submucosal lipomatosis of appendix.

  18. Spontaneous chylous peritonitis mimicking acute appendicitis: A case report and review of literature

    Institute of Scientific and Technical Information of China (English)

    Fu-Chi Fang; Sheng-Der Hsu; Chuang-Wei Chen; Teng-Wei Chen

    2006-01-01

    Acute abdominal pain with signs and symptoms of peritonitis due to sudden extravasation of chyle into the peritoneal cavity is a rare condition that is often mistaken for other disease processes. The diagnosis is rarely suspected preoperatively. We report a case of spontaneous chylous peritonitis that presented with typical symptoms of acute appendicitis such as intermittent fever and epigastric pain radiating to the lower right abdominal quadrant before admission.

  19. Co-infection with Enterobius vermicularis and Taenia saginata mimicking acute appendicitis.

    Science.gov (United States)

    Saravi, Kasra H; Fakhar, Mahdi; Nematian, Javad; Ghasemi, Maryam

    2016-01-01

    In this report, we describe an unusual case of verminous appendicitis due to Enterobius vermicularis and Taenia saginata in a 29-year-old woman from Iran. The histopathological examinations and parasitological descriptions of both worms found in the appendix lumen are discussed. The removed appendix exhibited the macroscopic and microscopic features of acute appendicitis. Antihelminthic therapy was initiated with single doses of praziquantel for the taeniasis and mebendazole for the enterobiasis, and the patient was discharged.

  20. Clinical outcome of Fitz-Hugh-Curtis syndrome mimicking acute biliary disease

    Institute of Scientific and Technical Information of China (English)

    Seong Yong Woo; Jin Il Kim; Dae Young Cheung; Se Hyun Cho; Soo-Heon Park; Joon-Yeol Han; Jae Kwang Kim

    2008-01-01

    AIM: To analyze the clinical characteristics of patients diagnosed with Fitz-Hugh-Curtis syndrome.METHODS: The clinical courses of patients that visited St. Mary's Hospital with abdominal pain from January 2005 to December 2006 and were diagnosed with Fitz-Hugh-Curtis syndrome were examined.RESULTS: Fitz-Hugh-Curtis syndrome was identified in 22 female patients of childbearing age; their mean age was 31.0 + 8.1 years. Fourteen of these cases presented with pain in the upper right abdomen alone or together with pain in the lower abdomen,and six patients presented with pain only in the lower abdomen. The first impression at the time of visit was acute cholecystitis or cholangitis in 10 patients and acute appendicitis or pelvic inflammatory disease in eight patients. Twenty-one patients were diagnosed by abdominal computer tomograghy (CT), and the results of abdominal sonography were normal for 10 of these patients. Ch/amydia trichomatis was isolated from 18 patients. Two patients underwent laparoscopic adhesiotomy and 20 patients were completely cured by antibiotic treatment.CONCLUSION: For women of childbearing age with acute pain in the upper right abdomen alone or together with pain in the lower abdomen, Fitz-HughCurtis syndrome should be considered during differential diagnosis. Moreover, in cases suspected to be Fitz-HughCurtis syndrome, abdominal c-r, rather than abdominal sonography, assists in the diagnosis.

  1. An unusual presentation of massive pulmonary embolism mimicking septal acute myocardial infarction treated with tenecteplase.

    Science.gov (United States)

    Fasullo, Sergio; Paterna, Salvatore; Di Pasquale, Pietro

    2009-02-01

    A 31-year-old man (175 cm, 82 kg) was referred to the emergency department 2 h after the sudden onset of acute dyspnea. Immediate ECG showed sinus tachycardia with ST elevations from V1 through V2 and a diagnosis of septal acute myocardial infarction was made. ECG on admission to the cardiology department showed the same results plus the S1-Q3-T3 pattern. Echocardiogram revealed a normally contracting left ventricle, a distended right ventricle with free wall hypokinesia and displacement of the interventricular septum towards the left ventricle. Thrombolytic therapy with tenecteplase 8000 IU and heparin 5000 IU was administered 5-10 min after hospitalisation and the patient was haemodynamically stable 30 min later. Echocardiogram performed 12 h after thrombolysis showed a normal left ventricle and a less distended right ventricle. Lung spiral computed tomography (CT) and lower abdominal CT on the fourth day showed large emboli in the inferior pulmonary arteries of the right and left lung. Rarely, massive pulmonary embolism may mimic anteroseptal acute myocardial infarction on ECG and this case demonstrates the utility of echocardiography for a differential diagnosis, as well as the efficacy of tenecteplase for thrombolytic therapy.

  2. Ovarian vein thrombosis mimicking acute abdomen: a case report and literature review

    Directory of Open Access Journals (Sweden)

    Arkadopoulos Nikolaos

    2011-12-01

    Full Text Available Abstract Background Ovarian vein thrombosis (OVT is a rare, but serious condition that affects mostly postpartum women. A high index of suspicion is required in order to diagnose this unusual cause of abdominal pain. Case presentation A 19-year-old woman at three days postpartum was admitted to our hospital because of severe right lower quandrant abdominal pain and fever 38.5'C. Physical examination revealed an acutely ill patient and right lower quadrant tenderness with positive rebound and Giordano signs. The patient underwent appendectomy which proved to be negative for acute appendicitis. Postoperatively fever and pain persisted and abdominal CT-scan with intravenous contrast agent demonstrated a thrombosed right ovarian vein. The patient was initiated on low-molecular weight heparin (LMWH and antibiotic treatment and a month later a new abdominal CT-scan showed a patent right ovarian vein. Discussion Pathophysiologically, OVT is explained by Virchow's triad, because pregnancy is associated with a hypercoagulable state, venous stasis due to compression of the inferior vena cava by the uterus and endothelial trauma during delivery or from local inflammation. Common symptoms and signs of OVT include lower abdomen or flank pain, fever and leukocytosis usually within the first ten days after delivery. The reported incidence of OVT ranges 0,05-0,18% of pregnancies and in most cases the right ovarian vein is the one affected. Anticoagulation and antibiotics is the mainstay of treatment of OVT. Complications of OVT include sepsis, extension of the thrombus to the inferior vena cava and renal veins, and pulmonary embolism. The incidence of pulmonary embolism is reported to be 13.2% and represents the main source of mortality due to OVT. Conclusions OVT is a rare condition, usually in the postpartum period. A high index of suspicion is required for the prompt diagnosis and management especially in cases that mimic acute abdomen.

  3. Acute renal infarction secondary to atrial fibrillation - mimicking renal stone picture.

    Science.gov (United States)

    Salih, Salih Bin; Al Durihim, Huda; Al Jizeeri, Ahmed; Al Maziad, Ghassan

    2006-06-01

    Acute renal infarction presents in a similar clinical picture to that of a renal stone. We report a 55-year-old Saudi female, known to have atrial fibrillation secondary to mitral stenosis due to rheumatic heart disease. She presented with a two day history of right flank pain that was treated initially as a renal stone. Further investigations confirmed her as a case of renal infarction. Renal infarction is under-diagnosed because the similarity of its presentation to renal stone. Renal infarction should be considered in the differential diagnosis of loin pain, particularly in a patient with atrial fibrillation.

  4. Acute scrotum due to arterial bleeding mimicking non-seminomatous germ cell tumor

    Institute of Scientific and Technical Information of China (English)

    F.Christoph; M.Schradert; A.Amirmaki; K.Miller

    2004-01-01

    Men with testicular tumors usually present with painless increase in testis size incidentally noticed by the patient. We report a case of a young patient presenting as an emergency with acute onset of massive right-sided testicular pain without previous injury. After physical examination testicular torsion could not be excluded. Ultrasound examination of the tesds was suspicious for tesdcular tumor. Surgical exploration of the right testis by inguinal approach was performed revealing subcapsular arterial bleeding due to a small nonseminomatous germ cell tumor non-palpable on clinical examination. (Asian J Andro12004 Dec;6:379-381)

  5. Spontaneous perforation of pyometra presenting as acute abdomen and pneumoperitoneum mimicking those of gastrointestinal origin.

    Science.gov (United States)

    Yamada, Takahiro; Ando, Nanako; Shibata, Naoshi; Suitou, Motomu; Takagi, Hiroshi; Matsunami, Kazutoshi; Ichigo, Satoshi; Imai, Atsushi

    2015-01-01

    Gastrointestinal (GI) perforation accounts for over 90% of acute abdomen and pneumoperitoneum. The presence of pneumoperitoneum secondary to spontaneously perforated pyometra is an interesting yet confusing finding given the absence of gastrointestinal (GI) perforation, because pyometra is more common in postmenopausal women. We report an instructive case of diffuse peritonitis caused by spontaneous perforation of pyometra. A 70-year-old postmenopausal female was admitted to surgical emergency with signs of diffuse peritonitis. After resuscitation, an emergency laparotomy was performed because of suspicion of GI perforation. At laparotomy, about 2,000 mL of purulent fluid was found to be present in peritoneal cavity, while GI tract was intact. A rent with a diameter of 5 mm was found on anterior fundus of uterus. A total abdominal hysterectomy with a bilateral salpingo-oophorectomy was performed. Despite intensive care and a course of antibiotics, the patient died of multiple organ failure resulting from sepsis on postoperative day 16. Our case illustrates the importance of clinical knowledge of acute gynecological diseases, which are not uncommonly encountered by the general surgeon. Moreover, good appreciation of pelvic anatomy and close collaboration with gynecology and GI surgery colleagues is essential as operative intervention is often required.

  6. Spontaneous Perforation of Pyometra Presenting as Acute Abdomen and Pneumoperitoneum Mimicking Those of Gastrointestinal Origin

    Directory of Open Access Journals (Sweden)

    Takahiro Yamada

    2015-01-01

    Full Text Available Gastrointestinal (GI perforation accounts for over 90% of acute abdomen and pneumoperitoneum. The presence of pneumoperitoneum secondary to spontaneously perforated pyometra is an interesting yet confusing finding given the absence of gastrointestinal (GI perforation, because pyometra is more common in postmenopausal women. We report an instructive case of diffuse peritonitis caused by spontaneous perforation of pyometra. A 70-year-old postmenopausal female was admitted to surgical emergency with signs of diffuse peritonitis. After resuscitation, an emergency laparotomy was performed because of suspicion of GI perforation. At laparotomy, about 2,000 mL of purulent fluid was found to be present in peritoneal cavity, while GI tract was intact. A rent with a diameter of 5 mm was found on anterior fundus of uterus. A total abdominal hysterectomy with a bilateral salpingo-oophorectomy was performed. Despite intensive care and a course of antibiotics, the patient died of multiple organ failure resulting from sepsis on postoperative day 16. Our case illustrates the importance of clinical knowledge of acute gynecological diseases, which are not uncommonly encountered by the general surgeon. Moreover, good appreciation of pelvic anatomy and close collaboration with gynecology and GI surgery colleagues is essential as operative intervention is often required.

  7. [Laboratory chemical analysis in ascites].

    Science.gov (United States)

    Satz, N

    1991-04-13

    Chemical analysis of ascitic fluid may be helpful in determining the underlying disease. We discuss the diagnostic accuracy of the common and newer chemical parameters (protein, LDH, lactate, glucose, cholesterol, triglycerides, phospholipids, fibronectin, albumin gradient [value of serum minus value of ascites], ferritin, tumor markers, immunomodulators, leukocytes, bacterial and cytologic examinations). We also review the pathogenesis and clinical findings of the most frequent ascites forms (benign hepatic, infective, malignant ascites, ascites associated with liver metastases or hepatocellular carcinoma, cardiac and pancreatic ascites) and the most important diagnosis criteria. In the malignant ascites a high cholesterol, a narrow albumin gradient or a high ferritin value have high diagnostic accuracy, but diagnosis is by the finding of malignant cells. For the diagnosis of infective ascites, bacteriology is mandatory even though the results are negative in most cases, particularly in spontaneous bacterial peritonitis where diagnosis has to be established clinically, by a low pH or by a high leukocyte count. Benign hepatic ascites is diagnosed by demonstrating an underlying chronic liver disease and laboratory examinations of the peritoneal fluid to exclude other causes. The laboratory tests in ascites associated with liver metastases or with hepatocellular carcinoma were similar to those in benign hepatic ascites and the two ascites forms must be separated by other clinical and technical findings. Pancreatic ascites can easily be distinguished from the other forms by the high amylase and lipase content.

  8. MR imaging of acute intermittent porphyria mimicking reversible posterior leukoencephalopathy syndrome

    Energy Technology Data Exchange (ETDEWEB)

    Utz, N.; Kinkel, B.; Hedde, J.P.; Bewermeyer, H. [Staedtisches Krankenhaus Koeln-Merheim, Koeln (Germany). Neurologische Klinik

    2001-12-01

    Reversible posterior leukoencephalopathy syndrome (PLS) is characterized by headache, altered mental function, visual disturbances and seizures. Neuroimaging studies suggest a white-matter oedema, predominantly in the posterior parietal-temporal-occipital regions of the brain. We present the case of a 30-year-old woman who had suffered her first attack of acute intermittent porphyria (AIP). Following 1 week of abdominal pain she developed several generalized seizures, and hallucinations, and exhibited a progressive deterioration of the consciousness. T2-weighted images, especially fluid-attenuated inversion recovery (FLAIR) sequences showed bilateral lesions in the posterior frontal, parietal and occipital cortex and subcortical white matter. Following treatment with haematin and a high carbohydrate diet the patient's condition improved. Follow-up magnetic resonance imaging (MRI) revealed complete resolution of the lesions. To our knowledge, this is the first report concerning a completely reversible PLS in AIP. (orig.)

  9. Acute exacerbation of Hashimoto thyroiditis mimicking anaplastic carcinoma of the thyroid: A complicated case.

    Science.gov (United States)

    Kanaya, Hiroaki; Konno, Wataru; Fukami, Satoru; Hirabayashi, Hideki; Haruna, Shin-ichi

    2014-12-01

    The fibrous variant of Hashimoto thyroiditis is uncommon, accounting for approximately 10% of all cases of Hashimoto thyroiditis. We report a case of this variant that behaved like a malignant neoplasm. The patient was a 69-year-old man who presented with a right-sided anterior neck mass that had been rapidly growing for 2 weeks. Fine-needle aspiration cytology revealed clusters of large multinucleated cells suggestive of an anaplastic carcinoma. A week after presentation, we ruled out that possibility when the mass had shrunk slightly. Instead, we diagnosed the patient with an acute exacerbation of Hashimoto thyroiditis on the basis of laboratory findings. We performed a right thyroid lobectomy, including removal of the isthmus, to clarify the pathology and alleviate pressure symptoms. The final diagnosis was the fibrous variant of Hashimoto thyroiditis, with no evidence of malignant changes. Physicians should keep in mind that on rare occasions, Hashimoto thyroiditis mimics a malignant neoplasm.

  10. Posterior reversible encephalopathy syndrome and acute post-streptococcal glomerulonephritis mimicking breakthrough seizures

    Directory of Open Access Journals (Sweden)

    Kamille Abdool

    2015-05-01

    Full Text Available We report the case of a 14-year-old boy with a past history of primary generalized seizures, who had been seizure-free for 2 years on sodium valproate and presented with generalized tonic clonic seizures suggestive of breakthrough seizures. Examination revealed hypertension, impetiginous lesions of the lower limbs, microscopic hematuria, elevated antistreptolysin O titre and low complement levels consistent with acute post-streptococcal glomerulonephritis. Cranial magnetic resonance imaging (MRI demonstrated changes consistent with posterior reversible encephalopathy syndrome. Hypertension was controlled with intravenous nitroglycerin followed by oral captopril and amlodipine. Brain MRI changes returned normal within 2 weeks. The nephritis went in to remission within 2 months and after 8 months the patient has been seizure free again. Posterior reversible encephalopathy syndrome appeared to have neither short nor intermediate effect on seizure control in this patient. The relationship between posterior reversible encephalopathy syndrome and seizures is reviewed.

  11. Occult renal cell carcinoma with acrometastasis and ipsilateral juxta-articular knee lesions mimicking acute inflammation

    Directory of Open Access Journals (Sweden)

    Bhaskar Borgohain

    2012-01-01

    Full Text Available Generally, skeletal peripheral metastases below the elbow and the knee are rare. Skeletal metastases to the hand or foot are very rare; but when they do it may be a revealing clinical finding. Purely lytic lesions are commonly seen in metastases from lung, renal, and thyroid tumors, but they are also known to occur in primary myeloma, brown tumor and lymphomas. A 70-year-old man was brought to the emergency department with acute painful swelling involving his right hand and the right knee. Due to significant accompanying soft tissue swellings cellulitis, acute osteomyelitis and gouty arthropathy were included in the initial differential diagnosis. Radiographs showed pure lytic bony lesion with complete disappearance of lower two third of the second metacarpal, trapezium and trapezoid bones of the right hand along with a lytic subarticular lesion of medial condyle of ipsilateral femur. Chest X-ray (CXR was normal but sonography of the abdomen readily demonstrated a large renal mass, later confirmed at biopsy as renal cell carcinoma (RCC. Clinicians should be cognizant of the strong association between digital acrometastases and renal cell carcinoma in male patients with normal CXR findings. In suspected hand acrometastasis associated with a soft tissue component outside the contours of normal bone, screening the abdomen by sonography should be done prior to bone biopsy and before costly or time-consuming investigations are offered. Metastatic RCC should be included in the differential diagnosis of all unilateral expansile bony lesions of the digit. It is particularly important if such lesion/lesions are accompanied by local inflammation. Screening the abdomen by sonography may be of particular value in such elderly male patient when Chest X-ray shows no abnormality.

  12. Unilateral leg edema in a cirrhotic patient with tense ascites

    Institute of Scientific and Technical Information of China (English)

    Stelios F Assimakopoulos; Konstantinos C Thomopoulos; Christine Kalogeropoulou; Ioannis Maroulis; Alexandra Lekkou; Christos Papakonstantinou; Constantine E Vagianos; Charalambos Gogos

    2006-01-01

    @@ TO THE EDITOR A 61 year old man with cirrhosis and hepatocellular carcinoma developed on the background of chronic hepatitis B was admitted because of acute and gradually intensified right thigh pain and swelling, which, within a few hours, was expanded to his right foot. The patient,due to ascites refractory to diuretics, was almost weekly subjected to large volume paracentesis of ascitic fluid for the last six months; meanwhile he has developed a left inguinal, a right femoral and an umbilical hernia. It should be noted that 48 h before admission, the patient was referred to the emergency room because of dyspnoea and 5 L of ascitic fluid were removed.

  13. [A Case of Intravascular Lymphoma Mimicking Acute Sinusitis in Which the Outcome was Unfortunate].

    Science.gov (United States)

    Kambara, Rumi; Horii, Arata; Osak, Yasuhiro; Inohara, Hidenori

    2015-06-01

    Intravascular large B-cell lymphomas (IVLBCL) are a rare and aggressive non-Hodgkin Lymphoma characterized by proliferation of malignant lymphoid cells into the small blood vessels of the whole body. Making a diagnosis is very difficult due to the lack of mass formation and lymph node enlargement, resulting in a poor prognosis. We report herein on a case of IVLBCL which was proved by a biopsy of the nasal mucosa during endoscopic sinus surgery. A 77-year-old woman was admitted with complaints of headache, rhinorrhea, and fever. Computed tomography showed a shadow in the ethmoid sinus on both sides but without polyps. We suspected acute sinusitis and started therapy, however, high fever persisted with worsening of the patient's general condition. Pathological analysis of biopsy specimens from the nasal cavity and sinuses revealed proliferation of malignant lymphoid cells into the small blood vessels and the final diagnosis was IVLBCL. Chemotherapy was initially effective for her general condition but she died 13 months after the first visit. It is important to suspect IVLBCL, if there is any deterioration of the patient's general condition and persistence of the disease against treatment. The nasal cavity is recommended as a site of random biopsy because of its rich population of small blood vessels.

  14. Hepato-splenic lymphoma: a rare entity mimicking acute hepatitis: A case report

    Institute of Scientific and Technical Information of China (English)

    Federico Perfetto; Roberto Tarquini; Franceco Mancuso; Simonetta di Lollo; Silvia Tozzini; Giampiero Belesi; Giacomo Laffi

    2003-01-01

    We reported a case of non-Hodgkin's lymphoma where liver involvement was the predominant clinical manifestation. A 27-year old man presented wiht markedly elevated serum aspartate aminotrasferase, alanine aminotransferase and lactate dehydrogenase, reduced prothrombin activity, thrombocytopenic purpura and hepato-splenomegaly without adenopathy. Viral, toxic,autoimmune and metabolic liver diseases were excluded.Bone marrow biopsy showed an intracapillary infiltration of T-lymphocytes with no evidence of lipid storage disease.Because of a progressive spleen enlargement, splenectomy was performed. Histological examination showed lymphomatous intrasinuses invasion of the spleen.Immunohistochemical investigation revealed the T phenotype of the neoplastic cells: CD45+, CD45RO+,CD3+, CD4-, CD8-, TIA1-. About 50 % of the lymphoid cells expressed CD56 antigen. The diagnosis of hepatosplenic T cell lymphoma was done. The patient was treated with chemotherapy, which induced a complete remission. Eighteen months later, he had a first relapse with increased aspartate aminotransferase, alanine aminotransferase, lactate dehydrogenase,thrombocytopenic purpura and blast in the peripheral blood.In spite of autologous bone marrow transplantation, he died twenty months after the diagnosis. Even in the absence of a mass lesion or lymphoadenopathy, hepatosplenic Tcell lymphoma should be considered in the differential diagnosis of a patient whose clinical course is atypical for acute hepatic dysfunction.

  15. Mimicking exposures to acute and lifetime concentrations of inhaled silver nanoparticles by two different in vitro approaches

    Directory of Open Access Journals (Sweden)

    Fabian Herzog

    2014-08-01

    Full Text Available In the emerging market of nano-sized products, silver nanoparticles (Ag NPs are widely used due to their antimicrobial properties. Human interaction with Ag NPs can occur through the lung, skin, gastrointestinal tract, and bloodstream. However, the inhalation of Ag NP aerosols is a primary concern. To study the possible effects of inhaled Ag NPs, an in vitro triple cell co-culture model of the human alveolar/airway barrier (A549 epithelial cells, human peripheral blood monocyte derived dendritic and macrophage cells together with an air–liquid interface cell exposure (ALICE system was used in order to reflect a real-life exposure scenario. Cells were exposed at the air–liquid interface (ALI to 0.03, 0.3, and 3 µg Ag/cm2 of Ag NPs (diameter 100 nm; coated with polyvinylpyrrolidone: PVP. Ag NPs were found to be highly aggregated within ALI exposed cells with no impairment of cell morphology. Furthermore, a significant increase in release of cytotoxic (LDH, oxidative stress (SOD-1, HMOX-1 or pro-inflammatory markers (TNF-α, IL-8 was absent. As a comparison, cells were exposed to Ag NPs in submerged conditions to 10, 20, and 30 µg Ag/mL. The deposited dose per surface area was estimated by using a dosimetry model (ISDD to directly compare submerged vs ALI exposure concentrations after 4 and 24 h. Unlike ALI exposures, the two highest concentrations under submerged conditions promoted a cytotoxic and pro-inflammatory response after 24 h. Interestingly, when cell cultures were co-incubated with lipopolysaccharide (LPS, no synergistic inflammatory effects were observed. By using two different exposure scenarios it has been shown that the ALI as well as the suspension conditions for the lower concentrations after 4 h, reflecting real-life concentrations of an acute 24 h exposure, did not induce any adverse effects in a complex 3D model mimicking the human alveolar/airway barrier. However, the highest concentrations used in the ALI setup, as well

  16. 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.

  17. Treatment and management of ascites and hepatorenal syndrome: an update.

    Science.gov (United States)

    Lenz, Kurt; Buder, Robert; Kapun, Lisbeth; Voglmayr, Martin

    2015-03-01

    Ascites and renal dysfunction are frequent complications experienced by patients with cirrhosis of the liver. Ascites is the pathologic accumulation of fluid in the peritoneal cavity, and is one of the cardinal signs of portal hypertension. The diagnostic evaluation of ascites involves assessment of its granulocyte count and protein concentration to exclude complications such as infection or malignoma and to allow risk stratification for the development of spontaneous peritonitis. Although sodium restriction and diuretics remain the cornerstone of the management of ascites, many patients require additional therapy when they become refractory to this treatment. In this situation, the treatment of choice is repeated large-volume paracentesis. Alteration in splanchnic hemodynamics is one of the most important changes underlying the development of ascites. Further splanchnic dilation leads to changes in systemic hemodynamics, activating vasopressor agents and leading to decreased renal perfusion. Small alterations in renal function influence the prognosis, which depends on the cause of renal failure. Prerenal failure is evident in about 70% of patients, whereas in about 30% of patients the cause is hepatorenal syndrome (HRS), which is associated with a worse prognosis. Therefore, effective therapy is of great clinical importance. Recent data indicate that use of the new definition of acute kidney injury facilitates the identification and treatment of patients with renal insufficiency more rapidly than use of the current criteria for HRS. In this review article, we evaluate approaches to the management of patients with ascites and HRS.

  18. Diagnosis of malignant ascites. Comparison of ascitic fibronectin, cholesterol, and serum-ascites albumin difference.

    Science.gov (United States)

    Prieto, M; Gómez-Lechón, M J; Hoyos, M; Castell, J V; Carrasco, D; Berenguer, J

    1988-07-01

    The ascitic fluid concentrations of cholesterol and fibronectin and the serum-ascites albumin difference were compared with two conventional tests of ascitic fluid, total protein and LDH, in their diagnostic ability for detection of malignancy in ascitic samples from 69 patients with ascites: 54 with ascites due to liver disease and 15 whose ascites was caused by peritoneal metastases. Sixteen cirrhotic patients with superimposed hepatocellular carcinoma in whom ascites was of uncertain etiology were considered separately. The mean ascitic fluid total protein, LDH, cholesterol, and fibronectin values in the peritoneal metastases group were 3.70 +/- 1.20 g/dl, 247.26 +/- 148.14 units/liter, 109.06 +/- 29.85 mg/dl, and 91.57 +/- 41.52 micrograms/ml, respectively, and all were significantly higher than the corresponding values in the liver disease group (P less than 0.001), which were 1.37 +/- 0.59 g/dl, 75.40 +/- 110.70 units/liter, 23.75 +/- 11.22 mg/dl, and 31.86 +/- 10.51 micrograms/ml, respectively. Mean serum-ascites albumin difference in the peritoneal metastases group was 0.62 +/- 0.38 g/dl, which was significantly different from the corresponding value in the liver disease group (1.92 +/- 0.41 g/dl, P less than 0.001). Both ascitic cholesterol above 46 mg/dl and an ascitic fibronectin concentration greater than 50 micrograms/ml had high diagnostic accuracy (97%) for malignancy, being higher than that achieved using a serum-ascites albumin difference under 1.1 g/dl and an ascitic total protein above 2.5 g/dl, which had accuracies of 94% and 93%, respectively. Ascitic fluid LDH was the least reliable test. No differences in the ascitic fluid analysis were found between cirrhotic patients with and without hepatocellular carcinoma.(ABSTRACT TRUNCATED AT 250 WORDS)

  19. Usefulness of serum-ascites albumin difference in separating transudative from exudative ascites. Another look.

    Science.gov (United States)

    Mauer, K; Manzione, N C

    1988-10-01

    The serum-ascites albumin difference is reported to be superior to ascitic total protein, ascitic-to-serum total protein ratio, lactic dehydrogenase, and ascitic-to-serum lactic dehydrogenase ratio in differentiating between ascites from liver disease and malignant ascites, S-A greater than 1.1 reflecting portal hypertension. We analyzed ascitic fluid from 46 consecutive patients with chronic liver disease, 28 patients with ascites associated with malignancy, 10 patients with right-sided heart failure, 4 patients with hypothyroidism, and 6 patients with miscellaneous causes of ascites to determine if this albumin difference is indeed a more valuable parameter. Analysis of our data confirms with a larger number of patients that the serum-ascites albumin difference is a more reliable indicator of transudative ascites, better termed portal hypertensive ascites. Malignant ascites without liver metastases had features of nonportal hypertensive ascites, and the serum-ascites albumin difference confirms this. The characteristics of malignant ascites associated with liver metastases, however, resemble those of the portal hypertensive ascites complicating liver disease. This new parameter is also helpful in distinguishing congestive heart failure with high protein ascites and portal hypertensive ascitic features from malignant ascites without liver metastases. Of particular note, myxedematous ascitic fluid, classically categorized as exudative, had an S-A greater than 1.1, indicating the possible role of portal hypertension in the development of ascites in these patients.

  20. Ascites: Pathogenesis and therapeutic principles

    DEFF Research Database (Denmark)

    Møller, Søren; Henriksen, Jens; 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, l...

  1. Necrobiosis lipoidica mimicking cellulitis

    Directory of Open Access Journals (Sweden)

    Joshi A

    1997-01-01

    Full Text Available A 57-year-old obese patient presented with a 5 month history of tender, indurated, erythematous plaques with superficial ulceration on the right shin. The lesions closely mimicked cellulitis but were unresponsive to antibiotics. Though the patient was not a known diabetic, on investigations she was found to be a diabetic. Histology confirmed the diagnosis of necrobiosis lipoidica. This acutely inflammed presentation of necrobiosis lipoidica is extremely rare.

  2. Lupus mimickers.

    Science.gov (United States)

    Calixto, Omar-Javier; Franco, Juan-Sebastian; Anaya, Juan-Manuel

    2014-08-01

    Systemic lupus erythematosus (SLE) is an autoimmune disease characterized by multisystem organ involvement, heterogeneity of clinical features, and variety in degree of severity. The differential diagnosis is a crucial aspect in SLE as many other autoimmune diseases portray clinical similarities and autoantibody positivity. Lupus mimickers refer to a group of conditions that exhibit both clinical features and laboratory characteristics, including autoantibody profiles that resemble those present in patients with SLE, and prompt a diagnostic challenge in everyday clinical practice. Thus, lupus mimickers may present as a lupus-like condition (i.e., 2 or 3 criteria) or as one meeting the classification criteria for SLE. Herein we review and classify the current literature on lupus mimickers based on diverse etiologies which include infections, malign and benign neoplasms, medications, and vaccine-related reactions.

  3. Ascite meconial - relato de caso

    OpenAIRE

    Celeste Gomez Sardinha Oshiro; Mariana Baptista Nishida; Natalia Novo Natalício; Patrícia Cunha Tagliaferro; Marco Aurélio Ciríaco Padilha

    2016-01-01

    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 ...

  4. Ayurvedic management of cirrhotic ascites

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    G Aswathy

    2016-01-01

    Full Text Available Cirrhosis is the final stage of most of the chronic liver diseases and is most invariably complicated by portal hypertension resulting in ascites. A case of chronic liver disease with portal hypertension (cryptogenic cirrhosis, managed at Amrita School of Ayurveda is discussed in this paper. The clinical picture was that of an uncomplicated cirrhotic ascites. Snehapāna (therapeutic oral administration of lipids followed by virecana (purgation was done after an initial course of nityavirecana (daily purgation. Later Vardhamāna pippalī rasāyana [administration of single drug - pippalī (piper longum in a structured dose pattern] was administered with an intention of rejuvenating liver cells. Ascites and lower limb oedema were completely resolved after the therapy. No recurrence of ascites has been reported after a follow up period of one year.

  5. Massive ascites of unknown origin

    Science.gov (United States)

    Yuan, Shi-Min

    2014-01-01

    Massive ascites of unknown origin is an uncommon condition, which represent a diagnostic challenge. Patients with delayed diagnosis and treatment may have a poor prognosis. A 22-year-old female was referred to this hospital due to a 4-year progressive abdominal distension with massive ascites of unknown origin. By thorough investigations, she was eventually diagnosed as chronic calcified constrictive pericarditis. She received pericardiectomy and had an uneventful postoperative course. With a few day paracentesis, ascites did not progress any more. She was doing well at 5-month follow-up and has returned to work. Extracardiac manifestations, such as massive ascites and liver cirrhosis, were rare in patients with constrictive pericarditis. Pericardiectomy can be a radical solution for the treatment of chronic constrictive pericarditis. In order to avoid delayed diagnosis and treatment, physicians have to bear in mind this rare manifestation of chronic calcified constrictive pericarditis. PMID:24600502

  6. Acute Corneal Hydrops Mimicking Infectious Keratitis as Initial Presentation of Keratoconus in a 10-Year-Old Child

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    Elise A. Slim

    2015-01-01

    Full Text Available Purpose. To report a case of acute hydrops in a 10-year-old child with advanced keratoconus. Case Presentation. A ten-year-old boy diagnosed as having right eye (RE infectious keratitis, not responding to antimicrobial therapy, was referred to our hospital. The diagnosis of infectious keratitis was established one month prior to his presentation following an episode of acute corneal whitening, pain, and drop in visual acuity. Topical fortified antibiotics followed by topical antiviral therapy were used with no improvement. Slit lamp examination showed significant corneal protrusion with edema surrounding a rupture in Descemet’s membrane in the RE. The diagnosis of acute corneal hydrops from advanced keratoconus was highly suspected and confirmed with corneal topography. Conclusion. Although a relatively rare disease at the age of 10 years, keratoconus can be rapidly progressive in the pediatric group. Keratoconus should always be considered in the differential diagnosis of progressive vision loss in this age group.

  7. Recurrent epiploic appendagitis mimicking appendicitis and cholecystitis

    Science.gov (United States)

    Hearne, Christopher B.; Taboada, Jorge

    2017-01-01

    Epiploic appendagitis (EA) is a rare cause of acute abdominal pain caused by inflammation of an epiploic appendage. It has a nonspecific clinical presentation that may mimic other acute abdominal pathologies on physical exam, such as appendicitis, diverticulitis, or cholecystitis. However, EA is usually benign and self-limiting and can be treated conservatively. We present the case of a patient with two episodes of EA, the first mimicking acute appendicitis and the second mimicking acute cholecystitis. Although recurrence of EA is rare, it should be part of the differential diagnosis of acute, localized abdominal pain. A correct diagnosis of EA will prevent unnecessary hospitalization, antibiotic use, and surgical procedures. PMID:28127129

  8. Acute myocardial infarction mimicking squamous cell lung cancer with bone metastases due to hypercalcemia: a case report

    Institute of Scientific and Technical Information of China (English)

    FANG Chong-feng; XU Geng; CHEN Yang-xin

    2010-01-01

    @@ Acute myocardial infarction (AMI), the most severe coronary artery disease, is one of the most frequent cardiac emergencies, and early diagnosis and treatment are very important to decrease the subsequent cardiac adverse events such as malignant arrhythmia and sudden cardiac death. But in fact, lots of diseases are similar to AMI in clinical practice, of which the most common are myocarditis, pulmonary embolism in department of cardiology. Here we report a case of AMI-like squamous cell lung cancer with bone metastases.

  9. CYTOLOGICAL DIAGNOSIS OF GELATINOUS ASCITES

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    Samith

    2013-04-01

    Full Text Available ABSTRACT: Pseudomyxoma peritonei (PMP is a condition characte rized by the accumulation of mucinous material in the peritoneal cavity (gela tinous ascites. Pseudomyxoma peritonei is an uncommon condition in which mucinous ascites causes progressive abdominal distension and gastrointestina l dysfunction. We present a case of 44 year old female who presented with gradually progres sive abdominal distension since 6 months. An ascitic tap was performed and the fluid wa s sent for cytological study. Cytology showed pools of acellular mucin. On laparotomy there was mucinous material in the abdomen that was evacuated. Appendix and omentum were found t o be thickened, hence appendicectomy was done and omental biopsy taken. Histopathological diagnosis of well differentiated mucinous adenocarcinoma of appendix with rupture and mucinous ascitis was made.

  10. KRAS (G12D Cooperates with AML1/ETO to Initiate a Mouse Model Mimicking Human Acute Myeloid Leukemia

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    Shanmin Zhao

    2014-01-01

    Full Text Available Background/Aims: It has been demonstrated that KRAS mutations represent about 90% of cancer-associated mutations, and that KRAS mutations play an essential role in neoplastic transformation. Cancer-associated RAS mutations occur frequently in acute myeloid leukemia (AML, suggesting a functional role for Ras in leukemogenesis. Methods: We successfully established a mouse model of human leukemia by transplanting bone marrow cells co-transfected with the K-ras (G12D mutation and AML1/ETO fusion protein. Results: Mice transplanted with AML/ETO+KRAS co-transduced cells had the highest mortality rate than mice transplanted with AML/ETO- or KRAS-transduced cells (115d vs. 150d. Upon reaching a terminal disease stage, EGFP-positive cells dominated their spleen, lymph nodes, peripheral blood and central nervous system tissue. Immunophenotyping, cytologic analyses revealed that AML/ETO+KRAS leukemias predominantly contained immature myeloid precursors (EGFP+/c-Kit+/Mac-1-/Gr-1-. Histologic analyses revealed that massive leukemic infiltrations were closely packed in dense sheets that effaced the normal architecture of spleen and thymus in mice transplanted with AML1/ETO + KRAS co-transduced cells. K-ras mRNA and protein expression were upregulated in bone marrow cells of the K-ras group and AML1/ETO + Kras group. The phosphorylation of MEK/ERK was significantly enhanced in the AML1/ETO + Kras group. The similar results of the AML1/ETO + Nras group were consistent with those reported previously. Conclusion: Co-transduction of KrasG12D and AML1/ETO induces acute monoblastic leukemia. Since expression of mutant K-ras alone was insufficient to induce leukemia, this model may be useful for investigating the multi-step leukemogenesis model of human leukemia.

  11. Pancreatobiliary Reflux Resulting in Pancreatic Ascites and Choleperitoneum after Gallbladder Perforation

    Directory of Open Access Journals (Sweden)

    Rachele Rapetti

    2008-11-01

    Full Text Available A 65-year-old man with chronic hepatitis C and no history of alcohol abuse was admitted to our liver unit for the recent development of massive ascites and presumed hepatorenal syndrome. In the preceding two weeks, he had received medical treatment for acute pancreatitis and cholecystitis. Abdominal paracentesis demonstrated a cloudy, orange peritoneal fluid, with total protein concentration 3.6 g/dl, serum-ascites albumin gradient 1.0 g/dl, and ratios of ascites-serum bilirubin and amylase approximately 8:1. Diagnostic imaging demonstrated no pancreatic pseudocysts. Ten days later, at laparotomy, acalculous perforation of the gallbladder was identified. After cholecystectomy, amylase concentration in the ascitic fluid dropped within a few days to 40% of serum values; ascites disappeared within a few weeks. We conclude that in the presence of a perforated gallbladder, pancreatobiliary reflux was responsible for this unusual combination of choleperitoneum and pancreatic ascites, which we propose to call pancreatobiliary ascites.

  12. [Case report: Löffler's syndrome due to Ascaris lumbricoides mimicking acute bacterial community--acquired pneumonia].

    Science.gov (United States)

    Acar, Ali; Oncül, Oral; Cavuşlu, Saban; Okutan, Oğuzhan; Kartaloğlu, Zafer

    2009-01-01

    In this study we present a patient with Loeffler's syndrome caused by Ascaris lumbricoides who presented with the clinical findings of community-acquired pneumonia (CAP). Our patient, who was twenty-five years old, and who had had symptoms such as coughing, expectorating, dyspnea and fever for approximately ten days, was hospitalized. We auscultated polyphonic rhonchuses at the both hemithoraxes. A chest X-ray revealed bilateral lower zone patch consolidation. Acute bacterial community acquired pneumonia (CAP) was diagnosed due to these findings and empirical antibiotic treatment was begun. Repeated sputum Gram stains were negative, and both sputum and blood cultures were sterile. A sputum smear was negative for acid-fast bacilli. The patient's fever and respiratory complaint did not respond to the empirical antibiotics therapy. During the course of advanced investigations, we measured peripheric eosinophilia, and high levels of total Eo and total IgE, and observed Ascaris lumbricoides eggs during stool examination. The patient was given a diagnosis of Loeffler's syndrome. Thereupon the patient was treated successfully with one dose of albendazol 400 mg. In conclusion, we suggest that Loeffler's syndrome must be considered early in the differential diagnosis for CAP when peripheric eosinophilia is seen in patients if they live in an endemic area for parasitic disease.

  13. High signal in cerebrospinal fluid mimicking subarachnoid haemorrhage on FLAIR following acute stroke and intravenous contrast medium.

    Science.gov (United States)

    Dechambre, S D; Duprez, T; Grandin, C B; Lecouvet, F E; Peeters, A; Cosnard, G

    2000-08-01

    We describe five cases of high signal in the cerebrospinal fluid (CSF) on fast-FLAIR images 24-48 h after onset of stroke. All the patients had undergone perfusion-weighted MRI within 6 h of the onset of the symptoms. The CSF was far brighter than the cortical gyri. The high signal was diffusely around both cerebral hemispheres in two cases and around one hemisphere in two others; it was focal, around the acute ischaemic lesion, in one. CT was normal in all cases. The CSF high signal was transient, decreasing in extent and intensity with time and resolving completely within 3-6 days. It was not associated with worsening of the clinical state or poor outcome. Our explanation of this phenomena is hypothetical: we speculate that it could be due to disruption of the blood-brain barrier resulting in leakage of protein, gadolinium chelates, or both in to the subarachnoid space. It should not be confused with subarachnoid haemorrhage.

  14. 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.

  15. Management of ascites with hydrothorax

    Energy Technology Data Exchange (ETDEWEB)

    LeVeen, H.H.; Piccone, V.A.; Hutto, R.B.

    1984-08-01

    Hydrothorax occurs in 5.3 percent of ascitic patients. Experience with 22 cases forms the basis of this report. Of the 22 cases, 21 were spontaneous and 1 was due to transdiaphragmatic incision. Usually fluid enters the chest through tiny defects in the diaphragm. These defects are often covered by pleuroperitoneum, but the high abdominal pressure raises a bleb on the superior surface of the diaphragm. Rupture produces hydrothorax. The ascites is often relieved with the onset of the hydrothorax. Blockage of the thoracic duct has produced chylous ascites. The thoracoabdominal communication is immediately confirmed by a scan of the chest and abdomen after intraperitoneal injection of technetium-99 colloid. The rate at which the technetium-99 enters the chest is related to the size of the defect in the diaphragm. A significant transfer should occur within 12 hours. Immediate transfer occurs with large defects. The ruptured blister on the diaphragm forms a one-way valve. Intrathoracic injection does not migrate into the peritoneal cavity. The valvular characteristics of the leak force ascitic fluid into the thorax because the differential pressure between the abdominal and pleural cavities is intensified by inspiration. If tension hydrothorax has occurred, urgent thoracocentesis and paracentesis may be required. A chest tube should not be introduced. The main principle of surgery is to supply a low resistance pathway for the return of fluid to the venous system and to eliminate the diaphragmatic defect by obliteration of the pleural space. A LeVeen peritoneovenous shunt is performed after emptying the abdomen of its fluid load. After completion of the shunt operation, the chest is emptied of fluid, and a sclerosing agent (tetracycline or nitrogen mustard) is injected into the pleural cavity. With this regime, the defect closed or was rendered insignificant in 18 of 22 patients.

  16. Chylous ascites as a complication of nephroureterectomy

    Directory of Open Access Journals (Sweden)

    Chi-Hang Hsiao

    2015-06-01

    Full Text Available Chylous ascites may be the result of many pathological conditions, including congenital defects of the lymphatic system, nonspecific bacterial, parasitic and tuberculous peritoneal infection, liver cirrhosis, malignant neoplasm, blunt abdominal trauma, and surgical injury. A 62-year-old woman presented with chylous ascites after undergoing nephroureterectomy and bladder cuff excision for her left ureteral urothelial carcinoma. The diagnosis of chylous ascites is made when the ratio of ascitese versus serum triglyceride is > 2. Patients with chylous ascites may be treated conservatively with total parenteral nutrition and/or a diet containing low fat and medium chain triglycerides. Refractory cases may require more aggressive intervention. We report a case of postoperative chylous ascites that was treated successfully with total parenteral nutrition for 14 days. A review of the relevant literature is presented and chylous ascites treatment is also discussed.

  17. 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.

  18. Isolated Fetal Ascite Associated with Cardiac Diseases

    Directory of Open Access Journals (Sweden)

    Vehbi Doğan

    2014-12-01

    Full Text Available Fetal ascite is defined as fluid accumulation in peritoneal cavity. It can be seen as isolated disease or an early sign of hydrops fetalis. Once fetal ascite is detected, a careful examination for hydops fetalis and possible underlying disease is necessary, since its prognosis and treatment depends mostly on the cause. Non-immunologic fetal ascite is an uncommon problem occurring for many reasons, such as urinary tract obstruction, congenital infections, genetic and metabolic diseases, gastrointestinal diseases and cardiovascular diseases. Here in this report we present two isolated fetal ascite that occurred secondary to cardiac diseases.

  19. 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.

  20. Gout: radiographic findings mimicking infection

    Energy Technology Data Exchange (ETDEWEB)

    Rousseau, I.; Raymond-Tremblay, D. [Dept. of Diagnostic Radiology, Centre Hospitalier de l' Univ. de Montreal, Que. (Canada); Cardinal, E. [Dept. of Radiology, Centre Hospitalier de l' Univ. de Montreal, Que. (Canada); Beauregard, C.G. [Dept. of Diagnostic Radiology, Hopital du Sacre-Coeur de Montreal,Que. (Canada); Braunstein, E.M. [Dept. of Radiology, Indiana University Hospital (United States); Saint-Pierre, A. [Rheumatology Unit, Centre Hospitalier de l' Univ. de Montreal, Que. (Canada)

    2001-10-01

    Objective: To describe radiographic features of gout that may mimic infection. Design and patients: We report five patients with acute bacterial gout who presented with clinical as well as radiological findings mimicking acute bacterial septic arthritis or osteomyelitis. Three patients had delay in the appropriate treatment with the final diagnosis being established after needle aspiration and identification of urate crystals under polarized light microscopy. Two patients underwent digit amputation for not responding to antibiotic treatment and had histological findings confirming the diagnosis of gout. Conclusion: It is important for the radiologist to be aware of the radiological manifestations of acute gout that can resemble infection in order to avoid inappropriate diagnosis and delay in adequate treatment. The definitive diagnosis should rely on needle aspiration and a specific search for urate crystals. (orig.)

  1. Value of ascitic fluid ferritin in the differential diagnosis of malignant ascites.

    Science.gov (United States)

    Kountouras, J; Boura, P; Tsapas, G; Charisis, K; Magoula, I; Tsakiri, I

    1993-01-01

    The ascitic fluid ferritin concentrations were compared with serum-ascites albumin gradient (SAAG), in their diagnostic ability for detection of malignancy in 60 patients with ascites: 29 with chronic liver disease alone (CLD) and 31 patients with various neoplasms. Of the patients with malignancy, 12 had liver metastases, 9 had no evidence of liver involvement, and 10 had hepatocellular carcinoma (HCC) with or without coexisting liver cirrhosis. Analysis of our data confirms that the ascitic ferritin is a more accurate indicator of malignant ascites (MA) than the SAAG. This new parameter is particularly helpful in distinguishing MA associated with HCC and/or metastatic liver disease from nonmalignant ascites due to CLD alone.

  2. An adult intussusception mimicking early appendicitis

    Institute of Scientific and Technical Information of China (English)

    Wei-Chun Tseng; Cheng-Ting Hsiao; Yu-Cheng Hung

    2012-01-01

    Adult intussusception is rare with variable clinical presentation. We reported a case of adult intussusception presenting with symptoms mimicking acute appendicitis. The patient presented as an abdominal pain from epigastric area with shifting gradually to RLQ. The atypical presentation of adult intussusception remains a diagnostic challenge to the emergency physician.

  3. Pathophysiology of cyclic hemorrhagic ascites and endometriosis.

    Science.gov (United States)

    Ussia, Anastasia; Betsas, George; Corona, Roberta; De Cicco, Carlo; Koninckx, Philippe R

    2008-01-01

    Massive hemorrhagic ascites (4470 mL, range 1-10 L) in women with endometriosis is a rare condition occurring predominantly in black women. Of the 43 case reports published, 42 are compatible with the hypothesis that the hemorrhagic ascites is predominantly a consequence of excessive ovarian transudation similar to a Meigs syndrome. Indeed, bilateral ovariectomy cures the condition without recurrences, whereas after unilateral ovariectomy or cystectomy recurrence rate is more than 50%; during ovarian suppression by luteinizing hormone-releasing hormone agonist ascites disappears, but reappears after treatment. Superficial pelvic endometriosis also contributes to the ascites because after superficial endometriosis destruction the recurrence rate is only 4 in 14. Based on these data, it is suggested, to scrutinize the ovaries for tumors given the analogy with Meigs syndrome. In women desiring fertility, conservative treatment with destruction of endometriosis only can be attempted given the cure rate of some 20%. It is unknown what the effect of ovulation induction would be.

  4. Post-pancreatitis Fat Necrosis Mimicking Carcinomatosis.

    Science.gov (United States)

    Smith, Joshua P; Arnoletti, J Pablo; Varadarajulu, Shyam; Morgan, Desiree E

    2008-01-01

    Acute pancreatitis can result in retroperitoneal fat necrosis, typically occurring in the peripancreatic region, with extension into the transverse mesocolon, omentum and mesenteric root. When evaluated with contrast enhanced computed tomography (CECT), acute peripancreatic post necrotic collections typically become lower in attenuation over time, and often appear as homogeneous fluid collections. Saponification as a complication of fat necrosis in patients with acute pancreatitis is a well recognized clinical entity. While retroperitonal fat necrosis is commonly seen on CECT, saponification is not a prominent imaging feature. We present a case of acute pancreatitis complicated by extensive saponification of fat throughout the retroperitoneum and peritoneal lining, mimicking carcinomatosis.

  5. [Concentration of lipids in ascitic fluid and the concentration gradient of albumin in blood and ascites: diagnostic significance].

    Science.gov (United States)

    Barbare, J C; Diab, G; Delavenne, J; Philippe, J M; Vorhauer, W; Latrive, J P; Capron, J P

    1989-11-01

    The aim of this study was to test the diagnostic value of ascitic fluid cholesterol and triglycerides concentrations and of serum-ascites albumin concentration gradient in the differentiation between cirrhotic and malignant ascites. These biological parameters were determined, on the one hand in 34 cirrhotic patients, 6 of them having an hepatocellular carcinoma and 6 others having a spontaneous bacterial peritonitis and, on the other hand, in 16 patients with malignant ascites, 13 of them having an abdominal extra-hepatic or pelvic cancer, and 3 others having an extra-abdominal cancer with multiple liver metastases. Ascitic carcinoembryonic antigen assay and ascitic fluid cytology were also done in the 50 patients. In differentiating the cirrhotic patients from those with malignancy, ascitic fluid cholesterol concentration (discriminating value less than 1.1 mmol/l) ascitic fluid triglycerides concentration (discriminating value 0.5 mmol/l) and serum-ascites albumin concentration gradient (discriminating value greater than 11 g/l) allowed a diagnostic efficiency of 0.92, 0.80 and 0.77, respectively. Ascitic fluid cytology showed presence of malignant cells in 3/6 patients with hepatocellular carcinoma associated with cirrhosis, in 9/16 patients having a malignant ascites, and was negative in other patients. Ascitic carcinoembryonic antigen assay was abnormal only in 3/16 patients with malignant ascites. These results suggest that measurement of ascitic fluid cholesterol concentration must be included in the initial evaluation of patients with ascites of unknown origin.

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

    Directory of Open Access Journals (Sweden)

    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.

  7. Massive ascites as a presenting manifestation of chronic lymphocytic leukemia

    Institute of Scientific and Technical Information of China (English)

    Neelam Siddiqui; Saeed Al-Amoudi; Aamer Aleem; Maha Arafah; Layla Al-Gwaiz

    2008-01-01

    Ascites is not an uncommon manifestation of certain solid tumors like gastrointestinal malignancies, ovarian cancer and breast cancer. However, it is unusual to encounter ascites in patients with hematological malignancies especially chronic leukemia. The patient described here presented with massive ascites and blood lymphocytosis. Further studies confirmed the diagnosis of chronic lymphocytic leukemia with ascites. The ascitic fluid was exudative, consisting of mature-looking B-lymphocytes, which were morphologically and immunophenotypically similar to peripheral blood and bone marrow cells. The patient was treated with chemotherapy and achieved a good response and diminution of ascitic fluid accumulation.

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

    DEFF Research Database (Denmark)

    Bendtsen, Flemming; Grønbæk, Henning; Aagaard, Niels Kristian

    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...

  9. Automated low-flow ascites pump for the treatment of cirrhotic patients with refractory ascites

    Science.gov (United States)

    Stirnimann, Guido; Banz, Vanessa; Storni, Federico; De Gottardi, Andrea

    2017-01-01

    Cirrhotic patients with refractory ascites (RA) can be treated with repeated large volume paracentesis (LVP), with the insertion of a transjugular intrahepatic portosystemic shunt (TIPS) or with liver transplantation. However, side effects and complications of these therapeutic options, as well as organ shortage, warrant the development of novel treatments. The automated low-flow ascites pump (alfapump®) is a subcutaneously-implanted novel battery-driven device that pumps ascitic fluid from the peritoneal cavity into the urinary bladder. Ascites can therefore be aspirated in a time- and volume-controlled mode and evacuated by urination. Here we review the currently available data about patient selection, efficacy and safety of the alfapump and provide recommendations for the management of patients treated with this new method. PMID:28203285

  10. PROGNOSIS OF EPITHELIAL OVARIAN CANCER RELATED TO ITS ASCITES

    Institute of Scientific and Technical Information of China (English)

    宋水勤; 张国楠; 吴艳丽; 周红; 赵素兰; 谢方; 陈毅男

    2001-01-01

    Objective: To investigate the relationship between the prognosis of Epithelial Ovarian Cancer (EOC) and its ascites. Methods: Retrospectively analysis is performed for the clinical, pathological and followed up data of 101 in-patients suffering from epithelial ovarian cancer and operated with tumor debulking surgery in our hospital from January 1986 to December 1993. The patients was divided into two groups based upon the first laparotomy finding with ascites(62) or without(39). Age average, cell type, advanced proportion and survival rate of the patients are evaluated by a c2 test. Results: For age average and cell type, no statistical difference was noted. However, there were more advanced cases in ascites group than in the other (P<0.01). The 3-, 4- and 5-year survival in the no-ascites group were 87.02%, 73.42%, 57.10% respectively compared with 65.02%, 38.66%, 28.12% in the ascites group. The 5-year survival rate of stage I, II,III, IV patients in no-ascites group are 77%, 70%, 41.1%, 0 respectively, compared with that of 60%, 56.8%, 15.46%, 0 respectively in the ascites group. The results shows that 3-, 4-, and 5-year survival in no-ascites group were significantly higher than those in ascites group(P<0.01). Conclusion: Presence of ascites is a factor of poor prognosis for EOC.

  11. Diagnosis and therapy of ascites in liver cirrhosis

    Institute of Scientific and Technical Information of China (English)

    Erwin Biecker

    2011-01-01

    Ascites is one of the major complications of liver cirrhosis and is associated with a poor prognosis. It is important to distinguish noncirrhotic from cirrhotic causes of ascites to guide therapy in patients with noncirrhotic ascites. Mild to moderate ascites is treated by salt restriction and diuretic therapy. The diuretic of choice is spironolactone. A combination treatment with furosemide might be necessary in patients who do not respond to spironolactone alone. Tense ascites is treated by paracentesis, followed by albumin infusion and diuretic therapy. Treatment options for refractory ascites include repeated paracentesis and transjugular intrahepatic portosystemic shunt placement in patients with a preserved liver function. Potential complications of ascites are spontaneous bacterial peritonitis (SBP) and hepatorenal syndrome (HRS). SBP is diagnosed by an ascitic neutrophil count > 250 cells/mm3 and is treated with antibiotics. Patients who survive a first episode of SBP or with a low protein concentration in the ascitic fluid require an antibiotic prophylaxis. The prognosis of untreated HRS type 1 is grave. Treatment consists of a combination of terlipressin and albumin. Hemodialysis might serve in selected patients as a bridging therapy to liver transplantation. Liver transplantation should be considered in all patients with ascites and liver cirrhosis.

  12. Clinical studies of hepatocellular carcinoma with liver cirrhosis and ascites.

    Directory of Open Access Journals (Sweden)

    Yuasa,Shiro

    1984-06-01

    Full Text Available A comparison was made of the clinical findings of 59 patients with liver cirrhosis (LC accompanied with hepatocellular carcinoma (HCC (of which 35 had ascites and 24 did not at the time of admission and 164 patients with LC, but without HCC (of which 39 had ascites and 125 did not. HCC patients were older and more often had hepatomegaly, vascular spider and pleural effusion than LC patients. Ascites was more frequently observed in HCC than in LC patients when the serum albumin level and the indocyanine green disappearance rate were relatively well maintained and when peripheral edema was absent. There was no difference in the ascitic protein concentration between LC and HCC patients. Malignant cells were detected in ascites only in 14% of the HCC patients. These facts indicate the presence of ascites-inducing factors in HCC patients which have no direct relation to serum colloid osmotic pressure and effective hepatic blood flow. Almost all of the HCC patients with ascites (96% died with ascites, whereas 54% of the LC patients with ascites recovered from the ascitic condition.

  13. Eosinophilic gastroenteritis with ascites and hepatic dysfunction

    Institute of Scientific and Technical Information of China (English)

    Hai-Bo Zhou; Jin-Ming Chen; Qin Du

    2007-01-01

    Eosinophilic gastroenteritis is a rare gastrointestinal disorder with eosinophilic infiltration of the gastrointestinal wall and various gastrointestinal dysfunctions. Diagnosis requires a high index of suspicion and exclusion of various disorders that are associated with peripheral eosinophilia.We report a case of eosinophilic gastroenteritis, which had features of the predominant subserosal type presenting with ascites and hepatic dysfunction, and which responded to a course of low-dose steroid.

  14. Strongyloides stercoralis hyperinfection causing eosinophilic ascites.

    Science.gov (United States)

    Shukla, Shailaja; Chauhan, Richa; Wadhwa, Shveta; Sehgal, Shivali; Singh, Smita

    2015-09-01

    Strongyloidiasis is associated with Strongyloides stercoralis, an intestinal nematode with greater prevalence in tropical and subtropical regions. Hyperinfection syndrome with dissemination may occur in immunosuppressed individuals. However, invasion of peritoneal cavity with peritoneal effusion is rarely reported in the literature. We report a case of S. stercoralis hyperinfection in a young alcoholic patient with Diabetes mellitus, liver disease and ascites. Diagnostic paracentesis showed numerous filariform larvae of S. stercoralis against a background of eosinophils.

  15. Bazex Syndrome with Hypoalbuminemia and Severe Ascites

    OpenAIRE

    2016-01-01

    Bazex syndrome is a rare paraneoplastic dermatosis. The underlying malignancy frequently is squamous cell carcinoma of the upper aerodigestive tract or cervical lymph nodes from an unknown primary site. We report a 63-year-old man with squamous cell carcinoma of cervical lymph nodes from an unknown primary site. He developed a mass on the right side of his neck, cutaneous lesions diagnosed as Bazex syndrome, hypoalbuminemia, and severe ascites. Right neck dissection was performed. After neck ...

  16. Eosinophilic gastroenteritis with ascites and colon involvement.

    Science.gov (United States)

    Levinson, J D; Ramanathan, V R; Nozick, J H

    1977-12-01

    The case of a 39-year old white man with eosinophilic gastroenteritis is presented. The major clinical features were gastric outlet obstruction, diarrhea and massive ascites. At surgery, significant involvement of the entire gastrointestinal tract from the gastric antrum to the sigmoid colon was found. Histologic documentation of colon involvement was obtained. The response to corticosteroids was prompt and sustained. At present, he is maintained on an alternating day schedule of steroid administration.

  17. Trastuzumab (Herceptin)-associated cardiomyopathy presented as new onset of complete left bundle-branch block mimicking acute coronary syndrome: a case report and literature review.

    Science.gov (United States)

    Tu, Chung-Ming; Chu, Kai-Ming; Yang, Shin-Ping; Cheng, Shu-Mung; Wang, Wen-Been

    2009-09-01

    Trastuzumab (Herceptin) is well documented in reducing suffering and mortality from breast cancer. The clinically most important side effect of Herceptin is cardiotoxicity, which is reported in 2.6% to 4.5% of patients receiving trastuzumab alone and in as many as 27% of patients when trastuzumab is combined with an anthracycline in metastatic disease. We reported the case of a 50-year-old woman who presented to our emergency department (ED) because of chest pain and shortness of breath. On physical examination, holosystolic murmur over apex could be heard. Pulmonary and abdominal examinations were unremarkable. Twelve-lead electrocardiography showed sinus tachycardia and new onset of complete left bundle-branch block. Emergent transthoracic echocardiography revealed generalized hypokinesia of left ventricle and akinesia over interventricular septum and apex. She subsequently underwent immediate coronary angiography that revealed normal coronary angiography, and left ventriculogram revealed generalized hypokinesia with severe left ventricle dysfunction with ejection fraction of 33%. During right heart catheterization and endomyocardial biopsy, cardiac tamponade developed and was successfully relieved by pericardial window. She was discharged event-free 3 weeks later with conservative treatment. Although new onset of complete left bundle-branch block in a patient with chest pain may be acute coronary syndrome, careful review of medicine history is mandatory to avoid unnecessary procedure and complications.

  18. Foreign body granuloma in the anterior abdominal wall mimicking an acute appendicular lump and induced by a translocated copper-T intrauterine contraceptive device: a case report

    Directory of Open Access Journals (Sweden)

    Ansari Maulana Mohammed

    2009-04-01

    Full Text Available Abstract Introduction Intrauterine contraceptive devices may at times perforate and migrate to adjacent organs. Such uterine perforation usually passes unnoticed with development of potentially serious complications. Case presentation A 25-year-old woman of North Indian origin presented with an acute tender lump in the right iliac fossa. The lump was initially thought to be an appendicular lump and treated conservatively. Resolution of the lump was incomplete. On exploratory laparotomy, a hard suspicious mass was found in the anterior abdominal wall of the right iliac fossa. Wide excision and bisection of the mass revealed a copper-T embedded inside. Examination of the uterus did not show any evidence of perforation. The next day, the patient gave a history of past copper-T Intrauterine contraceptive device insertion. Conclusions Copper-T insertion is one of the simplest contraceptive methods but its neglect with inadequate follow-up may lead to uterine perforation and extra-uterine migration. Regular self-examination for the "threads" supplemented with abdominal X-ray and/or ultrasound in the follow-up may detect copper-T migration early. To the best of our knowledge, this is the first report of intrauterine contraceptive device migration to the anterior abdominal wall of the right iliac fossa.

  19. Systemic sclerosis with portal hypertensive ascites responded to corticosteroid treatment

    Institute of Scientific and Technical Information of China (English)

    LENG Xiao-mei; SUN Xue-feng; ZHANG Xuan; ZHANG Wen; LI Meng-tao; ZENG Xiao-feng

    2012-01-01

    We describe a case of systemic sclerosis (SSc) complicated with portal hypertensive ascites which did not improve with diuretics and ascitic drainage.When corticosteroid added,her ascites diminished dramatically.Though portal hypertension can be imputed to other causes,such as polycystic liver in this case,it can occur in limited SSc with positive anti-centromere antibody and respond to corticosteroid treatment.

  20. An unusual presentation of fistulating Crohn’s disease: Ascites

    OpenAIRE

    Kia, Richard; White, David; Sarkar, Sanchoy

    2010-01-01

    Whilst ascites is a common presenting complaint in patients with decompensated chronic liver disease and disseminated malignancy, in Crohn’s disease however, it is exceptionally rare. We describe a patient with no prior history of inflammatory bowel or liver disease, presenting with rapid onset gross ascites and scrotal swelling. Further investigations revealed severe hypoalbuminemia and transudative ascitic fluid with normal other liver function tests and a negative liver screen. Computed to...

  1. 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

  2. Spontaneous Fungal Peritonitis in Ascites of Cardiac Origin

    Science.gov (United States)

    Gandhi, Seema; Attar, Bashar M.

    2017-01-01

    Spontaneous fungal peritonitis (SFP) is an infrequent but severe complication most commonly described in patients with liver cirrhosis. We present the first case of culture-proven SFP occurring in cardiogenic ascites. The diagnosis of SFP was clinically challenging as the initial ascites was consistent with the more common diagnosis of spontaneous bacterial peritonitis (SBP). The patient did not respond to antibacterial therapy, however, and the final diagnosis was only made with positive ascitic cultures that grew Candida glabrata. SFP should be considered in patients with either cardiac or cirrhotic ascites and have a delayed or lack of response to traditional SBP treatment.

  3. Clinical studies of resistant ascites in liver cirrhosis.

    Directory of Open Access Journals (Sweden)

    Yuasa,Shiro

    1984-06-01

    Full Text Available Resistant ascites was studied in 34 patients with liver cirrhosis and ascites. The patients were initially divided into 3 groups on the basis of the weekly cumulative ascites retention curve: patients relieved of ascites within 3 weeks of admission, patients relieved between 4 and 12 weeks and patients with ascites persisting beyond 13 weeks. "Resistant ascites" was defined as "ascites persisting for more than 13 weeks after admission to the hospital". The patients were then reclassified into 3 groups : Group A being those patients relieved of ascites within 12 weeks, Group B being those with resistant ascites and group C being those who died within 12 weeks of admission. There were no differences in age and sex distribution, etiology of liver cirrhosis, past medical history or physical findings among the 3 groups. However, Group B had higher levels of serum creatinine and blood urea nitrogen than Group A on admission. Serum bilirubin was higher and serum albumin was lower in Group C than in Group B, which indicates that Group C had greater liver cell failure.

  4. A subtle mimicker in emergency department

    Science.gov (United States)

    Angelis, Maria Vittoria De; Giacomo, Roberta Di; Muzio, Antonio Di; Onofrj, Marco; Bonanni, Laura

    2016-01-01

    Abstract Background: Movement disorder emergencies include any movement disorder which develops over hours to days, in which failure to appropriately diagnose and manage can result in patient morbidity or mortality. Movement disorder emergencies include acute dystonia: sustained or intermittent muscle contractions causing abnormal, often repetitive, movements. Acute dystonia is a serious challenge for emergency room doctors and neurologists, because of the high probability of misdiagnosis, due to the presence of several mimickers including partial seizures, meningitis, localized tetanus, serum electrolyte level abnormalities, strychnine poisoning, angioedema, malingering, catatonia, and conversion. Methods: We describe 2 examples, accompanied by videos, of acute drug-induced oro-mandibular dystonia, both subsequent to occasional haloperidol intake. Results: Management and treatment of this movement disorder are often difficult: neuroleptics withdrawal, treatment with benzodiazepines, and anticholinergics are recommended. Conclusion: Alternative treatment options are also discussed. PMID:27741141

  5. Malignant fibrous histiocytoma presenting as hemoperitoneum mimicking hepatocellular carcinoma rupture

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    Malignant fibrous histiocytoma (MFH) is a pleomorphic mesenchynal sarcoma. It is uncommonly arises primarily from the intra-peritoneal cavity. Primary peritoneal MFH with tumor bleeding and rupture is rare. We describe the imaging features of a 70-year-old patient presenting with ruptured hemorrhagic peritoneal MFH at subhepatic area, accompanied by massive hemoperitoneum,mimicking a ruptured pedunculated hepatocellular carcinoma. Computed tomography (CT) revealed a large heterogeneous enhanced subhepatic mass with adjacent liver, gallbladder and colon invasion. Tumor hemorrhage and rupture complicated with peritoneal seeding and massive bloody ascites were also detected.Angiography showed a hypervascular tumor fed by enlarged right hepatic arteries, cystic artery and omental branches of gastroepiploic artery. The patient underwent laparotomy for tumor resection, but the tumor recurred one month after operation. To our knowledge, the CT appearance of ruptured intraperitoneal MFH complicated by hemoperitoneum has not been previously described.

  6. [Sero-ascitic gradient of albumin: usefulness and diagnostic limitations].

    Science.gov (United States)

    Alba, D; Torres, E; Vázquez, J J

    1995-08-01

    The serum-ascites albumin (SAA) gradient has been defined as the serum albumin concentration minus the ascitic fluid albumin concentration. The SAA gradient is superior to the exudate-transudate concept to classify ascites, being a exact portal hypertension (PH) marker. An elevated SAA gradient (1.1 g/L or greater) correlates with PH, whereas a low gradient indicates no PH. The SAA gradient correlates well with PH in cirrhotic patients. It is also of particular utility to differentiate between congestive heart failure and malignant ascites without liver metastases (both of them with elevated ascites fluid proteins -AFP-). However, a low SAA gradient do not differentiate between tuberculous and malignant ascites. Consequently, there are still need for tests a cytology, culture for mycobacteria or ascites fluid polymorphonuclear cell count in some cases. The level of AFP, apart from the exudate-transudate concept, has some value for certain cases (a low level of AFP implicates a high risk of spontaneous bacterial peritonitis). The SAA gradient should replace the AFP concentration as the initial test to classify ascites.

  7. Production of inflammatory mediators by human macrophages obtained from ascites

    NARCIS (Netherlands)

    W.M. Pruimboom (Wanda); A.P.J. van Dijk (Arie); C.J.A.M. Tak (Corné); I.L. Bonta; J.H.P. Wilson (Paul); F.J. Zijlstra (Freek)

    1994-01-01

    textabstractAscites is a readily available source of human macrophages (Mø), which can be used to study Mø functions in vitro. We characterized the mediators of inflammation produced by human peritoneal Mø (hp-Mø) obtained from patients with portal hypertension and ascites. The production of the cy

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

    Directory of Open Access Journals (Sweden)

    Neary Paul C

    2011-05-01

    Full Text Available 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.

  9. 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.

  10. Acute chylous peritonitis due to acute pancreatitis.

    Science.gov (United States)

    Georgiou, Georgios K; Harissis, Haralampos; Mitsis, Michalis; Batsis, Haralampos; Fatouros, Michalis

    2012-04-28

    We report a case of acute chylous ascites formation presenting as peritonitis (acute chylous peritonitis) in a patient suffering from acute pancreatitis due to hypertriglyceridemia and alcohol abuse. The development of chylous ascites is usually a chronic process mostly involving malignancy, trauma or surgery, and symptoms arise as a result of progressive abdominal distention. However, when accumulation of "chyle" occurs rapidly, the patient may present with signs of peritonitis. Preoperative diagnosis is difficult since the clinical picture usually suggests hollow organ perforation, appendicitis or visceral ischemia. Less than 100 cases of acute chylous peritonitis have been reported. Pancreatitis is a rare cause of chyloperitoneum and in almost all of the cases chylous ascites is discovered some days (or even weeks) after the onset of symptoms of pancreatitis. This is the second case in the literature where the patient presented with acute chylous peritonitis due to acute pancreatitis, and the presence of chyle within the abdominal cavity was discovered simultaneously with the establishment of the diagnosis of pancreatitis. The patient underwent an exploratory laparotomy for suspected perforated duodenal ulcer, since, due to hypertriglyceridemia, serum amylase values appeared within the normal range. Moreover, abdominal computed tomography imaging was not diagnostic for pancreatitis. Following abdominal lavage and drainage, the patient was successfully treated with total parenteral nutrition and octreotide.

  11. Acute chylous peritonitis due to acute pancreatitis

    Institute of Scientific and Technical Information of China (English)

    Georgios K Georgiou; Haralampos Harissis; Michalis Mitsis; Haralampos Batsis; Michalis Fatouros

    2012-01-01

    We report a case of acute chylous ascites formation presenting as peritonitis (acute chylous peritonitis) in a patient suffering from acute pancreatitis due to hypertriglyceridemia and alcohol abuse.The development of chylous ascites is usually a chronic process mostly involving malignancy,trauma or surgery,and symptoms arise as a result of progressive abdominal distention.However,when accumulation of "chyle" occurs rapidly,the patient may present with signs of peritonitis.Preoperative diagnosis is difficult since the clinical picture usually suggests hollow organ perforation,appendicitis or visceral ischemia.Less than 100 cases of acute chylous peritonitis have been reported.Pancreatitis is a rare cause of chyloperitoneum and in almost all of the cases chylous ascites is discovered some days (or even weeks) after the onset of symptoms of pancreatitis.This is the second case in the literature where the patient presented with acute chylous peritonitis due to acute pancreatitis,and the presence of chyle within the abdominal cavity was discovered simultaneously with the establishment of the diagnosis of pancreatitis.The patient underwent an exploratory laparotomy for suspected perforated duodenal ulcer,since,due to hypertriglyceridemia,serum amylase values appeared within the normal range.Moreover,abdominal computed tomography imaging was not diagnostic for pancreatitis.Following abdominal lavage and drainage,the patient was successfully treated with total parenteral nutrition and octreotide.

  12. Chylous ascites following radical nephrectomy: a case report

    Directory of Open Access Journals (Sweden)

    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.

  13. Spinal MRI of vincristine neuropathy mimicking Guillain-Barre syndrome

    Energy Technology Data Exchange (ETDEWEB)

    Chang, Yun Woo; Yoon, Hye-Kyung; Cho, Jae Min [Department of Radiology, Samsung Medical Centre, Sungkyunkwan University School of Medicine, 50 Irwon-dong, Kangnam-gu, Seoul 135-710 (Korea); Sung, Ki Woong [Department of Paediatrics, Samsung Medical Centre, Seoul 135-710 (Korea)

    2003-11-01

    A 4.3-year-old girl with acute leukaemia, who was being treated with chemotherapy (including vincristine), developed paraplegia. Spinal MRI showed diffusely enhancing nerve roots on contrast-enhanced images. Spinal fluid analysis showed a normal protein level. Vincristine neuropathy mimicking Guillain-Barre syndrome is thought to be the cause of the MRI abnormalities. (orig.)

  14. [Refractory ascites and dilutional hyponatremia: current management and new aquaretics].

    Science.gov (United States)

    Torre Delgadillo, Aldo

    2005-01-01

    Ascites is the most common complication of cirrhosis and is associated with 50% mortality at 2 years if patients do not receive orthotopic liver transplantation. Recently the International Ascites Club defined ascites into three groups: In grade I ascites fluid is detected only by ultrasound; in grade II, ascites is moderate with symmetrical distention of the abdomen; and in Grade 3 ascites is large or tense with marked abdominal distention. About 10% of patients with ascites are refractory to treatment with diuretics. In refractory ascites, patients do not respond to highest doses of diuretics (spironolactone 400 mg/day and furosemide 160 mg/ day) or develop side effects (hyperkalemia, hyponatremia, hepatic encephalopathy, or renal failure) that prohibit their use. Patients may be treated either by repeated large volume paracentesis plus albumin or transjugular intrahepatic portosystemic shunts (TIPS). Dilutional hyponatremia in cirrhotic patients is defined as serum sodium < or = 130 mEq/L in the presence of an expanded extracellular fluid volume, as indicated by the presence of ascites and/or edema. This complication of cirrhotic patients with ascites has recently gained attention given that several reports indicate that when serum sodium concentration is combined with the Model for End-Stage liver disease (MELD) it improves the prognostic accuracy of MELD score in patients awaiting orthotopic liver transplant (OLT). The first step in the management of dilutional hyponatremia is fluid restriction and discontinuation of diuretics. Water restriction at 1,000 mL/day helps prevent the progressive decrease in serum sodium concentration but usually does not correct hyponatremia in most cases. Actually are developing drugs that are active orally and act by selectively antagonizing the specific receptors (V2 receptor) of arginine vasopressin. These agents act in the distal collecting ducts of the kidneys, by increasing solute free water excretion and, thus, improving

  15. Treatment of refractory hemodialysis ascites with maintenance peritoneal dialysis.

    Science.gov (United States)

    Ing, T S; Daugirdas, J T; Popli, S; Kheirbek, A O; Humayun, H M; Gandhi, V C; Chapa, S M

    1981-04-01

    In 5 patients who were receiving maintenance hemodialysis, ascites developed that was refractory to treatment by ultrafiltration during hemodialysis. Use of sequential isolated ultrafiltration and hemodialysis therapy either precipitated side effects or else required prolongation of total treatment time which the patients declined to accept. In 4 of the patients, ascites was believed to be primarily responsible for severe, progressive cachexia. Maintenance peritoneal dialysis was instituted in all patients, and abdominal fluid was removed gradually, over a period of 2 to 3 days. Ascites resolved promptly in each case. Three patients noted a dramatic improvement in appetite after relief of abdominal distension. Follow-up periods ranged from 6 to 4 1/2 years. Our results suggest that maintenance peritoneal dialysis can successfully control hemodialysis ascites.

  16. Pathogenetic background for treatment of ascites and hepatorenal syndrome

    DEFF Research Database (Denmark)

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

    2008-01-01

    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...... seek to improve liver function, ameliorate arterial hypotension and central hypovolemia, and reduce renal vasoconstriction. Ample treatment of ascites and HRS is important to improve the quality of life and prevent further complications, but since treatment of fluid retention does not significantly...... 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 with a large volume paracentesis, followed by volume expansion...

  17. 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...... seek to improve liver function, ameliorate arterial hypotension and central hypovolemia, and reduce renal vasoconstriction. Ample treatment of ascites and HRS is important to improve the quality of life and prevent further complications, but since treatment of fluid retention does not significantly...... 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 with a large volume paracentesis, followed by volume expansion...

  18. CSF ascites : a rare complication of ventriculoperitoneal shunt surgery.

    Directory of Open Access Journals (Sweden)

    Chidambaram B

    2000-10-01

    Full Text Available CSF ascites is a very rare complication of ventriculoperitoneal (VP shunt procedure. No definite explanation has been offered for the inability of the peritoneum to absorb the CSF. Two children who underwent VP shunting for hydrocephalus, presented with ascites 3 (1/2 years and 4 months respectively, after the shunt was placed. The treatment of choice is conversion of the VP shunt to a ventriculoatrial shunt.

  19. Morbidity and mortality after peritoneovenous shunt surgery for refractory ascites.

    OpenAIRE

    Rubinstein, D; McInnes, I; Dudley, F

    1985-01-01

    A prospective analysis of the morbidity and mortality after peritoneovenous shunting was carried out in 25 patients who had a total of 27 shunts for refractory ascites. Major complications were limited to the patients in whom ascites was secondary to hepatic rather than peritoneal disease. Immediate postoperative complications followed 17 out of the 23 shunts carried out in patients with liver disease and included septicaemia (two), profound hypotension (two), pulmonary oedema (one), and clin...

  20. 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.

  1. Chylous ascites:Treated with total parenteral nutrition and somatostatin

    Institute of Scientific and Technical Information of China (English)

    Qi Huang; Zhi-Wei Jiang; Jun Jiang; Ning Li; Jie-Shou Li

    2004-01-01

    AIM: To determine the effects of total parenteral nutrition and somatostatin on patients with chylous ascites.METHODS: Five patients were diagnosed with chylous ascites on the basis of laboratory findings of ascites sample from Nov 1999 to May 2003. Total parenteral nutrition and somatostatin or its analogue was administered to 4 patients,while the other one only received total parenteral nutrition.All the patients had persistent peritoneal drainage, with the quantity and quality of drainage fluid observed daily.Necessary supportive treatments were given to the patients individually during the therapy.RESULTS: Two of 4 patients who received somatostatin therapy obtained complete recovery within 10 d without any recurrence while on a normal diet. In these 2 patients,the peritoneal drainage reduced to zero in one and the other's decreased from 2 000 mL to 80 mL with a clear appearance and negative qualitative analysis of chyle. Recurrent chylous ascites, though relieved effectively by the same method every time, developed in one patient with advanced pancreatic cancer. The other patient's lymphatic fistula was blocked with the fibrin glue after conservative treatment. The patient who only received total parenteral nutrition was cured 24 d after therapy.CONCLUSION: Total parenteral nutrition along with somatostatin can relieve the symptoms and close the fistula in patients with chylous ascites rapidly. It appears to be an effective therapy available for the treatment of chylous ascites caused by various disorders.

  2. Evaluation and management of patients with refractory ascites

    Institute of Scientific and Technical Information of China (English)

    Bahaa Eldeen Senousy; Peter V Draganov

    2009-01-01

    Some patients with ascites due to liver cirrhosis become no longer responsive to diuretics. Once other causes of ascites such as portal vein thrombosis,malignancy or infection and non-compliance with medications and low sodium diet have been excluded,the diagnosis of refractory ascites can be made based on strict criteria. Patients with refractory ascites have very poor prognosis and therefore referral for consideration for liver transplantation should be initiated. Search for reversible components of the underlying liver pathology should be undertaken and targeted therapy, when available, should be considered. Currently, serial large volume paracentesis (LVP) and transjugular intrahepatic portasystemic stent-shunt (TIPS) are the two mainstay treatment options for refractory ascites. Other treatment options are available but not widely used either because they carry high morbidity and mortality (most surgical options) rates, or are new interventions that have shown promise but still need further evaluation. In this comprehensive review, we describe the evaluation and management of patients with refractory ascites from the prospective of the practicing physician.

  3. Peritoneal Tuberculosis Mimicking Peritoneal Carcinomatosis

    Directory of Open Access Journals (Sweden)

    Mehmet Akce

    2014-01-01

    Full Text Available A 67-year-old male presented with fatigue, abdominal pain , and 30-pound weight loss over 3 months. Computerized tomography (CT abdomen displayed ascites with thickening and enhancement of the peritoneum and mottled nodular appearing as soft tissue consistent with omental caking worrisome for peritoneal carcinomatosis. A paracentesis revealed white blood cell count of 2,500 with 98% lymphocytes and serum ascites albumin gradient of 0.9 g/L. No acid-fast bacilli were seen by microscopic exam and culture was negative. Purified protein derivative skin test (PPD was negative and CXR did not reveal any infiltrates. Esophagogastroduodenoscopy (EGD and colonoscopy were unrevealing. The patient underwent exploratory laparotomy with round ligament and peritoneal biopsies that revealed numerous necrotizing granulomas. Acid-fast bacteria Ziehl-Neelsen stain (AFB of the biopsy specimen revealed single acid-fast bacilli. Treatment for M. tuberculosis was initiated and final culture revealed that mycobacterium tuberculosis was sensitive to Isoniazid, Rifampin, Ethambutol, and Pyrazinamide. After 6 months of treatment, the ascites and peritoneal carcinomatosis resolved.

  4. The effect of abdominal massage in reducing malignant ascites symptoms.

    Science.gov (United States)

    Wang, Tsae-Jyy; Wang, Hung-Ming; Yang, Tsai-Sheng; Jane, Sui-Whi; Huang, Tse-Hung; Wang, Chao-Hui; Lin, Yi-Hsin

    2015-02-01

    As many as 50% of end-stage cancer patients will develop ascites and associated symptoms, including pain, tiredness, nausea, depression, anxiety, drowsiness, loss of appetite, dyspnea, perceived abdominal bloating, and immobility. Abdominal massage may stimulate lymph return to the venous system and reduce ascites-related symptoms. The purpose of this study was to test the effect of abdominal massage in reducing these symptoms and reducing ascites itself as reflected in body weight. For a randomized controlled design using repeated measures, a sample of 80 patients with malignant ascites was recruited from gastroenterology and oncology units of a medical center in northern Taiwan and randomly assigned to the intervention or the control group. A 15-minute gentle abdominal massage, using straight rubbing, point rubbing, and kneading, was administered twice daily for 3 days. The control group received a twice-daily 15-minute social interaction contact with the same nurse. Symptoms and body weight were measured in the morning for 4 consecutive days from pre- to post-test. In generalized estimation equation modeling, a significant group-by-time interaction on depression, anxiety, poor wellbeing, and perceived abdominal bloating, indicated that abdominal massage improved these four symptoms, with the greatest effect on perceived bloating. The intervention had no effect on pain, tiredness, nausea, drowsiness, poor appetite, shortness of breath, mobility limitation, or body weight. Abdominal massage appears useful for managing selected symptoms of malignant ascites.

  5. The ascites N-glycome of epithelial ovarian cancer patients.

    Science.gov (United States)

    Biskup, Karina; Braicu, Elena I; Sehouli, Jalid; Tauber, Rudolf; Blanchard, Véronique

    2017-03-22

    Epithelial ovarian cancer (EOC) is worldwide the sixth most lethal form of cancer occurring in women. More than one third of ovarian patients have ascites at the time of diagnosis and almost all of them have it when recurrence occurs. Although its effect on tumor cell microenvironment remains poorly understood, its presence is correlated with bad diagnosis. In previous studies, we proposed a novel glycan-based biomarker for the diagnosis of EOC, which showed an improved sensitivity and specificity at any stage of the disease and an improved discrimination between malignant and benign ovarian tumors. In this work, we report for the first time the N-glycome profiles of ascitic fluid from primary serous EOC patients and compare them with the serum N-glycomes of the same patients as well as of healthy controls. N-Glycans were digested from equivalent amount of ascites and serum from 18 EOC patients and from serum of 20 age-matched controls and measured by MALDI-TOF-MS. Ascites N-glycome showed increased antennarity, branching, sialylation and Lewis(X) motives compared to healthy serum. In addition, a correlation was established between ascites volume and degree of sialylation.

  6. 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.

  7. 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

  8. Observations on the mechanism and location of ascites reabsorption in man

    Energy Technology Data Exchange (ETDEWEB)

    Rector, W.G. Jr.; Ibarra, F.

    1987-04-01

    Animal data indicate that ascites is reabsorbed by a lymphatic mechanism and that these vessels are subdiaphragmatic in location. We evaluated the relative role of lymphatics in ascites reabsorption in man by comparing the ascites clearance and plasma appearance rates of intraperitoneally injected radiolabeled albumin to those of intraperitoneally injected labeled autologous red blood cells, which require, owing to their large size, lymphatic removal, in patients with cirrhosis and ascites. To evaluate the location of reabsorption, we repeated these measurements after replacing ascites in the subdiaphragmatic region with 500-1000 ml of intraperitoneally injected air, reasoning that this maneuver should slow or eliminate ascites reabsorption occurring at this site. We found that the transfer rates of albumin and red cells out of ascites were similar and that creation of pneumoperitoneum did not influence these rates. These data confirm that ascites protein reabsorption occurs via a lymphatic mechanism in man. They suggest, however, that these vessels may not be subdiaphragmatic in location.

  9. Chylous ascites secondary to hyperlipidemic pancreatitis with normal serum amylase and lipase

    Institute of Scientific and Technical Information of China (English)

    Fahmi Yousef Khan; Tssa Matar

    2007-01-01

    A 54-year old man with a family history of hyperlipidemia was admitted with a 12 h history of severe generalized abdominal pain associated with nausea, vomiting and abdominal distension. Examination of the abdomen revealed tenderness in the periumblical area with shifting dullness. Serum pancreatic amylase was 29 IU/L and lipase 44 IU/L, triglyceride 36.28 mmol/L. Ultrasound showed ascites. CT of the abdomen with contrast showed inflammatory changes surrounding the pancreas consistent with acute pancreatitis. Ultrasound (US)guided abdomen paracentesis yielded a milky fluid with high triglyceride content consistent with chylous ascites.The patient was kept fasting and intravenous fluid hydration was provided. Meperidine was administered for pain relief. On the following days the patient's condition improved and he was gradually restarted on a low-fat diet, and fat lowering agent (gemfibrozil) was begun,600 mg twice a day. On d 14, abdomen US was repeated and showed fluid free peritoneal cavity. The patient was discharged after 18 d of hospitalization with 600 mg gemfibrozil twice a day. At the time of discharge, the fasting triglyceride was 4.2 mmol/L. After four weeks the patient was seen in the clinic, he was well.

  10. Klebsiella pneumoniae pharyngitis mimicking malignancy: a diagnostic dilemma.

    Science.gov (United States)

    Yeh, C-F; Li, W-Y; Hsu, Y-B

    2014-12-01

    Acute pharyngitis is a common disease. However, acute pharyngitis caused by Klebsiella pneumoniae with a gross appearance mimicking hypopharyngeal malignancy has never previously been reported. We report the case of a 57-year-old man with a right hypopharyngeal tumor which was disclosed by fiberoptic laryngoscopy and computed tomography scan. However, both the frozen and final pathologies showed no evidence of malignant cells, and a bacterial culture revealed the growth of K. pneumoniae. The hypopharyngeal lesion completely regressed after 2 weeks of antibiotic treatment. Clinicians should perform biopsy along with tissue culture for tumor-like lesions because infectious agents can lead to lesions with malignancy-like appearance.

  11. 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.

  12. Progress in treatment of massive ascites and hepatorenal syndrome

    Institute of Scientific and Technical Information of China (English)

    Alexander L Gerbes; Veit Gulberg

    2006-01-01

    Massive ascites and hepatorenal syndrome (HRS) are frequent complications of liver cirrhosis. Thus, effective therapy is of great clinical importance. This concise review provides an update of recent advances and new developments. Therapeutic paracentesis can be safely performed even in patients with severe coagulopathy.Selected patients with a refractory or recurrent ascites are good candidates for non-surgical portosystemic shunts (TIPS) and may have a survival benefit and improvement of quality of life. Novel pharmaceutical agents mobilizing free water (aquaretics) are currently under test for the therapeutic potential in patients with ascites.Prophylaxis of hepatorenal syndrome in patients with spontaneous bacterial peritonitis is recommended and should be considered in patients with alcoholic hepatitis. Liver transplantation is the best therapeutic option with long-term survival benefit for patients with HRS. To bridge the time until transplantation, TIPS or Terlipressin and albumin are good options. Albumin dialysis can not be recommended outside prospective trials.

  13. 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...... 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-blocker......-treated patients was found in the present retrospective analysis. CONCLUSIONS: Treatment with beta-blockers may increase mortality in patients with cirrhosis and refractory ascites. However, the current evidence is sparse and high-quality studies are warranted to clarify the matter....

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

    Science.gov (United States)

    Domingos Nunes, Gonçalo Filipe; Fatela, Narcisa; Ramalho, Fernando

    2016-06-01

    Constrictive pericarditis (CP) is an uncommon disease resulting from chronic pericardial inflammation, fibrosis and calcification. Once 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 common and, in most cases, reversible after pericardiectomy. Nevertheless, development of persistent liver dysfunction may be a long-term complication. The present work 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.

  15. MANAGEMENT OF SYMPTOMATIC MALIGNANT ASCITES WITH DIURETICS AND PARACENTESIS: CASE REPORTS

    OpenAIRE

    Amer Hayat Khan; Andee Dzulkarnaen Zakaria; Syed Azhar Syed Sulaiman; Salleh S. Khairiyah; Muhammad Shahid Iqbal

    2012-01-01

    Malignant ascites is a widespread impediment of advanced cancer but to 20% of all cases of malignant ascites have unknown primary tumours. With the exception of ovarian cancer, the response of the ascites to treatment of the tumor is unsatisfactory and treatment related morbidity is common. The intent of most treatments for malignant ascites should be palliative with diuretics paracentesis were the common approach. A 53 years old, male patients who was admitted with history of abdominal diste...

  16. 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

  17. 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 ascites, during a growth pe

  18. Chylous ascites in cirrhosis-A case report

    Directory of Open Access Journals (Sweden)

    S Laudari

    2012-09-01

    Full Text Available Chylous ascites is a rare presentation in cirrhotic liver disease but its incidence has increased because of aggressive cardiothoracic/abdominal surgeries and increasing survival of patients with chronic liver disease and cancer. We report here a case presenting with spontaneous chylous ascites in cirrhosis of liver. It has been associated with poor prognosis. Journal of College of Medical Sciences-Nepal,2012,Vol-8,No-2, 42-45 DOI: http://dx.doi.org/10.3126/jcmsn.v8i2.6837

  19. Xanthogranulomatous cholecystitis mimicking gallbladder cancer.

    Science.gov (United States)

    Ewelukwa, Ofor; Ali, Omair; Akram, Salma

    2014-05-08

    Xanthogranulomatous cholecystitis (XGC) is a benign, uncommon variant of chronic cholecystitis characterised by focal or diffuse destructive inflammatory process of the gallbladder (GB). Macroscopically, it appears like yellowish tumour-like masses in the wall of the GB. This article reports on a 74-year-old woman with XGC mimicking GB cancer.

  20. Evaluation of Anticancer activity of Aerva Sanguinolenta (L.) (Amaranthaceae) on Ehrlich?s Ascites cell induced Swiss Mice

    OpenAIRE

    Asif Lalee; Pinaki Pal; Bolay Bhattacharaya; Amalesh Samanta

    2012-01-01

    The aim of this study is to investigate the effects of both ethanolic and aqueous extracts of Aerva sanguinolenta (Family: Amaranthaceae) by intraperitoneal route to Ehrlich ascites tumor bearing mice. After determination of acute toxicity [LD50 = 2250mg/kg body weight which was given through i.p. route] of the plant extract on Swiss albino mice. The protocol started with tumor inoculation of 2x106 cells i.p. After 24 hrs of tumor inoculation, ethanolic, aqueous extracts and vinblastine (stan...

  1. Rapid onset of massive ascites as the initial presentation of systemic lupus erythematosus.

    Science.gov (United States)

    Weinstein, P J; Noyer, C M

    2000-01-01

    Ascites in systemic lupus erythematosus (SLE) is rarely massive, and either accompanies the typical manifestations of active disease or results from nephrotic syndrome, protein-losing enteropathy, constrictive pericarditis, and conditions unrelated to lupus. Marked ascites has been attributed to chronic lupus peritonitis, characterized by the insidious onset of massive, painless ascites and unrelated to disease activity. Regardless of the etiology, ascites typically has a gradual onset and occurs after a diagnosis of SLE has been made. We describe a young woman presenting with the rapid development of massive ascites as the initial manifestation of SLE.

  2. 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

  3. Respiratory distress due to malignant ascites palliated byhyperthermic intraperitoneal chemotherapy

    Institute of Scientific and Technical Information of China (English)

    Marijn Marinus Leonardus van den Houten; Thijs Ralf van Oudheusden; Michael Derek Philip Luyer; Simon Willem Nienhuijs; Ignace Hubertus Johannes Theodorus de Hingh

    2015-01-01

    Malignant ascites is a common symptom in patientswith peritoneal cancer. Current assumption is that anincreased vascular permeability and obstruction oflymphatic channels lead to the accumulation of fluidin the abdominal cavity. This case report describes aseverely symptomatic patient with malignant ascites.The previously healthy 73-year-old male was presentedwith abdominal distention causing respiratory distress.Computed tomography revealed large amounts ofascites, a recto-sigmoidal mass with locoregionallymphadenopathy and an omental cake. Biopsy takenduring colonoscopy revealed an adenocarcinoma ofthe colon with signet cell differentiation. A widespreadperitoneal carcinomatosis was found during a diagnosticlaparoscopy. The extent of peritoneal diseaserendered the patient not suitable for cytoreductivesurgery with curative intent. The ascites proved to berefractory to ultrasound-guided paracentesis; thus, adecision was made to perform palliative hyperthermicintraperitoneal chemotherapy without cytoreductivesurgery. Consequently, ascites production stopped,and the respiratory distress was relieved thereafter.The postoperative recovery was uneventful. Ascitesrecurred eight months later, and a second hyperthermicintraperitoneal chemotherapy procedure was performed.The patient was still alive at the time of writing, 16 moafter the initial diagnosis.

  4. 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

  5. Multicystic Hepatocarcinoma Mimicking Liver Abscess

    Directory of Open Access Journals (Sweden)

    Evangelos Falidas

    2013-01-01

    Full Text Available The diagnosis of hepatocellular carcinoma (HCC became easier in relation to the improved radiological examinations; however, the neoplasm may occur under atypical presentations mimicking other benign or malignant processes. Multicystic HCC mimicking a liver abscess associated with septic-type fever and leukocytosis is rare, has a poor prognosis, and poses diagnostic and therapeutic dilemmas. We present the case of an 80-year-old patient, who presented with fever, leukocytosis, and large cystic masses involving right and left lobes of the liver initially considered abscesses and finally diagnosed as HCC after open drainage and liver biopsy. Although the patient died on the tenth postoperative day due to pulmonary oedema, the authors emphasize the high index of suspicion needed in the diagnosis of this unusual presentation of HCC.

  6. Reabsorption of ascites and the factors that affect this process in cirrhosis.

    Science.gov (United States)

    Akay, Sinan; Ozutemiz, Omer; Kilic, Murat; Karasu, Zeki; Akyildiz, Murat; Karasulu, Ercument; Baka, Meral; Doganavsargil, Basak; Ersoz, Galip; Ulukaya, Sezgin; Alper, Isik; Ates, Utku; Batur, Yucel

    2008-10-01

    Ascites is one of the main features of liver decompensation in cirrhosis, and it is considered to be a dynamic process. In this study, we aimed to (1) measure the reabsorption rate of ascites; (2) evaluate whether these findings were related to features of ascites, hemodynamics, and serum measurements; and (3) examine morphologic changes in the diaphragm of cirrhotic patients. In all, 42 cirrhotic patients with ascites were enrolled in the study to comprise our study group. Using the dextran 70 test, patient ascites volumes and reabsorption rates were measured. Biopsies from the peritoneal side of the diaphragm were also processed for scanning electron microscopy and lymphatic immunohistochemical studies from the cirrhotic patients and control cadavers. The mean ascites reabsorption rate was 4.5 +/- 4.5 (0.18-14.6) mL/min, which correlated significantly with the calculated ascites volume (r = 0.75, P ascites viscosity was 1.07 +/- 0.07 (0.99-1.17) centipoise, which demonstrated a high degree of negative correlation with the ascites reabsorption rate (r = -0.77, P ascites reabsorption rates than patients without this particular history. The size of lymphatic stomata in scanning electron microscopy depictions was increased, and lymphatic lacunae were dilated in immunohistochemical studies in the cirrhotic patients with ascites. However, these findings were not uniform in every cirrhotic patient with ascites. The volume and viscosity of ascites seem to influence its reabsorption rate. Additionally, previous episodes of spontaneous bacterial peritonitis may be responsible for the decreased ascites reabsorption rates observed in certain patient populations.

  7. Successful use of daily intravenous infusion of C1 esterase inhibitor concentrate in the treatment of a hereditary angioedema patient with ascites, hypovolemic shock, sepsis, renal and respiratory failure

    OpenAIRE

    Pham, Hoang; Santucci, Stephanie; Yang, William H

    2014-01-01

    Hereditary angioedema (HAE) is a rare autosomal dominant disease most commonly associated with defects in C1 esterase inhibitor (C1-INH). HAE manifests as recurrent episodes of edema in various body locations. Atypical symptoms, such as ascites, acute respiratory distress syndrome, and hypovolemic shock, have also been reported. Management of HAE conventionally involves the treatment of acute attacks, as well as short- and long-term prophylaxis. Since attacks can be triggered by several facto...

  8. Intervention for pleural effusions and ascites following liver transplantation

    Energy Technology Data Exchange (ETDEWEB)

    Adetiloye, V.A. [Radiology Department, Birmingham Children`s Hospital NHS Trust, Ladywood Middleway, Birmingham B16 8ET (United Kingdom)]|[Radiology Department, College of Health Sciences, Obafemi Awolowo University, Ile-Ife (Nigeria); John, P.R. [Radiology Department, Birmingham Children`s Hospital NHS Trust, Ladywood Middleway, Birmingham B16 8ET (United Kingdom)

    1998-07-01

    Background. Small volumes of fluid in the pleural and peritoneal cavities are common after paediatric liver transplantation. Occasionally, larger fluid collections develop and need intervention by aspiration or insertion of a drain. Objective. To assess the incidence of moderate and large pleural and peritoneal fluid collections following paediatric liver transplantation, the need for intervention and the outcome following radiological and non-radiological treatment, with the ultimate objective of recommending a treatment protocol for such post-operative fluid collections. Materials and methods. A total of 184 consecutive liver grafts in 164 children were reviewed. Results. Of 184 grafts, 31 (16.8 %) developed excessive fluid collections requiring intervention (19 pleural effusions, 8 ascites and 4 effusions and ascites). The effusions were first diagnosed between days 1 and 44 after transplant and the ascites between days 1 and 14. The initial diagnosis was made radiologically in 21 (91 %) of 23 pleural effusions and in 10 (83 %) of 12 ascites. No identifiable cause or association was seen in 18 (58 %) of 31 cases. The mean duration of the pleural effusions and ascites, from onset of treatment to resolution, ranged from 33 {+-} 42 days (SD) to 35 {+-} 48 days and from 36 {+-} 47 days to 39 {+-} 46 days respectively. Comparison of the modes of interventional treatment (i. e. unguided, radiological and surgical) showed no statistically significant difference in the outcome of the management. Conclusions. Post-transplantation pleural effusions and ascites requiring intervention are often without definite cause. They are more common with reduced grafts, but this cannot completely explain the occurrence or the protracted duration of accumulation in spite of combined interventional management. The outcome of treatment is not significantly influenced by the mode of intervention except in cases where surgical intervention is indicated. Patients could be managed

  9. Leptin levels in the differential diagnosis between benign and malignant ascites

    Institute of Scientific and Technical Information of China (English)

    Mehmet Buyukberber; Mehmet Koruk; M Cemil Savas; Murat T Gulsen; Yavuz Pehlivan; Rukiye Deveci; Alper Sevinc; Serdar Gergerlioglu

    2007-01-01

    AIM: To evaluate the role of leptin levels in the differential diagnosis of ascites.METHODS: Ascitic leptin, TNFα and serum leptin levels were measured in 77 patients with ascites (35 with malignancies, 30 cirrhosis and 12 tuberculosis). Control serum samples were obtained from 20 healthy subjects.Leptin and TNFα levels were measured by ELISA. Body mass index (BMI) and percentage of body fat (BFM) by skin fold measurement were calculated for all patients and control groups. Peritoneal biopsy, ascites cytology and cultures or biochemical values were used for the diagnosis of patients.RESULTS: In patients with malignancies, the mean serum and ascites leptin levels and their ratios were significantly decreased compared to the other patient groups and controls. In tuberculosis peritonitis, ascitic fluid TNFα levels were significantly higher than malignant ascites and cirrhotic sterile ascites. BMI and BFM values did not distinguish between patients and controls.CONCLUSION: In patients with malignant ascites,levels of leptin and TNFα were significantly lower than in patients with tuberculous ascites.

  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. Transient elastography with the XL probe rapidly identifies patients with nonhepatic ascites

    Directory of Open Access Journals (Sweden)

    Mueller S

    2012-05-01

    Full Text Available Anna Kohlhaas1, Esteban Durango1, Gunda Millonig1, Cecile Bastard2, Laurent Sandrin2, Mohammad Golriz3, Arianeb Mehrabi3, Markus W Büchler3, Helmut Karl Seitz1, Sebastian Mueller11Department of Medicine and Center for Alcohol Research, Liver Disease and Nutrition, Salem Medical Center, University of Heidelberg, Heidelberg, Germany; 2Department of Research and Development, Echosens, Paris, France; 3Department of General, Visceral and Transplantation Surgery, University of Heidelberg, Heidelberg, GermanyBackground: In contrast with other elastographic techniques, ascites is considered an exclusion criterion for assessment of fibrosis stage by transient elastography. However, a normal liver stiffness could rule out hepatic causes of ascites at an early stage. The aim of the present study was to determine whether liver stiffness can be generally determined by transient elastography through an ascites layer, to determine whether the ascites-mediated increase in intra-abdominal pressure affects liver stiffness, and to provide initial data from a pilot cohort of patients with various causes of ascites.Methods and results: Using the XL probe in an artificial ascites model, we demonstrated (copolymer phantoms surrounded by water that a transient elastography-generated shear wave allows accurate determination of phantom stiffness up to a water lamella of 20 mm. We next showed in an animal ascites model that increased intra-abdominal pressure does not affect liver stiffness. Liver stiffness was then determined in 24 consecutive patients with ascites due to hepatic (n = 18 or nonhepatic (n = 6 causes. The cause of ascites was eventually clarified using routine clinical, imaging, laboratory, and other tools. Valid (75% or acceptable (25% liver stiffness data could be obtained in 23 patients (95.8% with ascites up to an ascites lamella of 39 mm. The six patients (25% with nonhepatic causes of ascites (eg, pancreatitis, peritoneal carcinomatosis had a

  12. Decidualized Ovarian Mass Mimicking Malignancy

    Directory of Open Access Journals (Sweden)

    Lufee Wong

    2015-01-01

    Full Text Available Deciduosis classically occurs in the context of known endometriosis in the pelvis, most commonly in the ovaries, but also in the peritoneum. However, ovarian deciduosis outside the context of endometriosis is rare and makes diagnosis difficult, especially as the sonographic appearance suggests a malignant process. We report a case of decidualized ovarian mass in a patient without prior history of endometriosis that mimicked an ovarian malignancy. MRI may be a useful imaging modality to monitor these lesions and guide management. Consultation with a multidisciplinary team accustomed to such conditions will help to tailor the management to each individual.

  13. Antitumour activity of Bauhinia variegata on Dalton's ascitic lymphoma.

    Science.gov (United States)

    Rajkapoor, B; Jayakar, B; Murugesh, N

    2003-11-01

    The antitumour activity of the ethanol extract of Bauhinia variegata (EBV) has been evaluated against Dalton's ascitic lymphoma (DAL) in Swiss albino mice. A significant enhancement of mean survival time of EBV-treated tumour bearing mice was found with respect to control group. EBV treatment was found to enhance peritoneal cell counts. After 14 days of inoculation, EBV is able to reverse the changes in the haemotological parameters, protein and PCV consequent to tumour inoculation.

  14. 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.

  15. Chylous Ascites in a Patient with Inflammatory Myofibroblastic Tumor

    Directory of Open Access Journals (Sweden)

    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.

  16. Mild toxic anterior segment syndrome mimicking delayed onset toxic anterior segment syndrome after cataract surgery

    Directory of Open Access Journals (Sweden)

    Su-Na Lee

    2014-01-01

    Full Text Available Toxic anterior segment syndrome (TASS is an acute sterile postoperative anterior segment inflammation that may occur after anterior segment surgery. I report herein a case that developed mild TASS in one eye after bilateral uneventful cataract surgery, which was masked during early postoperative period under steroid eye drop and mimicking delayed onset TASS after switching to weaker steroid eye drop.

  17. Modulation of ConA-induced inflammatory ascites by histamine - short communication.

    Science.gov (United States)

    Baintner, Károly

    2015-03-01

    The early phase of the ConA-induced inflammatory ascites was studied, with special reference to histamine. Concanavalin A (ConA), a cell-surface binding lectin was injected i.p. (25 mg/kg bw) to mice. After 1 h the animals were killed, the ascitic fluid collected and measured. Other agents were injected s.c., 10 min before the ConA-challenge. Exogenous histamine markedly inhibited the ConA-induced ascites. Release of endogenous vasoactive agents from the mast cells by Compound 48/80 had a similar, but slight effect. Cromolyn, a mast cell stabilizing agent, and chloropyramine, a histamine H1 receptor antagonist was ineffective. Although histamine increases endothelial permeability, it did not enhance the formation of ascitic fluid, on the contrary, it inhibited the ConA-induced ascites, presumably due to its known hypotonic effect. It is concluded that ConA-induced ascites is not mediated by mast cell histamine.

  18. Factors predicting mortality after tips for refractory ascites: a single center experience

    OpenAIRE

    2010-01-01

    Introduction: Transjugular intrahepatic porto-systemic shunt (TIPS) is an accepted indication for treating refractory ascites. Different models have been proposed for the prediction of survival after TIPS; aim of present study was to evaluate the factors associated with mortality after TIPS for refractory ascites. Methods: Seventy-three consecutive patients undergoing a TIPS for refractory ascites in our centre between 2003 and 2008, were prospectively recorded in a database ad were the s...

  19. Prognostic significance of new onset ascites in patients with pancreatic cancer

    OpenAIRE

    Luzardo German; Boe Brian A; Osborne Dana; Zervos Emmanuel E; Goldin Steven B; Rosemurgy Alexander S

    2006-01-01

    Abstract Background The purpose of this study was to determine risk factors for development of malignant ascites and its prognostic significance in patients with pancreatic cancer. Methods A prospective database was queried to identify patients with pancreatic cancer who develop ascites. Stage at presentation, size, and location of primary tumor, treatment received and length of survival after onset of ascites were determined. Results A total of 15 patients were identified. Of which 4 patient...

  20. Lenalidomide and Dexamethasone for a Patient of POEMS Syndrome Presenting with Massive Ascites

    OpenAIRE

    Shuji Ueda; Sayoko Yonemoto; Kazumasa Oka; Naohiko Fujii; Keiichi Nakata; Hitomi Matsunaga; Seiko Kataoka; Yuki Iwama; Hiroyuki Narahara; Yuichi Yasunaga; Yoshiaki Inui; Sumio Kawata

    2014-01-01

    POEMS syndrome is a multisystem disorder characterized by polyneuropathy, organomegaly, endocrinopathy, monoclonal gammopathy, and skin changes. POEMS syndrome is a rare cause of refractory ascites. We report the case of a patient with POEMS syndrome presenting with massive ascites who was treated with very-low-dose lenalidomide and dexamethasone. A 57-year-old Japanese man was admitted to our hospital with pleural effusion, massive ascites, and leg edema. The diagnosis of POEMS syndrome was ...

  1. Arterial blood pressure is closely related to ascites development in compensated HCV-related cirrhosis.

    Directory of Open Access Journals (Sweden)

    Eduardo Vilar Gomez

    Full Text Available BACKGROUND: Arterial blood pressure (BP is a reliable marker of circulatory dysfunction in cirrhotic patients. There are no prospective studies evaluating the association between different levels of arterial BP and ascites development in compensated cirrhotic patients. Therefore, we evaluated the relationship between arterial BP and ascites development in compensated cirrhotic patients. MATERIALS AND METHODS: A total of 402 patients with compensated HCV-related cirrhosis were prospectively followed during 6 years to identify ascites development. At baseline, patients underwent systolic, diastolic and mean arterial pressure (MAP measurements. Any history of arterial hypertension was also recorded. The occurrence of events such as bleeding, hepatocellular carcinoma, death and liver transplantation prior to ascites development were considered as competing risk events. RESULTS: Over a median of 156 weeks, ascites occurred in 54 patients (13%. At baseline, MAP was significantly lower in patients with ascites development (75.9 mm/Hg [95%CI, 70.3-84.3] than those without ascites (93.6 mm/Hg [95% CI: 86.6-102.3]. After adjusting for covariates, the 6-year cumulative incidence of ascites was 40% (95%CI, 34%-48% for patients with MAP<83.32 mm/Hg. In contrast, cumulative incidences of ascites were almost similar among patients with MAP values between 83.32 mm/Hg and 93.32 mm/Hg (7% [95% CI: 4%-12%], between 93.32 mm/Hg and 100.31 mm/Hg (5% [95% CI: 4%-11%] or higher than 100.31 mm/Hg (3% [95% CI: 1%-6%]. The MAP was an independent predictor of ascites development. CONCLUSIONS: The MAP is closely related to the development of ascites in compensated HCV-related cirrhosis. The risk of ascites development increases in 4.4 fold for subjects with MAP values <83.32 mm/Hg.

  2. Crise de feocromocitoma simulando um infarto agudo do miocárdio em paciente com artérias coronárias normais Pheochromocytoma-induced segmental myocardial dysfunction mimicking an acute myocardial infarction in a patient with normal coronary arteries

    Directory of Open Access Journals (Sweden)

    Eduardo S. Darzé

    2004-02-01

    Full Text Available Relatamos o caso de um paciente com alterações eletrocardiográficas e disfunção miocárdica segmentar induzidas por feocromocitoma, simulando infarto agudo do miocárdio. A angiografia coronariana foi normal e houve normalização completa do eletrocardiograma e ecocardiograma, após terapia com um bloqueador alfa-adrenérgico e ressecção do tumor. Espasmo coronariano foi o provável mecanismo envolvido na produção dessas alterações, ilustrando a importância de manter um alto grau de suspeição clínica em pacientes com evento miocárdico inesperado em meio a uma crise hipertensiva.We report a case of pheochromocytoma-induced segmental myocardial dysfunction and electrocardiographic abnormalities mimicking an acute anterior myocardial infarction, probably due to coronary spasm. Coronary angiography showed normal coronaries, and the electrocardiographic and echocardiographic changes resolved completely after therapy with an alpha-adrenergic blocker and tumor removal. Our case illustrates the importance of maintaining a high index of suspicion in patients presenting with an unexpected myocardial event and a hypertensive crisis.

  3. Predictive value of FibroScan on liver ascites cause by cirrhosis

    OpenAIRE

    Han, Ping; Ji, Dong; Zhang, Jian; Li, Fan; Li, Bing; Shao, Qing; Chen, Guo-Feng

    2011-01-01

    Objective To investigate the predictive value of FibroScan for liver ascites caused by cirrhosis.Methods A total of 651 patients with liver cirrhosis were subjected to FibroScan examination in People’s Liberation Army 302 Hospital from December 2009 to June 2010 and were enrolled in the present study.Among the patients,185 suffered from liver cirrhosis with ascites(all patients initially had ascites) and 466 did not suffer from ascites.After obtaining the FibroScan value,the difference in liv...

  4. 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...

  5. Huge uterine-cervical diverticulum mimicking as a cyst

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    S Chufal

    2012-01-01

    Full Text Available Here we report an incidental huge uterine-cervical diverticulum from a total abdominal hysterectomy specimen in a perimenopausal woman who presented with acute abdominal pain. The diverticulum was mimicking with various cysts present in the lateral side of the female genital tract. Histopathological examination confirmed this to be a cervical diverticulum with communication to uterine cavity through two different openings. They can attain huge size if left ignored for long duration and present a diagnostic challenge to clinicians, radiologists, as well as pathologists because of its extreme rarity. Therefore, diverticula should also be included as a differential diagnosis. Its histopathological confirmation also highlights that diverticula can present as an acute abdomen, requiring early diagnosis with appropriate timely intervention. Immunohistochemistry CD 10 has also been used to differentiate it from a mesonephric cyst.

  6. Huge uterine-cervical diverticulum mimicking as a cyst.

    Science.gov (United States)

    Chufal, S; Thapliyal, Naveen; Gupta, Manoj; Pangtey, Nirmal

    2012-01-01

    Here we report an incidental huge uterine-cervical diverticulum from a total abdominal hysterectomy specimen in a perimenopausal woman who presented with acute abdominal pain. The diverticulum was mimicking with various cysts present in the lateral side of the female genital tract. Histopathological examination confirmed this to be a cervical diverticulum with communication to uterine cavity through two different openings. They can attain huge size if left ignored for long duration and present a diagnostic challenge to clinicians, radiologists, as well as pathologists because of its extreme rarity. Therefore, diverticula should also be included as a differential diagnosis. Its histopathological confirmation also highlights that diverticula can present as an acute abdomen, requiring early diagnosis with appropriate timely intervention. Immunohistochemistry CD 10 has also been used to differentiate it from a mesonephric cyst.

  7. 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.

  8. PROTEN TYROSINE PHOSPHATASE ACTIVITY IN RAT ASCITES HEPATOMA CELLS

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    M.Saadat

    1998-10-01

    Full Text Available Protein tyrosine phosphatases (PTPases regulate tyrosine phosphorylation of target proteins involved in several aspects of cellular functions. Enzyme activities of the PTPases in cytosolic and particulate fractions of rat ascites hepatoma cell lines were determined and compared with those of normal rat liver. Our present data revealed that although there was no neoplatic-specific alteration of the PTPase activity in examined hepatomas, the activity in particulate fractions of island type of hepatomas was remarkably decreased compared with either rat liver or free type hepatomas.

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

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    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.

  10. [Guidelines for diagnosis and management of cirrhotic ascites and its complications. The Israeli Association for the Study of the Liver].

    Science.gov (United States)

    Sikuler, Emanuel; Ackerman, Zvi; Braun, Marius; Baruch, Yaakov; Bruck, Refael; Safadi, Rifaat; Shlomai, Amir; Ben-Ari, Ziv

    2012-12-01

    Ascites is the most common manifestation of decompensated liver cirrhosis. The life expectancy of cirrhotic patients developing uncomplicated ascites is 50% for 3 years. Refractory ascites, electrolyte imbalance, hepato-renal syndrome and spontaneous bacterial peritonitis may develop. Successful treatment can improve symptoms and outcomes. This article summarizes the Israeli Association for the Study of the Liver guidelines for diagnosis and management of cirrhotic ascites and its complications.

  11. Permanent catheters for recurrent ascites-a critical and systematic review of study methodology

    DEFF Research Database (Denmark)

    Christensen, Lars; Wildgaard, Lorna Elizabeth; Wildgaard, Kim

    2016-01-01

    was to systematically asses the methodology of factors and endpoints reported in studies investigating permanent catheters for recurrent ascites treatment. Methods Using a systematic search strategy, we critically assessed the methodology when treating refractory ascites using a permanent catheter. Studies critically...

  12. Immediate diagnostic criteria for bacterial infection of ascitic fluid. Evaluation of ascitic fluid polymorphonuclear leukocyte count, pH, and lactate concentration, alone and in combination.

    Science.gov (United States)

    Stassen, W N; McCullough, A J; Bacon, B R; Gutnik, S H; Wadiwala, I M; McLaren, C; Kalhan, S C; Tavill, A S

    1986-05-01

    We prospectively evaluated the ascitic fluid (AF) polymorphonuclear cell (PMN) count, pH, and lactate concentration in single ascitic fluids from 60 patients to determine their relative predictive values for the immediate diagnosis of ascitic fluid infection. Nine of the 60 ascitic fluids were malignant. Of the remaining 51 samples, nine from cirrhotic patients were infected. The mean AF pH, lactate concentration, and PMN count in the infected group were 7.20 +/- 0.19, 80 +/- 51 mg/dl, and 18,199 +/- 19,650 cells/mm3, respectively, and all were significantly different from the corresponding values in noninfected ascites. Mean arterial blood-ascitic fluid (B-AF) pH and lactate gradients in the infected group were 0.23 +/- 0.17 and -46 +/- 31 mg/dl, respectively, and were significantly different from the corresponding values in noninfected ascites (p less than 0.05). Significant differences were not found between infected and malignant ascites, except for the AF PMN count (p less than 0.001). In cirrhosis with ascites, an AF pH less than or equal to 7.34 was the most specific single test (100%) and had the highest diagnostic accuracy (98%). In the larger group of patients with ascites of diverse etiology, a B-AF pH gradient greater than or equal to 0.10 or an AF PMN count greater than or equal to 500 cells/mm3 were the single tests with the highest diagnostic accuracy (92%). Combining an AF PMN count greater than 500 cells/mm3 with any of the other diagnostic criteria increased the specificity and diagnostic accuracy (up to 98%) compared to the best single criterion. Although our data support the use of a number of different combinations of AF measurements for the immediate diagnosis of infection, the simplest and most readily obtainable measurements are the pH and PMN count. Therefore, in the clinical setting we recommend the use of either an AF pH less than or equal to 7.34 or a B-AF pH gradient greater than or equal to 0.10 in combination with an AF PMN count

  13. 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

  14. Employment of synchronized cells and flow microfluorometry in investigations on the JB-1 ascites tumour chalones.

    Science.gov (United States)

    Bichel, P; Barfod, N M; Jakobsen, A

    1975-11-01

    In most experimental ascites tumours the growth rate decreases with increasing age and cell number. This decrease is caused by a prolongation of the cell cycle and an increasing accumulation of non-cycling cells in resting (or quiescent) G1 and G2 compartments. In cell-free ascitic fluid from the JB-1 ascites tumour in the plateau phase of growth lowmolecular-weight substances have been found which reversibly and specifically arrest JB-1 cells in G1 and G2. The present paper describes an in-vitro model for testing the effect of the humoral growth inhibitors contained in the ascitic fluid. The test system is based on synchronized JB-1 cells analysed by flow-through cytofluorometry. Addition to the synchronous cells of a ultrafiltrate (less than 50000 Daltons) of the JB-1 ascitic fluid was found to induce a complete, but temporary arrest of the cells at the G1-S border.

  15. A rare case of vitamin B12 deficiency with ascites.

    Science.gov (United States)

    Rajsekhar, Putta; Reddy, Mugannagari Maheshwar; Vaddera, Sameeraja; Rajini, G; Tikeli, Vinil

    2014-07-01

    Vitamin B12 deficiency is widespread than assumed in population. At risk are older people, pregnant women, vegans, patients with renal and intestinal diseases. Vitamin B12 deficiency can present with various hematological, gastrointestinal and neurological manifestations. In the population, the prevalence of vitamin B12 deficiency in younger people is 5% to 7% which is less compared to elderly people. In developing countries, deficiency is much more common, starting in early life and persisting across the life span. Here, we present a 16-year-old female patient presenting with ascites since 2 months who was subsequently investigated and diagnosed to have nutritional megaloblastic anaemia secondary to vitamin B12 deficiency after exclusion of other infective, neoplastic, autoimmune and inflammatory diseases. Inspite, patient was treated with antitubercular drugs but she did not respond. After supplementation of Vitamin B12, ascites responded well. Inadequate intake due to low consumption of animal source foods is the main cause of low serum vitamin B12 in younger adults and likely the main cause in poor population worldwide.

  16. Humanlike Robots - Synthetically Mimicking Humans

    Science.gov (United States)

    Bar-Cohen, Yoseph

    2012-01-01

    Nature inspired many inventions and the field of technology that is based on the mimicking or inspiration of nature is widely known as Biomimetics and it is increasingly leading to many new capabilities. There are numerous examples of biomimetic successes including the copying of fins for swimming, and the inspiration of the insects and birds flight. More and more commercial implementations of biomimetics are appearing and behaving lifelike and applications are emerging that are important to our daily life. Making humanlike robots is the ultimate challenge to biomimetics and, for many years, it was considered science fiction, but such robots are becoming an engineering reality. Advances in producing such robot are allowing them to perform impressive functions and tasks. The development of such robots involves addressing many challenges and is raising concerns that are related to fear of their application implications and potential ethical issues. In this paper, the state-of-the-art of humanlike robots, potential applications and challenges will be reviewed.

  17. Eradication of intractable malignant ascites by abdominocentesis, reinfusion of concentrated ascites, and adoptive immunotherapy with dendritic cells and activated killer cells in a patient with recurrent lung cancer: a case report

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    Kimura Hideki

    2008-12-01

    Full Text Available Abstract Introduction Malignant ascites is often a sign of a terminal stage in several malignant diseases. To control ascites, drainage and intra-abdominal chemotherapy are often used in those patients but eradication of ascites is difficult and prognosis is poor. Case presentation A 55-year-old woman was admitted to our hospital on 26 January 2007 with dyspnea, abdominal distention and oliguria. Abdominocentesis revealed peritoneal carcinomatosis resulting from abdominal recurrence from lung cancer. To alleviate the dyspnea and abdominal distention, we drained the ascites aseptically and infused them intravenously back into the patient after removal of tumor cells by centrifugation, and then concentration by apheresis. After the drainage of ascites, we intraperitoneally infused activated killer cells and dendritic cells from the patient's tumor-draining lymph nodes, together with 4.5 × 105U interleukin-2 in 50 ml saline by 2.1 ml/hour infuser balloon. Drastic decreases in the tumor cell count and in ascite retention were observed after several courses of ascites drainage, intravenous infusion and intraperitoneal immunotherapy. The plasma protein level was maintained during the treatment notwithstanding the repeated drainage of ascites. Cell surface marker analysis, cytotoxic activities against autologous tumor cells and interferon-gamma examination of ascites suggested the possibility that these effects were mediated by immunological responses of activated killer cells and dendritic cells infused intraperitoneally. Conclusion Combination of local administration of immune cells and infusion of concentrated cell free ascites may be applicable for patients afflicted with refractory ascites.

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

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    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.

  19. Antitumor activity and antioxident role of Bauhinia racemosa against Ehrlich ascites carcinoma in Swiss albino mice

    Institute of Scientific and Technical Information of China (English)

    Malaya GUPTA; Upal Kanti MAZUMDER; Ramanathan Sambath KUMAR; Thangavel Siva KUMAR

    2004-01-01

    AIM: To study the antitumor effect and antioxidant role of Bauhinia racemosa. METHODS: Antitumor activity and antioxidant status of methanol extract (50, 100, and 200 mg/kg) of Bauhinia racemosa stem bark was evaluated against Ehrlich ascites carcinoma (EAC) tumor in mice. Acute and short-term toxicity studies were performed initially in order to ascertain the safety of methanol extract of Bauhinia racemosa (MEBR). After 24 h of tumor inoculation, the extract was administered daily for 14 d. After administration of the last dose followed by 18 h fasting, mice were then sacrificed for observation of antitumor activity. The effect of MEBR on the growth of transplantable murine tumor, life span of EAC bearing hosts and simultaneous alterations in the hematological profile and liver biochemical parameters (lipid peroxidation, antioxidant enzymes) were estimated. RESULTS: The MEBR showed decrease in tumor volume, packed cell volume and viable cell count, and increased the nonviable cell count and mean survival time thereby increasing life span of EAC tumor bearing mice. Hematological profile reverted to more or less normal levels in extract treated mice. Treatment with MEBR decreased the levels of lipid peroxidation and increased the levels of glutathione, superoxide dismutase and catalase. CONCLUSION: The methanol extract of Bauhinia racemosa stem bark exhibited antitumor effect by modulating lipid peroxidation and augmenting antioxidant defense system in EAC bearing mice.

  20. Impaired innate immune response of leukocytes from ascitic fluid of patients with spontaneous bacterial peritonitis.

    Science.gov (United States)

    Nieto, Juan Camilo; Sánchez, Elisabet; Romero, Cristina; Román, Eva; Poca, Maria; Guarner, Carlos; Juárez, Cándido; Soriano, Germán; Vidal, Silvia

    2015-11-01

    An ascitic microenvironment can condition the immune response of cells from cirrhotic patients with spontaneous bacterial peritonitis. To characterize this response, we determined the cytokine concentrations in ascitic fluid and analyzed the phenotype and function of ascitic leukocytes at diagnosis and after antibiotic-induced resolution in sterile ascites and ascitic fluid of 2 spontaneous bacterial peritonitis variants: positive and negative bacteriological culture. At diagnosis, a high concentration was found of IL-6 and IL-10 in the ascitic fluid from negative and positive bacteriological culture. The IL-6 concentration correlated with the percentage of neutrophils (R = 0.686, P peritonitis burst was fully recovered. Higher concentrations of IL-6 and IL-10 correlated with the presence of low granular CD 14(low) macrophages (R = -0.436, P = 0.005 and R = 0.414, P = 0.007, respectively). Positive culture spontaneous bacterial peritonitis macrophages expressed the lowest levels of CD16, CD86, CD11b and CD206, and HLA-DR, suggesting an impaired global function. Treatment increased all markers on the positive culture macrophages and CD11b and CD86 on negative culture macrophages. In negative culture spontaneous bacterial peritonitis, this increase was accompanied by phagocytic function recovery. The antibiotics then reverted the marker levels on positive and negative culture macrophages to the levels on sterile ascitis macrophages and restored ascitic negative culture cell function.

  1. 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)

  2. Clinical significance of CT-defined minimal ascites in patients with gastric cancer

    Institute of Scientific and Technical Information of China (English)

    Dong Kyung Chang; Ji Won Kim; Byung Kwan Kim; Kook Lae Lee; Chi Sung Song; Joon Koo Han; In Sung Song

    2005-01-01

    AIM: To study the clinical significance of minimal ascites,which was only defined by the CT and whose nature was not determined preoperatively, in the relationship with the peritoneal carcinomatosis.METHODS: The medical records and the dynamic CT films of 118 patients with gastric cancer were reviewed.Factors associated with peritoneal carcinomatosis were analyzed in 40 patients who had CT-defined ascites of which the nature was surgically confirmed.RESULTS: Only 12.5-25% of the CT-defined minimal ascites, whose volume was estimated to be less than 50 mL, were associated with peritoneal carcinomatosis.When the estimated CT-defined ascitic volume was 50 mL or more, peritoneal carcinomatosis was identified in 75-100%. When CT-defined lymph node enlargements were not found beyond the regional gastric area,perigastricinvasions were not suspected, and the size of tumor was less than 3 cm, peritoneal carcinomatosis seemed significantly less accompanied at the univariate analysis. However, except for the minimal volume of CTdefined ascites in comparison with the mild or more,other factors were not confirmed multivariately.CONCLUSION: In the patients with gastric cancer, CTdefined minimal ascites alone is rarely associated with peritoneal carcinomatosis, if it does not accompany other signs suggestive of malignant seeding. Therefore,consideration of active curative resection should not be hesitated, if CT-defined minimal ascites is the only delusive sign.

  3. Prognostic significance of new onset ascites in patients with pancreatic cancer

    Directory of Open Access Journals (Sweden)

    Luzardo German

    2006-03-01

    Full Text Available Abstract Background The purpose of this study was to determine risk factors for development of malignant ascites and its prognostic significance in patients with pancreatic cancer. Methods A prospective database was queried to identify patients with pancreatic cancer who develop ascites. Stage at presentation, size, and location of primary tumor, treatment received and length of survival after onset of ascites were determined. Results A total of 15 patients were identified. Of which 4 patients (1 stage II, 3 stage III underwent pancreaticoduodenectomy and manifested with ascites 2, 3, 24 and 47 months after surgery (tumor size 2.9 ± 1.32 cm. All but one of the remaining 11 patients (tumor size 4.4 ± 3.38 cm presented with metastatic disease, and all developed malignant ascites 9 months after diagnosis, dying 2 months later. Resected patients lived longer before the onset of ascites, but not after. Conclusion Once diagnosed, ascites in pancreatic cancer patients heralds imminent death. Limited survival should be considered when determining the aggressiveness of further intervention.

  4. 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.

  5. Peritoneal benign cystic mesothelioma in a patient with presentation of ascites, a case report

    Directory of Open Access Journals (Sweden)

    S. Peyvandi

    2007-01-01

    Full Text Available Abstract Cystic mesotheloma is an uncommon lesion of the peritoneum occurring predominantly in women of reproductive age. The case was a 21 years girl presented with 4 years history of mild abdominal distension and periodic pain. The results of the clinical examinations were normal. Sonography and CT scan confirmed gross ascites. The results of paraclinical tests were normal without any positive findings for etiology of ascites. During laparoscopy multiple transparent cysts were found in pelvic and culdesac. All cysts were removed by laparoscopy. Histology confirmed benign cystic mesotheloma. Reviewing the records revealved that this case is the second case of mesothelial cysts that presented with ascites.

  6. 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...... transition, followed by an increased content of both ions in S phase concomitant with water uptake. The effect of substituting extracellular monovalent ions was investigated by bromodeoxyuridine incorporation and showed marked reduction after Na+ and Cl(-) substitution. In spectrofluorometric measurements...... DiBaC4(3) showed a reduced Cl(-) conductance in S compared with G(1) followed by transmembrane potential (E(m)) hyperpolarization in S. Cl(-) substitution by impermeable anions strongly inhibited proliferation and increased free, intracellular Ca2+ ([Ca2+]i), whereas a more permeable anion had little...

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

    Science.gov (United States)

    Spencer, T L; Lehninger, A L

    1976-02-15

    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.

  8. Myelodysplastic changes mimicking MDS following treatment for osteosarcoma

    DEFF Research Database (Denmark)

    Løhmann, Ditte

    Myelodysplastic changes mimicking MDS following treatment for osteosarcoma Ditte Juel Adolfsen Løhmann, Department of Pediatrics, Aarhus University Hospital, Skejby, Denmark Authors: Ditte Juel Adolfsen Løhmann and Henrik Hasle. Therapy-related myelodysplastic syndrome/acute myeloid leukaemia (t-MDS....../AML) is a feared long-term complication of paediatric cancer including osteosarcoma. Few develop t-MDS/AML, but it is not known how many have significant haematological changes after finishing treatment for osteosarcoma. In this study we reviewed biochemistry from a consecutive series of children for up to two...... MDS (refractory anaemia with excess blasts) with monosomy 7 was found and a hematopoietic stem cell transplant was performed. In the other case MDS without excess of blasts was found and a spontaneous normalization of the biochemistry occurred. In conclusion in our study most patients treated...

  9. Leishmaniasis recidiva cutis of the lips mimicking granulomatous cheilitis

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    Özlem Ekiz

    2015-01-01

    Full Text Available Leishmaniasis recidiva cutis (LRC is an unusual form of acute cutaneous leishmaniasis. Herein, we present a case of LRC of the lips mimicking granulomatous cheilitis. An 8-year-old, Syrian child admitted with a swelling and disfigurement of his lips for 4 years. Abundant intra and extracellular Leishmania amastigotes were determined in the smear prepared from the lesion with Giemsa stain. Histopathology showed foamy histiocytes and leishmania parasites within the cytoplasm of macrophages in the epidermis and a dense dermal mixed type inflammatory cell infiltrate composed of lymphocytes, foamy histiocytes with multinucleated giant cells. On the basis of anamnestic data, the skin smears results, clinical and histopathologic findings, LRC was diagnosed. The patient was treated with meglumine antimoniate intramuscularly and fluconazole orally. Cryotherapy was applied to the residual papular lesions. The lesion improved markedly at the first month of the treatment.

  10. Successful management of chylous ascites with total parenteral nutrition, somatostatin, and fibrin glue

    Institute of Scientific and Technical Information of China (English)

    HUANG Qi; GE Bu-jun; LIU Li-ming; TU Zhi-yuan; ZHANG Guo-fen; FAN Yue-zu

    2007-01-01

    @@ Chylous ascites, an uncommon disease usually caused by obstruction or rupture of the peritoneal or retroperitoneal lymphatic glands, is defined as the accumulation of chyle in the peritoneal cavity.

  11. Successful management of chylous ascites with total parenteral nutrition and octreotide in children

    Directory of Open Access Journals (Sweden)

    Chao Yang

    2013-12-01

    Full Text Available Purpose: To evaluate the effects of total parenteral nutrition and octreotide on pediatric patients with chylous ascites post-operative. Methods: Four patients were diagnosed with chylous ascites from nov 2009 to nov 2012. Total parenteral nutrition and octreotide was administered to 2 patients, while the other two only received fasting and total parenteral nutrition. All patients had persistent peritoneal drainage, with the quantity and quality of drainage fluid observed daily. Results: Two patients who received somatostatin therapy completely recovered within 7d without any recurrence while on a normal diet. The other two patients who only received fasting and total parenteral nutrition was cured 24-30d after therapy. Conclusion: Total parenteral nutrition along with octreotide can relieve the symptoms and close the chyle leakage in patients with chylous ascites rapidly. It seems to be an effective therapy available for the treatment of chylous ascites.

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

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    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.

  13. Molecular Profiling and Clinical Outcome of High-Grade Serous Ovarian Cancer Presenting with Low- versus High-Volume Ascites

    Directory of Open Access Journals (Sweden)

    Tomer Feigenberg

    2014-01-01

    Full Text Available Epithelial ovarian cancer consists of multiple histotypes differing in etiology and clinical course. The most prevalent histotype is high-grade serous ovarian cancer (HGSOC, which often presents at an advanced stage frequently accompanied with high-volume ascites. While some studies suggest that ascites is associated with poor clinical outcome, most reports have not differentiated between histological subtypes or tumor grade. We compared genome-wide gene expression profiles from a discovery cohort of ten patients diagnosed with stages III-IV HGSOC with high-volume ascites and nine patients with low-volume ascites. An upregulation of immune response genes was detected in tumors from patients presenting with low-volume ascites relative to those with high-volume ascites. Immunohistochemical studies performed on tissue microarrays confirmed higher expression of proteins encoded by immune response genes and increased tumorinfiltrating cells in tumors associated with low-volume ascites. Comparison of 149 advanced-stage HGSOC cases with differential ascites volume at time of primary surgery indicated low-volume ascites correlated with better surgical outcome and longer overall survival. These findings suggest that advanced stage HGSOC presenting with low-volume ascites reflects a unique subgroup of HGSOC, which is associated with upregulation of immune related genes, more abundant tumor infiltrating cells and better clinical outcomes.

  14. Structural changes of the diaphragmatic peritoneum in patients with schistosomal hepatic fibrosis: its relation to ascites.

    Science.gov (United States)

    Ismail, A H; Mohamed, F S

    1986-06-01

    The histopathologic changes of the peritoneum of the hemidiaphragm were studied in 30 patients with schistosomal liver disease and compared with ten control subjects. The diaphragmatic peritoneum of patients with ascites was markedly thickened with infiltration of inflammatory cells and collagen bundles resembling the interstitial changes of peripheral lymphedema. Obliteration of diaphragmatic lymphatic stomata with restricted lymph flow as well as excess lymph formation from portal hypertension are both major factors in the magnitude and intractability of ascites associated with schistosomal hepatic fibrosis.

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

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    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

  16. Hepatitis, gallbladder hydrops, splenomegaly, and ascites in a child with scarlet fever.

    Science.gov (United States)

    Wang, Li Yueh; Young, Ton-Ho

    2012-11-01

    We report a case of scarlet fever associated with hepatitis, gallbladder hydrops, splenomegaly, and ascites in a 15-year-old girl. The girl presented with fever and skin rash. Leukocyte, liver enzyme, and serum C-reactive protein concentrations were elevated. Ultrasonography revealed marked gallbladder wall thickening, diffuse liver parenchymal disease with moderate splenomegaly, and moderate ascites throughout the abdominal and pelvic cavities. Blood cultures for group A β-hemolytic streptococci were negative. Complete recovery was facilitated with antibiotic treatment.

  17. Chemotherapy with laparoscope-assisted continuous circulatory hyperthermic intraperitoneal perfusion for malignant ascites

    Institute of Scientific and Technical Information of China (English)

    2010-01-01

    AIM:To investigate the procedure, feasibility and effects of laparoscopeassisted continuous circulatory hyperthermic intraperitoneal perfusion chemotherapy (CHIPC) in treatment of malignant ascites induced by peritoneal carcinomatosis from gastric cancers. METHODS: From August 2006 to March 2008, the laparoscopic approach was used to perform CHIPC on 16 patients with malignant ascites induced by gastric cancer or postoperative intraperitoneal seeding. Each patient underwent CHIPC three times after laparosco...

  18. Pellegrini-Stieda syndrome mimicking acute septic arthritis.

    Science.gov (United States)

    Scheib, J S; Quinet, R J

    1989-01-01

    This case illustrates the potential severity of an uncommon and generally benign condition of the knee--the Pellegrini-Stieda syndrome. The regional bone scan clearly showed the etiologic role of the inflamed ligamentous attachment site. Therapy should include joint rest, nonsteroidal anti-inflammatory agents, and possibly ice for symptomatic relief.

  19. Idiopathic Renal Infarction Mimicking Appendicitis

    Science.gov (United States)

    Lisanti, Francesco; Scarano, Enrico

    2017-01-01

    Renal infarction is a rare cause of referral to the emergency department, with very low estimated incidence (0.004%–0.007%). Usually, it manifests in patients aged 60–70 with risk factors for thromboembolism, mostly related to heart disease, atrial fibrillation in particular. We report a case of idiopathic segmental renal infarction in a 38-year-old patient, presenting with acute abdominal pain with no previous known history or risk factors for thromboembolic diseases. Because of its aspecific clinical presentation, this condition can mimic more frequent pathologies including pyelonephritis, nephrolithiasis, or as in our case appendicitis. Here we highlight the extremely ambiguous presentation of renal infarct and the importance for clinicians to be aware of this condition, particularly in patients without clear risk factors, as it usually has a good prognosis after appropriate anticoagulant therapy. PMID:28203466

  20. MANAGEMENT OF SYMPTOMATIC MALIGNANT ASCITES WITH DIURETICS AND PARACENTESIS: CASE REPORTS

    Directory of Open Access Journals (Sweden)

    Amer Hayat Khan

    2012-10-01

    Full Text Available Malignant ascites is a widespread impediment of advanced cancer but to 20% of all cases of malignant ascites have unknown primary tumours. With the exception of ovarian cancer, the response of the ascites to treatment of the tumor is unsatisfactory and treatment related morbidity is common. The intent of most treatments for malignant ascites should be palliative with diuretics paracentesis were the common approach. A 53 years old, male patients who was admitted with history of abdominal distention for past 3 month associated with altered bowel habit and mucus per rectum and significant loss weight. Patients was diagnosed as malignant ascites with multicentric hepatoma with abdominal lymphodenopathy, lung, liver and vertebral body metastasis and left portal vein thrombosis. Patient was managed with temporary external paracentesis (pigtail catheter and oral furosemide 40 mg daily and spironolactone 100 mg daily. Although abdominal paracentesis, diuretics and peritoneovenous shunting are commonly used procedures in management of malignant ascites, there are no randomized controlled trials evaluating the efficacy and safety of these therapies.

  1. Fibrin glue application in the management of refractory chylous ascites in children.

    Science.gov (United States)

    Zeidan, S; Delarue, A; Rome, A; Roquelaure, B

    2008-04-01

    The purpose of this retrospective review of the charts of 6 children who underwent surgical treatment of chylous ascites refractory to conservative measures between 1993 and 2006 was to evaluate the efficiency of fibrin glue application for control of lymph leakage. Five children had postoperative chylous ascites (neuroblastoma, 4; cystic lymphangioma, 1) and 1 had a congenital malformation. Surgical exploration revealed large areas of diffuse lymphatic leakage in all of the patients. Lymphatic fistula was not identified intraoperatively in any patient. Ingestion of lipophilic dye in a concentrated fatty meal was not helpful in locating a lymph fistula. Absorbable mesh was used in association with glue application in the last 3 patients treated. Control of ascites was achieved immediately in 2 patients and within 3 weeks in 2 patients. Repeat surgery was required in the remaining 2 patients. The mean follow-up time was 4.3 years. One patient died of tumor recurrence 12 months after surgical treatment without relapse of the ascites. Two mild late recurrences were observed at 6 and 11 months after surgery and were managed conservatively. The findings of this study show that fibrin glue application on absorbable mesh after dissection of the leakage zones is easy, safe, and effective. We recommend that surgery with glue application be repeated until control of ascites is achieved. We suggest fibrin glue application as a preventive measure against postoperative chylous ascites.

  2. Cancer-derived VEGF plays no role in malignant ascites formation in the mouse

    Institute of Scientific and Technical Information of China (English)

    Bayasi Guleng; Tsuneo Ikenoue; Yasushi Fukushima; Keita Morikane; Makoto Miyagishi; Kazunari Taira; Takao Kawabe; Masao Omata; Keisuke Tateishi; Fumihiko Kanai; Amarsanaa Jazag; Miki Ohta; Yoshinari Asaoka; Hideaki Ijichi; Yasuo Tanaka; Jun Imamura

    2005-01-01

    AIM: Vascular endothelial growth factor (VEGF) is a potent mediator of peritoneal fluid accumulation following tumor progression. This study investigated the role of VEGF secreted by cancerous cells in the formation of malignant ascites.METHODS: VEGF expression was eliminated byknockdown in the pancreas cancer cell-line PancO2 using vector-based short-hairpin type RNA interference (RNAi).Malignant ascites formation in the mouse was analyzed by intraperitoneal injection of PancO2 cells expressing VEGF or with expression knockdown.RESULTS: The VEGF knockdown PancO2 cell was successfully established. Knockdown of VEGF did not affect cancer cell proliferation in vitro or in vivo. The volume of ascites following peritoneal expansion of the tumor in VEGF knockdown cells and control cells did not differ statistically in this in vivo study. Moreover, the VEGF concentration in the ascites did not differ statistically.CONCLUSION: Malignant ascites formation might be mediated by VEGF production in noncancerous tissues,such as stromal compartments. An anti-VEGF strategy against malignant ascites could be applied to various tumors regardless of whether they secrete VEGF.

  3. A strategy to eradicate well-developed Krebs-2 ascites in mice.

    Science.gov (United States)

    Potter, Ekaterina A; Dolgova, Evgenia V; Proskurina, Anastasia S; Minkevich, Alexandra M; Efremov, Yaroslav R; Taranov, Oleg S; Omigov, Vladimir V; Nikolin, Valeriy P; Popova, Nelly A; Bayborodin, Sergey I; Ostanin, Alexander A; Chernykh, Elena R; Kolchanov, Nikolay A; Shurdov, Mikhail A; Bogachev, Sergey S

    2016-03-01

    We describe the strategy, which allows curing experimental mice engrafted with Krebs-2 ascites. The strategy is based on the facts that i) Krebs-2 tumor-initiating stem cells (TISCs) are naturally capable of internalizing fragments of extracellular double-stranded DNA (dsDNA); ii) upon delivery into TISCs, these dsDNA fragments interfere with the on-going DNA repair process so that TISCs either die or lose their tumorigenic potential. The following 3-step regimen of therapeutic procedures leading to eradication of Krebs-2 ascites is considered. Firstly, three timed injections of cyclophosphamide (CP) exactly matching the interstrand cross-link (ICL) repair phases that lead to synchronization of ascites cells in late S/G2/M. Secondly, additional treatment of ascites 18 hours post each CP injection (at NER/HR transition timepoint) with a composite dsDNA-based preparation interfering with the NER and HR repair pathways, so that tumorigenic properties of ascites cells are compromised. Thirdly, final treatment of mice with a combination of CP and dsDNA injections as ascites cells undergo apoptotic destruction, and the surviving TAMRA+ TISCs arrested in late S/G2/M phases massively enter into G1/S, when they regain sensitivity to CP+dsDNA treatment. Thus, this regimen assures that no viable cells, particularly Krebs-2 TISCs, remain.

  4. Hepatic Mucormycosis Mimicking Veno-occlusive Disease: Report of a Case and Review of the Literature.

    Science.gov (United States)

    Yang, Chen; Friess, Stuart H; Dehner, Louis P

    2016-01-01

    The clinical history of a 12-year-old boy with trisomy 21 who suffered from relapsed pre-B cell acute lymphocytic leukemia with clinical symptoms of hepatic veno-occlusive disease and death is reported. The postmortem findings were significant for hepatic mucormycosis with selective involvement of the central veins, sinusoids, and portal tracts resulting in obstruction of the outflow tract and massive hepatocellular necrosis. Hematogenous dissemination of mucormycosis causing acute splenitis and hemorrhagic intestinal necrosis were also observed. To our knowledge, mucormycosis invasion of the central veins, sinusoids, and portal tracts by fungal hyphae resulting in a syndrome mimicking hepatic veno-occlusive disease has not been previously reported.

  5. Long-term albumin infusion improves survival in patients with cirrhosis and ascites: An unblinded randomized trial

    Institute of Scientific and Technical Information of China (English)

    Roberto Giulio Romanelli; Paolo Gentilini; Giacomo Laffi; Giorgio La Villa; Giuseppe Barletta; Francesco Vizzutti; Fabio Lanini; Umberto Arena; Vieri Boddi; Roberto Tarquini; Pietro Pantaleo

    2006-01-01

    AIM: To investigate the effects of long-term albumin administration on survival, recurrence of ascites and onset of other complications.METHODS: One hundred consecutive patients admitted for first-onset ascites were randomized to receive diuretics plus human albumin 25 g/wk in the first year and 25g every two wk thereafter (group 1) or diuretics alone (group 2). The primary endpoint was survival without liver transplantation. Secondary endpoints were recurrence of ascites and occurrence of other complications.RESULTS: Median follow-up was 84 (2-120) mo. Albumin-treated patients had significantly greater cumulative survival rate (Breslow test= 7.05, P= 0.0078) and lower probability of ascites recurrence (51% versus 94%,P<0.0001). Chronic albumin infusion resulted in a mean increase in survival of 16 mo.CONCLUSION: Long-term albumin administration after first-onset ascites significantly improves patients' survival and decreases the risk of ascites recurrence.

  6. Ovarian Heterotopic Pregnancy Clinically Mimicking Endometrioma

    Directory of Open Access Journals (Sweden)

    Nilüfer ONAK KANDEMİR

    2010-01-01

    Full Text Available Heterotopic pregnancy is a very uncommon entity with a difficult preoperative diagnosis. In the present study, we presented an ovarian heterotopic pregnancy case, clinically mimicking endometrioma developed in a 33-year-old female following an in vitro fertilization procedure. The importance of clinical, histopathological, and immunohistochemical examinations in the diagnosis of heterotopic pregnancy are emphasized.

  7. Toward restrictions on boson stars as black hole mimickers

    Energy Technology Data Exchange (ETDEWEB)

    Guzman, F S, E-mail: guzman@ifm.umich.mx [Instituto de Fisica y Matematicas, Universidad Michoacana de San Nicolas de Hidalgo, Edificio C3, Cd. Universitaria, 58040 Morelia, Michoacan (Mexico)

    2011-09-22

    The status of boson stars as black hole mimickers is presented among other mimickers. We focus on the analysis of the emission spectrum of a simple accretion disk model. We describe the free parameters that allow a boson star to become a black hole mimicker and present an example of a particular astrophysical case.

  8. Antitumor and radiosensitizing effects of withaferin A on mouse Ehrlich ascites carcinoma in vivo

    Energy Technology Data Exchange (ETDEWEB)

    Sharada, A.C. [Dept. of Radiobiology, Kasturba Medical Coll., Manipal (India); Solomon, F.E. [Dept. of Radiobiology, Kasturba Medical Coll., Manipal (India); Uma Devi, P. [Dept. of Radiobiology, Kasturba Medical Coll., Manipal (India); Udupa, N. [Coll. of Pharmaceutical Sciences, Manipal (India); Srinivasan, K.K. [Coll. of Pharmaceutical Sciences, Manipal (India)

    1996-06-01

    The antitumor and radiosensitizing effects of withaferin A (WA), a steroidal lactone from Withania somnifera, was studied on Ehrlich ascites carcinoma in vivo. The acute LD{sub 50(14)} for WA in Swiss mice was {proportional_to}80 mg/kg. Twenty-four hours after i.p. inoculation of 10{sup 6} tumor cells, WA was injected i.p. at different dose fractions (5 or 7.5 mg/kg x 8, 10 mg/kg x 5, 20 or 30 mg/kg x 2) with or without abdominal gamma irradiation (RT, 7.5 Gy) after the first drug dose. Increase in life span and tumor-free survival were studied up to 120 days. The drug inhibited tumor growth and increased survival, which was dependent on the WA dose per fraction rather than the total dose. Combination of RT with all the drug schedules increased tumor cure and tumor-free survival, the best effect seen after 2 fractions of 30 mg/kg each. In another experiment WA was given as 2 (40 mg/kg x 2), 3 (30 mg/kg x 3) or 4 (20 mg/kg x 4) fractions at 5, 7 or 10 days after tumor inoculation with or without RT after the first drug dose. At 7 and 10 days after inoculation the drug was effective only at 40 mg/kg x 2, but with RT 30 mg/kg x 3 produced an equal effect (20% survival) on 7 day old tumors. (orig.).

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

    Science.gov (United States)

    Landry, Y; Lehninger, A L

    1976-08-15

    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.

  10. In vitro cytotoxic studies of red algae Portieria hornemannii and Spyridia fusiformis against Dalton’s lymphoma ascite and Ehrlich ascite carcinoma cell lines

    Directory of Open Access Journals (Sweden)

    Murugesan Subbiah

    2016-11-01

    Full Text Available Objective: To study the in vitro cytotoxic activities of methanol extract of Portieria hornemannii (P. hornemannii and Spyridia fusiformis (S. fusiformis using Dalton’s lymphoma ascite and Ehrlich ascite carcinoma cell lines. Methods: The effect of cytotoxicity of P. hornemannii and S. fusiformis was evaluated with the concentrations (100 to 200 μg/mL and assessed for the antitumour activity vs. the selected cell lines using Trypan blue assay. Results: The methanol extracts of P. hornemannii and S. fusiformis showed potent cytotoxic activity with IC50 values of (209.00 ± 0.05 µg/mL and (190.00 ± 0.05 µg/mL against the Dalton’s lymphoma ascite cell line and IC50 values of (190.00 ± 0.05 µg/mL and (182.00 ± 0.05 µg/mL against the Ehrlich ascite carcinoma cell line respectively. In vitro cytotoxicity against the tested cancer cell lines showed strong activity by the abnormal activities of algal residue in the normal cells. Conclusions: The methanol solvent residue of red algae (P. hornemannii and S. fusiformis could be a good candidate. It would be a novel marine resource as a antitumor medicine demonstrated by cytotoxic studies that the above marine algae can be a potential candidate sources as antitumor drugs

  11. In vitro cytotoxic studies of red algaePortieria hornemannii andSpyridia fusiformis against Dalton’s lymphoma ascite and Ehrlich ascite carcinoma cell lines

    Institute of Scientific and Technical Information of China (English)

    Murugesan Subbiah; Bhuvaneswari Sundaresan; Thamizh Selvam Natarajan; Sivamurugan Vajiravelu

    2016-01-01

    ABSTRACT Objective:To study thein vitro cytotoxic activities of methanol extract ofPortieria hornemannii(P. hornemannii)andSpyridia fusiformis (S. fusiformis) usingDalton’s lymphoma ascite and Ehrlich ascite carcinoma cell lines. Methods:The effect of cytotoxicity ofP. hornemannii andS. fusiformis was evaluated with the concentrations (100 to 200μg/mL) and assessed for the antitumour activityvs. the selected cell lines using Trypan blue assay. Results:The methanol extracts ofP. hornemannii andS. fusiformisshowed potent cytotoxic activity with IC50values of (209.00 ± 0.05)µg/mL and (190.00 ± 0.05)µg/mL against the Dalton’s lymphoma ascite cell line and IC50 values of (190.00 ± 0.05)µg/mL and (182.00 ± 0.05)µg/mL against the Ehrlich ascite carcinoma cell line respectively.In vitro cytotoxicity against the tested cancer cell lines showed strong activity by the abnormal activities of algal residue in the normal cells. Conclusions:The methanol solvent residue of red algae (P. hornemannii andS. fusiformis) could be a good candidate. It would be a novel marine resource as a antitumor medicine demonstrated by cytotoxic studies that the above marine algae can be a potential candidate sources as antitumor drugs.

  12. Scrub typhus presenting as an acute abdomen

    Directory of Open Access Journals (Sweden)

    PP Abhilash Kundavaram

    2014-01-01

    Full Text Available Scrub typhus is a mite-borne infectious disease caused by Orientia tsutsugamushi, which presents as an acute febrile illness with headache, myalgia, breathlessness, and an eschar, a pathognomonic sign, in a varying proportion of patients. However, this illness can present unusually with fever and severe abdominal pain mimicking acute abdomen. A careful search for an eschar in all patients with an acute febrile illness would provide a valuable diagnostic clue and avoid unnecessary investigations and surgical exploration.

  13. Scrub typhus presenting as an acute abdomen

    OpenAIRE

    PP Abhilash Kundavaram; Sohini Das; M Varghese George

    2014-01-01

    Scrub typhus is a mite-borne infectious disease caused by Orientia tsutsugamushi, which presents as an acute febrile illness with headache, myalgia, breathlessness, and an eschar, a pathognomonic sign, in a varying proportion of patients. However, this illness can present unusually with fever and severe abdominal pain mimicking acute abdomen. A careful search for an eschar in all patients with an acute febrile illness would provide a valuable diagnostic clue and avoid unnecessary investigatio...

  14. Scrub typhus presenting as an acute abdomen.

    Science.gov (United States)

    Kundavaram, Abhilash Pp; Das, Sohini; George, Varghese M

    2014-01-01

    Scrub typhus is a mite-borne infectious disease caused by Orientia tsutsugamushi, which presents as an acute febrile illness with headache, myalgia, breathlessness, and an eschar, a pathognomonic sign, in a varying proportion of patients. However, this illness can present unusually with fever and severe abdominal pain mimicking acute abdomen. A careful search for an eschar in all patients with an acute febrile illness would provide a valuable diagnostic clue and avoid unnecessary investigations and surgical exploration.

  15. Predictive value of FibroScan on liver ascites cause by cirrhosis

    Directory of Open Access Journals (Sweden)

    Ping HAN

    2011-11-01

    Full Text Available Objective To investigate the predictive value of FibroScan for liver ascites caused by cirrhosis.Methods A total of 651 patients with liver cirrhosis were subjected to FibroScan examination in People’s Liberation Army 302 Hospital from December 2009 to June 2010 and were enrolled in the present study.Among the patients,185 suffered from liver cirrhosis with ascites(all patients initially had ascites and 466 did not suffer from ascites.After obtaining the FibroScan value,the difference in liver cirrhosis caused by chronic hepatitis B and liver cirrhosis caused by chronic hepatitis C and other liver cirrhosis were analyzed.A Receive Operating Characteristic(ROC curve was drawn and the area under the curve(AUROC was analyzed to determine the cutoff value,sensitivity,specificity,positive predictive value,and negative predictive value of the FibroScan for predicting ascites.Results The FibroScan value of patients with liver cirrhosis caused by chronic hepatitis C [27.0(20.6-44.3kPa] was obviously higher than that of patients with liver cirrhosis caused by chronic hepatitis B [23.6(13.7-37.7kPa,P < 0.01].Moreover,the average FibroScan value of the other liver cirrhosis patients was 23.8(13.7-50.1kPa,which isn′t different from the FibroScan value of liver cirrhosis patients with chronic hepatitis C or B.The FibroScan median of the liver cirrhosis patients with ascites [45.0(33.1-69.1 kPa] was significantly higher than that of the liver cirrhosis patients without ascites [19.1(12.1-26.3 kPa,P < 0.01].The AUROC value of the FibroScan for predicting ascites was 0.895(95% CI: 0.869-0.918,the cutoff value of the diagnosis was 27.7 kPa,sensitivity was 88.2%,specificity was 81.5%,the positive predictive rate was 66.5%,and the negative predictive rate was 94.3%.Conclusion FibroScan can effectively predict the likelihood of ascites formation in patients with cirrhosis and has value for clinical application.

  16. Specific chalone inhibition of the regeneration of the JB-1 ascites tumour studied by flow microfluorometry.

    Science.gov (United States)

    Bichel, P; Barfod, N M

    1977-03-01

    The variation in the DNA distribution in the JB-1 and the Lla2 ascites tumour was investigated by means of flow microfluorometry (FMF) in the plateau stage and during the initiation of the regenerative growth induced by percutaneous aspiration. The study showed that a considerable influx of cells with G1DNA content into the S phase occurred in both tumours about 10 hr after aspiration. In the JB-1 tumour, these initial regenerative changes could be reversibly blocked by injections of cell-free plateau JB-1 ascitic fluid or an ultrafiltrate of this ascites. In contrast to these observations no delay in the regenerative changes was observed in the L1a2 tumour after treatment with JB-1 ascites or the ultrafiltrate. The study supports the assumption of a specific growth regulation of the JB-1 ascites tumour and emphasizes the suitability of FMF analyses in cell-kinetic studies in which short-term fluctuations take place in the distribution of cells with different DNA content.

  17. Lenalidomide and Dexamethasone for a Patient of POEMS Syndrome Presenting with Massive Ascites.

    Science.gov (United States)

    Ueda, Shuji; Yonemoto, Sayoko; Oka, Kazumasa; Fujii, Naohiko; Nakata, Keiichi; Matsunaga, Hitomi; Kataoka, Seiko; Iwama, Yuki; Narahara, Hiroyuki; Yasunaga, Yuichi; Inui, Yoshiaki; Kawata, Sumio

    2014-01-01

    POEMS syndrome is a multisystem disorder characterized by polyneuropathy, organomegaly, endocrinopathy, monoclonal gammopathy, and skin changes. POEMS syndrome is a rare cause of refractory ascites. We report the case of a patient with POEMS syndrome presenting with massive ascites who was treated with very-low-dose lenalidomide and dexamethasone. A 57-year-old Japanese man was admitted to our hospital with pleural effusion, massive ascites, and leg edema. The diagnosis of POEMS syndrome was made based on the combination of the following findings: peripheral neuropathy, organomegaly, endocrinopathy, serum monoclonal protein elevation, skin changes, plasma VEGF elevation, and evidence of extravascular volume overload. Renal dysfunction induced by biopsy-proven renal involvement of POEMS syndrome was observed. Massive ascites of the patient dramatically diminished with long-time treatment of very-low-dose lenalidomide and dexamethasone. Lenalidomide seems to be a very promising therapy for POEMS syndrome presenting with extravascular volume overload such as edema, pleural effusion, and ascites. Very-low-dose lenalidomide might be effective especially for the patients with POEMS-related nephropathy.

  18. Lenalidomide and Dexamethasone for a Patient of POEMS Syndrome Presenting with Massive Ascites

    Directory of Open Access Journals (Sweden)

    Shuji Ueda

    2014-01-01

    Full Text Available POEMS syndrome is a multisystem disorder characterized by polyneuropathy, organomegaly, endocrinopathy, monoclonal gammopathy, and skin changes. POEMS syndrome is a rare cause of refractory ascites. We report the case of a patient with POEMS syndrome presenting with massive ascites who was treated with very-low-dose lenalidomide and dexamethasone. A 57-year-old Japanese man was admitted to our hospital with pleural effusion, massive ascites, and leg edema. The diagnosis of POEMS syndrome was made based on the combination of the following findings: peripheral neuropathy, organomegaly, endocrinopathy, serum monoclonal protein elevation, skin changes, plasma VEGF elevation, and evidence of extravascular volume overload. Renal dysfunction induced by biopsy-proven renal involvement of POEMS syndrome was observed. Massive ascites of the patient dramatically diminished with long-time treatment of very-low-dose lenalidomide and dexamethasone. Lenalidomide seems to be a very promising therapy for POEMS syndrome presenting with extravascular volume overload such as edema, pleural effusion, and ascites. Very-low-dose lenalidomide might be effective especially for the patients with POEMS-related nephropathy.

  19. Ascites bacterial burden and immune cell profile are associated with poor clinical outcomes in the absence of overt infection.

    Directory of Open Access Journals (Sweden)

    Kevin J Fagan

    Full Text Available Bacterial infections, most commonly spontaneous bacterial peritonitis in patients with ascites, occur in one third of admitted patients with cirrhosis, and account for a 4-fold increase in mortality. Bacteria are isolated from less than 40% of ascites infections by culture, necessitating empirical antibiotic treatment, but culture-independent studies suggest bacteria are commonly present, even in the absence of overt infection. Widespread detection of low levels of bacteria in ascites, in the absence of peritonitis, suggests immune impairment may contribute to higher susceptibility to infection in cirrhotic patients. However, little is known about the role of ascites leukocyte composition and function in this context. We determined ascites bacterial composition by quantitative PCR and 16S rRNA gene sequencing in 25 patients with culture-negative, non-neutrocytic ascites, and compared microbiological data with ascites and peripheral blood leukocyte composition and phenotype. Bacterial DNA was detected in ascitic fluid from 23 of 25 patients, with significant positive correlations between bacterial DNA levels and poor 6-month clinical outcomes (death, readmission. Ascites leukocyte composition was variable, but dominated by macrophages or T lymphocytes, with lower numbers of B lymphocytes and natural killer cells. Consistent with the hypothesis that impaired innate immunity contributes to susceptibility to infection, high bacterial DNA burden was associated with reduced major histocompatibility complex class II expression on ascites (but not peripheral blood monocytes/macrophages. These data indicate an association between the presence of ascites bacterial DNA and early death and readmission in patients with decompensated cirrhosis. They further suggest that impairment of innate immunity contributes to increased bacterial translocation, risk of peritonitis, or both.

  20. Spherical Boson Stars as Black Hole mimickers

    CERN Document Server

    Guzman, F S; 10.1103/PhysRevD.80.084023

    2010-01-01

    We present spherically symmetric boson stars as black hole mimickers based on the power spectrum of a simple accretion disk model. The free parameters of the boson star are the mass of the boson and the fourth order self-interaction coefficient in the scalar field potential. We show that even if the mass of the boson is the only free parameter it is possible to find a configuration that mimics the power spectrum of the disk due to a black hole of the same mass. We also show that for each value of the self-interaction a single boson star configuration can mimic a black hole at very different astrophysical scales in terms of the mass of the object and the accretion rate. In order to show that it is possible to distinguish one of our mimickers from a black hole we also study the deflection of light.

  1. Cardiac sarcoidosis mimicking right ventricular dysplasia.

    Science.gov (United States)

    Shiraishi, Jun; Tatsumi, Tetsuya; Shimoo, Kazutoshi; Katsume, Asako; Mani, Hiroki; Kobara, Miyuki; Shirayama, Takeshi; Azuma, Akihiro; Nakagawa, Masao

    2003-02-01

    A 59-year-old woman with skin sarcoidosis was admitted to hospital for assessment of complete atrioventricular block. Cross-sectional echocardiography showed that the apical free wall of the right ventricle was thin and dyskinetic with dilation of the right ventricle. Thallium-201 myocardial imaging revealed a normal distribution. Both gallium-67 and technetium-99m pyrophosphate scintigraphy revealed no abnormal uptake in the myocardium. Right ventriculography showed chamber dilation and dyskinesis of the apical free wall, whereas left ventriculography showed normokinesis, mimicking right ventricular dysplasia. Cardiac sarcoidosis was diagnosed on examination of an endomyocardial biopsy specimen from the right ventricle. A permanent pacemaker was implanted to manage the complete atrioventricular block. After steroid treatment, electrocardiography showed first-degree atrioventricular block and echocardiography revealed an improvement in the right ventricular chamber dilation. Reports of cardiac sarcoidosis mimicking right ventricular dysplasia are extremely rare and as this case shows, right ventricular involvement may be one of its manifestations.

  2. Brown tumor mimicking maxillary sinus mucocele as the first manifestation of primary hyperparathyroidism

    DEFF Research Database (Denmark)

    Guldfred, Liviu-Adelin; Daugaard, Søren; von Buchwald, Christian

    2012-01-01

    We describe the first case of brown tumor mimicking a maxillary sinus mucocele as the first manifestation of the patient's primary hyperparathyroidism. A 34-year old woman presented with a 14 days history of elevation of the right orbit, retrobulbar pain and cheek anesthesia. The CT and MR...... evaluation showed a mass, initially described as mucocele of the right maxillary sinus. The laboratory studies revealed hyperparathyroidism. The patient underwent acute surgery, and the mass appeared clinically as mucocele. The histological examination of the resected lesion revealed changes representing...... either giant cell granuloma or brown tumor. The finding of hyperparathyroidism confirmed the diagnosis of brown tumor. To our knowledge, this is the first report of cystic brown tumor mimicking a mucocele of the maxillary sinus....

  3. [Morgagni hernia mimicking intrathoracic lipomatous tumor].

    Science.gov (United States)

    Pinto, Carlos Silva; Bernardo, João; Eugénio, Luís; Antunes, Manuel J

    2013-01-01

    Morgagni hernia is the rarest type of diaphragmatic hernia, accounting for 2% of all cases. It consists in the thoracic protrusion of fat and/or abdominal viscera through a congenital defect in a retro or parasternal position. The clinical importance of this pathological entity is associated with the fact that it can be asymptomatic, mimicking other diseases, such as a large intrathoracic lipoma, as it happened in the case presented here. Incorrect diagnosis can cause catastrophic complications during surgery.

  4. Intra-abdominal gout mimicking pelvic abscess

    Energy Technology Data Exchange (ETDEWEB)

    Chen, Chia-Hui; Chen, Clement Kuen-Huang [Kaohsiung Veterans General Hospital, Department of Radiology, Kaohsiung (Taiwan); National Yang-Ming University, School of Medicine, Taipei (Taiwan); Yeh, Lee-Ren; Pan, Huay-Ban; Yang, Chien-Fang [Kaohsiung Veterans General Hospital, Department of Radiology, Kaohsiung (Taiwan)

    2005-04-01

    Gout is the most common crystal-induced arthritis. Gouty tophi typically deposit in the extremities, especially toes and fingers. We present an unusual case of intrapelvic tophaceous gout in a patient suffering from chronic gouty arthritis. CT and MRI of the abdomen and pelvic cavity disclosed calcified gouty tophi around both hips, and a cystic lesion with peripheral enhancement in the pelvic cavity along the course of the iliopsoas muscle. The intra-abdominal tophus mimicked pelvic abscess. (orig.)

  5. Benzalkonium Chloride Intoxication Mimicking Herpes Zoster Encephalitis

    OpenAIRE

    Güler, Ekrem; Olgar, Şeref; Davutoğlu, Mehmet; Garipardıç, Mesut; Karabiber, Hamza

    2011-01-01

    Benzalkonium chloride (BAC) is a frequently used disinfectant and its most well-known side effect is contact dermatitis. In this report, two children who had vesicular dermatitis, headache, lethargy, fever and encephalopathy mimicking Herpes zoster encephalitis were presented. Their consciousness level improved on the second day. From the medical history it was understood that the mother had applied 20% BAC solution to the scalps of two children. The aim of the presentation of this report is ...

  6. Benzalkonium Chloride Intoxication Mimicking Herpes Zoster Encephalitis

    OpenAIRE

    Ekrem Güler; Şeref Olgar; Mehmet Davutoğlu; Mesut Garipardıç; Hamza Karabiber

    2014-01-01

    Benzalkonium chloride (BAC) is a frequently used disinfectant and its most well-known side effect is contact dermatitis. In this report, two children who had vesicular dermatitis, headache, lethargy, fever and encephalopathy mimicking Herpes zoster encephalitis were presented. Their consciousness level improved on the second day. From the medical history it was understood that the mother had applied 20% BAC solution to the scalps of two children. The aim of the presentation of this report is...

  7. Intradural extramedullary tuberculoma mimicking en plaque meningioma

    Directory of Open Access Journals (Sweden)

    Ozek Erdinc

    2009-01-01

    Full Text Available In this paper we report an 18 year old woman with an intradural extramedullary tuberculoma mimicking en plaque meningioma located in the thoracic region. The patient was operated via thoracic laminoplasty and tumor was totally resected. On the follow-up examination the magnetic resonance imaging demonstrated the total excision of the tumor. Here we describe a case of intradural extramedullary tuberculoma of the spinal cord as a complication of tuberculosis meningitis in a previously healthy young female.

  8. Methomyl-Induced Severe Acute Pancreatitis: Possible Etiological Association

    Directory of Open Access Journals (Sweden)

    Ioannides M

    2005-03-01

    Full Text Available CONTEXT: N-methyl carbamate insecticides are widely used in homes, gardens and agriculture. They share the capacity to inhibit cholinesterase enzymes with organophosphates and therefore share similar symptomatology during acute and chronic exposures. One of the serious effects of organophosphate and carbamate intoxication is the development of acute pancreatitis and subsequent intrapancreatic fluid formation. CASE REPORT: An 18-year old Caucasian man was admitted to our Intensive Care Unit with cholinergic crisis symptomatology, after the ingestion of an unknown amount of a carbamate insecticide (methomyl. Pseudocholinesterase levels were 2 kU/L on the day of admission (reference range: 5.4-13.2 kU/L. Two days after admission, an abdominal CT scan revealed blurring of the peripancreatic fat planes, inflammation and swelling of the pancreas, and a substantial amount of ascitic fluid in the left anterior pararenal space and pelvis. Paracentesis and analysis of the ascitic fluid demonstrated findings diagnostic of pancreatic ascites. There had been no other evident predisposing factors for acute pancreatitis, other than methomyl intoxication. Eleven days after admission, pseudocholinesterase levels returned to normal, while a new abdominal CT scan revealed the formation of intrapancreatic fluid collection. The patient was discharged in good physical condition two weeks after admission. A follow up abdominal CT scan performed one month later showed a significant reduction in the size of the intrapancreatic fluid. DISCUSSION: Acute pancreatitis is not uncommon after organophosphate intoxication and carbamates share the same risk as organophosphorus pesticides. The development of acute pancreatitis and subsequent intrapancreatic fluid collection after methomyl intoxication has not previously been reported. This is the first case reported of acute pancreatitis and pancreatic ascite formation after anticholinesterase insecticide ingestion.

  9. 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.

  10. 43. Inhibition effect of Solanum nigrum. L juice on S180 ascites cancer cells

    Institute of Scientific and Technical Information of China (English)

    2001-01-01

    To study the action and application of Solanum nigrum.L Juice (abbreviate: S.J) on inhibiting tumors of S180 ascites cancer. Methods: Build mice tumor model through injecting S180 ascites cancer into mice's right armbet .48 male mice from KunMing of four to six weeks were randomly divided into 4 groups: Solanum Nigrum L Juice—high dosage (3mg/ml), middle dosage (1.5mg/ml), low dosage (0.75mg/ml); control group. After taking medicine for 15 days, kill the mice and measure the weight of tumor、spleen and thymus. Result: ①Tumor weights in middle and high dosage group are lighter than control group(P<0.05). ②Spleen index of test groups are different from control group(P<0.05). Conclusion: Solanum. nigrum.L Juice has inhibitory roles to S180 ascites cells.

  11. A flow cytometric in vivo chalone assay using retransplanted old murine JB-1 ascites tumour cells.

    Science.gov (United States)

    Barfod, N M

    1981-07-01

    A flow cytometric in vivo chalone assay is described. Transplantation of old JB-1 ascites tumour cells to new hosts induced an influx of tumour cells, with G1 DNA content, to the S phase. This induction could be reversibly and specifically blocked by injections of an ultrafiltrate of old JB-1 ascites fluid. The method described is superior to a previously published in vivo chalone assay using regenerating ascites tumours. Owing to a reduced variability in time of onset of DNA synthesis, a smaller scatter of observations is achieved and thus the number of mice per group may be reduced using the new method. In contrast to the older technique, the present one does not necessitate killing of mice during the observation period.

  12. 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.

  13. Acute myelogenous leukemia and acute leukemic appendicitis: A case report

    Institute of Scientific and Technical Information of China (English)

    Po-Jen Hsiao; Shih-Ming Kuo; Jia-Hong Chen; Hsuen-Fu Lin; Pau-Ling Chu; Shih-Hua Lin; Ching-Liang Ho

    2009-01-01

    Acute myelogenous leukemia (AML) can involve the gastrointestinal tract but rarely involves the appendix.We report a male patient who had 1 year partial remission from AML and who presented with apparent acute appendicitis as the initial manifestation of leukemia relapse. Pathological findings of the appendix revealed transmural infiltrates of myeloblasts, whichindicated a diagnosis of leukemia. Unfortunately, the patient died from progression of the disease on the 19th d after admission. Although leukemic cell infiltration of the appendix is uncommon, patients with leukemia relapse can present with symptoms mimicking acute appendicitis.

  14. Refractory ascites in systemic lupus erythematosus: further biological support of intraperitoneal steroid treatment as a suitable therapeutical option.

    Science.gov (United States)

    Atisha-Fregoso, Yemil; Hernández-Ramírez, Diego F; Olivares-Martínez, Elizabeth; Núñez-Alvarez, Carlos A; Llorente, Luis; Hernández-Molina, Gabriela

    2017-03-01

    The objective of this report was to evaluate the ascitic fluid of a patient with refractory lupus ascites (proband) at different time points-pre- and post-intraperitoneal treatment with dexamethasone-using a multiparametric approach which included the presence of autoantibodies and pro- and anti-inflammatory cytokines and chemokines, and a proteomic analysis. As controls, we studied two additional patients also with lupus ascites (only at basal evaluation) and two patients with ascites due to alcoholic liver cirrhosis. High levels of anti-dsDNA and anti-nucleosomes autoantibodies were detected in the ascitic fluid of all lupus patients and remained elevated in the proband throughout the follow-up. All lupus patients have detectable ascitic high levels of IL-6, IL-8, IL-10, TNF-α, MCP-1, and IGF-1 which diminished gradually in the proband after intraperitoneal dexamethasone. In the proteomic analysis of the ascitic fluid, a marked increment of apolipoprotein A1 was observed and again, it diminished gradually after intraperitoneal treatment. Our findings further support the use of intraperitoneal steroids as an effective therapeutic option for refractory ascites in systemic lupus erythematosus.

  15. 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

    , but detectable increment in the overall lymph drainage was only found in a patient with a very low pre-shunt value. The findings do not support the 'overflow' theory of ascites formation but rather the 'lymph imbalance' theory. For clinical evaluation of peritoneovenous shunting in the treatment of ascites...

  16. 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

  17. Ascitic and solid Ehrlich tumor inhibition by Chenopodium ambrosioides L. treatment.

    Science.gov (United States)

    Nascimento, Flávia R F; Cruz, Gustavo V B; Pereira, Paulo Vitor S; Maciel, Márcia C G; Silva, Lucilene A; Azevedo, Ana Paula S; Barroqueiro, Elizabeth S B; Guerra, Rosane N M

    2006-04-25

    The leaves of Chenopodium ambrosioides L. [Chenopodiaceae] ('mastruz') have been indicated for the treatment of several diseases, among which the cancer. There are no results focusing the effect of C. ambrosioides treatment on tumor development in vivo. The aim of this study was to investigate the effect of treatment with C. ambrosioides on Ehrlich tumor development. Swiss mice were treated by intraperitoneal route (i.p.) with hydroalcoholic extract from leaves of C. ambrosioides (5 mg/kg) or with PBS (control group) 48 h before or 48 h later the Ehrlich tumor implantation. The tumor cells were implanted on the left footpad (solid tumor) or in the peritoneal cavity (ascitic tumor). To determine the solid tumor growth, footpad was measured each 2 days until the fourteenth day, when the feet were weighed. Ascitic tumor development was evaluated after 8 days of tumor implantation by quantification of the ascitic fluid volume and tumor cell number. The i.p. administration of C. ambrosioides extract before or after the tumor implantation significantly inhibited the solid and ascitic Ehrlich tumor forms. This inhibition was observed in ascitic tumor cell number, in the ascitic volume, in the tumor-bearing foot size and foot weight when compared to control mice. The treatments also increased the survival of tumor-bearing mice. In conclusion, C. ambrosioides has a potent anti-tumoral effect which was evident with a small dose and even when the treatment was given two days after the tumor implantation. This effect is probably related with anti-oxidant properties of C. ambrosioides.

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

    Directory of Open Access Journals (Sweden)

    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.

  19. 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...

  20. 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.

  1. Antineoplasic effect of aqueous extract of plectranthus amboinicus in ehrlich ascites carcinoma.

    Science.gov (United States)

    Brandao, Eduardo M; Brandão, Paulo H D M; Souza, Ivone A; Paiva, Gerson S; de C Carvalho, Marcos; Lacerda, Claudio M

    2013-01-01

    There are 46,000 new cases of peritoneal carcinomatosis per year in the USA and 17,700 in Brazil. New media, including plant derivatives, are being tested in its treatment. Plectranthus amboinicus is a medicinal plant widely used in Brazil, especially in the northeast region, for the treatment of various diseases, including cancer. This present study evaluates the intraperitoneal use of aqueous extracts of Plectranthus amboinicus (AEPa) at a dose of 200 mg / kg for the treatment of the ascitic form of Ehrlich carcinoma. It is concluded also the AEPa produced antineoplastic effect in ascitic form of Ehrlich carcinoma.

  2. Ovarian fibroma with marked ascites and elevated serum levels of CA-125 in a young girl.

    Science.gov (United States)

    Sugiyama, Akihide; Urushihara, Naoto; Fukumoto, Koji; Fukuzawa, Hiroaki; Nagae, Hideki; Watanabe, Kentaro; Mitsunaga, Maki; Hasegawa, Shiro; Koyama, Masashi

    2011-05-01

    We report a case of ovarian fibroma with marked ascites and elevated serum CA-125 levels in a young girl. Ovarian fibromas are rare in children. They usually present as a solid mass and may be associated with ascites and elevated serum CA-125 levels. Because of their solid nature and these associations, they can be mistaken for a malignant tumor, resulting in unnecessary oophorectomy. Ovarian fibromas are benign neoplasms, and the prognosis is extremely good. Surgical management should be an ovarian-sparing tumor excision. Although uncommon in pediatric patients, ovarian fibromas should be included in the differential diagnosis of ovarian mass in children.

  3. 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

    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 ...

  4. Delayed traumatic diaphragmatic hernia mimicking hydropneumothorax

    Directory of Open Access Journals (Sweden)

    Rachna Wadhwa

    2014-01-01

    Full Text Available Traumatic diaphragmatic hernia (TDH is generally a consequence of thoraco-abdominal trauma. Anaesthetic problems arise due to herniation of abdominal contents into the thoracic cavity causing diaphragmatic dysfunction, lung collapse, mediastinal shift and haemodynamic instability. Diagnosis depends on history, clinical signs and radiological investigations. Sometimes, it may be misdiagnosed as hydropneumothorax due to the presence of air and fluid in the viscera lying in the pleural cavity. We report a case of TDH mimicking hydropneumothorax on radiological investigations and subsequent surgical management, which led to serious complications.

  5. Benzalkonium Chloride Intoxication Mimicking Herpes Zoster Encephalitis

    Directory of Open Access Journals (Sweden)

    Ekrem Güler

    2011-06-01

    Full Text Available Benzalkonium chloride (BAC is a frequently used disinfectant and its most well-known side effect is contact dermatitis. In this report, two children who had vesicular dermatitis, headache, lethargy, fever and encephalopathy mimicking Herpes zoster encephalitis were presented. Their consciousness level improved on the second day. From the medical history it was understood that the mother had applied 20% BAC solution to the scalps of two children. The aim of the presentation of this report is to draw attention to the fact that BAC application to the scalp for treating pediculosis capitis may resemble the herpes encephalitis clinical picture.

  6. Immunoglobulin G4-Related Disease Mimicking Asthma

    Directory of Open Access Journals (Sweden)

    Hiroshi Sekiguchi

    2013-01-01

    Full Text Available Immunoglobulin (Ig G4-related disease (also known as ‘IgG4-related sclerosing disease’, ‘IgG4-related systemic disease’ or ‘hyper-IgG4-disease’ is a recently recognized systemic fibroinflammatory disease associated with IgG4-positive plasma cells in tissue lesions. IgG4-related disease was initially described as autoimmune pancreatitis, but it is now known to affect virtually any organ. The authors describe a patient presenting with multi-organ manifestations, including airway inflammation mimicking asthma, pulmonary parenchymal infiltrates, intrathoracic lymphadenopathy, submandibular gland swelling and a kidney mass.

  7. Brucellosis in spondyloarthritis mimicking an exacerbation.

    Science.gov (United States)

    Garip, Y; Eser, F; Erten, S; Yilmaz, O; Yildirim, P

    2014-01-01

    Spondyloarthritis are a group of chronic inflammatory diseases that affect the axial skeleton, entheses and peripheral joints and may have extraarticular manifestations such as uveitis, psoriasis and inflammatory bowel disease. Brucellosis is a systemic infectious disease, endemic in Middle East, Latin America, and Mediterranean countries, which may present manifestations that resemble other diseases posing serious problems of differential diagnosis. Some hallmarks of Brucellosis may mimic a spondyloarthritis flare. In this paper, authors present a clinical case of brucellosis occurring in a patient with spondyloarthritis. Clinical symptoms initially mimicked exacerbation of spondyloarthritis.

  8. Hypertrophic Nonunion Humerus Mimicking an Enchondroma

    Directory of Open Access Journals (Sweden)

    N. K. Magu

    2014-01-01

    Full Text Available Introduction. Although fractures of humeral shaft show excellent results with conservative management, nonunion does occur. Case Report. We bring forth the case of a young male with a 1.5-year-old hypertrophic nonunion of the humerus mimicking an enchondroma. The initial X-ray images of the patient appeared to be an enchondroma, which only on further evaluation and histopathological analysis was diagnosed conclusively to be a hypertrophic nonunion. Discussion. Enchondromas are often incidentally diagnosed benign tumours. It is however not common to misdiagnose a hypertrophic nonunion to be an enchondroma. We present this case to highlight the unique diagnostic dilemma the treating team had to face.

  9. Successful use of daily intravenous infusion of C1 esterase inhibitor concentrate in the treatment of a hereditary angioedema patient with ascites, hypovolemic shock, sepsis, renal and respiratory failure.

    Science.gov (United States)

    Pham, Hoang; Santucci, Stephanie; Yang, William H

    2014-01-01

    Hereditary angioedema (HAE) is a rare autosomal dominant disease most commonly associated with defects in C1 esterase inhibitor (C1-INH). HAE manifests as recurrent episodes of edema in various body locations. Atypical symptoms, such as ascites, acute respiratory distress syndrome, and hypovolemic shock, have also been reported. Management of HAE conventionally involves the treatment of acute attacks, as well as short- and long-term prophylaxis. Since attacks can be triggered by several factors, including stress and physical trauma, prophylactic therapy is recommended for patients undergoing surgery. Human plasma-derived C1-INH (pdC1-INH) concentrate is indicated for the treatment of both acute HAE attacks and pre-procedure prevention of HAE episodes in patients undergoing medical, dental, or surgical procedures. We report the first case of a patient with HAE who experienced an abdominal attack precipitated by a retroperitoneal bleed while being converted from warfarin to heparin in preparation for surgery. Subsequently, the patient had a protracted course in hospital with other complications, which included hypovolemic shock, ascites, severe sepsis from nosocomial pneumonia, renal and respiratory failure. Despite intensive interventions, the patient remained in a critical state for months; however, after a trial of daily intravenous infusion of pdC1-INH concentrate (Berinert®, CSL Behring GmbH, Marburg, Germany), clinical status improved, particularly renal function. Therefore, pdC1-INH concentrate may be an effective treatment option to consider for critically-ill patients with HAE.

  10. Bartonella henselae Infection: An Uncommon Mimicker of Autoimmune Disease

    Directory of Open Access Journals (Sweden)

    Despoina N. Maritsi

    2013-01-01

    Full Text Available We present a case of a seven-year-old immunocompetent female patient who developed systemic symptoms mimicking an autoimmune rather than an infectious disease. The patient presented with rash, biquotidian fever, night sweats, and arthralgias. There was no antecedent history of cat contact. Investigations showed increased inflammatory markers, leukocytosis, thrombocytosis, hypercalcemia, and raised angiotensin-converting enzyme. Interferon-gamma releasing assay for tuberculosis infection was negative. Abdominal imaging demonstrated multifocal lesions of the liver and spleen (later proved to be granulomata, chest X-ray showed enlarged hilar lymph nodes, and ophthalmology review revealed uveitis. Clinical, laboratory, and imaging features pointed towards sarcoidosis. Subsequently, raised titers (IgM 1 : 32, IgG 1 : 256 against Bartonella confirmed the diagnosis of B. henselae infection. She was treated with gentamycin followed by ciprofloxacin; repeat investigations showed complete resolution of findings. The presence of hepatic and splenic lesions in children with bartonellosis is well documented. Our case, however, exhibited certain unusual findings such as the coexistence of acute ocular and systemic involvement in an immunocompetent host. Serological testing is an inexpensive and effective way to diagnose bartonellosis in immunocompetent patients; we suggest that bartonella serology is included in the baseline tests performed on children with prolonged fever even in the absence of contact with cats in countries where bartonellosis is prevalent.

  11. Autoimmune pancreatitis with atypical imaging fi ndings that mimicked an endocrine tumor

    Institute of Scientific and Technical Information of China (English)

    Cindy; Neuzillet; Céline; Lepère; Mostafa; El; Hajjam; Laurent; Palazzo; Monique; Fabre; Hajer; Turki; Pascal; Hammel; Philippe; Rougier; Emmanuel; Mitry

    2010-01-01

    Autoimmune pancreatitis(AIP) is a rare cause of recurrent acute pancreatitis or chronic pancreatitis in middleaged patients,and is characterised by a marked infiltration of lymphocytes and plasma cells in pancreatic tissue.Diagnosis of focal forms can be diff icult as AIP may mimic pancreatic adenocarcinoma.Pediatric cases of AIP are exceptional.We report the case of a 15-yearold girl who had a focal AIP and associated cholangitis,with a very unusual vascularized mass that mimicked a pancreatic endocrine tu...

  12. Atypical lymphocytes in malaria mimicking dengue infection in Thailand

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    Polrat Wilairatana

    2010-09-01

    Full Text Available Polrat Wilairatana1, Noppadon Tangpukdee1, Sant Muangnoicharoen1, Srivicha Krudsood2, Shigeyuki Kano31Department of Clinical Tropical Medicine, 2Department of Tropical Hygiene, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand; 3Department of Tropical Medicine and Malaria, Research Institute, National Center for Global Health and Medicine, Tokyo, JapanAbstract: Patients with uncomplicated falciparum or vivax malaria usually present with acute febrile illness and thrombocytopenia similar to dengue infection. We retrospectively studied atypical lymphocytes (AL and atypical lymphocytosis (ALO, defined as AL > 5% of total white blood cells in 1310 uncomplicated malaria patients. In 718 falciparum malaria patients, AL and ALO on day 0 were found in 53.2% and 5.7% of the patients, respectively, with median AL on admission of 1% (range 0%–10%, whereas in 592 vivax malaria patients, AL and ALO on day 0 were found in 55.4% and 9.5% of the patients, respectively, with median AL on admission of 1% (range 0%–14%. After antimalarial treatment, AL and ALO declined in both falciparum and vivax malaria. However, AL and ALO remained in falciparum malaria on days 7, 14, and 21, whereas AL and ALO remained in vivax malaria on days 7, 14, 21, and 28. In both falciparum and vivax malaria patients, there was a positive correlation between AL and total lymphocytes, but a negative correlation between AL and highest fever on admission, white blood cells, and neutrophils, eosinophils, and platelets (P < 0.05. In conclusion, AL or ALO may be found in uncomplicated falciparum and vivax malaria mimicking dengue infection. In tropical countries where both dengue and malaria are endemic, presence of AL or ALO in any acute febrile patients with thrombocytopenia (similar to the findings in dengue malaria could not be excluded. Particularly if the patients have risk of malaria infection, confirmative microscopic examination for malaria should be carried out

  13. Penicillium marneffei chylous ascites in acquired immune deficiency syndrome: A case report

    Institute of Scientific and Technical Information of China (English)

    Yin-Zhong Shen; Zhen-Yan Wang; Hong-Zhou Lu

    2012-01-01

    Penicillium marneffei (P.marneffei) infection usually occurs with skin,bone marrow,lung or hepatic involvement.However,no cases of P.marneffei infection with chylous ascites have been reported thus far.In this report,we describe the first case of acquired immune deficiency syndrome (AIDS) which has been complicated by a P.marneffei infection causing chylous ascites.We describe the details of the case,with an emphasis on treatment regimen.This patient was treated with amphotericin B for 3 mo,while receiving concomitant therapy with an efavirenz-containing antiretroviral regimen,but cultures in ascitic fluid were persistently positive for P.marneffei.The infection resolved after treatment with high-dose voriconazole (400 mg every 12 h) for 3 mo.P.marneffei should be considered in the differential diagnosis of chylous ascites in human immunodeficiency virus patients.High-dose voriconazole is an effective,well-tolerated and convenient option for the treatment of systemic infections with P.marneffei in AIDS patients on an efavirenz-containing antiretroviral regimen.

  14. Chylous ascites associated with chylothorax; a rare sequela of penetrating abdominal trauma: a case report

    Directory of Open Access Journals (Sweden)

    Plummer Joseph M

    2007-11-01

    Full Text Available Abstract We present the case of a patient with the rare combination of chylous ascites and chylothorax resulting from penetrating abdominal injury. This patient was successfully managed with total parenteral nutrition. This case report is used to highlight the clinical features and management options of this uncommon but challenging clinical problem.

  15. Genetics of ascites resistance and tolerance in chicken: A random regression approach

    NARCIS (Netherlands)

    Kause, A.; Dalen, van S.; Bovenhuis, H.

    2012-01-01

    Resistance and tolerance are two complementary mechanisms to reduce the detrimental effects of parasites, pathogens, and production diseases on host performance. Using body weight and ascites data on domesticated chicken Gallus gallus domesticus, we demonstrate the use of random regression animal mo

  16. 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...

  17. Ascitic fluid analysis for diagnosis and monitoring of spontaneous bacterial peritonitis

    Institute of Scientific and Technical Information of China (English)

    Oliviero Riggio; Stefania Angeloni

    2009-01-01

    Polymorphonuclear (PMN) cell count in the ascitic fluid is essential for the diagnosis and management of spontaneous bacterial peritonitis (SBP). To date, PMN cell count is routinely performed by traditional manual counting. However, this method is time-consuming, costly, and not always timely available. Therefore, considerable efforts have been made in recent years to develop an alternative test for a more rapid diagnosis and monitoring of SBP. The use of urinary reagent strips was proposed to achieve an "instant" bedside diagnosis of SBP. A series of reports evaluated the urine strip test for SBP diagnosis and reported promising results. However, a recent large multicenter study revealed a surprising lack of diagnostic efficacy of the urine screening test for SBP diagnosis. Another method, more recently proposed as an alternative to the manual PMN count, is the measurement of lactoferrin in ascitic fluid, but the data available on the diagnostic value of this test are limited to a single study. However,both urinary reagent strips and ascitic lactoferrin tests are qualitative methods and need, therefore, to be further confirmed by standard cytology of the ascitic fluid.To date, the only quantitative method proposed as a valid alternative to manual PMN counting is automated blood cell counters, commonly used in all laboratories for blood cell counting. Data available in the literature on the diagnostic performance of this method are limited but very promising, and this tool seems to have the potential to replace the manual counting method.

  18. Organisms causing spontaneous bacterial peritonitis in children with liver disease and ascites in Southern Iran

    Institute of Scientific and Technical Information of China (English)

    Mahmood Haghighat; Seyed Mohsen Dehghani; Abdolvahab Alborzi; Mohammad Hadi Imanieh; Bahman Pourabbas; Mehdi Kalani

    2006-01-01

    AIM: To determine the causative agents of spontaneous bacterial peritonitis (SBP) in children with liver disease and ascites in our center.METHODS: During a 2.5 year period, from September 2003 to March 2006, 12 patients with 13 episodes of SBP were studied. In all cases at the time of admission serum albumin and glucose, urinalysis and urine culture was performed. Analysis [white blood cell (WBC) count with differential, albumin, glucose], gram stain, culture by BACTEC method and antibiogram was done on ascitic fluids. Abdominal paracentesis was repeated after 48h of antibiotic therapy for bacteriologic assay. The patients were followed for at least three months in a gastroenterology clinic.RESULTS: There were 7 girls (58%) and 5 boys (42%)with a median age of 5.2 years (range, 6 mo to 16 years). All cases had positive ascitic fluid culture. Gram stain was positive in 5 (38.5%) of them. The isolated organisms were S. pneumoniae in 5 (38.5%), E. coli in 2(15.3%), S. viridans in 2 (15.3%), and K. pneumoniae,H. influenza, Enterococci, and nontypable Streptococcus each in one (7.7%). All of them except Enterococci were sensitive to ciprofloxacin and ceftriaxone. All ascitic fluid cultures were negative after 48 h of antibiotic therapy.CONCLUSION: S. pneumoniae is the most common cause of SBP in the pediatric age group and we recommend a third generation cephalosporine (e.g., Ceftriaxione or Cefotaxime) for empirical therapy in children with SBP.

  19. CYTOTOXICITY OF ARTEMISININ-RELATED ENDOPEROXIDES TO EHRLICH ASCITES TUMOR-CELLS

    NARCIS (Netherlands)

    WOERDENBAG, HJ; MOSKAL, TA; PRAS, N; MALINGRE, TM; ELFERALY, FS; KAMPINGA, HH; KONINGS, AWT

    1993-01-01

    A series of artemisinin-related endoperoxides was tested for cytotoxicity to Ehrlich ascites tumor (EAT) cells using the microculture tetrazolium (MTT) assay. Artemisinin [1] had an IC50 value of 29.8 muM. Derivatives of dihydroartemisinin [2], being developed as antimalarial drugs (artemether [3],

  20. 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...

  1. 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

  2. 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.

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

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    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

  4. Mimicked Web Page Detection over Internet

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    Y. Narasimha Rao

    2014-01-01

    Full Text Available Phishing is process of steeling valuable information such as ATM pins, Credit card details over internet. Where the attacker creates mimicked web pages from the legitimate web pages to fool users. In this paper, we propose an effective anti-phishing solution, by combining image based visual similarity based approach to detect plagiarized web pages. We used effective algorithms for our detection mechanism, speeded up Robust Features (SURF algorithm in order to generate signature based on extracting stable key points from the screen shot of the web page. When a legitimate web page is registered with our system, this algorithm applied on that web page in order to generate signatures, and these signatures are stored in the database for our trained system. When there is a suspected web page, this algorithm is applied to generate both the signatures of the suspected page and is verified against our database of corresponding legitimate web pages. Our results verified that our proposed system is very effective to detect the mimicked web pages with minimal false positives

  5. Mimicking Seawater For Culturing Marine Bacteria

    DEFF Research Database (Denmark)

    Rygaard, Anita Mac; Sonnenschein, Eva; Gram, Lone

    2015-01-01

    Only about 1% of marine bacteria have been brought into culture using traditional techniques. The purpose of this study was to investigate if mimicking the natural bacterial environment can increase culturability.We used marine substrates containing defined algal polymers or gellan gum as solidif......Only about 1% of marine bacteria have been brought into culture using traditional techniques. The purpose of this study was to investigate if mimicking the natural bacterial environment can increase culturability.We used marine substrates containing defined algal polymers or gellan gum...... as solidifying agents, and enumerated bacteria from seawater and algal exudates. We tested if culturability could be influenced by addition of quorum sensing signals (AHLs). All plates were incubated at 15°C. Bacterial counts (CFU/g) from algal exudates from brown algae were highest on media containing algal...... polymers. In general, bacteria isolated from algal exudates preferred more rich media than bacteria isolated from seawater. Overall, culturability ranged from 0.01 to 0.8% as compared to total cell count. Substitution of agar with gellan gum increased the culturability of seawater bacteria approximately...

  6. Body Posture Angle Affects the Physiological Indices of Patients With Liver Cirrhosis Ascites.

    Science.gov (United States)

    Hsu, Wen-chuan; Ho, Lun-hui; Lin, Mei-hsiang; Chiu, Hsiu-ling

    2016-01-01

    The study objective was to compare the effect of different angles of lying positions on the physiological indices of patients with cirrhosis ascites. Chronic liver disease and cirrhosis were ranked 9th among the top 10 causes of death. Ascites is the most common cirrhosis comorbidity. Body posture can affect pulmonary ventilation and arterial oxygen partial pressure, making it an important clinical nursing intervention significantly affecting patient recovery. This was a quasi-experimental study design. From a medical center in Taiwan, 252 patients with cirrhosis ascites were recruited. Subjects were randomly divided into three groups by bed angle: 15°, 30°, and 45°. Physiological indices were measured at 5, 10, 15, 20, 25, and 30 minutes to determine any changes in heart rate, respiration rate, and oxygenation saturation. Data analysis included descriptive statistics and the generalized estimating equation for statistical analysis with significance set at α= 0.05. After controlling for confounding variables, the three groups differed significantly in heart rate at 20, 25, and 30 minutes, oxygenation saturations at 15 and 20 minutes, and respiration rate at 5 and 10 minutes (α< 0.05). Body posture can affect pulmonary ventilation and arterial oxygen partial pressure and is thus an important clinical nursing intervention that significantly affects the recovery of patients. When caring for patients with cirrhosis ascites, nurses should help patients to choose the most comfortable angle for them with no particular restrictions. Our results can be used to guide nurses in making a plan for health education and nursing that improves the quality of care for patients with chronic liver disease and cirrhosis patients with ascites.

  7. 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.

  8. Chronic lupus peritonitis is characterized by the ascites with a large content of interleukin-6.

    Science.gov (United States)

    Watanabe, Ryu; Fujii, Hiroshi; Kamogawa, Yukiko; Nakamura, Kyohei; Shirai, Tsuyoshi; Ishii, Tomonori; Harigae, Hideo

    2015-01-01

    Systemic lupus erythematosus (SLE) is an autoimmune disease and can cause multi-organ damage. Peritoneal involvement, also called lupus peritonitis, is a rare but sometimes fatal manifestation. Deposition of immune complexes consisting of immunoglobulin G and complement is considered to be involved in the pathogenesis of lupus peritonitis; however, it remains unknown whether inflammatory cytokines contribute to the pathology of this manifestation. Here we present two patients with treatment-resistant lupus peritonitis: a 37-year-old woman with a 26-year history of SLE who had been treated with prednisolone and cyclophosphamide followed by azathioprine and a 65-year-old woman with a 33-year history of SLE who had been treated with prednisolone alone. Both patients were admitted to our department because of abdominal distention. Computed tomography scans showed massive ascites. Ascitic fluid examinations of both patients showed leukocytosis with no evidence of malignancy or infection. After eliminating other causes for ascites, they were diagnosed with lupus peritonitis. Despite the intensified immunosuppressive therapy, they died of uncontrolled peritonitis several months after admission. Examinations of the ascites at admission also revealed a large content of interleukin (IL)-6, compared with other inflammatory cytokines, IL-1β and tumor necrosis factor-α. In fact, the ascitic IL-6 levels of these two patients were 12,389 pg/mL and 5,486 pg/mL, much higher than their serum IL-6 levels of 36 pg/mL and 140 pg/mL, respectively. We therefore suggest that IL-6 may contribute to the pathogenesis of lupus peritonitis and that the inhibition of IL-6 signaling may provide a novel therapeutic strategy for lupus peritonitis.

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

    DEFF Research Database (Denmark)

    Henriksen, J H; Ring-Larsen, Helmer; 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 between...... (plasma minus ascitic fluid) oncotic pressure (rlin = 0.74, P less than 0.001) but significantly higher than that (P less than 0.005), indicating a 'non-equilibrium' in the splanchnic Starling forces. The results point to a multivariate genesis and perpetuation of cirrhotic ascites as laid down...

  10. Orbital Lymphoma Mimicking Lacrimal Gland Pleomorphic Adenoma

    Directory of Open Access Journals (Sweden)

    Diego Strianese

    2013-09-01

    Full Text Available Purpose: To describe the case of a patient affected by orbital lymphoma mimicking pleomorphic adenoma of the lacrimal gland. Methods: This was a retrospective case report. Results: We present the case of a patient with 15-year history of slowly progressive left proptosis and inferomedial bulbar dislocation who had the presumptive diagnosis of lacrimal gland pleomorphic adenoma based on clinical and radiological features. The patient underwent lateral orbitotomy and lacrimal gland excision. Postoperative histological features were consistent with low-grade B-cell non-Hodgkin lymphoma. Conclusion: The accepted clinico-radiological criteria used for the diagnosis of lacrimal gland fossa lesions might have a certain false-positive rate, even in recent years. The initial surgical approach with the appropriate choice between fine-needle aspiration biopsies, intraoperative biopsies and lacrimal gland excisions might be a challenge.

  11. EVENTRATION OF LEFT HEMIDIAPHRAGM MIMICKING AS CAVITY

    Directory of Open Access Journals (Sweden)

    Kansal

    2015-10-01

    Full Text Available Eventration of diaphragm is a condition in which there is abnormal elevation of the diaphragm as a result of thinning of muscular layer. It can be congenital as well as acquired. It is more common left sided. Herniation of the abdominal contents can be there. Clinical manifestations range from asymptomatic to life threatening respiratory distress requiring mechanical ventilator support. Ultrasound provides valuable information regarding the integrity of the diaphragm. Other imaging modalities include fluoroscopy, CT and MRI that provide valuable information when diagnosis is in doubt. We are presenting a case report of 25-year-old male with eventration of left hemidiaphragm mimicking as cavity. After taking detail history, examination and proper investigations we finally reached to this diagnosis.

  12. Case report. Pityriasis versicolor mimicking Pityriasis rotunda.

    Science.gov (United States)

    Aste, Nicola; Pau, Monica; Aste, Natalia; Biggio, P

    2002-04-01

    Pityriasis versicolor is a common dermatomycosis, occurring throughout the world, characterized by irregular, slightly scaly patches, varying in color from red/light brown to white. Pityriasis rotunda, on the other hand, is an uncommon disease, reported in specific ethnic groups, and characterized by perfectly round or oval patches of varying color, with a scaly surface. The histologic pattern is that of ichthyosis vulgaris. We report here the case of a male patient, aged 31, from Sardinia (Italy), affected by Pityriasis versicolor mimicking Pityriasis rotunda. Mycological examination allowed us to formulate the correct diagnosis, and ensuing treatment with antifungal drugs was entirely successful. The authors, while pointing out the rarity of this case, stress the possibility that Pityriasis versicolor mimics Pityriasis rotunda and vice-versa, especially in those countries in which the two diseases are endemic. More widespread recourse to microscopic examination can help avoid the risk of mistaken diagnosis and consequent incorrect treatment.

  13. Contiguous spinal metastasis mimicking infectious spondylodiscitis

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Chul Min; Lee, Seung Hun [Dept. of Radiology, Hanyang University Hospital, Seoul (Korea, Republic of); Bae, Ji Yoon [Dept. of Pathology, National Police Hospital, Seoul (Korea, Republic of)

    2015-12-15

    Differential diagnosis between spinal metastasis and infectious spondylodiscitis is one of the occasional challenges in daily clinical practice. We encountered an unusual case of spinal metastasis in a 75-year-old female breast cancer patient that mimicked infectious spondylodiscitis. Magnetic resonance imaging (MRI) showed diffuse bone marrow infiltrations with paraspinal soft tissue infiltrative changes in 5 contiguous cervical vertebrae without significant compression fracture or cortical destruction. These MRI findings made it difficult to differentiate between spinal metastasis and infectious spondylodiscitis. Infectious spondylodiscitis such as tuberculous spondylodiscitis was regarded as the more appropriate diagnosis due to the continuous involvement of > 5 cervical vertebrae. The patient's clinical presentation also supported the presumptive diagnosis of infectious spondylodiscitis rather than spinal metastasis. Intravenous antibiotics were administered, but clinical symptoms worsened despite treatment. After pathologic confirmation by computed tomography-guided biopsy, we were able to confirm a final diagnosis of spinal metastasis.

  14. Tentorium schwannoma mimicking meningioma: an unusual location.

    Science.gov (United States)

    Calişaneller, Tarkan; Ozen, Ozlem; Altinörs, Nur; Caner, Hakan

    2008-07-01

    A 60-year-old female was admitted to our clinic complaining of a long-lasting headache. Cranial magnetic resonance imagining examination of the patient revealed a 22x24 mm extra-axial, well-demarcated, mass lesion based on the left tentorium. The patient underwent a craniotomy and the tumor was totally excised with the adjacent tentorium. The histopathological examination of the tumor complied with the diagnosis of schwannoma. The rest of the clinical course was uneventful and the patient was released from the hospital without any neurological deficit. Intracranial schwannomas can rarely originate from atypical dural locations and radiological techniques are not always helpful in distinguishing tentorial schwannoma from tentorial meningioma. We presented a patient with a tentorium schwannoma mimicking meningioma and discussed the current literature.

  15. Lumbar Epidural Varix Mimicking Perineural Cyst

    Science.gov (United States)

    Pusat, Serhat; Kural, Cahit; Aslanoglu, Atilla; Kurt, Bulent

    2013-01-01

    Lumbar epidural varices are rare and usually mimick lumbar disc herniations. Back pain and radiculopathy are the main symptoms of lumbar epidural varices. Perineural cysts are radiologically different lesions and should not be confused with epidural varix. A 36-year-old male patient presented to us with right leg pain. The magnetic resonance imaging revealed a cystic lesion at S1 level that was compressing the right root, and was interpreted as a perineural cyst. The patient underwent surgery via right L5 and S1 hemilaminectomy, and the lesion was coagulated and removed. The histopathological diagnosis was epidural varix. The patient was clinically improved and the follow-up magnetic resonance imaging showed the absence of the lesion. Lumbar epidural varix should be kept in mind in the differential diagnosis of the cystic lesions which compress the spinal roots. PMID:23741553

  16. A Case of Pancreatic Undifferentiated Carcinoma Mimicking Proximal-Type Epithelioid Sarcoma

    Directory of Open Access Journals (Sweden)

    Nobuyuki Ohike

    2016-01-01

    Full Text Available We herein report a case of pancreatic undifferentiated/anaplastic carcinoma pathologically mimicking proximal-type epithelioid sarcoma. The patient was a 35-year-old female who complained of epigastralgia and back pain and presented with tarry stools and weight loss. A growing, hemorrhagic pancreatic mass more than 6 cm in diameter and multiple liver masses were revealed on abdomen images. A liver biopsy showed malignant cells and chemotherapy using TS-1 was performed, however, the patient accumulated a large amount of ascites by diffuse peritoneal dissemination and died after seven months. An autopsy demonstrated the manifestation of a large whitish, expansive-infiltrative mass with severe hemorrhage, measuring 18 x 13 cm, seated primarily in the head of the pancreas. Microscopically, the tumor showed a medullary growth consisted of pleomorphic spindle to epithelioid cells, which were loosely cohesive and included rhabdoid morphology. The glandular component, suggestive of ductal adenocarcinoma, could not be found even with extensive sampling. Immunohistochemical studies showed a diffuse positivity of cytokeratin (AE1/AE3, epithelial membrane antigen, vimentin, and CD34 and a negativity of specific differentiation markers. In addition, a loss of SMARCB1/INI-1 protein expression was observed, although its alterations were not confirmed at the deoxyribonucleic acid level. No KRAS mutations were detected. The tumor was considered as pancreatic undifferentiated/anaplastic carcinoma from the similarity to "monomorphic anaplastic subtype of pancreatic undifferentiated rhabdoid carcinoma" recently proposed by Agaimy A et al. However, its histological, immunohistological and molecular characters were completely identical to those of PES, thus the clinical treatment and care for proximal-type epithelioid sarcoma may be recommended rather than those for undifferentiated/anaplastic carcinoma as a subtype of ductal adenocarcnoma.

  17. One-step purification of mouse monoclonal antibodies from ascitic fluid by DEAE Affi-Gel blue chromatography.

    Science.gov (United States)

    Bruck, C; Portetelle, D; Glineur, C; Bollen, A

    1982-09-30

    Monoclonal antibodies can be purified directly from ascitic fluids by chromatography on a DEAE Affi-gel blue column. Optimal conditions were determined for the recovery of immunoglobulins free of contaminating protease and nuclease activities.

  18. Proteomic identification of fucosylated haptoglobin alpha isoforms in ascitic fluids and its localization in ovarian carcinoma tissues from Mexican patients

    OpenAIRE

    Garibay-Cerdenares, Olga Lilia; Hernández-Ramírez, Verónica Ivonne; Osorio-Trujillo, Juan Carlos; Hernández-Ortíz, Magdalena; Gallardo-Rincón, Dolores; Cantú de León, David; Encarnación-Guevara, Sergio; Villegas-Pineda, Julio César; Talamás-Rohana, Patricia

    2014-01-01

    Background Ovarian cancer is the most lethal gynecologic disease due to delayed diagnosis, and ascites production is a characteristic of patients in advanced stages. The aim of this study was to perform the proteomic analysis of ascitic fluids of Mexican patients with ovarian carcinoma, in order to detect proteins with a differential expression pattern in the continuing search to identify biomarkers for this disease. Methods Samples were collected from 50 patients from the Instituto Nacional ...

  19. 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.

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

    OpenAIRE

    Sujata Maiti Choudhury; Malaya Gupta; Upal Kanti Majumder

    2010-01-01

    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 v...

  1. 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....

  2. Efficacy of ascitic ultrafiltration with intraperitoneal reinfusion of the concentrated ascites on refractory ascites in patients with liver cirrhosis%腹水超滤浓缩回输腹腔术治疗肝硬化顽固性腹水疗效分析

    Institute of Scientific and Technical Information of China (English)

    巨立中; 黄志诚; 耿秀萍; 程瑞专

    2012-01-01

    目的 探讨腹水超滤浓缩回输腹腔术治疗肝硬化顽固性腹水的疗效.方法 将56 例肝硬化顽固性腹水患者随机分为2 组,均给予保肝、利尿及抗病毒治疗.在此基础上,对治疗组行腹水超滤浓缩回输腹腔术加小剂量人血白蛋白静脉滴注(静滴)(每滤出1000 ml 腹水,静滴人血白蛋白4 g),对对照组行大量放腹水加大剂量人血白蛋白静滴(每抽出1000 ml 腹水,静滴人血白蛋白8 g).结果 术后第14 天,治疗组患者24 h 尿量、血清ALB 水平均高于对照组(P 均<0.05),且治疗组总有效率高于对照组(P<0.05).结论 腹水超滤浓缩回输腹腔术是一种安全有效的治疗肝硬化顽固性腹水的方法.%Objective To investigate the efficacy of ascitic ultrafiltratioii with iniraperitoneal reinfusion of the concentrated ascites or. refractory ascites in patients with liver cirrhosis. Methods Totally 56 cirrhotic patients with refractory ascites were randomized into a treatment group and a control group. The patients in the two groups received conventional therapy including hepato-protective, diuretic and antiviral therapy. In addition, the treatment group underwent ascitic ultrafiltration with intraperitoneal reinfu-sion of the concentrated ascites and intravenous infusion of a small dose of human scrum ALB (4 g for every 1000 ml of ascitic fluid removed), while Lite control group received large volume paracenlesis and intravenous infusion of a large dose of human serum ALB (8 g for eveny 1000 ml of ascitic fluid removed). Results After 14 days of treatment, the 24-hour urine volume and serum ALB level in the treatment group were higher than those in the control group (P<0.05). The total effective rate in the treatment group was higher than that in the control group (P<0.05). Conclusion Ascitic ultrafiltratioii with mtraperitoneal reinfusion of the concentrated as-cites is safe and effective in the treatment of refractor}' ascites in cirrhotic patients.

  3. 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.

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

    DEFF Research Database (Denmark)

    Krag, A; Bendtsen, F; Henriksen, J H;

    2010-01-01

    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...... (130 (SD 46) vs 78 (SD 29) mumol/l, pdeveloped hepatorenal syndrome type 1 within 3 months was higher in the group with low CI than in the high CI group (43% vs 5%, p = 0.04). Patients with the lowest CI (N = 8) had significantly poorer survival at 3, 9, and 12 months...

  5. 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.

  6. The effects of elevated levels of sodium chloride on ascites and related problems in turkeys.

    Science.gov (United States)

    Morrison, W D; Ferguson, A E; Pettit, J R; Cunnigham, D C

    1975-01-01

    The response of young poults to diets containing 0.7, 1.2, 1.7 and 2.7 per cent sodium chloride was studied. Water intake, feed intake and wieght gain were not significantly influenced by treatment. Only the highest level caused a significant increase in mortality. Ascites was not a consistent finding even on high levels of salt. A straight line best described the response but confidence limits were large and this was also true for heart, kidney and lung lesions. Lesions showing myocardial distension with pericardial adhesions, severe congestion of the lungs and enlarged pale kidneys seemed more indicative of salt intoxication than classic ascites. Microscopically heterophilic (eosinophilic) lung and meningeal infiltrates accompanied by myocardial degeneration and adhesions were suggestive, but not specific, of salt intoxication.

  7. Effect of TNF gene-transfected LAK cells on the ascitic liver carcinoma-bearing mice

    Institute of Scientific and Technical Information of China (English)

    Guo Liang Lou; Xue Tao Cao; Bi He Min; Wei Ping Zhang; Pei Lin Meng

    2000-01-01

    AIM To investigate the therapeutic effect of TNF gene transfected LAK cells on ascitic liver carcinoma-bearing mice.METHODS TNF gene was transfected into murine LAK cells by retrovirus. Low dose TNF gene-transfectcdLAK cells and IL-2 were i.p. injected into murine model. Cytotoxicity of gene transfected LAK cells wasstudied in vitro growth and the survival time of murine model was observed.RESULTS TNF gene-transfected LAK cells secreted higher level of TNF than that of normal LAK cells orcontrol gene-transfected LAK ceils. The in vitro growth ability and cytotoxicity of TNF gene-transfectedLAK cells were markedly inhibited by anti-TNF monoclonal antibodies. Significant therapeutic effect onascitic liver carcinoma-bearing mice was achieved.CONCLUSION TNF gene-transfected LAK cells have therapeutic effect on ascitic liver carcinoma-bearingmice.

  8. Pancreaticoportal Fistula in Association with Antiphospholipid Syndrome Presenting as Ascites and Portal System Thrombosis

    Directory of Open Access Journals (Sweden)

    Li-Hsin Chang

    2002-01-01

    Full Text Available Fistulous communication between the pancreas and the portal venous system is extremely rare and is usually a complication of chronic pancreatitis or pancreatic pseudocysts. A patient who presented with abdominal pain and ascites secondary to a pancreaticoportal fistula and portal system thrombosis is described. The diagnosis was made by endoscopic retrograde cholangiopancreatography and confirmed by immediate postprocedure computed tomographic scanning. Laboratory studies identified concomitant antiphospholipid syndrome. The patient responded favourably to supportive medical therapy.

  9. Splenic artery embolization for the treatment of refractory ascites after liver transplantation.

    Science.gov (United States)

    Quintini, Cristiano; D'Amico, Giuseppe; Brown, Chase; Aucejo, Federico; Hashimoto, Koji; Kelly, Dympna M; Eghtesad, Bijan; Sands, Mark; Fung, John J; Miller, Charles M

    2011-06-01

    Refractory ascites (RA) is a challenging complication after orthotopic liver transplantation. Its treatment consists of the removal of the precipitating factors. When the etiology is unknown, supportive treatment can be attempted. In severe cases, transjugular intrahepatic portosystemic shunts, portocaval shunts, and liver retransplantation have been used with marginal results. Recently, splenic artery embolization (SAE) has been described as an effective procedure for reducing portal hyperperfusion in patients undergoing partial or whole liver transplantation. Here we describe our experience with SAE for the treatment of RA. Between June 2004 and June 2010, 6 patients underwent proximal SAE for RA. Intraoperative flow measurements, graft characteristics, embolization portal vein (PV) velocities before and after SAE, and spleen/liver volume ratios were collected and analyzed. The response to treatment was assessed with imaging (ultrasound/computed tomography) and on the basis of clinical outcomes (weight changes, diuretic requirements, and the time to ascites resolution). The PV velocity decreased significantly for each patient after the embolization (median = 66.5 cm/second before SAE and median = 27.5 cm/second after SAE, P patients experienced a significant postprocedural weight loss (mean = 88.1 ± 28.4 kg before SAE and mean = 75.8 ± 28.4 kg after SAE, P patients experienced a complete resolution of ascites after a median time of 49.5 days (range = 12-295 days). No patient presented with postembolization complications. In conclusion, SAE was effective in reducing the PV velocity immediately after the procedure. Clinically, this translated into a dramatic weight loss, a reduction of diuretic use, and a resolution of ascites. SAE appears to be a safe and effective treatment for RA.

  10. Meig’s Syndrome:A Triad of Pleural Effusion, Abdominal Ascites, and Benign Ovarian Fibroma

    Institute of Scientific and Technical Information of China (English)

    Yaseen Ali; Amila M. Parekh; Rahul K. Rao; Taseen Ali; Linda S. Schneider; Jordan Garvey; Mirza R. Baig

    2015-01-01

    Background:Meig’s syndrome is a rare syndrome characterized by a triad of recurrent pleural effusions, ascites, and the finding of a benign ovarian fibroma on diagnostic imaging and histopathological evaluation. Patients can present with any of the constellation of symptoms attributing to the disease state. With pleural effusions they can present with shortness of breath, chest pressure, dyspnea on exertion; symptoms that can be confused with the exacerbation of congestive heart failure. Ascites can present with abdominal tenseness, pain, bloating, cramping, constipation, and elevated liver enzymes. The ifnding of a benign ovarian ifbroma is found only during diagnostic imaging and histopathological evaluation. Case report:The patients was an 85-year-old female with a recent history of coronary artery bypass graft surgery for her severe coronary artery disease presented with the chief complaint of generalized malaise, abdominal pain, constipation of few days. She was initially scheduled to have her second therapeutic thoracentesis for her recurrent pleural effusion as an outpatient procedure but complained of the former symptoms and was admitted for observation and treatment of her abdominal symptoms. Her recurrent pleural effusions were initially attributed to the complications of her coronary artery bypass graft surgery for her severe coronary artery disease. During the admission and evaluation she was diagnosed with Meig’s syndrome. She underwent a left oophorectomy with total abdominal hysterectomy that led to the resolution of all her symptoms. Conclusion:Meig’s syndrome is a rare syndrome characterized by the triad of recurrent pleural effusions, ascites, and the ifnding of a benign ovarian ifbroma. The diagnosis and knowledge of this syndrome holds the key to its treatment. The treatment generally involves the resection of the ovarian ifbroma. After the resection of the ovarian ifbroma patients recover from the inconvenient pleural effusions and

  11. pH regulation in sensitive and multidrug resistant Ehrlich ascites tumor cells

    DEFF Research Database (Denmark)

    Litman, Thomas; Pedersen, S F; Kramhøft, B;

    1998-01-01

    Maintenance and regulation of intracellular pH (pHi) was studied in wild-type Ehrlich ascites tumor cells (EHR2) and five progressively daunorubicin-resistant, P-glycoprotein (P-gp)-expressing strains, the maximally resistant of which is EHR2/1.3. Steady-state pHi was similar in cells expressing ...... to aspects of development of drug resistance other than P-gp....

  12. Inhibition of cysteine peptidase activity in ascitic fluid in pancreatic cancer patients.

    Directory of Open Access Journals (Sweden)

    Adam Skalski

    2011-04-01

    Full Text Available The work's objective is to answer the question whether there is any possibility of activity inhibition of cysteine peptidases inhibitors playing an important role in key processes accompanying cancer formation, including pancreas. There is a justified speculation that specific inhibitors of these enzymes may inhibit development of cancer processes by inhibiting their activity. In vitro studies confirmed that these enzymes in ascitic fluid were inhibited with egg whites inhibitors even to 90% of their original activity.

  13. Studies on Antitumor Activity of Bryophyllum calycinum Salisb. against Ehrlich Ascites Carcinoma in Swiss Albino Mice

    OpenAIRE

    Devbhuti D1,*; Gupta JK; Devbhuti P*,1

    2012-01-01

    The aim of the present study is to evaluate the antitumor effect of Bryophyllum calycinum Salisb. (Family: Crassulaceae) against Ehrlich Ascites Carcinoma (EAC) bearing Swiss albino mice. The effect of methanol and aqueous extracts of Bryophyllum calycinum Salisb. on tumor growth was studied by the following parameters: percentage inhibition of ascetic cells and percentage inhibition of tumor weight. Methanol and aqueous extracts were administered at doses of 100,200 and 400 mg/kg body weight...

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

    Directory of Open Access Journals (Sweden)

    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

  15. Spot urinary sodium for assessing dietary sodium restriction in cirrhotic ascites

    Institute of Scientific and Technical Information of China (English)

    Mohammed Abdelhamid El-Bokl; Bahaa Eldeen Senousy; Khaled Zakaria El-Karmouty; Inas El-Khedr Mohammed; Sherif Monier Mohammed; Sherif Sadek Shabana; Hassan Shalaby

    2009-01-01

    AIM: To evaluate the accuracy of spot urinary Na/K and Na/creatinine (Cr) ratios as an alternative to 24-h urinary sodium in monitoring dietary compliance in patients with liver cirrhosis and ascites treated with diuretics. METHODS: The study was carried on 40 patients with liver cirrhosis and ascites treated with diuretic therapy. Patients were divided into two groups according to 24-h urinary sodium. We measured spot urine Na/K ratio, Na/ Cr ratio and 24-h urinary sodium. Student's t test was used to compare the interval variables and χ2 test to compare the nominal variables between the two groups. Receiver operator characteristic curve was used to identify the best cutoff point for Na/K and Na/Cr ratio. RESULTS: The best cutoff point for Na/K ratio was 2.5 ( P < 0.001) and area under the curve (AUC) was 0.9, and for Na/Cr ratio, the best cutoff point was 35 ( P < 0.001) and AUC was 0.885. Na/K ratio showed higher sensitivity and accuracy compared to Na/Cr ratio (87.5% and 87% for Na/K ratio; 81% and 85% for Na/Cr ratio, respectively). CONCLUSION: Spot urine Na/K ratio has adequate accuracy for assessment of dietary sodium restriction compared with 24-h urinary sodium in patients with liver cirrhosis and ascites.

  16. [Possibility of achieving the Pasteur effect by ascites carcinoma cells in vivo].

    Science.gov (United States)

    Tagi-zade, S B; Shapot, V S

    1971-01-01

    Possibility of Pasteur effect in cancer cells in vivo was studied on mice with Ehrlich ascites carcinoma and rats with carcinoma of ovaries++. The experiments were run in two series. In the first series, all animals were saturated with oxygen through inhalation. In this series, part of the animals were given glucose subcutaneously. In the second series, all animals were given oxygen intraperitoneally and some of the animals with carcinoma of ovaries++ were given glucose subcutaneously. Values of inhibition of glycolytic activity in cancer cells under various experimental conditions were estimated through a calculated coefficient. Results of the experiment evidenced that inhalational saturation of animals with oxygen did not inhibit glycolysis of ascites cells in vivo while after intraperitoneal administration of oxygen, coefficient of inhibition of glycolytic activity in mice with Ehrlich ascites++ carcinoma after 45-65 min was 50-615, respectively. Experiments on rats showed that inhibition of glycolytic activity in rats can be revealed during simultaneous administration of oxygen intraperitoneally and of glucose subcutaneously. The authors reached the conclusion that under adequate supply of cancer cells with oxygen respiration can suppress glycolysis at the level of organism as well.

  17. 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

  18. 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

  19. Spontaneous Bacterial Peritonitis Caused by Listeria monocytogenes Associated with Ascitic Fluid Lymphocytosis: A Case Report and Review of Current Empiric Therapy

    Directory of Open Access Journals (Sweden)

    Todd Yecies

    2013-01-01

    Full Text Available Spontaneous bacterial peritonitis (SBP is a potentially deadly complication of ascites. We describe a case of SBP caused by Listeria monocytogenes in a patient with alcoholic cirrhosis. This was associated with the unusual finding of ascitic fluid lymphocytosis, which previously had only been associated with tuberculoid or malignant ascites. Given increasing rates of cefotaxime-resistant SBP alongside the possibility of Listeriosis, the use of cefotaxime as first-line therapy in SBP should be reevaluated.

  20. Mimicking Bone - Chemical and Physical Challenges

    Directory of Open Access Journals (Sweden)

    Sophie C Cox

    2014-08-01

    Full Text Available It is known that chemical and physical features of bone contribute to its functionality, reactivity and mechanical performance. This fundamental rationale underpins the author’s research strategy. This paper presents a summary of efforts to fabricate a synthetic structure, referred to as a scaffold, that both chemically and physical emulates the intricate structure of bone. An understanding of key features of bone tissue that contribute to its remarkable properties is presented as a background to this work. Novel work aimed at improving the understanding of the synthesis of a ceramic biomaterial, namely hydroxyapatite, that is chemically similar to bone mineral is discussed. A case study involving the manufacture of porous scaffolds by 3D printing is also presented. In summary, this article highlights a number of on-going challenges that multidisciplinary tissue engineers aim to solve to get one step closer to mimicking bone, which clinically could improve the quality of life for millions of people worldwide.  Photo credit: By Doc. RNDr. Josef Reischig, CSc. (Author's archive [CC-BY-SA-3.0 (http://creativecommons.org/licenses/by-sa/3.0], via Wikimedia Commons

  1. Microfabricated adhesive mimicking gecko foot-hair

    Science.gov (United States)

    Geim, A. K.; Dubonos, S. V.; Grigorieva, I. V.; Novoselov, K. S.; Zhukov, A. A.; Shapoval, S. Yu.

    2003-07-01

    The amazing climbing ability of geckos has attracted the interest of philosophers and scientists alike for centuries. However, only in the past few years has progress been made in understanding the mechanism behind this ability, which relies on submicrometre keratin hairs covering the soles of geckos. Each hair produces a miniscule force ~10-7 N (due to van der Waals and/or capillary interactions) but millions of hairs acting together create a formidable adhesion of ~10 N cm-2: sufficient to keep geckos firmly on their feet, even when upside down on a glass ceiling. It is very tempting to create a new type of adhesive by mimicking the gecko mechanism. Here we report on a prototype of such 'gecko tape' made by microfabrication of dense arrays of flexible plastic pillars, the geometry of which is optimized to ensure their collective adhesion. Our approach shows a way to manufacture self-cleaning, re-attachable dry adhesives, although problems related to their durability and mass production are yet to be resolved.

  2. Controlled Deposition of HAp Mimicking Tooth Enamel

    Institute of Scientific and Technical Information of China (English)

    2005-01-01

    Chemical compositions and microsturcture of mature human tooth enamel were investigated by XRD , FTIR and SEM to further understand the characteristics of tooth enamel. In order to obtain apatite crystals chemically and structurally similar to those in tooth enamel, biomimetic way was employed. Selfassembled monolyers terminated with-SO3 H groups were used as deposition substrates and 1.5 SBF ( the concentrations of Ca2+ and PO43- ions 1.5 times than those in simulated body fluid ) with and without 5 ppm F- were used as soaking medium. The XRD and FTIR results showed that both the deposited fluoride-substituted hydroxyapatite( F-HAp ) crystals in 1.5 SBF with F- and hydroxyapatite ( HAp ) crystals in 1.5 SBF were carbonate-containing, mimicking human tooth enamel in chemical compositions. The SEM photos showed that needle-like F-HAp crystals bad large aspect ratios and grew in bundles, which were similar to the crystals in human tooth enamel.The results provide available information on dental restoration.

  3. Lymphocitic infundibuloneurohypophysitis mimicking a pituitary adenoma

    Directory of Open Access Journals (Sweden)

    Hubertus Maximilian Mehdorn

    2011-04-01

    Full Text Available A rare case of infundibulo-neurohypophysitis mimicking a pituitary adenoma is presented. A 69-years-old female patient developed polyuria and polydipsia. Laboratory analysis revealed central diabetes insipidus. No hormonal abnormalities. Cranial-magnetic resonance imaging (MRI showed a left sided mass in the adenohypophysis presuming a pituitary adenoma. The mass had contact to both internal carotids. Admission to our department for neurosurgical treatment followed. Ophthalmo - logic examination and neurological examination yielded normal findings. A second MRI focussing on the sellar-region showed a leftsided (T2-MRI.hyperintense, distended adenohypophysis, without contrast enhancement in T1. The stalk appeared thickened. T1- weighted sequences of the neurohypophysis showed loss of signal intensity. We diagnosed an infundibulo-neurohypophysitis and abstai - ned from surgical removal. The patient was discharged under treatment with corticosteroids and desmopressin. Hypophysitis is rare and shows special clinical characteristics. Despite defined radiological features to differentiate between hypophysitis and adenoma the possibility of misdiagnosis, and unnecessary surgical procedures, should always kept in mind.

  4. THE CHANGES OF RENAL HEMODYNAMICS IN THE FORMATION OF ASCITES INDUCED BY PORTAL HYPERTENSION

    Institute of Scientific and Technical Information of China (English)

    詹锋; 黄烈城

    2002-01-01

    Objective The renal hemodynamic alteration was sequentially studied in dogs with ascites due to portal hypertension.Methods The model of portal hypertension was established by the constriction of hepatic vein. Effective renal plasma flow (ERPF), systemic blood pressure, urinary excretion of sodium were measured. Eighteen dogs were studied until the ascites occurred.Results The ascites was generally detected between the sixth day and the eighth day after the portal hypertension occurred, the average being the seventh day. Mean artery pressure (MAP) and renal vascular resistance (RVR) were firstly changed after the portal vein pressure increased. MAP fell 17% (130.37mmHg±16.2 mmHg before the portal hypertension, 108.32 mmHg±10.47 mmHg after the portal hypertension on the 1st day, p<0.001) and RVR increased by 31% (0.38 mmHg. ml-1. min-1±0.09 mmHg. ml-1. min-1 before the portal hypertension, 0.5 mmHg. ml-1. min-1±0.15mmHg. ml-1. min-1 after the portal hypertension, P<0.05) after the portal hypertension occurred on the 2nd day, thereafter, MAP decreased and RVR increased continually. ERPF also fell in the forepart, but there was only significant difference in the appearance of ascites (P<0.05). Urinary excretion of sodium gradually fell after portal hypertension and reached the lowest value on the 7th day, and there was statistical significance from the 2nd day (59.86 mmol/min±25.96 mmol/min before portal hypertension, 31.95 mmol/min±18.79mmol/min after the portal hypertension on the 2nd day, p<0.05).Conclusion Our research indicates that the hemodynamics has been changed before the ascites occurred. The earliest change occurs in MAP and RVR, but no marked change is found in ERPF.

  5. Guillain Barre syndrome mimicking cerebral death

    Directory of Open Access Journals (Sweden)

    Rajdev S

    2003-01-01

    Full Text Available Guillain Barre Syndrome, an acute diffuse demyelinating disorder, predominantly present with the motor manifestations with few variants. The present report describes an unusual presentation of GBS, which initially suggested brain death. A 14 years old male presented with sudden onset of rapidly progressive weakness of all four limbs which progressively evolved into clinical condition simulating brain death.

  6. Non-harmful insertion of data mimicking computer network attacks

    Energy Technology Data Exchange (ETDEWEB)

    Neil, Joshua Charles; Kent, Alexander; Hash, Jr, Curtis Lee

    2016-06-21

    Non-harmful data mimicking computer network attacks may be inserted in a computer network. Anomalous real network connections may be generated between a plurality of computing systems in the network. Data mimicking an attack may also be generated. The generated data may be transmitted between the plurality of computing systems using the real network connections and measured to determine whether an attack is detected.

  7. Infrasellar craniopharyngioma mimicking a clival chordoma : a case report.

    Directory of Open Access Journals (Sweden)

    Kachhara R

    2002-04-01

    Full Text Available An unusual case of entirely infrasellar craniopharyngioma mimicking a clival chordoma is described. Only 22 cases of craniopharyngioma with nasopharyngeal extension have been reported in the literature. Of the reported cases, most were primarily intracranial with secondary downward extension; only two were thought to originate from an infrasellar location. The present case is another example of an entirely infrasellar craniopharyngioma, with extensive clival destruction, mimicking a clival chordoma. Relevant literature on the subject is reviewed.

  8. 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

  9. Redox signaling in acute pancreatitis

    Directory of Open Access Journals (Sweden)

    Salvador Pérez

    2015-08-01

    Full Text Available 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.

  10. Redox signaling in acute pancreatitis.

    Science.gov (United States)

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

    2015-08-01

    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.

  11. Noncavernous arteriovenous shunts mimicking carotid cavernous fistulae

    Science.gov (United States)

    Kobkitsuksakul, Chai; Jiarakongmun, Pakorn; Chanthanaphak, Ekachat; Singhara Na Ayudya, Sirintara (Pongpech)

    2016-01-01

    PURPOSE The classic symptoms and signs of carotid cavernous sinus fistula or cavernous sinus dural arteriovenous fistula (AVF) consist of eye redness, exophthalmos, and gaze abnormality. The angiography findings typically consist of arteriovenous shunt at cavernous sinus with ophthalmic venous drainage with or without cortical venous reflux. In rare circumstances, the shunts are localized outside the cavernous sinus, but mimic symptoms and radiography of the cavernous shunt. We would like to present the other locations of the arteriovenous shunt, which mimic the clinical presentation of carotid cavernous fistulae, and analyze venous drainages. METHODS We retrospectively examined the records of 350 patients who were given provisional diagnoses of carotid cavernous sinus fistulae or cavernous sinus dural AVF in the division of Interventional Neuroradiology, Ramathibodi Hospital, Bangkok between 2008 and 2014. Any patient with cavernous arteriovenous shunt was excluded. RESULTS Of those 350 patients, 10 patients (2.85%) were identified as having noncavernous sinus AVF. The angiographic diagnoses consisted of three anterior condylar (hypoglossal) dural AVF, two traumatic middle meningeal AVF, one lesser sphenoid wing dural AVF, one vertebro-vertebral fistula (VVF), one intraorbital AVF, one direct dural artery to cortical vein dural AVF, and one transverse-sigmoid dural AVF. Six cases (60%) were found to have venous efferent obstruction. CONCLUSION Arteriovenous shunts mimicking the cavernous AVF are rare, with a prevalence of only 2.85% in this series. The clinical presentation mainly depends on venous outflow. The venous outlet of the arteriovenous shunts is influenced by venous afferent-efferent patterns according to the venous anatomy of the central nervous system and the skull base, as well as by architectural disturbance, specifically, obstruction of the venous outflow. PMID:27767958

  12. Leber hereditary optic neuropathy mimicking neuromyelitis optica.

    Science.gov (United States)

    McClelland, Collin M; Van Stavern, Gregory P; Tselis, Alex C

    2011-09-01

    Leber hereditary optic neuropathy (LHON) is rarely associated with multiple sclerosis-like features. We present a case of a 65-year-old African American woman with LHON masquerading as neuromyelitis optica (NMO). We highlight the features of the clinical examination and MRI that were suggestive of an alternative diagnosis and review the literature regarding LHON and multiple sclerosis. The diagnosis of LHON should be considered in all cases of acute or subacute bilateral optic neuropathy, including presumed seronegative NMO.

  13. Co-Encapsulation of Doxorubicin With Galactoxyloglucan Nanoparticles for Intracellular Tumor-Targeted Delivery in Murine Ascites and Solid Tumors

    Directory of Open Access Journals (Sweden)

    Manu M. Joseph

    2014-10-01

    Full Text Available Doxorubicin (Dox treatment is limited by severe toxicity and frequent episodes of treatment failure. To minimize adverse events and improve drug delivery efficiently and specifically in cancer cells, encapsulation of Dox with naturally obtained galactoxyloglucan polysaccharide (PST001, isolated from Tamarindus indica was attempted. Thus formed PST-Dox nanoparticles induced apoptosis and exhibited significant cytotoxicity in murine ascites cell lines, Dalton’s lymphoma ascites and Ehrlich’s ascites carcinoma. The mechanism contributing to the augmented cytotoxicity of nanoconjugates at lower doses was validated by measuring the Dox intracellular uptake in human colon, leukemic and breast cancer cell lines. PST-Dox nanoparticles showed rapid internalization of Dox into cancer cells within a short period of incubation. Further, in vivo efficacy was tested in comparison to the parent counterparts - PST001 and Dox, in ascites and solid tumor syngraft mice models. Treatment of ascites tumors with PST-Dox nanoparticles significantly reduced the tumor volume, viable tumor cell count, and increased survival and percentage life span in the early, established and prophylactic phases of the disease. Administration of nanoparticles through intratumoral route delivered more robust antitumor response than the intraperitoneal route in solid malignancies. Thus, the results indicate that PST-Dox nanoparticles have greater potential compared to the Dox as targeted drug delivery nanocarriers for loco regional cancer chemotherapy applications.

  14. 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 AND 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...

  15. MicroRNA-155 is upregulated in ascites in patients with spontaneous bacterial peritonitis

    Science.gov (United States)

    Lutz, Philipp; M´haimid, Mohamed; Pohlmann, Alessandra; Lehmann, Jennifer; Jansen, Christian; Schierwagen, Robert; Klein, Sabine; Strassburg, Christian P.; Spengler, Ulrich; Trebicka, Jonel

    2017-01-01

    MircoRNA’s (miR) have been recognised as important modulators of gene expression and potential biomarkers. However, they have been rarely investigated in bio fluids apart from blood. We investigated the association of miR-125b and miR-155 with complications of cirrhosis. Ascites was prospectively collected from patients with cirrhosis undergoing paracentesis at our department. miR’s were determined in the supernatant using qPCR and normalized by SV-40. Clinical parameters were assessed at paracentesis and during follow-up. 76 specimens from 72 patients were analysed. MiR’s were not associated to age, sex or aetiology of cirrhosis. MiR-125b levels differed between patients with low and high MELD score, and miR-125b levels showed an inverse correlation to serum creatinine (r2 = −0.23; p = 0.05). MiR-155 was elevated in patients with spontaneous bacterial peritonitis (SBP) (n = 10; p = 0.04). MiR-155 levels differed between patients with and without 30-day survival (p = 0.02). No association of ascites levels of investigated miR’s to size of varices, episodes of gastrointestinal bleeding or hepatorenal syndrome was observed. While miR-125b levels in ascites seem to be associated with liver and renal dysfunction, miR-155 might be implicated in local immune response in SBP. PMID:28074870

  16. Microheterogeneity of transthyretin in serum and ascitic fluid of ovarian cancer patients

    Directory of Open Access Journals (Sweden)

    Mustea Alexander

    2005-10-01

    Full Text Available Abstract Background Transthyretin (TTR, a traditional biomarker for nutritional and inflammatory status exists in different molecular variants of yet unknown importance. A truncated form of TTR has recently been described to be part of a set of biomarkers for the diagnosis of ovarian cancer. The main aim of the study was therefore to characterize differences in microheterogeneity between ascitic fluid and plasma of women affected with ovarian cancer and to evaluate the tumor site as the possible source of TTR. Methods Subjects were 48 women with primary invasive epithelial ovarian cancer or recurrent ovarian carcinoma. The control group consisted of 20 postmenopausal women. TTR and retinol-binding protein (RBP levels were measured by enzyme-linked immunoassay (ELISA and C-reactive protein (CRP levels by a high-sensitivity latex particle turbidimetric assay. The molecular heterogeneity of TTR was analysed using immunoprecipitation and matrix-associated laser desorption ionization time-of-flight mass spectrometry (MALDI-TOF-MS. Presence of TTR in tumor tissue was determined with indirect peroxidase immunostaining. Results TTR and RBP (μg/ml levels in serum were 148.5 ± 96.7 and 22.5 ± 14.8 in affected women compared to 363.3 ± 105.5 and 55.8 ± 9.3 in healthy postmenopausal women (p 40 mg/ml (p = 0.08 for TTR; p Conclusion The severity of the cancer associated catabolism as well as the inflammation status affect serum TTR and RBP levels. Neither TTR nor its truncated form originates from tumor tissue and its occurrence in ascites may well reflect the filtration from blood into ascitic fluid.

  17. Funiculitis mimicking appendicitis: A rare culprit

    Directory of Open Access Journals (Sweden)

    Lindsey L. Perea

    2017-01-01

    Full Text Available Acute appendicitis is an extremely common cause for pediatric admissions, most notably presenting with right lower quadrant pain. There are few other etiologies for a young male to have pain aside from appendicitis. We present a young boy who presented with right lower quadrant abdominal pain and fevers, but was found to have funiculitis. Funiculitis, or inflammation of the spermatic cord, is a very rare condition in the pediatric population, almost always occurring in the elderly with urinary flow conditions. We share our case to remind providers the importance of a full differential diagnosis.

  18. Hemorrhagic chondroid chordoma mimicking pituitary apoplexy

    Energy Technology Data Exchange (ETDEWEB)

    Lee, H.J.; Kalnin, A.J.; Holodny, A.I. [Dept. of Radiology, University Hospital, Newark, NJ (United States); Schulder, M.; Grigorian, A. [Dept. of Neurosurgery, University Hospital, Newark, NJ (United States); Sharer, L.R. [Dept. of Pathology, University Hospital, Newark, NJ (United States)

    1998-11-01

    We describe a hemorrhagic chondroid chordoma involving the sella turcica with suprasellar extension. The CT and MRI appearances mimiked a hemorrhagic pituitary adenoma. Chondroid chordoma is a variant composed of elements of both chordoma and cartilaginous tissue. An uncommon bone neoplasm, located almost exclusively in the spheno-occipital region, it is usually not considered in the differential diagnosis of a tumor with acute hemorrhage in the sellar region. We discuss the clinical and radiological characteristics which may allow one to differentiate chondroid chordoma from other tumors of this area. (orig.) With 3 figs., 9 refs.

  19. Presence of hepcidin-25 in biological fluids: Bile,ascitic and pleural fluids

    Institute of Scientific and Technical Information of China (English)

    Jayantha; Arnold; Arvind; Sangwaiya; Vijay; Manglam; Frank; Geoghegan; Mark; Thursz; Mark; Busbridge

    2010-01-01

    AIM: To examine body fluids such as ascitic fluid (AF),saliva,bile and pleural effusions for the presence of hepcidin using a novel radioimmunoassay (RIA).METHODS: Serum samples were collected from 25 healthy volunteers (mean age: 36 ± 11.9 years,11 males,14 females).In addition bile was obtained from 12 patients undergoing endoscopic retrograde cholangiopancreatography (mean age: 66.9 ± 16.7 years,M:F = 5:7).Saliva was collected from 17 healthy volunteers (mean age: 35 ± 9.9 years,M:F = 8:9).Pleural and AF...

  20. Chylous ascites in a cheetah (Acinonyx jubatus) with venoocclusive liver disease.

    Science.gov (United States)

    Terrell, Scott P; Fontenot, Deidre K; Miller, Michele A; Weber, Martha A

    2003-12-01

    An 11-yr-old female cheetah (Acinonyx jubatus) was diagnosed clinically with hepatic and renal disease and euthanatized after an extended illness. Postmortem examination revealed 8-10 L of milky white fluid in the abdominal cavity and markedly dilated lymphatic vessels within the intestinal mesentery. The abdominal fluid was a chylous effusion based on the cytologic predominance of lymphocytes and macrophages and comparison of cholesterol and triglyceride levels in the fluid and in serum. Gross and histopathologic lesions in the liver were consistent with a diagnosis of venoocclusive liver disease. Chylous ascites is uncommon with human chronic liver disease and is rarely identified in animals.

  1. Antitumour activity of Prosopis cineraria (L.) Druce against Ehrlich ascites carcinoma-induced mice.

    Science.gov (United States)

    Robertson, Stellaa; Narayanan, N; Raj Kapoor, B

    2011-04-01

    The antitumour activity of the hydroalcoholic extract of the leaf (PCL) and stem bark (PCB) of Prosopis cineraria (L.) in Swiss albino mice was evaluated against an Ehrlich ascites carcinoma (EAC) tumour model. The activity was assessed using survival time, peritoneal cells, haematological studies, lipid peroxidation, antioxidant enzymes such as superoxide dismutase, catalase, glutathione peroxidase, glutathione S-transferase, solid tumour mass and in vitro cytotoxicity. PCL and PCB were found to be potent and possessed significant cytotoxicity towards EAC tumour cells.

  2. 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.

  3. Differential Diagnosis of a Severe Late Onset Ovarian Hyperstimulation Syndrome Associated with Prolonged Ascites Production – a Case Report

    Directory of Open Access Journals (Sweden)

    Ujvari E

    2005-01-01

    Full Text Available Capsule: A case of severe late onset ovarian hyperstimulation syndrome (OHSS with prolonged ascites production. Difficulties of differential diagnosis and management. Objective: This report describes a case of extremely prolonged, severe ovarian hyperstimulation syndrome. Results: 17 litres of ascites have been removed from the abdominal cavity by repeated paracenteses until the 25th week of pregnancy, which progressed after the complete resolution of symptoms to the 34th week, when cesarean section was done. Conclusion: Severe ovarian hyperstimulation syndrome can occasionally follow an unusually prolonged course. Chronic formation of abundant ascites, the presence of ovarian enlargement and elevated levels of certain tumour markers might raise the probability of ovarian cancer. Adequate differential diagnosis and management resulted in delivery of a healthy newborn.

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

    Directory of Open Access Journals (Sweden)

    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.

  5. the denver tube Combined with antiviral drugs In the treatment of HBV-related Cirrhosis with Refractory ascites:a Report of three Cases

    Institute of Scientific and Technical Information of China (English)

    Xiao-jin Wang; Li-qin Shi; Qing-chun Fu; Liu-da Ni; Feng Zhou; Jin-wei Chen; Cheng-wei Chen

    2014-01-01

    Treatment of nucleos(t)ide antiviral drugs for decompensated HBV-related cirrhosis can signiifcantly improve the prognosis. But those patients with refractory ascites possibly deteriorate due to the complications of ascites before any beneift from anti-viral drugs could be observed. Therefore, it is important to ifnd a way to help the patients with HBV-related cirrhosis and refractory ascites to receive the full beneifts 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 beneifts and maximize efifcacy of antiviral treatment.

  6. An unusual case of haemoperitonium and bladder invasion due to placenta percreta in the third trimester mimicking threatened uterine rupture

    Directory of Open Access Journals (Sweden)

    Shama Khan

    2016-02-01

    Full Text Available Placenta praevia percreta is a rare but potentially lethal complication of pregnancy. It has an increasing clinical significance due to its association with previous caesarian section and uterine curettage. Herein we report a patient with placenta percreta, presenting in the emergency as 33 weeks of gestation with acute pain in abdomen and haemorrhagic shock, mimicking silent spontaneous uterine rupture, managed by emergency caesarian section followed by cesarian hysterectomy and bladder repair. [Int J Reprod Contracept Obstet Gynecol 2016; 5(2.000: 556-558

  7. Studies on responsiveness of hepatoma cells to catecholamines. IV. Lack of adrenergic activation of phosphorylase in rat ascites hepatoma cells.

    Science.gov (United States)

    Miyamoto, K; Yanaoka, T; Sanae, F; Wakusawa, S; Koshiura, R

    1986-10-01

    Glycogen phosphorylase a activity in 7 rat ascites hepatoma cell lines treated with adrenergic agents, phenylephrine, epinephrine and isoproterenol, was investigated as compared with that in freshly isolated rat hepatocytes. Basal phosphorylase activities in hepatoma cells except AH7974 cells were lower than that in hepatocytes. Phosphorylase in hepatoma cells was not activated by any of the agents, while the enzyme activity in hepatocytes was clearly increased in a dose- and time-dependent manner. Phosphorylase in hepatocytes was sensitive to glucagon, but it was found to be insensitive to glucagon in all hepatoma cells. The present results suggest that rat ascites hepatoma cells may escape the glycogenolytic regulation by catecholamines and glucagon.

  8. THE STUDY OF ELEMENE OF INDUCTION APOPTOSIS ON ASCITES HEPATOMA CELL LINE Hca-F25/CL-16A3

    Institute of Scientific and Technical Information of China (English)

    Zuo Yunfei; Zhang Yaozheng; Zhang Hong

    1998-01-01

    Objective: To investigate the effect of inducing apoptosis of Elemene on ascites hepatoma cell line HcaF25/cL-16A3. By using immunhistochemistry and DNA electrophoresis, the mechanism of Elemene antitumor was studied. Results: The results showed that the Elemene can inhibit expression of bcl-2 in ascites hepatoma cell line Hca-F25/CL-16A3, and the Eiemene also can make DNA fragmentation in this cell line in vitro and in vivo.Conclusion: The data suggest that Elemene can inhibit the growth of tumor by inducing apoptosis.

  9. Mesalamine treatment mimicking relapse in a child with ulcerative colitis

    Institute of Scientific and Technical Information of China (English)

    Iva Hojsak; Ana M Pavić; Sanja Kolaček

    2014-01-01

    Background: There are reports on mesalamine-induced bloody diarrhea mimicking ulcerative colitis (UC) relapse, mostly in adults. Methods: Herein we present a case of a child with UC who developed relapse of hemorrhagic colitis related to mesalamine. Results: A 10-year-old girl developed severe symptoms mimicking UC relapse 3 weeks after introduction of mesalamine therapy. After mesalamine was withdrawn, her symptoms improved, but deteriorated again during the challenge of mesalamine despite concomitant use of corticosteroids. Conclusion: This is the fi rst case report on such a young child during the concomitant use of corticosteroids.

  10. Generalized intramuscular granulocytic sarcoma mimicking polymyositis

    Energy Technology Data Exchange (ETDEWEB)

    Fritz, Jan; Claussen, Claus D.; Pereira, Philippe L.; Horger, Marius S. [Eberhard-Karls-University, Department of Diagnostic Radiology, Tuebingen (Germany); Vogel, Wichard [Eberhard-Karls-University, Department of Internal Medicine-Oncology, Tuebingen (Germany); Wehrmann, Martin [Eberhard-Karls-University, Department of Pathology, Tuebingen (Germany)

    2007-10-15

    We report a case of granulocytic sarcoma exclusively manifesting as diffuse intramuscular infiltration of the proximal upper and lower limb girdle and the torso muscles in a patient with previous history of acute myelogenous leukemia 5a. Whole-body CT showed widespread distribution of ill-defined intramuscular, homogeneously enhancing lesions. On whole-body MRI, lesions were homogeneously hyperintense on fat saturated T2-weighted images, isointense on T1-weighted images and strongly enhancing after intravenous gadolinium contrast administration. Histopathology revealed muscular infiltration of blast cells with identical immunochemistry to the initial manifestation of leukemia, diagnostic for an extramedullary relapse manifesting as granulocytic sarcoma. CT and MRI characteristics of this previously undocumented manifestation of granulocytic sarcoma should assist in the identification of such cases. (orig.)

  11. 小儿胰源性腹水%Pancreatic Ascites in Children

    Institute of Scientific and Technical Information of China (English)

    王凤兰; 孙岩; 陶文芳

    1994-01-01

    The pancreatic ascites caused by the upper abdominal trauma is rarely found in children.4 patients with pancreatic ascites were admitted in our department with chief complaint of abdominal distension,pain,and loss of weight and increase of abdominal contour.The main clinical findings for the diagnosis are the history of an abdominal trauma and Cameron's trilogy which includes the increase of amylase in the serum.and the thoracic and abdominal fluid.The crucial treatment is the early effective drainage.%小儿胰源性腹水4例,主要表现为腹胀,腹痛,大量腹水,腹围增加,体重减轻,消瘦.腹水中淀粉酶和白蛋白增高是本病的特征.诊断主要依据腹部外伤史,Cameron三联征.早期充分腹腔引流是治疗成功的关键.

  12. The proton stoichiometry of electron transport in Ehrlich ascites tumor mitochondria.

    Science.gov (United States)

    Villalobo, A; Lehninger, A L

    1979-06-10

    Initial rate measurements of the stoichiometric relationships between H+ ejection, K+ and Ca2+ uptake, and electron transport were carried out on mitochondria from Ehrlich ascites tumor cells grown in mice. With succinate as substrate and N-ethylmaleimide to prevent interfering H+ reuptake via the phosphate carrier, close to 8 H+ were ejected per oxygen atom reduced (H+/O ejection ratio = 8.0); with the NAD-linked substrates pyruvate or pyruvate + malate, the H+/O ejection ratio was close to 12. The average H+/site ratio (H+ ejected/2e-/energy-conserving site) was thus close to 4. The simultaneous uptake of charge-compensating cations, either K+ (in the presence of valinomycin) or Ca2+, was also measured, yielding average K+/site uptake ratios of very close to 4 and Ca2+/site ratios close to 2. It was also demonstrated that each calcium ion enters the respiring tumor mitochondria carrying two positive electric charges. These stoichiometric data observed in mitochondria from Ehrlich ascites tumor cells thus are in complete agreement with similar data on normal rat liver and rat heart mitochondria and suggest that the H+/site ratio of mitochondrial electron transport may be 4 generally. It was also observed that the rate of deltaH+ back-decay in anaerobic tumor mitochondria following oxygen pulses is some 6- to 8-fold greater than in rat liver mitochondria tested at equal amounts of mitochondrial protein.

  13. Inhibition of oxidative phosphorylation in ascites tumor mitochondria and cells by intramitochondrial Ca2+.

    Science.gov (United States)

    Villalobo, A; Lehninger, A L

    1980-03-25

    Accumulation of Ca2+ (+ phosphate) by respiring mitochondria from Ehrlich ascites or AS30-D hepatoma tumor cells inhibits subsequent phosphorylating respiration in response to ADP. The respiratory chain is still functional since a proton-conducting uncoupler produces a normal stimulation of electron transport. The inhibition of phosphorylating respiration is caused by intramitochondrial Ca2+ (+ phosphate). ATP + Mg2+ together, but not singly, prevents the inhibitory action of Ca2+. Neither AMP, GTP, GDP, nor any other nucleoside 5'-triphosphate or 5'-diphosphate could replace ATP in this effect. Phosphorylating respiration on NAD(NADP)-linked substrates was much more susceptible to the inhibitory effect of intramitochondrial Ca2+ than succinate-linked respiration. Significant inhibition of oxidative phosphorylation is given by the endogenous Ca2+ present in freshly isolated tumor mitochondria. The phosphorylating respiration of permeabilized Ehrlich ascites tumor cells is also inhibited by Ca2+ accumulated by the mitochondria in situ. Possible causes of the Ca2+-induced inhibition of oxidative phosphorylation are considered.

  14. Sirolimus Therapy for Patients With Lymphangioleiomyomatosis Leads to Loss of Chylous Ascites and Circulating LAM Cells.

    Science.gov (United States)

    Harari, Sergio; Elia, Davide; Torre, Olga; Bulgheroni, Elisabetta; Provasi, Elena; Moss, Joel

    2016-08-01

    A young woman received a diagnosis of abdominal, sporadic lymphangioleiomyomatosis (LAM) and multiple abdominal lymphangioleiomyomas and was referred for recurrent chylous ascites responding only to a fat-free diet. On admission, pulmonary function test (PFT) results showed a moderate reduction in the transfer factor for carbon monoxide with normal exercise performance. The serum vascular endothelial growth factor D (VEGF-D) level was 2,209 pg/mL. DNA sequences, amplified at loci kg8, D16S3395, D16S3024, D16S521, and D16S291 on chromosome 16p13.3, showed a loss of heterozygosity (LOH) only for kg8. Fat-free total parenteral nutrition in association with sirolimus (2 mg po daily) was initiated. Serum sirolimus levels were maintained at concentrations between 5 and 15 ng/mL. After 1 month, reintroduction of a low-fat oral feeding was achieved without recurrence of ascites. PFT results were stable. Interestingly, clinical improvement was associated with a reduction in the VEGF-D serum level (1,558 pg/mL). LOH at the kg8 biomarker in blood LAM cells was no longer detected.

  15. Multiple Intramuscular Gouty Tophi Mimicking Deep Tissue Abscesses: A Case Report

    Science.gov (United States)

    Luu, Van T

    2014-01-01

    Introduction: Gout is a common metabolic disorder resulting from supersaturation of uric acid in extracellular fluid and deposition of monosodium urate monohydrate crystals in tissues triggering inflammatory response. Depositions of uric acid crystal outside articular structures cause tophi and are commonly found at peripheral areas of the body which have a lower temperature. Deposition of uric acid crystals in the central area of the body is not uncommon and may be overlooked. Case presentation: A 55-year-old Pacific Islander man with a history of chronic tophaceous gout was admitted because of acute right knee pain. Physical examination revealed signs of inflammation over the right knee. Arthrocentesis was performed but no synovial fluid obtained. The patient was empirically treated with prednisone, colchicine, and febuxostat. On the next day, there was progression of inflammation up to the right mid-thigh. MRI of the right femur was obtained to exclude abscess and necrotizing faciitis. Multiple pockets of abscesses were identified within the vastus medialis and vastus intermedius adjacent to the femoral shaft. This prompted immediate surgical consultation and incision and drainage. Intraoperative findings revealed healthy muscles and deposition of soft-tan material in the vastus medialis and vastus intermedius along and above the shaft of the femur. Culture of the surgical aspirate was negative and pathology showed needle-shaped structures consistent with uric acid crystals. Empiric antibiotic was discontinued. The patient's condition improved after treatment for acute gout. Pegloticase was also added to the treatment regimen during an outpatient follow up visit with his rheumatologist. At six month follow up, the patient reported excellent improvements in clinical symptoms. Discussion: Atypical presentations of chronic tophaceous gout can be a great mimicker, causing diagnostic challenges for clinicians. Our patient who had multiple intramuscular tophi

  16. Efficacy of tolvaptan in patients with refractory ascites in aclinical setting

    Institute of Scientific and Technical Information of China (English)

    2015-01-01

    AIM To elucidate the efficacies of tolvaptan (TLV)as a treatment for refractory ascites compared withconventional treatment.METHODS: We retrospectively enrolled 120 refractoryascites patients between January 1, 2009 and September31, 2014. Sixty patients were treated with oral TLVat a starting dose of 3.75 mg/d in addition to sodiumrestriction (〉 7 g/d), albumin infusion (10-20 g/wk), andstandard diuretic therapy (20-60 mg/d furosemide and25-50 mg/d spironolactone) and 60 patients with largevolume paracentesis in addition to sodium restriction(less than 7 g/d), albumin infusion (10-20 g/wk), andstandard diuretic therapy (20-120 mg/d furosemide and25-150 mg/d spironolactone). Patient demographicsand laboratory data, including liver function, werenot matched due to the small number of patients.Continuous variables were analyzed by unpaired t -testor paired t -test. Fisher's exact test was applied in casescomparing two nominal variables. We analyzed factorsaffecting clinical outcomes using receiver operatingcharacteristic curves and multivariate regressionanalysis. We also used multivariate Cox's proportionalhazard regression analysis to elucidate the risk factorsthat contributed to the increased incidence of ascites.RESULTS: TLV was effective in 38 (63.3%) patients.The best cut-off values for urine output and reducedurine osmolality as measures of refractory ascitesimprovement were 〉 1800 mL within the first 24 h and〉 30%, respectively. Multivariate regression analysisindicated that 〉 25% reduced urine osmolality [oddsratio (OR) = 20.7; P 〈 0.01] and positive hepatitis Cviral antibodies (OR = 5.93; P = 0.05) were positivelycorrelated with an improvement of refractory ascites,while the total bilirubin level per 1.0 mg/dL (OR = 0.57;P = 0.02) was negatively correlated with improvement.In comparing the TLV group and controls, only theserum sodium level was significantly lower in the TLVgroup (133 mEq/L vs

  17. Acute headache as a presenting symptom of tacrolimus encephalopathy.

    NARCIS (Netherlands)

    Kiemeneij, I.M.; Leeuw, H.F. de; Ramos, L.; Gijn, J. van

    2003-01-01

    A 24 year old woman presented with a sudden excruciating headache mimicking an acute vascular event. She had undergone a lung transplantation because of cystic fibrosis and was receiving maintenance treatment with tacrolimus and prednisone. Ancillary investigation excluded vascular causes. Magnetic

  18. 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.

  19. 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 cirrhos...

  20. Contribution of the Kallikrein/Kinin System to the Mediation of ConA-Induced Inflammatory Ascites.

    Science.gov (United States)

    Baintner, Károly

    2016-03-01

    Intraperitoneal administration of concanavalin A (ConA, 25 mg/kg b.w.), a cell-binding plant lectin was used for inducing inflammatory ascites, and potential inhibitors were tested in 1 h and 2.5 h experiments, i.e. still before the major influx of leucocytes. At the end of the experiment the peritoneal fluid was collected and measured. The ConA-induced ascites was significantly (p<0.01) and dose-dependently inhibited by icatibant (HOE-140), a synthetic polypeptide antagonist of bradykinin receptors. Aprotinin, a kallikrein inhibitor protein also had significant (p<0.01), but less marked inhibitory effect. L-NAME, an inhibitor of NO synthesis, and atropine methylnitrate, an anticholinergic compound, were ineffective. It is concluded, that the kallikrein/kinin system contributes to the mediation of the ConA-induced ascites by increasing subperitoneal vascular permeability, independent of the eventual vasodilation produced by NO. It is known, that membrane glycoproteins are aggregated by the tetravalent ConA and the resulting distortion of membrane structure may explain the activation of the labile prekallikrein. Complete inhibition of the ConA-induced ascites could not be achieved by aprotinin or icatibant, which indicates the involvement of additional mediators.

  1. 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 aff

  2. In-depth proteomics of ovarian cancer ascites: combining shotgun proteomics and selected reaction monitoring mass spectrometry.

    Science.gov (United States)

    Elschenbroich, Sarah; Ignatchenko, Vladimir; Clarke, Blaise; Kalloger, Steve E; Boutros, Paul C; Gramolini, Anthony O; Shaw, Patricia; Jurisica, Igor; Kislinger, Thomas

    2011-05-06

    Epithelial ovarian cancer (EOC) is the most common gynecological cancer and the ninth most common cancer overall. Major problems associated with EOC include poorly characterized disease progression, disease heterogeneity, lack of early detection markers and the development of chemoresistance. Early detection and treatment of EOC would significantly benefit from routine screening tests on available biofluids. We built on our experience in analyzing ovarian cancer ascites and present an analysis pipeline that combines discovery-based proteomics, bioinformatics prioritization and targeted proteomics quantification using Selected Reaction Monitoring Mass Spectrometry (SRM-MS). Ascitic fluids from patients with serous-type epithelial ovarian cancer were analyzed using comprehensive shotgun proteomics and compared to noncancerous ascitic fluids from patients with benign ovarian tumors. Integration of our data with published mRNA transcriptomic and proteomic data sets led to a panel of 51 candidate proteins. Systematic SRM-MS assay development was performed for a subset of these proteins using both synthetic peptides (13 proteins) and stable isotope labeled standards (4 proteins). Subsequently, precise relative quantification by stable isotope dilution-SRM (SID-SRM) in independent ascites and serum samples was performed as a proof-of-concept validation. The analysis strategy outlined here lays the foundation for future experiments using both larger numbers of patient samples and additional candidate proteins, and provides a template for the proteomics-based discovery of cancer biomarkers.

  3. Proton irradiation in a single fraction for hepatocellular carcinoma patients with uncontrollable ascites. Technical considerations and results

    Energy Technology Data Exchange (ETDEWEB)

    Hata, Masaharu [Tsukuba Univ., Ibaraki (Japan). Proton Medical Research Center; Tsukuba Univ., Ibaraki (Japan). Dept. of Radiation Oncology; Yokohama City Univ. Graduate School of Medicine, Kanagawa (Japan). Dept. of Radiology; Tokuuye, Koichi; Fukumitsu, Nobuyoshi; Hashimoto, Takayuki; Akine, Yasuyuki [Tsukuba Univ., Ibaraki (Japan). Proton Medical Research Center; Tsukuba Univ., Ibaraki (Japan). Dept. of Radiation Oncology; Sugahara, Shinji; Ohnishi, Kayoko; Nemoto, Keiko; Ohara, Kiyoshi [Tsukuba Univ., Ibaraki (Japan). Dept. of Radiation Oncology; Tohno, Eriko [Tsukuba Univ., Ibaraki (Japan). Dept. of Radiology; Sakae, Takeji [Tsukuba Univ., Ibaraki (Japan). Proton Medical Research Center

    2007-08-15

    Purpose: To present technical considerations and results of proton irradiation in a single fraction for hepatocellular carcinoma (HCC) patients with uncontrollable ascites. Patients and Methods: Three HCC patients with uncontrollable ascites underwent proton irradiation of 24 Gy in a single fraction. Hepatic tumors were solitary in two patients, and multiple in one, and tumor sizes were 30, 30, and 33 mm in maximum diameter. No patient had lymph node or distant metastases. The center position of radiation fields was determined and the beam range was adjusted, using CT data taken immediately before irradiation to compensate for changes in the volume of ascites. Adjustment of the beam range was within 6 mm in water-equivalent thickness. Results: All irradiated tumors showed objective responses, and were controlled during the follow-up period. Of the three patients, two were alive with no evidence of disease at 13 and 30 months, respectively, after treatment. The remaining patient died of ruptured esophageal varices 6 months after treatment. No therapy-related toxicity of grade 3 or more was observed. Conclusion: Proton beams were successfully adjusted immediately before irradiation. Single-dose irradiation with precisely adjusted proton beams may be tolerable for HCC patients with uncontrollable ascites. (orig.)

  4. Trichophyton Schoenleinii-induced widespread tinea corporis mimicking parapsoriasis.

    Science.gov (United States)

    Mansouri, P; Farshi, S; Khosravi, A R; Naraghi, Z S; Chalangari, R

    2012-06-01

    We report a case of extensive tinea corporis in an 80-year-old woman on her forearms, thighs, legs, buttocks and trunk, mimicking parapsoriasis due to Trichophyton schoenleinii, without scalp involvement. Diagnosis of Trichophyton schoenleinii was confirmed by microscopy and mycological culture specimens.

  5. Diffuse Large B Cell Lymphoma Mimicking Granulomatosis with Polyangiitis

    Directory of Open Access Journals (Sweden)

    Mohammad E. Naffaa

    2016-01-01

    Full Text Available In a patient with systemic multiorgan disease with overlapping features, the differential diagnosis included infectious diseases, malignancies, and systemic autoimmune or inflammatory diseases. We present an unusual case of a young male with B cell lymphoma who presented with symptoms mimicking systemic vasculitis and review the existing literature.

  6. Diffuse Large B Cell Lymphoma Mimicking Granulomatosis with Polyangiitis

    Science.gov (United States)

    Horowitz, Netanel; Ben-Itzhak, Ofer; Braun-Moscovici, Yolanda

    2016-01-01

    In a patient with systemic multiorgan disease with overlapping features, the differential diagnosis included infectious diseases, malignancies, and systemic autoimmune or inflammatory diseases. We present an unusual case of a young male with B cell lymphoma who presented with symptoms mimicking systemic vasculitis and review the existing literature. PMID:27293945

  7. Cutaneous lymphoid hyperplasia mimicking cutaneous lymphoma in a hyperthyroid cat.

    Science.gov (United States)

    Snead, Elisabeth; Kerr, Moira; Macdonald, Valerie

    2013-10-01

    A 12-year-old neutered male domestic shorthair cat presented for chronic, localized, swelling and crusting of the left upper lip, weight loss, sporadic vomiting, and focal alopecia between the scapulae was diagnosed with hyperthyroidism and regional eosinophilic lymphadenitis. Treatment with methimazole exacerbated an underlying hypersensitivity disorder leading to marked generalized lymphadenopathy that histologically mimicked lymphoma.

  8. Primary Papillary Mucinous Adenocarcinoma of the Ureter Mimicking Genitourinary Tuberculosis

    Directory of Open Access Journals (Sweden)

    Hanni Gulwani

    2010-01-01

    Full Text Available Primary adenocarcinomas of the renal pelvis and ureter are rare and account for less than 1% of all malignancies at this site. We report a case of primary papillary mucinous adenocarcinoma of the ureter that clinically mimicked genitourinary tuberculosis. Early diagnosis is important for the better outcome.

  9. Calcified Klatskin tumor mimicking intrahepatic stone: case report.

    Science.gov (United States)

    Park, H S; Han, J K; Lee, H S; Lee, K H; Kim, S H; Kim, K W; Kim, Y J; Kim, H-C; Choi, B I

    2005-01-01

    Calcification is a relatively uncommon manifestation of malignant liver neoplasm. Calcifications in peripheral cholangiocarcinomas but not in Klatskin tumor have been reported. We present a rare case of Klatskin tumor that had dystrophic calcification mimicking a intrahepatic stone in a 65-year-old man.

  10. Osteoid osteoma of the radial styloid mimicking de quervain tenosynovitis.

    Science.gov (United States)

    Chloros, George D; Themistocleous, George S; Papagelopoulos, Panayiotis J; Khaldi, Lubna; Efstathopoulos, Dimitrios G; Soucacos, Panayotis N

    2007-10-01

    A very unusual location of osteoid osteoma arising in the radial styloid is presented, which strongly mimicked de Quervain tenosynovitis, thereby resulting in the patient undergoing an additional unnecessary operation and a substantial delay of more than 2 years in diagnosis.

  11. Achromobacter xylosoxidans infection presenting as a pulmonary nodule mimicking cancer.

    Science.gov (United States)

    Claassen, Stephanie L; Reese, Jason M; Mysliwiec, Vincent; Mahlen, Steven D

    2011-07-01

    Achromobacter xylosoxidans is typically isolated from pulmonary sources, presenting as pneumonia in immunosuppressed individuals. We describe a novel clinical presentation of A. xylosoxidans infection presenting as multiple spiculated, pulmonary nodules mimicking cancer for which the patient underwent a wedge resection of the lung for diagnosis and staging of presumptive cancer.

  12. Headache attributed to unruptured saccular aneurysm, mimicking hemicrania continua.

    Science.gov (United States)

    Vikelis, Michail; Xifaras, Michail; Magoufis, Georgios; Gekas, Georgios; Mitsikostas, Dimos Dimitrios

    2005-06-01

    Unruptured cerebral arterial aneurysms most often remain asymptomatic, but they may cause headache or other symptoms or signs. We describe herewith a case of headache attributed to an unruptured internal carotid artery aneurysm, clearly mimicking the phenotype of hemicrania continua. Potential pathophysiological explanations and recommendations for recognition of similar cases are discussed.

  13. Retropharyngeal Calcific Tendinitis Mimicking a Retropharyngeal Phlegmon

    Directory of Open Access Journals (Sweden)

    Nathalie Gabra

    2013-01-01

    Full Text Available Background. Acute retropharyngeal tendinitis is a little known but not an uncommon condition. It was first described by Hartley in 1964 as an inflammation of the longus colli muscle secondary to calcium crystals deposition on its insertion. The calcifications are mostly located on the oblique portion of the muscle at the level of C1-C2. Methods. We will describe this disease through 4 cases that presented in our institution. Results. The most common symptoms are severe neck pain, odynophagia, and a painful restriction of neck movement. It is associated with mild fever and inflammatory lab findings such as a slight elevation of white blood cell count, erythrocyte sedimentation rate, and C-reactive protein. CT scan is recommended as the first-line imaging modality to establish a diagnosis. Treatments consist of NSAIDs and analgesics to accelerate the healing process. If symptoms are severe, a course of corticosteroids is required. Conclusion. Since the clinical and laboratory findings of this condition and those of a retropharyngeal abscess overlap, it is important to establish the right diagnosis in order to prevent more invasive procedures. A good knowledge of this clinical entity by otolaryngologists would prevent delays in hospital discharge and unnecessary anxiety.

  14. Cytotoxic and antiproliferative activity of Securidaca longepedunculata aqueous extract on Ehrlich ascites carcinoma cells in Swiss albino mice.

    Directory of Open Access Journals (Sweden)

    R A Lawal

    2012-12-01

    Full Text Available Summary: Securidaca longepedunculata is a savannah shrub found growing in tropical Africa. It is reputed to have more than a hundred medicinal uses and is a major component of anticancer decoctions in Nigeria. An attempt was made in this study to determine the in vitro and in vivo cytotoxic activity and possible pro-apoptotic effect of Securidaca longepedunculata aqueous root bark extract on Ehrlich ascites carcinoma cells. In vitro cytotoxic activity was determined using the Trypan blue assay by incubating Ehrlich ascites carcinoma cells with various concentrations of Securidaca longepedunculata aqueous extract. In vivo study was carried out by intraperitoneal administration of varied doses of Securidaca longepedunculata to tumour-bearing mice. Isolated DNA from Ehrlich ascites carcinoma cells in treated and untreated animals was used for DNA fragmentation assay on agarose gel. Securidaca longepedunculata Aqueous extract, Securidaca longepedunculata was cytotoxic to Ehrlich ascites both in vivo and in vitro. The IC50 of Securidaca longepedunculata was 67 µg/ml. Securidaca longepedunculata caused a decrease in angiogenesis as observed in the reduction in weight of treated animals and a reduction in volume of ascitic fluid in treated mice.  DNA fragmentation assay of Ehrlich ascites carcinoma cells from treated animals depicted a possible pro-apoptotic effect of the Securidaca longepedunculata extract due to the ladder forming pattern which was comparable to that of the standard drug (fluorouracil. Securidaca longepedunculata aqueous extract had a cytotoxic and pro-apoptotic effect on Ehrlich ascites carcinoma cells. Industrial relevance: The use of Securidaca longepedunculata in traditional medicine in the treatment and management of cancer has been brought to the fore. Development of herbal drugs from the crude extracts could be achieved due to findings suggesting the plant could increase life span in patients with advanced stages of cancer

  15. [Extracellular fluid, plasma and interstitial volume in cirrhotic patients without clinical edema or ascites].

    Science.gov (United States)

    Noguera Viñas, E C; Hames, W; Mothe, G; Barrionuevo, M P

    1989-01-01

    Extracellular fluid volume (E.C.F.) and plasma volume (P.V.), were measured with sodium sulfate labeled with 35I and 131I human serum albumin, respectively, by the dilution technique in control subjects and in cirrhotic patients without clinical ascites or edema, renal or hepatic failure, gastrointestinal bleeding or diuretics. Results are expressed as mean +/- DS in both ml/m2 and ml/kg. In normal subjects E.C.F. (n = 8) was 7,533 +/- 817 ml/m2 (201.3 +/- 182 ml/kg), P.V. (n = 11) 1,767 +/- 337 ml/m2 (47.2 +/- 9.3 ml/kg), and interstitial fluid (I.S.F.) (n = 7) 5,758 +/- 851 ml/m2 (Table 2). In cirrhotic patients E.C.F. (n = 11) was 10,318 +/- 2,980 ml/m2 (261.7 +/- 76.8 ml/kg), P.V. (n = 12) 2,649 +/- 558 ml/m2 (67.7 +/- 15.6 ml/kg) and I.S.F. (n = 11) 7,866 +/- 2,987 ml/m2 (Table 3). Cirrhotic patients compared with normal subjects have hypervolemia due to a significant E.C.F. and P.V. expansion (p less than 0.02 and less than 0.001 respectively) (Fig. 1). Reasons for E.C.F. and P.V. abnormalities in cirrhotic patients may reflect urinary sodium retention related to portal hipertension which stimulates aldosterone release or enhanced renal tubular sensitivity to the hormone. However, it is also possible that these patients, in the presence of hypoalbuminemia (Table 1), have no clinical edema or ascites due to increased glomerular filtration, suppressed release of vasopressin, increased natriuretic factor, and urinary prostaglandin excretion, in response to the intravascular expansion, all of which increased solute and water delivery to the distal nephron and improved renal water excretion. We conclude that in our clinical experience cirrhotic patients without ascites or edema have hypervolemia because of a disturbance in E.C.F.

  16. 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.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.

  17. Swelling and Replicative DNA Synthesis of Detergent-treated Mouse Ascites Sarcoma Cells

    Directory of Open Access Journals (Sweden)

    Seki,Shuji

    1978-04-01

    Full Text Available Previous investigation showed that mouse ascites sarcoma cells permeabilized with appropriate concentrations of detergents (Triton X-100, Nonidet P-40 and Brij 58 had high replicative DNA synthesis in the presence of the four deoxyribonucleoside triphosphates, ATP, Mg2+ and proper ionic environment. The present study showed the optimum detergent concentration for DNA synthesis coincided closely with the minimum detergent concentration for inducing cell swelling. Phase contrast microscopy and electron microscopy of Triton-permeabilized cells showed the characteristic swollen cytoplasms and nucleus. Autoradiographic study showed that the DNA synthesis in permeable cells was confined to the nucleus. Cell viability and [3H] deoxythymidine uptake were impaired at much lower concentrations of Triton X-100 than the optimum concentration for in vitro DNA synthesis. In Triton-permeabilized cells, the minimum Triton concentration that produced cell swelling also seemed to produce high repliative DNA synthesis, which reflects the in vivo state of DNA synthesis.

  18. Fractionation and characterization of euchromatin isolated from mouse ascites sarcoma cells

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    Inaba,Kozo

    1978-12-01

    Full Text Available Euchromatin specimen prepared by the usual method formed large clumps and had various shapes under electron microscopy. A method of separation of the euchromatin specimen into chromatin fractions having relatively homogeneous form was examined and partial characterization of these fractions was carried out. The heavy euchromatin fraction was a large network of thin fibrils (about 100 A in diameter and various thick fibers. The intermediate euchromatin fraction consisted of relatively homogeneous networks of thick knobby fibers (about 250 A in diameter. The light euchromatin fraction had metworks of thick fibers. These chromatin fractions were quantitatively prepared from sonicated nuclei of mouse ascites sarcoma cells. Twenty-one or twenty-two bands of non-histone proteins besides histones were detected in these chromatin fractions by SDS-polyacrylamide gel electrophoresis. There were significant differences in the electrophoretic patterns of non-histone proteins among these chromatin fractions.

  19. Ascites due to pre-sinusoidal portal hypertension in dogs: a retrospective analysis of 17 cases.

    Science.gov (United States)

    James, F E; Knowles, G W; Mansfield, C S; Robertson, I D

    2008-05-01

    Accumulation of a pure transudate abdominal effusion in the absence of significant hypoalbuminaemia is uncommon in dogs and is due to pre-sinusoidal portal hypertension. Reported causes of pre-sinusoidal portal hypertension vary, but suggest a reasonable prognosis. A retrospective analysis of 17 dogs that presented to our institution with ascites due to pre-sinusoidal portal hypertension identified idiopathic hepatic fibrosis or canine chronic hepatitis as the underlying cause in the majority of cases. Twelve (70.5%) dogs were 4 years of age or younger at time of presentation. Total serum protein was higher in dogs with chronic hepatitis than it was in dogs without inflammatory disease. The prognosis was generally poor and no histological, imaging or biochemical parameters were useful as prognostic indicators. Dogs died or were euthanased due to severe clinical signs associated with the portal hypertension and/or perceived poor prognosis.

  20. Human umbilical cord mesenchymal stem cells improve liver function and ascites in decompensated liver cirrhosis patients.

    Science.gov (United States)

    Zhang, Zheng; Lin, Hu; Shi, Ming; Xu, Ruonan; Fu, Junliang; Lv, Jiyun; Chen, Liming; Lv, Sa; Li, Yuanyuan; Yu, Shuangjie; Geng, Hua; Jin, Lei; Lau, George K K; Wang, Fu-Sheng

    2012-03-01

    Decompensated liver cirrhosis (LC), a life-threatening complication of chronic liver disease, is one of the major indications for liver transplantation. Recently, mesenchymal stem cell (MSC) transfusion has been shown to lead to the regression of liver fibrosis in mice and humans. This study examined the safety and efficacy of umbilical cord-derived MSC (UC-MSC) in patients with decompensated LC. A total of 45 chronic hepatitis B patients with decompensated LC, including 30 patients receiving UC-MSC transfusion, and 15 patients receiving saline as the control, were recruited; clinical parameters were detected during a 1-year follow-up period. No significant side-effects and complications were observed in either group. There was a significant reduction in the volume of ascites in patients treated with UC-MSC transfusion compared with controls (P decompensated LC. UC-MSC transfusion, therefore, might present a novel therapeutic approach for patients with decompensated LC.

  1. Cyathula prostrata:A potent source of anticancer agent against daltons ascites in Swiss albino mice

    Institute of Scientific and Technical Information of China (English)

    Priya K; Krishnakumari S; Vijayakumar M

    2013-01-01

    Objective:To evaluate the anticancer activity of the methanolic extract of Cyathula prostrata inEhrlich ascites carcinoma(EAC)-bearing mice with methotrexate as positive control in the advanced stage of tumorigenesis.Methods:EAC was induced in swiss albino mice by injecting 106 cell/mL of tumor cell suspension intraperitoneal.The methanolic extract of Cyathula prostrata effect on the tumor cell viability,DNA fragmentation andMTT assay were carried out.Results:Methanolic extract attenuated percentage increased in the cell survival time when compared to control group.However, the effect was less than that of methotrexat.Methotrexat and the extracts reversed the tumor-induced alterations inDNA fragmentation andMTT assay.Conclusions:The present study suggests that the methanol extract ofCyathula prostratahas significant anticancer activity and that is comparableto that of methotrexate.

  2. Screening differentially expressed genes in mouse hepatocarcinoma ascites cell line with high potential of lymphatic metastasis

    Institute of Scientific and Technical Information of China (English)

    Xiao-Nan Cui; Jian-Wu Tang; Li Hou; Bo Song; Li Li; Ji-Wei Liu

    2005-01-01

    AIM: To screen genes differentially expressed in mouse hepatocarcinoma ascites cell line with high potential of lymphatic metastasis.METHODS: A subtracted cDNA library of mouse hepatocarcinoma cell line with high potential of lymphatic metastatic Hca-F and its synogenetic cell line Hca-P with a low metastatic potential was constructed by suppression subtracted hybridization(SSH) method. The screened clones of the subtracted library were sequenced and GeneBank homology search was performed.RESULTS: Fourteen differentially expressed cDNA fragments of Hca-F were obtained with two novel genes.CONCLUSION: SSH is a useful technique to detect differentially expressioned genes and an effective method to clone novel genes.

  3. Anticancer activity of Jasminum angustifolium Linn against Ehrlich ascites carcinoma cells bearing mice

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    Pradeep Rajkumar

    2012-06-01

    Full Text Available Objective: Present investigations were carried out for evaluation of antitumor and in vitro antioxidant activity of ethanol and aqueous extracts of Jasminum angustifolium Linn. Methods: For its antitumor activity, Ehrlich ascites carcinoma (EAC induced swiss albino mice were used and were divided into five group with 6 animal each.The antitumor effect was assessed using viable tumour cell count, packed cell volume, body weight, mean survival time and percentage increase in life span. Apart from that, hematological and liver enzyme studies were noticed upon the ethanol and aqueous extracts of Jasminum angustifolium Linn administered at 500 mg/kg per day for 14 days, after 24 hours of tumor inoculation. Results: Treatment with extracts significantly restored the altered parameters to normal when compared to cancer control group. Conclusion: The results suggest that ethanol extract of Jasminum angustifolium Linn possess significant antitumor effects in EAC tumour bearing mice. [J Exp Integr Med 2012; 2(3.000: 271-275

  4. Detection of ascitic feline coronavirus RNA from cats with clinically suspected feline infectious peritonitis.

    Science.gov (United States)

    Soma, Takehisa; Wada, Makoto; Taharaguchi, Satoshi; Tajima, Tomoko

    2013-10-01

    Ascitic feline coronavirus (FCoV) RNA was examined in 854 cats with suspected feline infectious peritonitis (FIP) by RT-PCR. The positivity was significantly higher in purebreds (62.2%) than in crossbreds (34.8%) (P<0.0001). Among purebreds, the positivities in the Norwegian forest cat (92.3%) and Scottish fold (77.6%) were significantly higher than the average of purebreds (P=0.0274 and 0.0251, respectively). The positivity was significantly higher in males (51.5%) than in females (35.7%) (P<0.0001), whereas no gender difference has generally been noted in FCoV antibody prevalence, indicating that FIP more frequently develops in males among FCoV-infected cats. Genotyping was performed for 377 gene-positive specimens. Type I (83.3%) was far more predominantly detected than type II (10.6%) (P<0.0001), similar to previous serological and genetic surveys.

  5. Acute pancreatitis

    Science.gov (United States)

    ... its blood vessels. This problem is called acute pancreatitis. Acute pancreatitis affects men more often than women. Certain ... pancreatitis; Pancreas - inflammation Images Digestive system Endocrine glands Pancreatitis, acute - CT scan Pancreatitis - series References Forsmark CE. Pancreatitis. ...

  6. Cystitis - acute

    Science.gov (United States)

    Uncomplicated urinary tract infection; UTI - acute cystitis; Acute bladder infection; Acute bacterial cystitis ... cause. Menopause also increases the risk for a urinary tract infection. The following also increase your chances of having ...

  7. Conservative management of eosinophilic enteritis presenting with acute abdominal syndrome

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    Marco Bassi

    2013-04-01

    Full Text Available Eosinophilic enteritis, an increasing recognized condition, is rare and often presents with non-specific symptoms. We report a case of a 46-year old female who presented with acute onset abdominal pain and nausea associated with ascites, small bowel thickening and peripheral eosinophilia. Diagnosis was confirmed by biopsies taken at esophagogastroduodenoscopy demonstrating diffuse infiltration by inflammatory cells, mainly eosinophils. Appropriate therapy was instituted. The patient recovered well and was symptom-free at 1-month follow up. In this report, we discuss the clinical presentation and the diagnostic criteria of the eosinophilic enteritis, and examine the pathophysiological theories and therapeutic strategies. The relevant literature on eosinophilic enteritis is summarized.

  8. Detection of Laminin in Serum and Ascites from Patients with Epithelial Ovarian Tumor

    Institute of Scientific and Technical Information of China (English)

    初永丽; 杨元先; 林美华; 王泽华

    2002-01-01

    The change in serum laminin (LN) level and its clinical significance in epithelial ovarian tumor were investigated. The LN levels in serum and ascites samples from 69 patients with epithelial ovarian tumor and 42 cases as control group before and after operation were analyzed by radioimmunoassay. The results showed that the serum LN levels in the patients with malignant tumors (157. 85 ± 14.37 ng/ml) were significantly higher than that in the control group (125.14 47.03ng/ml) and in the patients with benign tumors (128. 36±8. 75 ng/ml)(both P<0. 01) before operation. The serum LN levels in the malignant group were decreased significantly after operation as compared with those before operation (P<0. 05). The serum LN levels in low-differentiated tumors was higher than those in moderate-differentiated tumors and high-differentiated tumors (P<0. 05). The LN levels in ascites (172.94±15.26 ng/ml) was significantly higher than in serum (161.34±6.59ng/ml) (P<0. 05) in malignant tumors. The serum LN levels in the patients with lymph node metastasis (165.41± 19.91 ng/ml) was obviously higher than those without lymph node metastasis (152.35±10. 34 ng/ml)(P<0. 05). It was concluded that LN levels in serum and acistes were remarkably increased in malignant epithelial ovarian tumors, suggesting that LN might be one of important diameters reflecting tumor biological characteristics.

  9. Sclerosing epithelioid fibrosarcoma as a rare cause of ascites in a young man: a case report

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    Smith Philip J

    2008-07-01

    Full Text Available Abstract Introduction Sclerosing epithelioid fibrosarcoma is a rare but distinct variant of fibrosarcoma that not only presents as a deep-seated mass on the limbs and neck but can also occur adjacent to the fascia or peritoneum, as well as the trunk and spine. We report the case of an intra-abdominal sclerosing epithelioid fibrosarcoma, which to best of the authors' knowledge has not been described previously. The patient discussed here developed lung metastases but is still alive 1-year post-diagnosis. Case presentation A 29-year-old man presented with a 2-week history of progressive abdominal distension and pain and was found to have marked ascites. A full liver screen was unremarkable with abdominal and chest computed tomography scans only confirming ascites. After a diagnostic laparotomy, biopsies were taken from the greater omentum and peritoneal nodules. Histopathology revealed a malignant tumour composed of sheets and cords of small round cells set in collagenized stroma. After further molecular investigation at the Mayo Clinic, USA, the diagnosis of a high-grade sclerosing epithelioid fibrosarcoma was confirmed. Conclusion Sclerosing epithelioid fibrosarcoma is an extremely rare tumour, which is often difficult to diagnose and which few pathologists have encountered. This case is particularly unusual because of the intra-abdominal origin of the tumour. Owing to the rarity of sclerosing epithelioid fibrosarcoma, there is no clear evidence regarding the prognosis of such a tumour, although sclerosing epithelioid fibrosarcoma is able to metastasize many years post-presentation. It is important that physicians and pathologists are aware of this unusual tumour.

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

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    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

  11. The effects of feed restriction and ambient temperature on growth and ascites mortality of broilers reared at high altitude.

    Science.gov (United States)

    Ozkan, S; Takma, C; Yahav, S; Sögüt, B; Türkmut, L; Erturun, H; Cahaner, A

    2010-05-01

    The development of ascites was investigated in broilers at low versus high altitudes, cold versus normal ambient temperatures (AT), and 3 feeding regimens. One-day-old chicks obtained at sea level were reared at high altitude (highA; 1,720 m; n = 576) with 2 AT treatments, low AT from 3 wk onward at highA (highA/cold) and normal AT from 3 wk onward at highA (highA/norm), or at sea level (normal AT from 3 wk onward at low altitude, lowA/norm; n = 540). Under highA/cold, AT ranged between 16 to 17 degrees C in the fourth week, 17 to 19 degrees C in the fifth week, and 19 to 21 degrees C thereafter. Under highA/norm and lowA/norm, AT was 24 degrees C in the fourth week and ranged between 22 to 24 degrees C thereafter. Broilers in each condition were divided into 3 groups: feed restriction (FR) from 7 to 14 d, FR from 7 to 21 d, and ad libitum (AL). Ascites mortality and related parameters were recorded. Low mortality (0.4%) occurred under lowA/norm conditions. Under highA/norm, mortality was lower in females (8.6%) than in males (13.8%) and was not affected by the feeding regimen. The highA/cold treatment resulted in higher mortality but only in males; it was 44.2% among highA/cold AL-fed males and only about 26% under the FR regimens, suggesting that FR helped some males to better acclimatize to the highA/cold environment and avoid ascites. However, mortality was only 13.3% in AL-fed males at highA/norm and FR did not further reduce the incidence of ascites under these conditions. Thus, avoiding low AT in the poultry house by slight heating was more effective than FR in reducing ascites mortality at highA. Compared with FR from 7 to 14 d, FR from 7 to 21 d did not further reduce mortality and reduced growth. At 47 d, the majority of surviving broilers at highA had high levels of hematocrit and right ventricle:total ventricle weight ratio (>0.29), but they were healthy and reached approximately the same BW as their counterparts at low altitude. This finding may

  12. Hemodynamic Consequences of Malignant Ascites in Epithelial Ovarian Cancer Surgery*: A Prospective Substudy of a Randomized Controlled Trial.

    Science.gov (United States)

    Hunsicker, Oliver; Fotopoulou, Christina; Pietzner, Klaus; Koch, Mandy; Krannich, Alexander; Sehouli, Jalid; Spies, Claudia; Feldheiser, Aarne

    2015-12-01

    Malignant ascites (MA) is most commonly observed in patients scheduled for epithelial ovarian cancer (EOC) surgery and is supposed as a major risk factor promoting perioperative hemodynamic deterioration. We aimed to assess the hemodynamic consequences of MA on systemic circulation in patients undergoing cytoreductive EOC surgery.This study is a predefined post-hoc analysis of a randomized controlled pilot trial comparing intravenous solutions within a goal-directed algorithm to optimize hemodynamic therapy in patients undergoing cytoreductive EOC surgery. Ascites was used to stratify the EOC patients prior to randomization in the main study. We analyzed 2 groups according to the amount of ascites (NLAS: none or low ascites [500 mL]). Differences in hemodynamic variables with respect to time were analyzed using nonparametric analysis for longitudinal data and multivariate generalized estimating equation adjusting the analysis for the randomized study groups of the main study.A total of 31 patients in the NLAS and 16 patients in the HAS group were analyzed. Although cardiac output was not different between groups suggesting a similar circulatory blood flow, the HAS group revealed higher heart rates and lower stroke volumes during surgery. There were no differences in pressure-based hemodynamic variables. In the HAS group, fluid demands, reflected by the time to reindication of a fluid challenge after preload optimization, increased steadily, whereas stroke volume could not be maintained at baseline resulting in hemodynamic instability after 1.5 h of surgery. In contrast, in the NLAS group fluid demands were stable and stroke volume could be maintained during surgery. Clinically relevant associations of the type of fluid replacement with hemodynamic consequences were particularly observed in the HAS group, in which transfusion of fresh frozen plasma (FFP) was associated to an improved circulatory flow and reduced vasopressor and fluid demands, whereas the

  13. Granuloma inguinale mimicking as squamous cell carcinoma of penis

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    Abhishek Pilani

    2014-01-01

    Full Text Available Granuloma inguinale (GI is an acquired chronic, slowly progressive, mildly contagious disease of venereal origin, characterized by granulomatous ulceration of the genitalia and neighboring sites, with little or no tendency to spontaneous healing caused by Klebsiella (Calymmatobacterium granulomatis. A 55-year-old male presented with fissured, foul smelling, fungating growth over prepuce with phimosis mimicking squamous cell carcinoma (SCC without lymphadenopathy. It started with painless papulonodular showed pseudoepitheliomatous hyperplasia, infiltration in dermis, acanthosis and vacuolated macrophages suggestive of GI and not showing any histopathological features of SCC. Patient was successfully treated by giving cotrimoxazole twice a day for 21 days. Here, we presented a case of GI mimicking SCC of penis, which was diagnosed on basis of histopathology and treated with excision followed by medical therapy with cotrimoxazole.

  14. A Case of Abdominal Sarcoidosis in a Patient with Acute Myeloid Leukemia

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    Vadsala Baskaran

    2013-01-01

    Full Text Available The allogeneic bone marrow transplantation usually preceded by induction chemotherapy, in fit patients, represents the gold standard in the acute myeloid leukaemia. In the last years, many trials have been set up with the view of improving the number of remissions during the induction by adding new drugs. Several early or late side effects have been described in the literature. We herein present a patient with acute myeloid leukaemia patient who, after chemotherapy, developed ascites that turned out to be abdominal sarcoidosis.

  15. Mimicking biological functionality with polymers for biomedical applications

    Science.gov (United States)

    Green, Jordan J.; Elisseeff, Jennifer H.

    2016-12-01

    The vast opportunities for biomaterials design and functionality enabled by mimicking nature continue to stretch the limits of imagination. As both biological understanding and engineering capabilities develop, more sophisticated biomedical materials can be synthesized that have multifaceted chemical, biological and physical characteristics designed to achieve specific therapeutic goals. Mimicry is being used in the design of polymers for biomedical applications that are required locally in tissues, systemically throughout the body, and at the interface with tissues.

  16. Localized IgG4-related Cholecystitis Mimicking Gallbladder Cancer.

    Science.gov (United States)

    Inoue, Tadahisa; Okumura, Fumihiro; Mizushima, Takashi; Nishie, Hirotada; Iwasaki, Hiroyasu; Anbe, Kaiki; Ozeki, Takanori; Kachi, Kenta; Fukusada, Shigeki; Suzuki, Yuta; Watanabe, Kazuko; Sano, Hitoshi

    2015-01-01

    We encountered a case of localized IgG4-cholecystitis mimicking gallbladder cancer with focal/segmental type1 autoimmune pancreatitis (AIP). In this case, we were unable to exclude a diagnosis of gallbladder cancer and thus performed radical cholecystectomy. Type1 AIP is often associated with gallbladder lesions, accompanied by generally diffuse, circumferential thickening of the gallbladder wall. Although localized IgG4-related cholecystitis is extremely rare, differentiating this condition from gallbladder cancer is often very difficult.

  17. Embryonal rhabdomyosarcoma of the biliary tree mimicking a choledochal cyst

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    Nemade Bhushan

    2007-01-01

    Full Text Available Embryonal rhabdomyosarcoma (ERMS of biliary tree is a rare type of mesenchymal neoplasm diagnosed at surgery or by preoperative liver biopsy. We present a one year eight months old child who mimicked a choledochal cyst and was eventually treated with surgery, chemotherapy with IRS IV protocol and adjuvant postoperative radiotherapy to surgical bed with 6 MV photons to a dose of 5040cGy in 28 fractions.

  18. Osteofibrous dysplasia of clavicle clinically mimicking chronic osteomyelitis

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    Nirmal Raj Gopinathan

    2016-01-01

    Full Text Available Osteofibrous dysplasia or ossifying fibroma is an uncommon benign fibro-osseous lesion of childhood, commonly described in the maxilla and the mandible. Among long bones, it usually presents in the tibia as a painless swelling or anterior bowing. Ossifying fibroma of clavicle has never been reported in English literature, to the best of our knowledge. Here, we would like to present an unusual case of osteofibrous dysplasia of clavicle clinically mimicking chronic osteomyelitis.

  19. Osteolytic nasal polyp of the maxillary sinus mimicking malignancy

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    Arvind Karikal

    2014-01-01

    Full Text Available We present an osteolytic nasal polyp of the maxillary sinus with clinical features and radiographic features mimicking that of a malignancy. Maxillary sinusitis being a common inflammatory condition progressed to cause destruction of the maxillary bone and spread into the facial soft tissue, which is quite a rare occurrence. We have discussed in detail the clinical, radiological, histopathology and management of this uncommon presentation of a common case.

  20. Spitz Nevus on the Earlobe Mimicking Cutaneous Leishmaniasis

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    İbrahim Özmen

    2010-06-01

    Full Text Available Spitz nevus is a benign, usually acquired melanocytic tumor which is seen especially in children and adolescents. It usually appears as a pink or light-brown, smooth-surfaced, well-circumscribed and asymptomatic papulonodular lesion. A large group of dermatologic disorders should be considered in the differential diagnosis. Herein we present a case of Spitz nevus with a two month history of a nodular lesion on the earlobe which mimicks cutaneous leishmaniasis clinically.

  1. Tuberculosis of the skull mimicking a bony tumor

    OpenAIRE

    2016-01-01

    We present a rare case of calvarial tuberculosis mimicking a solitary bone tumor, which was surgically removed. A 52-year-old female presented with a right forehead swelling, which gradually enlarged over the course of 2 years, with no symptoms or raised intracranial pressure or neurological deficits. Plain and contrast-enhanced brain computed tomography scans were done, revealing a punched-out lesion of the right frontal bone, with a nonenhancing lytic mass. With an initial diagnosis of an i...

  2. A case of gallbladder mass: Malakoplakia (The tumor mimicker

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    Kanwaljeet Singh

    2017-01-01

    Full Text Available Diagnosis of malakoplakia presenting as gall bladder mass is a diagnostic dilemma faced by pathologists, radiologists, and surgeons. Malakoplakia is a rare inflammatory disorder and tumor mimicker usually occurring in the urinary tract, may occasionally be found in gall bladder. Here, we present a rare case, presenting as gall bladder mass in a known case of gallstone disease, clinically suspected as carcinoma and later turned out to be malakoplakia in gall bladder.

  3. Heparin-Mimicking Polymers: Synthesis and Biological Applications

    Science.gov (United States)

    2016-01-01

    Heparin is a naturally occurring, highly sulfated polysaccharide that plays a critical role in a range of different biological processes. Therapeutically, it is mostly commonly used as an injectable solution as an anticoagulant for a variety of indications, although it has also been employed in other forms such as coatings on various biomedical devices. Due to the diverse functions of this polysaccharide in the body, including anticoagulation, tissue regeneration, anti-inflammation, and protein stabilization, and drawbacks of its use, analogous heparin-mimicking materials are also widely studied for therapeutic applications. This review focuses on one type of these materials, namely, synthetic heparin-mimicking polymers. Utilization of these polymers provides significant benefits compared to heparin, including enhancing therapeutic efficacy and reducing side effects as a result of fine-tuning heparin-binding motifs and other molecular characteristics. The major types of the various polymers are summarized, as well as their applications. Because development of a broader range of heparin-mimicking materials would further expand the impact of these polymers in the treatment of various diseases, future directions are also discussed. PMID:27739666

  4. The Effect of the First Spontaneous Bacterial Peritonitis Event on the Mortality of Cirrhotic Patients with Ascites: A Nationwide Population-Based Study in Taiwan

    OpenAIRE

    Hung, Tsung-Hsing; Tsai, Chen-Chi; Hsieh, Yu-Hsi; Tsai, Chih-Chun; Tseng, Chih-Wei; Tseng, Kuo-Chih

    2016-01-01

    Background/Aims Spontaneous bacterial peritonitis (SBP) contributes to poorer short-term mortality in cirrhotic patients with ascites. However, it is unknown how long the effect of the first SBP event persists in these patients. Methods The National Health Insurance Database, derived from the Taiwan National Health Insurance Program, was used to identify and enroll 7,892 cirrhotic patients with ascites who were hospitalized between January 1 and December 31, 2007. All patients were free from ...

  5. Acute Bronchitis

    Science.gov (United States)

    ... Smoking also slows down the healing process. Acute bronchitis treatment Most cases of acute bronchitis can be treated at home.Drink fluids, but ... bronchial tree. Your doctor will decide if this treatment is right for you. Living with acute bronchitis Most cases of acute bronchitis go away on ...

  6. Acute renal infarction: an unusual cause of abdominal pain.

    Science.gov (United States)

    Javaid, Muhammad M; Butt, Mohammed A; Syed, Yadullah; Carr, Patrick

    2009-01-01

    Acute renal infarction is an uncommon and under-diagnosed disease. Its clinical presentation is nonspecific and often mimics other more common disease entities. The diagnosis is usually missed or delayed, which frequently results in irreversible renal parenchyma damage. High index of suspicion is required for early diagnosis, as timely intervention may prevent loss of kidney function. We report a case of acute renal infarction following coronary angiography in a patient with paroxysmal atrial fibrillation who initially presented with acute abdominal pain mimicking appendicitis.

  7. Tumor inhibitory activity of methanolic and ethyl acetate soluble extracts of Thuja occidentalis L. on mice bearing Ehrlich ascites carcinoma.

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    Archana M Navale

    2014-06-01

    Full Text Available Thuja occidentalis (Cupressaceae is an ornamental plant of European origin. It has been used in folk medicine for the treatment of cancer. Mice bearing Ehrlich Ascites Carcinoma (EAC mice were treated with methanolic extract (165 mg/kg, ethyl acetate soluble fraction (30 mg/kg and combination of both extracts of TO. Inhibition of tumor growth, increase in survival time of animal with treatment, and hematological parameters were determined. Both methanolic and ethyl acetate soluble fractions of TO exerted tumor growth inhibitory activity in mice bearing EAC. Combination treatment of two extracts showed more pronounced effect. In conclusion, Methanolic and ethyl acetate soluble extracts of TO exhibit anticancer activity against Ehrlich ascites carcinoma in mice. Thus, it has anticancer potential and should be further evaluated in higher models.

  8. A case of successful management with splenectomy of intractable ascites due to congenital dyserythropoietic anemia type Ⅱ-induced cirrhosis

    Institute of Scientific and Technical Information of China (English)

    Themistoklis Vassiliadis; Ioannis Tsitouridis; Antonios Antoniadis; Panagiotis Semertzidis; Anna Kioumi; Evangelos Premetis; Nikolaos Eugenidis; Vassilia Garipidou; Vassilios Perifanis; Konstantinos Tziomalos; Olga Giouleme; Kalliopi Patsiaoura; Michalis Avramidis; Nikolaos Nikolaidis; Sofia Vakalopoulou

    2006-01-01

    The congenital dyserythropoietic anemias comprise a group of rare hereditary disorders of erythropoiesis,characterized by ineffective erythropoiesis as the predominant mechanism of anemia and by characteristic morphological aberrations of the majority of erythroblasts in the bone marrow. Congenital dyserythropoietic anemia type Ⅱ is the most frequent type. All types of congenital dyserythropoietic anemias distinctly share a high incidence of iron loading. Iron accumulation occurs even in untransfused patients and can result in heart failure and liver cirrhosis. We have reported about a patient who presented with liver cirrhosis and intractable ascites caused by congenital dyserythropoietic anemia type Ⅱ. Her clinical course was further complicated by the development of autoimmune hemolytic anemia. Splenectomy was eventually performed which achieved complete resolution of ascites, increase of hemoglobin concentration and abrogation of transfusion requirements.

  9. The isolation of lysosomes from Ehrlich ascites tumor cells following pretreatment of mice with Triton WR-1339.

    Science.gov (United States)

    Horvat, A; Baxandall, J; Touster, O

    1969-08-01

    A method is described for obtaining highly purified lysosomes from Ehrlich ascites tumo cells grown in mice injected with Triton WR-1339. The isolated particles show a high specific activity for aryl sulfatase, representing an 80-90-fold purification over the homogenate, and a 15-18% yield of the total enzyme activity. Mitochondrial and microsomal marker enzymes are present in negligible amounts (0.2% of the activity of the homogenate). The biochemical evidence for a rather high degree of homogeneity of the fraction is supported by the electron microscopic examination of the purified lysosomes. The intracellular localizations of N-acetyl-beta-glucosaminidase, NADH-cytochrome c reductase and NADPH-cytochrome c reductase in Ehrlich ascites cells are also reported, the first two being present in highest concentration in the combined mitochondrial-lysosomal fraction and the third in the microsomal fraction.

  10. Isolation and partial identification of eight endogenous G1 inhibitors of JB-1 ascites tumor cell proliferation.

    Science.gov (United States)

    Barfod, N M

    1982-06-01

    Eight endogenous G1 inhibitors of the proliferation of JB-1 ascites tumor cells have been isolated and characterized. The activity of the inhibitors has been analyzed on synchronized JB-1 (murine plasmacytoma) and L1A2 (murine sarcoma) cells in vitro using flow cytometry. The purified inhibitors have been tested for in vivo activity on partially synchronized JB-1 and L1A2 ascites tumors in situ. Four of the inhibitors exhibited a high degree of cell specificity (chalone-like inhibitors) and were chemically related, whereas the other four showed no cell specificity. In most extractions, the amount of cell-specific activity is more than 50% of the total G1-inhibitory activity. Most of the inhibitors are low-molecular-weight peptides and glycopeptides.

  11. Transjugular Intrahepatic Portosystemic Shunt for Treatment of Cirrhosis-related Chylothorax and Chylous Ascites: Single-institution Retrospective Experience

    Energy Technology Data Exchange (ETDEWEB)

    Kikolski, Steven G., E-mail: skikolski@ucsd.edu; Aryafar, Hamed, E-mail: haryafar@ucsd.edu; Rose, Steven C., E-mail: scrose@ucsd.edu [University of California San Diego Health Sciences, Department of Radiology (United States); Roberts, Anne C., E-mail: acroberts@ucsd.edu [University of California San Diego Health Sciences, Department of Vascular and Interventional Radiology (United States); Kinney, Thomas B., E-mail: tbkinney@ucsd.edu [University of California San Diego Health Sciences, Department of Radiology (United States)

    2013-08-01

    PurposeTo investigate the efficacy and safety of the use of transjugular intrahepatic portosystemic shunt (TIPS) creation to treat cirrhosis-related chylous collections (chylothorax and chylous ascites).MethodsWe retrospectively reviewed data from four patients treated for refractory cirrhosis-related chylous collections with TIPS at our institution over an 8 year period.ResultsOne patient had chylothorax, and three patients had concomitant chylothorax and chylous ascites. There were no major complications, and the only procedure-related complications occurred in two patients who had mild, treatable hepatic encephalopathy. All patients had improvement as defined by decreased need for thoracentesis or paracentesis, with postprocedure follow-up ranging from 19 to 491 days.ConclusionTIPS is a safe procedure that is effective in the treatment of cirrhosis-related chylous collections.

  12. Ascites in the Puerperium in the Context of a Woman with Turner Syndrome Who Conceived through Assisted Reproductive Technology

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    Nikolaos Tsagkas

    2015-01-01

    Full Text Available The case is about a young female who delivered twins by caesarean section (CS. On the 4th postoperative day, she presented with ascites which was resistant to empirical antibiotic and diuretic treatment. The woman was affected by Turner syndrome (TS; she had a medical background of chronic use of hormonal medication since puberty and conceived through ART- (assisted reproduction techniques- IVF-oocyte donation. It is important to exhibit high suspicion for clot formation in the hepatic vasculature during the puerperium, especially in the case of history of chronic hormone treatment. Ascites albumin gradient and Doppler values lead to the diagnosis of thrombosis and the administration of high doses of anticoagulants is considered to be fundamental.

  13. 肝硬化腹水诊治争议问题%Controversial problems in management of cirrhotic ascites

    Institute of Scientific and Technical Information of China (English)

    谢渭芬; 曾欣

    2014-01-01

    Ascites is an important indicator of poor prognosis of liver cirrhosis.Although several guidelines and consensus statements on the management of ascites have been published in the past years,there are still a lot of controversial problems in this regard.The current contro-versial problems and difficulties in the management of ascites,such as the timing of sodium supplementation or sodium restriction,the selec-tion of diuretics,the application value of aquaretics,the strategy of albumin administration after large-volume paracentesis,and the indica-tions and efficacy of transjugular intrahepatic portosystemic shunt,are reviewed.It is pointed out that further studies on these problems with evidence-based medicine means will enhance the diagnosis and treatment of cirrhotic ascites and improve patients'prognosis.%腹水是肝硬化预后不良的重要指标。近年来尽管出台了很多有关肝硬化腹水的指南和共识,但其处理中仍存在一些争议。回顾了目前肝硬化腹水处置中的难点及争议问题,如补钠和限钠的时机、利尿剂的选择、利水剂的应用价值、大量放腹水后补充白蛋白的方案、经颈静脉肝内门体分流术的指征和疗效等;并指出运用循证医学手段解决上述争议性问题,有助于提高肝硬化腹水的诊疗水平,改善患者预后。

  14. 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

    2015-11-01

    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.

  15. Bacterial DNA induces the complement system activation in serum and ascitic fluid from patients with advanced cirrhosis.

    Science.gov (United States)

    Francés, Rubén; González-Navajas, José M; Zapater, Pedro; Muñoz, Carlos; Caño, Rocío; Pascual, Sonia; Márquez, Dorkas; Santana, Francia; Pérez-Mateo, Miguel; Such, José

    2007-07-01

    Translocation of intestinal bacteria to ascitic fluid is, probably, the first step in the development of spontaneous bacterial peritonitis in patients with cirrhosis. Proteins of the complement system are soluble mediators implicated in the host immune response to bacterial infections and its activation has been traditionally considered to be an endotoxin-induced phenomenon. The aim of this study was to compare the modulation of these proteins in response to the presence of bacterial DNA and/or endotoxin in patients with advanced cirrhosis and ascites in different clinical conditions. Groups I and II consisted of patients without/with bacterial DNA. Group III included patients with spontaneous bacterial peritonitis and Group IV with patients receiving norfloxacin as secondary long-term prophylaxis of spontaneous bacterial peritonitis. Serum and ascitic fluid levels of endotoxin and truncated residues of the complement system were measured by ELISA. The complement system is triggered in response to bacterial DNA, as evidenced by significantly increased levels of C3b, membrane attack complex, and C5a in patients from Groups II and III compared with patients without bacterial DNA (Group I) and those receiving norfloxacin (Group IV). Gram classification did not further differentiate the immune response between patients within groups II and III, even though endotoxin levels were, as expected, significantly higher in patients with bacterial DNA from gram-negative microorganisms. The complement protein activation observed in patients with bacterial DNA in blood and ascitic fluid is indistinguishable from that observed in patients with spontaneous bacterial peritonitis and may occur in an endotoxin-independent manner.

  16. Effect of age of feed restriction and microelement supplementation to control ascites on production and carcass characteristics of broilers.

    Science.gov (United States)

    Camacho, M A; Suárez, M E; Herrera, J G; Cuca, J M; García-Bojalil, C M

    2004-04-01

    Three experiments were conducted, from January until September 2001, to estimate the optimized age to apply feed restriction to control mortality from ascites, with no negative effects on production and carcass characteristics of broilers. For each experiment, 1,200 1-d-old mixed Ross x Peterson chicks were reared in floor pens (50 chicks in each) and fed commercial feed. Feed restriction was applied for 8 h/d for 14 d at 21 or 28 d of age in experiment 1, 14 or 21 d in experiment 2, and 7 or 14 d in experiment 3. In experiments 2 and 3, a microelement supplement (without or with) was tested; the control groups received feed ad libitum and no supplement. Body weight gain, feed conversion, total mortality, and mortality from ascites, leg problems, and carcass characteristics were considered at the end of each experiment. The data were analyzed as a completely randomized design, or as a 2 x 2 factorial to estimate main and interaction effects (experiments 2 and 3). Additional analyses, including the control, were done; means comparisons were by orthogonal contrasts. The production and carcass characteristics of the restricted groups were lower than the control but were not statistically different in experiments 2 and 3, although the optimized age for feed restriction was at 7 d. Total mortality and mortality from ascites decreased by restriction, but leg problems increased without supplement. The results indicated that quantitative feed restriction and microelement supplementation at 7 d of age reduced mortality from ascites and leg problems and permitted compensatory growth sufficient to equal the production characteristics of the control group at 49 d of age. However, it is necessary to determine the specific microelements to be supplemented and to estimate the effects of season and genetic line.

  17. Obese rats exhibit high levels of fat necrosis and isoprostanes in taurocholate-induced acute pancreatitis.

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    Javier Pereda

    Full Text Available BACKGROUND: Obesity is a prognostic factor for severity in acute pancreatitis in humans. Our aim was to assess the role of oxidative stress and abdominal fat in the increased severity of acute pancreatitis in obese rats. METHODOLOGY: Taurocholate-induced acute pancreatitis was performed in lean and obese Zucker rats. Levels of reduced glutathione, oxidized glutathione, L-cysteine, cystine, and S-adenosylmethionine were measured in pancreas as well as the activities of serine/threonine protein phosphatases PP1 and PP2A and tyrosin phosphatases. Isoprostane, malondialdehyde, triglyceride, and free fatty acid levels and lipase activity were measured in plasma and ascites. Lipase activity was measured in white adipose tissue with and without necrosis and confirmed by western blotting. FINDINGS: Under basal conditions obese rats exhibited lower reduced glutathione levels in pancreas and higher triglyceride and free fatty acid levels in plasma than lean rats. S-adenosyl methionine levels were markedly increased in pancreas of obese rats. Acute pancreatitis in obese rats led to glutathione oxidation and lower reduced glutathione levels in pancreas together with decreased activities of redox-sensitive phosphatases PP1, and PP2A. S-adenosyl methionine levels decreased but cystine levels increased markedly in pancreas upon pancreatitis. Acute pancreatitis triggered an increase in isoprostane levels in plasma and ascites in obese rats. Free fatty acid levels were extremely high in pancreatitis-associated ascitic fluid from obese rats and lipase was bound with great affinity to white adipose tissue, especially to areas of necrosis. CONCLUSIONS: Our results show that oxidative stress occurs locally and systemically in obese rats with pancreatitis favouring inactivation of protein phosphatases in pancreas, which would promote up-regulation of pro-inflammatory cytokines, and the increase of isoprostanes which might cause powerful pulmonary and renal

  18. IDIOPATHIC OMENTAL INFARCTION : A RARE CAUSE OF ACUTE PAIN ABDOMEN

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    Narendra Nath

    2015-02-01

    Full Text Available Omental torsion leading on to omental infarction is an unusual cause of acute abdominal pain in adults. Often the condition mimics common causes of acute abdomen like acute cholecystitis, acute appendicitis or acute pancreatitis. A review of literature reveals that this enigmatic condition has been managed both non - operatively and by surgery in the past. We report the case of a 46 - year - old man who presented with a 4 - day history of severe right - sided abdominal pain mimicking acute cholecystitis. Abdominal CT scan revealed a right upper quadrant mass with a whirl - like appearance, suspicious for omental infarction. He was started on conservative management with analgesics and antibiotics. He improved symptomatically and was discharged

  19. Effects of diet and stress mimicked by corticosterone administration on early postmortem muscle metabolism of broiler chickens.

    Science.gov (United States)

    Lin, H; Sui, S J; Jiao, H C; Jiang, K J; Zhao, J P; Dong, H

    2007-03-01

    Three experiments were conducted to evaluate the effects of preslaughter physiological states mimicked by long- or short-term administration of corticosterone (CORT) and dietary energy sources on muscle glycogen contents and meat quality of broiler chickens. In experiment 1, the broilers were fed a high lipid diet (LD) or a normal diet (ND) that differed in carbohydrate (3.8%) and lipid (2.5%) contents from 21 d of age. From 28 d of age onwards, 50% of the chickens in each dietary treatment were subjected to CORT treatment (30 mg/kg of diet). At 7 and 11 d after CORT supplementation, musculus pectoralis major was sampled before and immediately after slaughter and analyzed for glycogen, pH, and R-value. In experiment 2, broilers, fed with the LD or ND diet from 21 d of age were subjected to 1 single s.c. injection of CORT (4 mg/kg of BW) for 3 h to mimicked acute stress at 46 d of age. In experiment 3, broiler chickens were supplied with water supplemented with glucose (30 g/L) for 1 wk before slaughter and were then subjected to the same CORT treatment as experiment 2. Blood and muscle samples were respectively obtained before and immediately after slaughter and analyzed for plasma glucose, urate and lactic acid, and muscle variables. Plasma concentrations of glucose and urate were significantly increased by acute CORT administration, whereas the lactic acid was not changed. Neither dietary energy source nor water glucose supplementation had any influence on the plasma variables. Dietary energy source or water glucose supplementation could not alter glycogen stores in musculus pectoralis major. Breast muscle glycogen stores were increased by stress mimicked by long-term CORT administration rather than by acute treatment. Preslaughter stress reactions had no relation to the depletion of breast muscle glycogen during the initial postmortem period. The initial breast muscle pH was significantly decreased by long-term CORT administration. The result suggests that short

  20. The Interstitial Lymphatic Peritoneal Mesothelium Axis in Portal Hypertensive Ascites: When in Danger, Go Back to the Sea

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    M. A. Aller

    2010-01-01

    Full Text Available Portal hypertension induces a splanchnic and systemic low-grade inflammatory response that could induce the expression of three phenotypes, named ischemia-reperfusion, leukocytic, and angiogenic phenotypes.During the splanchnic expression of these phenotypes, interstitial edema, increased lymph flow, and lymphangiogenesis are produced in the gastrointestinal tract. Associated liver disease increases intestinal bacterial translocation, splanchnic lymph flow, and induces ascites and hepatorenal syndrome. Extrahepatic cholestasis in the rat allows to study the worsening of the portal hypertensive syndrome when associated with chronic liver disease. The splanchnic interstitium, the mesenteric lymphatics, and the peritoneal mesothelium seem to create an inflammatory pathway that could have a key pathophysiological relevance in the production of the portal hypertension syndrome complications. The hypothetical comparison between the ascitic and the amniotic fluids allows for translational investigation. From a phylogenetic point of view, the ancestral mechanisms for amniotic fluid production were essential for animal survival out of the aquatic environment. However, their hypothetical appearance in the cirrhotic patient is considered pathological since ultimately they lead to ascites development. But, the adult human being would take advantage of the potential beneficial effects of this “amniotic-like fluid” to manage the interstitial fluids without adverse effects when chronic liver disease aggravates.

  1. Hyperthermic intraperitoneal chemotherapy as palliative treatment for malignant ascites A single-center experience and a review of the literature.

    Science.gov (United States)

    Graziosi, Luigina; Marino, Elisabetta; De Angelis, Verena; Rebonato, Alberto; Donini, Annibale

    L’ascite maligna rappresenta il quadro avanzato di anormale accumulo di liquido intraperitoneale in pazienti con carcinosi peritoneale. Questa condizione clinica può rappresentare la condizione terminale di questa patologia a pessima prognosi inficiando inoltre la qualità di vita dei pazienti. Le opzioni terapeutiche includono differenti procedure che hanno tuttavia una limitata efficacia e alcune criticità; diuretici, paracentesi, shunt veno-peritoneali, inibitori delle metallo proteasi, immunomodulatori e agenti biologici rappresentano alcuni esempi di queste procedure. Nessuno di questi approcci terapeutici rappresenta a oggi lo standard of care per questa patologia data la scarsa efficienza e l’alto grado di effetti collaterali. L’introduzione della chirurgia citoriduttiva e della chemio terapia ipertermica intraperitoneale sembra essere un approccio terapeutico valido nel trattamento dell’ascite maligna refrattaria, introdotto nelle ultime due decadi e che tutt’ora necessita di validazione scientifica. In questo lavoro condividiamo la nostra esperienza di tre casi affetti da ascite maligna refrattaria trattati con HIPEC; facciamo inoltre una revisione della letteratura.

  2. Characterization of a G1 inhibitor from old JB-1 ascites tumor fluid. Interaction with polyions and ion exchangers.

    Science.gov (United States)

    Barfod, N M; Bichel, P

    1976-09-17

    In most experimental ascites tumors the growth rate decreases with increasing age and cell number. This decrease is caused by a prolongation of the cell cycle and an increasing accumulation of noncycling cells in resting (or quiescent) G1 and G2 compartments. In cell-free ascitic fluid from the JB-1 ascites tumor in the plateau phase of growth, low molecular weight substances have been found which reversibly and specifically arrest JB-1 cells in G1 and G2. In order to characterize the JB-1 G1 inhibitor we have investigated the effect of ion exchangers and polyions on the activity of this inhibitor assayed in vitro by means of a partially synchronized JB-1 cell population analyzed by flow microfluorometry. The results indicate that polyanions and cation exchangers (immobilized polyanions) bind and abolish the G1-inhibitory activity. From this it is suggested that the G1 inhibitor is of a basic or polycationic nature. Since anion exchangers (immobilized polycations) are without effect on this activity it was surprising to find that polycations also neutralize the activity. The results indicate that this occurs by blocking an anionic G2-inhibitor receptor on the cell, thus preventing the polycationic G1 inhibitor from being bound to this receptor.

  3. A Neglected Case of Massive Urinary Ascites Secondary to Posterior Urethral Valve: A Developing World’s Scenario

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    Kanchan Kayastha

    2012-07-01

    Full Text Available Developing countries are not only lagging behind in health facilities but also literacy of the population. Many uneventfully manageable conditions use to present after complications have been occurred. Negligence of the poor people and their blind faith on the fraudulent quacks and peers add burden to the poor health facilities in the resource poor countries. This could be one of important reasons of higher mortality rate in our hospitals especially in neonates with poor reserves to combat these crises for long. Urinary ascites due to in-utero bladder perforation secondary to posterior urethral valves is a rare entity. This condition is being prevented in developed countries by Fetendo which involves decompression of the urinary bladder by vesico-amniotic shunting or by endoscopic in-utero valve ablation. For instance if bladder perforation has occurred, it can be amenable to drainage of urinary ascites with valve ablation. However, we received a delayed presenting case of in-utero bladder perforation with massive urinary ascites secondary to posterior urethral valve necessitating urgent intervention.

  4. Biochemical and pathological studies on the effects of levamisole and chlorambucil on Ehrlich ascites carcinoma-bearing mice

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    Fakhry S. Salem

    2011-01-01

    Full Text Available Clinicopathological studies on the effects of combining immunostimulant drugs (levamisole with anti-cancer drugs (chlorambucil revealed the enhancement of the latter against Ehrlich ascites carcinoma-bearing mice and resulted in a reduction in the size of tumour. An evaluation of liver and kidney functions showed a significant increase of alanine transaminase (ALT, aspartate transaminase (AST and creatinine in all groups. Histopathological studies of one group that received an intraperitoneal injection of Ehrlich ascites carcinoma cells (2.5 × 106 showed that hepatic parenchyma revealed degenerative changes. The portal area was oedematous and showed rounded cell aggregations. Cell death within hypertrophied Kupper cells was observed in some hepatic cells. The neoplastic emboli could be seen either inside blood vessels or hepatic sinusoids, while another group which had been treated orally with a combination of Leukeran™ (0.2 mg/kg body weight and levamisole (5 mg/kg body weight revealed that hepatic parenchyma revealed massive necrosis with proliferative bile duct epithelium. No neoplastic cells were observed without the hepatic parenchyma, while the renal cortex presented a large number of lymphocytes and plasma cells forming bands or aggregates, mainly around the blood vessels. It was concluded that the addition of levamisole to chlorambucil improved the anti-cancer effect of chlorambucil against Ehrlich ascites carcinoma. However, it had adverse effects on the liver and kidneys as shown by liver and kidney function tests and confirmed by histopathology.

  5. 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.

  6. Development and validation of the self-completed ascites impact measure to understand patient motivation for requesting a paracentesis

    Directory of Open Access Journals (Sweden)

    Crawford B

    2012-06-01

    Full Text Available Bruce Crawford,1 Elizabeth Piault,2 Walter Gotlieb,3 Florence Joulain41Mapi Values, Tokyo, Japan; 2Mapi Values, Boston, MA, USA; 3McGill University, Montreal, Quebec, Canada; 4Sanofi, Paris, FranceBackground: The Ascites Impact Measure (AIM was developed to record patients' daily experiences of symptoms that trigger a request for a paracentesis.Methods: Development of the AIM followed a rigorous step-wise approach, including a review of the literature, expert opinions, and qualitative research involving patients who experience symptomatic malignant ascites. The AIM's measurement properties were assessed using data from two international trials, including 59 ovarian cancer patients with symptomatic malignant ascites.Results: Following the literature review and expert discussions to develop the conceptual model, ten patients with symptomatic malignant ascites were interviewed in the item elicitation phase, resulting in a draft questionnaire with four questions. Validation analyses consisted of 59 patients pooled from two international trials. Inter-items correlations for the AIM were good (r > 0.60, except for the Pain item. Internal consistency reliability (α = 0.89 improved after removing the Pain item from the Total Symptom score (TSS. Test-retest reliability was sufficient. Scores significantly improved after paracentesis except for the Pain item. Preliminary estimates indicate that a two-point improvement on the three-item TSS (without the Abdominal Pain item could be interpreted as clinically meaningful.Conclusion: The Abdominal Pain item appears to behave differently than the other three items, and could be more related to cancer. While the validity of the AIM TSS (four-item is acceptable, removing the Pain item from the TSS scoring algorithm demonstrated better construct validity. In addition, test-retest reliability and responsiveness were found to be similar to the results for the four-item AIM TSS. The Pain item should be used as a

  7. 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.)

  8. 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

  9. Inhibition of Ehrlich ascites carcinoma by Manilkara zapota L. stem bark in Swiss albino mice

    Institute of Scientific and Technical Information of China (English)

    M Abu Osman; M Mamunur Rashid; M Abdul Aziz; M Rowshahul Habib; M Rezaul karim

    2011-01-01

    To evaluate the antitumor activity of Manilkara zapota (M. zapota) L. stem bark against Ehrlich ascites carcinoma (EAC) in Swiss albino mice. Methods: The in vivo antitumour activity of the ethyl acetate extract of stem bark of M. zapota L. (EASM) was evaluated at 50, 100 and 200 mg/kg bw against EAC using mean survival time. After administration of the extract of M. zapota, viable EAC cell count and body weight in the EAC tumour hosts were observed. The animal was also observed for improvement in the haematological parameters (e.g., heamoglobin content, red and white blood cells count and differential cell count) after EASM treatment. Results: Intraperitoneal administration of EASM reduced viable EAC cells, increased the survival time, and restored altered haematological parameters. Significant efficacy was observed for EASM at 100 mg/kg dose (P<0.05). Conclusions: It can be concluded that the ethyl acetate extract of stem bark of M. zapota L. possesses significant antitumour activity.

  10. Antiproliferative and hepatoprotective activity of metabolites from Corynebacterium xerosis against Ehrlich Ascites Carcinoma cells

    Institute of Scientific and Technical Information of China (English)

    Farhadul Islam; Soby Ghosh; Jahan Ara Khanam

    2014-01-01

    Objective: To find out the effective anticancer drugs from bacterial products, petroleum ether extract of Corynebacterium xerosis.Methods:parameters like tumor weight measurement, tumor cell growth inhibition in mice and survival time of tumor bearing mice, etc. Hepatoprotective effect of the metabolites was determined by observing biochemical, hematological parameters.Results:It has been found that the petroleum ether extract bacterial metabolite significantly Antiproliferative activity of the metabolite has been measured by monitoring the decrease cell growth (78.58%; P<0.01), tumor weight (36.04 %; P<0.01) and increase the life span of tumor bearing mice (69.23%; P<0.01) at dose 100 mg/kg (i.p.) in comparison to those of untreated Ehrlich ascites carcinoma (EAC) bearing mice. The metabolite also alters the depleted hematological parameters like red blood cell, white blood cell, hemoglobin (Hb%), etc. towards normal in tumor bearing mice. Metabolite show no adverse effect on liver functions regarding blood glucose, serum alkaline phosphatases, glutamic pyruvic transaminase, glutamic oxaloacetic transaminase activity and serum billirubin, etc. in normal mice. Histopathological observation of these mice organ does not show any toxic effect on cellular structure. But in the case of EAC bearing untreated mice these hematological and biochemical parameters deteriorate extremely with time whereas petroleum ether extract bacterial metabolite receiving EAC bearing mice nullified the toxicity induced by EAC cells.Conclusion:Study results reveal that metabolite possesses significant antiproliferative and hepatoprotective effect against EAC cells.

  11. Combination antitumor effect with central nervous system depressants on rat ascites hepatomas.

    Science.gov (United States)

    Koshiura, R; Miyamoto, K; Sanae, F

    1980-02-01

    Combined effect of twenty-one central nervous system depressants with several antitumor agents was studied in the in vitro and in vivo experimental systems, using rat ascites hepatoma call lines, AH13 and AH44, sensitive and insensitive to alkylating agents, respectively. Reserpine remarkably enhanced the cytotoxic effect of 1-(gamma-chloropropyl)-2-chloromethylpiperidine hydrobromide (CAP-2) both on AH13 and AH44 cells. In the in vivo combined experiments, reserpine also synergistically enhanced the life-prolonging effect of CAP-2 on AH13-bearing rats and, although CAP-2 was not potent on the prolongation of life span of AH44-bearing rats and reserpine was also ineffective at the doses examined, the life span of tumor-bearing rats receiving the combined administration was apparently prolonged compared with control groups. Thus, there was a parallelism between in vitro and in vivo experiments. These findings suggested that the antitumor-enhancing effect of reserpine might be due to the direct action on the tumor cells, and a possible mechanism that reserpine inhibited the DNA damage-repairing activity of the cells was contradictory. Other mechanisms are also discussed.

  12. [Expression of vimentin and prekeratins in solid and ascites variants of Zajdela hepatoma].

    Science.gov (United States)

    Karavanova, I D; Troianovskiĭ, S M; Bannikov, G A

    1987-04-01

    Using indirect immunofluorescence with monoclonal antibodies against prekeratins and vimentin, the contents and intracellular distribution of these proteins have been investigated in Seidel hepatoma cells. In ascitic tumour, cells were organized in multicellular unilayer spheric or ellipsoid complexes with an inner cavity. Such complexes have been found to express intracellular vimentin and chaotically distributed prekeratin filaments. One of the constituents of the normal epithelial basal membrane--laminin was not found on the basal surface of cellular complexes but was localized in their inner lumens only. The expression of vimentin and prekeratin filaments was preserved in metastatic tumour cells found in paratracheal lymph nodes and in the majority of solid tumour cells induced by subcutaneous cell injections. In both cases tumour cells did not form regular morphological structures and laminin was visualized as extracellular granules and short fibrils. In several cases subcutaneous injections of Seidel hepatoma cells gave rise to adenocarcinomas. Prekeratin filaments in these tumours were localized predominantly under cellular membranes. Laminin "membranes" outlined the basal surface of adenomatous structures. Vimentin in these cellular structures was completely absent. It is suggested that vimentin expression in Seidel hepatoma cells was suppressed with morphological normalization of tumour structures manifested in the regular distribution of intercellular contacts and in basal membrane reconstitution.

  13. Alterations in Arterial Blood Parameters in Patients with Liver Cirrhosis and Ascites

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    Konstantinos Charalabopoulos, Dimitrios Peschos, Leonidas Zoganas, George Bablekos, Christos Golias, Alexander Charalabopoulos, Dimitrios Stagikas, Angi Karakosta, Athanasios Papathanasopoulos, George Karachalios, Anna Batistatou

    2007-01-01

    Full Text Available In cirrhotic patients, in addition to hepatocytes and Kuppfer cells dysfunction circulatory anatomic shunt and ventilation/perfusion (VA/ Q ratio abnormalities can induce decrease in partial pressure of oxygen in arterial blood (PaO2, in oxygen saturation of hemoglobin (SaO2 as well as various acid-base disturbances. We studied 49 cases of liver cirrhosis (LC with ascites compared to 50 normal controls. Causes were: posthepatic 37 (75.51%, alcoholic 7 (14.24%, cardiac 2 (4.08%, and cryptogenic 3 (6.12%. Complications were: upper gastrointestinal bleeding 24 (48.97, hepatic encephalopathy 20 (40.81%, gastritis 28 (57.14%, hepatoma 5 (10.2%, renal hepatic syndrome 2 (4.01%, HbsAg (+ 24 (48.97%, and hepatic pleural effusions 7 (14.28%. Average PaO2 and SaO2 were 75.2 mmHg and 94.5 mmHg, respectively, compared to 94.2 mmHg and 97.1 mmHg of the control group, respectively (p value in both PaO2 and SaO2 was pA/Q inequality can induce a decrease in PaO2 and SaO2 as well as various acid-base disturbances. As a result, pulmonary resistance is impaired and patients more likely succumb to infections and adult respiratory distress syndrome.

  14. The Palliative Management of Refractory Cirrhotic Ascites Using the PleurX© Catheter

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    Jason Reinglas

    2016-01-01

    Full Text Available Background. Treatment options are limited for patients with refractory cirrhotic ascites (RCA. As such, we assessed the safety and effectiveness of the PleurX catheter for RCA. Methods. A retrospective analysis was performed on all patients with RCA who have undergone insertion of the PleurX catheter between 2007 and 2014 at our clinic. Results. Thirty-three patients with RCA were included in the study; 4 patients were lost to follow-up. All patients were still symptomatic despite bimonthly large volume paracentesis and were not candidates for TIPS or PV shunt. Technical success was achieved in 100% of patients. The median duration the catheter remained in situ was 117.5 days, with 95% CI of 48–182 days. Drain patency was maintained in 90% of patients. Microorganisms consistent with spontaneous bacterial peritonitis (SBP from a catheter source were isolated in 38% of patients. The median time to infection was 105 days, with 95% CI of 34–233 days. All patients were treated for SBP successfully with antibiotics. Conclusion. Use of the PleurX catheter for the management of RCA carries a high risk for infection when the catheter remains in situ for more than 3 months but has an excellent patency rate and did not result in significant renal injury.

  15. 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.)

  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. Hepatoprotective effect of acetone semicarbazone on Ehrlich ascites carcinoma induced carcinogenesis in experimental mice

    Institute of Scientific and Technical Information of China (English)

    Farhadul Islam; Shaikh Mohummad Mohsin Ali; Jahan Ara Khanam

    2013-01-01

    Objective:To determine the hepatoprotective effect of acetone semicarbazone (ASC) in vivo in normal and Ehrlich ascites carcinoma (EAC) bearing male Swiss albino mice. Methods:Drug-induced changes in biochemical and behavioral parameters at dose of 2.0 mg/kg body weight for 14 d and nullifying the toxicity induced by EAC cells were studied. The histopathology studies of the protective effects of ASC on vital organs were also assessed. Results:The administration of ASC made insignificant changes in body weight and behavioral (salivation, diarrhea, muscular numbness) changes during treatment period due to minor toxicity were minimized after the treatment in normal mice. The biochemical parameters, including serum glutamate pyruvate transaminase, glutamate oxaloactate transaminase, alkaline phosphatase, serum glucose, cholesterol, urea, triglyceride and billirubin changed modestly in normal mice receiving ASC. Though the treatment continued, these values gradually decreased to normal level after the treatment. In EAC bearing mice, the toxic effects due to EAC cells in all cases were nullified by treatment with the ASC. Significant abnormalities were not detected in histology of the various organs of the normal mice treated with ASC. Conclusions: ASC can, therefore, be considered safe in formulating novel anticancer drug, as it exhibits strong protective effect against EAC cell bearing mice.

  18. Symptomatic ecchordosis physaliphora mimicking as an intracranial arachnoid cyst.

    Science.gov (United States)

    Filis, Andreas; Kalakoti, Piyush; Nanda, Anil

    2016-06-01

    Ecchordosis physaliphora (EP) is a rare, benign tumor derived from the notochordal remnants. Usually slow growing with an indolent course, most cases are incidental findings on autopsy. Limited data exists on symptomatic patients with EP. Diagnosis mainly relies on correlating histopathologic findings confirming the notochordal elements with MRI. We herein present a middle aged woman with symptomatic EP in the pre-pontine cistern that mimicked an arachnoid cyst on preoperative scans. Additionally, we emphasize the pathological and radiological characteristics of EP that could aid in prompt diagnosis of the lesion with emphasis on considering EP as a differential for mass lesions localized in the pre-pontine cistern.

  19. Aneurysm of the common iliac vein mimicking a pelvic mass

    Energy Technology Data Exchange (ETDEWEB)

    Yoon, Eun Joo; Kim, Dong Hun [Dept. of Radiology, Chosun University College of Medicine, Gwangju (Korea, Republic of); Suk, Eun Ha [Dept. of Anesthesiology and Pain Medicine, Seonam University College of Medicine, Namwon (Korea, Republic of)

    2013-07-15

    Venous aneurysm, especially of primary origin, is rare. The authors report a case of a 63-year-old female who was admitted for back pain and an aneurysm of the common iliac which was detected incidentally. CT, magnetic resonance (MR), Doppler ultrasonography, and conventional venography showed an aneurysm of the left common iliac vein measuring 4.5 , 00D7, 3, 00D7, 4 cm. Because there were no complications of the aneurysm, no further treatment was administered. Herein, we describe findings of a venous aneurysm of the common iliac vein mimicking a pelvic mass on CT and MR scans and with a review of the literature.

  20. Intracortical bone metastasis mimicking intracortical osteoid osteoma: a case report

    Energy Technology Data Exchange (ETDEWEB)

    Shin, Yu Ri; Kim, Jee Young [St. Vincent' s Hospital, The Catholic University of Korea, Suwon (Korea, Republic of)

    2007-08-15

    Cortical metastasis usually occurs in the diaphysis of the long bones with the appearance of a cookie-bite pattern; this is associated with cortical destruction extending into the soft tissue as well as into the medullary cavity, or there can be a periosteal reaction. We report here on a 66-year-old woman who was diagnosed with intracortical metastasis in the proximal metaphysis of the right femur as an initial metastatic focus from primary lung cancer. CT detected an intracortical osteolytic lesion without cortical destruction or thickening. The MR images showed extensive peritumoral edema in the surrounding soft tissue and adjacent bone marrow edema, and this all mimicked osteoid osteoma.

  1. Enterobiasis in Ectopic Locations Mimicking Tumor-Like Lesions

    OpenAIRE

    Silvio Pampiglione; Francesco Rivasi

    2009-01-01

    Both the clinical and the histopathological diagnostic difficulties of oxyuriasis in unusual sites and their importance from a clinical point of view are pointed out. The authors report two ectoptic cases of enterobiasis observed in Northern Italy, one located in a fallopian tube of a 57-year-old woman and the other in a perianal subcutaneous tissue of a 59-year-old man, mimicking tumor-like lesions. The authors take advantage of the occasion to focus the attention of the medical world on thi...

  2. A huge renal capsular leiomyoma mimicking retroperitoneal sarcoma

    Directory of Open Access Journals (Sweden)

    Lal Anupam

    2009-01-01

    Full Text Available A huge left renal capsular leiomyoma mimicking retroperitoneal sarcoma presented in a patient as an abdominal mass. Computed tomography displayed a large heterogeneous retro-peritoneal mass in the left side of the abdomen with inferior and medial displacement as well as loss of fat plane with the left kidney. Surgical exploration revealed a capsulated mass that was tightly adherent to the left kidney; therefore, total tumor resection with radical left nephrectomy was performed. Histopathology ultimately confirmed the benign nature of the mass. This is the largest leiomyoma reported in literature to the best of our knowledge.

  3. Iliacus pyomyositis mimicking septic arthritis of the hip joint.

    Science.gov (United States)

    Chen W-S; Wan Y-L

    1996-01-01

    The iliacus muscle is closely associated with the psoas muscle, femoral nerve, hip joint, pelvic and intraabdominal structures; thus, its disorders may present as lower abdominal pain, hip pain, or femoral neuropathy. Iliacus pyomyositis, a primary bacterial infection of the skeletal muscle not secondary to a contiguous skin, bone, or soft-tissue infection, presenting as hip pain, femoral neuropathy, and sympathetic effusion of the hip joint in an 8-year-old boy mimicked septic arthritis of the hip joint. Computed tomography was helpful in delineating the accurate location of the lesion. Surgical drainage and appropriate antibiotic therapy led to complete resolution and full functional recovery.

  4. Subcutaneous phaeohyphomycosis due to Pyrenochaeta romeroi mimicking a synovial cyst

    Directory of Open Access Journals (Sweden)

    Aurelien Dinh

    2016-08-01

    Full Text Available Opportunistic subcutaneous fungal infections are increasing nowadays due to the growing number of medical conditions causing immunosuppression, especially organ transplant. The incidence rate of subcutaneous phaeohyphomycosis is very low. Most studies found are case reports. They showed a wide variation of clinical presentations. Pyrenochaeta romeroi, a fungus from the Dematiaceae group is a saprophyte found in soil and plants and a possible causative agent of phaeohyphomycosis. We present a rare case of subcutaneous phaeohyphomycosis caused by P. romeroi mimicking a synovial cyst in a diabetic patient.

  5. Lepra reaction with lucio phenomenon mimicking cutaneous vasculitis.

    Science.gov (United States)

    Misra, Durga Prasanna; Parida, Jyoti Ranjan; Chowdhury, Abhra Chandra; Pani, Krushna Chandra; Kumari, Niraj; Krishnani, Narendra; Agarwal, Vikas

    2014-01-01

    Leprosy is a disease typically found in the tropics. Patients with leprosy can have varying presentation with constitutional symptoms, joint pains, skin nodules, and rarely a vasculitis-like picture with skin ulcers and neuropathy. We present a young lady who presented with the rare manifestation of skin infarcts mimicking cutaneous vasculitis, diagnosed on histopathology to have Lucio phenomenon on a background of lepromatous leprosy. With increasing migration and widespread use of biologic response modifiers, clinicians all over the world need to be aware of various presentations of leprosy as well as needing to keep an open mind while considering the differential diagnoses of vasculitis.

  6. Dual anaplastic large cell lymphoma mimicking meningioma: A case report

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Keun Ho; Kim, Ki Hwan; Lee, Ghi Jai; Lee, Hye Kyung; Shim, Jae Chan; Lee, Kyoung Eun; Suh, Jung Ho [Seoul Paik Hospital, Inje University College of Medicine, Seoul (Korea, Republic of); Lee, Chae Heuck [Dept. of Neurosurgery, Ilsan Paik Hospital, Inje University College of Medicine, Goyang (Korea, Republic of)

    2014-01-01

    Anaplastic large cell lymphoma (ALCL) is a rare T cell lymphoma composed of CD30-positive lymphoid cells. Most ALCLs present as nodal disease, with skin, bone, soft tissue, lung, and liver as common extranodal sites. ALCL rarely occurs in the central nervous system and is even more infrequent in the dura of the brain. We report a case of dural-based ALCL secondary to systemic disease in a 17-year-old male that mimicked meningioma on magnetic resonance imaging and angiography.

  7. Endometriosis mimicking the perianal fistula tract: Case report

    Directory of Open Access Journals (Sweden)

    Gül Türkcü

    2014-09-01

    Full Text Available Endometriosis is the presence of endometrial glands and stroma outside the uterine cavity. Nowadays, in many cases, although routine use of episiotomy perineal endo metriosis is extremely rare. A 36 year old female patient was referred to our hospital with complaints of pain in the perianal region for five months. On physical examination, stiffness was palpated and then magnetic resonance im aging (MRI was performed. MRI is compatible with fistula tract. The lesion was excised and the histopathological appearance correspond to endometriosis. Perianal endo metriosis is rare in the perianal region and in the clinic mimicking perianal fistulas and malignancy should be kept in mind in the differential diagnosis

  8. Simple bone cyst of mandible mimicking periapical cyst

    Directory of Open Access Journals (Sweden)

    Charan Babu HS

    2012-05-01

    Full Text Available Simple bone cysts (SBC are pseudocysts occurring less commonly in the maxillofacial region. The uncertain and unclear etiopathogenesis led to numerous synonyms to refer this particular cyst. These cysts are devoid of an epithelial lining and are usually empty or contain blood or straw-colored fluid. In jaws initially it mimics a periapical cyst and later can lead to cortical bone expansion warranting for radical approach, which is seldom required. SBC is predominantly diagnosed in first two decades of life. Here we report a case of solitary bone cyst mimicking a periapical cyst of a mandibular molar in a 37-year-old patient.

  9. Simple bone cyst of mandible mimicking periapical cyst.

    Science.gov (United States)

    Hs, Charan Babu; Rai, Bhagawan Das; Nair, Manju A; Astekar, Madhusudan S

    2012-05-29

    Simple bone cysts (SBC) are pseudocysts occurring less commonly in the maxillofacial region. The uncertain and unclear etiopathogenesis led to numerous synonyms to refer this particular cyst. These cysts are devoid of an epithelial lining and are usually empty or contain blood or straw-colored fluid. In jaws initially it mimics a periapical cyst and later can lead to cortical bone expansion warranting for radical approach, which is seldom required. SBC is predominantly diagnosed in first two decades of life. Here we report a case of solitary bone cyst mimicking a periapical cyst of a mandibular molar in a 37-year-old patient.

  10. Brucellosis mimicking Henoch-Schönlein purpura.

    Science.gov (United States)

    Massasso, David; Gibson, Kathryn

    2007-06-04

    A young male immigrant from Syria with a vasculitic-appearing leg rash, asymmetrical polyarthritis, microscopic haematuria, and raised inflammatory markers was provisionally diagnosed with Henoch-Schönlein purpura. Skin biopsy showed leukocytoclastic vasculitis. Low-grade fevers persisted despite non-steroidal anti-inflammatory therapy, and Brucella sp. was subsequently grown from both blood and synovial fluid aspirates. Further tests gave positive results for B. abortus, and triple antibiotic therapy produced a rapid clinical response. Cutaneous vasculitis has rarely been described in brucellosis, and this is the first report in the English medical literature of brucellosis mimicking Henoch-Schönlein purpura.

  11. A CUTANEOUS HORN MIMICKING POLYDACTYLY: A CASE REPORT

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    Funda Tamer

    2015-04-01

    Full Text Available A cutaneous horn is a general name for cornified material protruding from skin. On the other hand, polydactyly is a common congenital anomaly of the hand and foot which is characterized by extra finger or toe. A cutaneous horn might mimick polydactyly by resembling an extra toe. Hereby, we present a 72-year-old white Caucasian male with an extra toe-like projection on his fourth toe. Initially, polydactyly was suspected, however a cutaneous horn was also considered. The lesion was surgically removed. The histopathological examination of the specimen revealed hyperkeratosis, and thus confirmed the  lesion to be a cutaneous horn. 

  12. Hızma Induced Papul of Nose Mimicking Pyogenic Granuloma

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    Mualla Polat

    2014-09-01

    Full Text Available The application of body piercing is popular among young people, who consider it as a sign of marginality, beauty, or group identity. Piercing procedure is observed to cause a large number of complications such as infections, pain, inflammatory reactions, bleeding, dental fractures or fissures, and gingival damage, etc., mostly in young individuals. Hizma is a traditional body ornament worn by Anatolian women via a piercing procedure. Herein, we describe a papule of nose mimicking pyogenic granuloma as an uncommon complication of Hızma.

  13. Effect of S-1 combined with cisplatin intraperitoneal circulatory hyperthermia perfusion treatment on malignant molecule expression in gastric cancer patients with ascites as well as side effect assessment

    Institute of Scientific and Technical Information of China (English)

    Shuo Jian

    2016-01-01

    Objective:To study the effect of S-1 combined with cisplatin intraperitoneal circulatory hyperthermia perfusion on malignant molecule expression in gastric cancer patients with ascites as well as the related side effect.Methods: Gastric cancer patients with ascites who were treated in our hospital from February 2012 to July 2015 were selected as research subjects and randomly divided into perfusion chemotherapy group and routine chemotherapy group, and then overall chemotherapy conditions, ascites FGF molecule content, peripheral blood immune function indexes and the degree of side effect were compared between two groups. Results:Average treatment cycles of perfusion chemotherapy group were more than those of routine chemotherapy group, and ascites drainage volume within two cycles of chemotherapy was significantly less than that of routine chemotherapy group; after two cycles of chemotherapy, bFGF, FGF-2, FGF19 and FGFR4 content in ascites of perfusion chemotherapy group were significantly lower than those of routine chemotherapy group, CD3+CD4+, CD3+CD56+ and CD3-CD56+ cell content in peripheral blood were higher than those of routine chemotherapy group, and CD3+CD8+ cell content was lower than that of routine chemotherapy group; during chemotherapy, the number of cases with decreased numeration of leukocyte, abnormal liver function, abnormal kidney function and diarrhea of perfusion chemotherapy group were significantly lower than those of routine chemotherapy group.Conclusions: S-1 combined with cisplatin intraperitoneal circulatory hyperthermia perfusion chemotherapy can more effectively improve treatment compliance, suppress ascites, kill gastric cancer cells and improve immune function. It has fewer side effect and is the ideal way to treat gastric cancer with ascites.

  14. Tissue-Mimicking Materials Using Segmented Polyurethane Gel and Their Acoustic Properties

    Science.gov (United States)

    Yoshida, Tomoji; Tanaka, Kouhei; Kondo, Toshio; Yasukawa, Kazuhiro; Miyamoto, Nobuaki; Taniguchi, Masahiko; Shikinami, Yasuo

    2012-07-01

    Accurate testing of an instrument by phantoms requires a tissue-mimicking material that has the acoustic velocity and density defined in the International Electrotechnical Commission (IEC) standard, and furthermore the tissue-mimicking material must be stable over time. To achieve the tissue-mimicking materials with the desired acoustic velocity and density defined in the IEC standard, new materials have been developed. The form of tissue-mimicking materials reported comprised polystyrene and poly(methyl methacrylate) (PMMA) particles dispersed in segmented polyurethane gel. They were stable over a period of 40 days and the changes in weight and acoustic velocity did not exceed 0.5%.

  15. Hepatic tuberculosis mimicking metastasis in a case of carcinoma sigmoid colon.

    Science.gov (United States)

    Husain, Musharraf; Khan, Sabina; Hassan, Mohammad Jaseem

    2015-01-01

    Tuberculosis (TB) presenting as isolated liver mass without clinical evidence of TB is difficult to diagnose preoperatively and is usually mimicked by primary or metastatic carcinoma of the liver. Hepatic TB associated with carcinoma colon is a rare association which has very rarely been reported in the literature. This case illustrates the diagnostic difficulties of hepatic TB and the need to consider it in the differential diagnosis of hepatic nodular lesions in carcinoma colon patients. Here, we report a case of 48-year-old female who presented in the casualty with features of acute intestinal obstruction. Preoperatively a mass was seen at the hepatic flexure along with three lesions in the liver presumed to be metastatic in origin. However, histopathology of the mass revealed adenocarcinoma colon and the liver lesion proved to be hepatic TB. We wish to highlight that on encountering a hepatic lesion in a carcinoma colon patient the possibility of hepatic TB should also be kept in mind apart from the obvious possibility of metastasis especially in an endemic country like India.

  16. Chronic Multifocal Inflammation of the Alveolar Bone Mimicking Malignancy: A Case Report

    Directory of Open Access Journals (Sweden)

    Shahidi Sh.

    2012-03-01

    Full Text Available ronic inflammation of the alveolar bone is a great clinical and radiologic mimic, which merits recognition by the clinician and pathologist. The patient can thus be reassured of the proper early treatment and a favorable prognosis. Occasionally, it is difficult to differentiate inflammatory lesions from malign-ant tumors. The aim of this report is to present a case with an inflammatory lesion mimicking malignant condition.We report a 19-year-old male complaining of rapid onset gingival swelling of the right side of both jaws and looseness of the right upper molar teeth in 20 days. Based on the acute onset of the gingival hyperplasia, severe looseness of the affected teeth especially in the maxilla, and the patient's age, multifocal rapid growing malignant condition was not ruled out. The lesion was misdiagnosed as a malignant condition by clinical and radiographic examination. The whole body bone scan showed no significant increased uptake in the right oral cavity compatible with no active bony pathology. The surgical pathology findings of the lesion showed severe chronic inflammation with surface epithelial hyperplasia.The initial diagnosis of the lesion was malignant condition but it was ruled out by bone scan and histological appearance.

  17. Hepatic tuberculosis mimicking metastasis in a case of carcinoma sigmoid colon

    Directory of Open Access Journals (Sweden)

    Musharraf Husain

    2015-01-01

    Full Text Available Tuberculosis (TB presenting as isolated liver mass without clinical evidence of TB is difficult to diagnose preoperatively and is usually mimicked by primary or metastatic carcinoma of the liver. Hepatic TB associated with carcinoma colon is a rare association which has very rarely been reported in the literature. This case illustrates the diagnostic difficulties of hepatic TB and the need to consider it in the differential diagnosis of hepatic nodular lesions in carcinoma colon patients. Here, we report a case of 48-year-old female who presented in the casualty with features of acute intestinal obstruction. Preoperatively a mass was seen at the hepatic flexure along with three lesions in the liver presumed to be metastatic in origin. However, histopathology of the mass revealed adenocarcinoma colon and the liver lesion proved to be hepatic TB. We wish to highlight that on encountering a hepatic lesion in a carcinoma colon patient the possibility of hepatic TB should also be kept in mind apart from the obvious possibility of metastasis especially in an endemic country like India.

  18. Metabolic acidosis mimicking diabetic ketoacidosis after use of calorie-free mineral water.

    Science.gov (United States)

    Dahl, Gry T; Woldseth, Berit; Lindemann, Rolf

    2012-09-01

    A previously healthy boy was admitted with fever, tachycardia, dyspnea, and was vomiting. A blood test showed a severe metabolic acidosis with pH 7.08 and an anion gap of 36 mmol/L. His urine had an odor of acetone. The serum glucose was 5.6 mmol/L, and no glucosuria was found. Diabetic ketoacidosis could therefore be eliminated. Lactate level was normal. Tests for the most common metabolic diseases were negative. Because of herpes stomatitis, the boy had lost appetite and only been drinking Diet Coke and water the last days. Diet Coke or Coca-Cola Light is sweetened with a blend containing cyclamates, aspartame, and acesulfame potassium, all free of calories. The etiology of the metabolic acidosis appeared to be a catabolic situation exaggerated by fasting with no intake of calories. The elevated anion gap was due to a severe starvation ketoacidosis, mimicking a diabetic ketoacidosis. Pediatricians should recommend carbohydrate/calorie-containing fluids for rehydration of children with acute fever, diarrhea, or illness.

  19. A Patient With Plaque Type Morphea Mimicking Systemic Lupus Erythematosus

    Directory of Open Access Journals (Sweden)

    Wardhana Wardhana

    2015-04-01

    Full Text Available Morphea is an uncommon connective tissue disease with the most prominent feature being thickening or fibrosis of the dermal without internal organ involvement. It is also known as a part of localized scleroderma. Based on clinical presentation and depth of tissue involvement, morphea is classified into several forms, and about two thirds of adults with morphea have plaque type. Overproduction of collagen production by fibroblast is the cause of abnormality in morphea, and the hyperactivity mechanism of fibroblast is still unknown, although there are several mechanisms already proposed. Plaque type morphea is actually a benign and self limited. Plaque type morphea that mimicking systemic lupus erythematosus in clinical appearance, such as alopecia and oral mucosal ulcers, is uncommon. A case of plaque type morphea mimicking systemic lupus erythematosus in a 20 year old woman was discussed. The patient was treated with local and systemic immunosuppressant and antioxydant. The patient’s condition is improved without any significant side effects. Key words: morphea, plaque type.

  20. Characterization of various tissue mimicking materials for medical ultrasound imaging

    Science.gov (United States)

    Thouvenot, Audrey; Poepping, Tamie; Peters, Terry M.; Chen, Elvis C. S.

    2016-04-01

    Tissue mimicking materials are physical constructs exhibiting certain desired properties, which are used in machine calibration, medical imaging research, surgical planning, training, and simulation. For medical ultrasound, those specific properties include acoustic propagation speed and attenuation coefficient over the diagnostic frequency range. We investigated the acoustic characteristics of polyvinyl chloride (PVC) plastisol, polydimethylsiloxane (PDMS), and isopropanol using a time-of-light technique, where a pulse was passed through a sample of known thickness contained in a water bath. The propagation speed in PVC is approximately 1400ms-1 depending on the exact chemical composition, with the attenuation coefficient ranging from 0:35 dB cm-1 at 1MHz to 10:57 dB cm-1 at 9 MHz. The propagation speed in PDMS is in the range of 1100ms-1, with an attenuation coefficient of 1:28 dB cm-1 at 1MHz to 21:22 dB cm-1 at 9 MHz. At room temperature (22 °C), a mixture of water-isopropanol (7:25% isopropanol by volume) exhibits a propagation speed of 1540ms-1, making it an excellent and inexpensive tissue-mimicking liquid for medical ultrasound imaging.

  1. Acute respiratory failure in scrub typhus patients

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    Jyoti Narayan Sahoo

    2016-01-01

    Full Text Available Respiratory failure is a serious complication of scrub typhus. In this prospective study, all patients with a diagnosis of scrub typhus were included from a single center Intensive Care Unit (ICU. Demographic, clinical characteristics, laboratory, and imaging parameters of these patients at the time of ICU admission were compared. Of the 55 scrub typhus patients, 27 (49% had an acute respiratory failure. Seventeen patients had acute respiratory distress syndrome, and ten had cardiogenic pulmonary edema. Respiratory supported patients were older had significant chronic lungs disease and high severity illness scores (Acute Physiology and Chronic Health Evaluation-II and Sequential Organ Failure Assessment score. At ICU admission, these patients presented with more deranged laboratory markers, including high bilirubin, high creatine kinase, high lactate, metabolic acidosis, low serum albumin, and presence of ascites. The average ICU and hospital stay were 4.27 ± 2.74 and 6.53 ± 3.52 days, respectively, in the respiratory supported group. Three patients died in respiratory failure group, while only one patient died in nonrespiratory failure group.

  2. Torsion of a lipoma of parietal peritoneum: a rare case mimicking acute appendicitis.

    Science.gov (United States)

    Shrestha, Binod Bade; Karmacharya, Mikesh

    2014-06-18

    Lipomas are found most often on the torso, neck, upper thighs, upper arms and armpits; they can also occur almost anywhere in the body. Parietal peritoneum lipoma is a rare intraoperative finding during abdominal surgery. We present a case of a torted, pedunculated parietal wall lipoma in the right iliac fossa that gave rise to a clinical diagnosis of appendicitis. So far only one case has been reported.

  3. Torsion of a lipoma of parietal peritoneum: a rare case mimicking acute appendicitis

    OpenAIRE

    2014-01-01

    Lipomas are found most often on the torso, neck, upper thighs, upper arms and armpits; they can also occur almost anywhere in the body. Parietal peritoneum lipoma is a rare intraoperative finding during abdominal surgery. We present a case of a torted, pedunculated parietal wall lipoma in the right iliac fossa that gave rise to a clinical diagnosis of appendicitis. So far only one case has been reported.

  4. Primary adult midgut volvulus mimicking acute appendicitis: A case report and review of the literature

    Directory of Open Access Journals (Sweden)

    Jeffrey J. Leow

    2016-01-01

    Conclusion: While rare, adult midgut volvulus has the potential for morbidity and mortality if not diagnosed early with intestinal ischaemia and related sequlae. Clinicians should consider this and if in doubt, perform an early contrast CT scan.

  5. Acute torsion of a retroperitoneal renal transplant mimicking renal vein thrombosis.

    Science.gov (United States)

    Winter, Thomas C; Clarke, Andrea Lynn; Campsen, Jeffrey

    2013-09-01

    When imaging a renal transplant, the combination of absent flow in the main renal vein and reversed diastolic flow in the intrarenal arteries is considered highly suggestive of renal vein thrombosis. We present a case of torsion of a transplant kidney presenting with identical findings. Renal transplant torsion in general is a rare entity, previously described only in intraperitoneally placed organs; this case is the first that we are aware of with torsion occurring in a retroperitoneally placed graft.

  6. Acute parietal lobe infarction presenting as Gerstmann’s syndrome and cognitive decline mimicking senile dementia

    OpenAIRE

    Chen TY; Chen CY; Yen CH; Kuo SC; Yeh YW; Chang S; Huang SY

    2013-01-01

    Tien-Yu Chen,1 Chun-Yen Chen,1,3 Che-Hung Yen,2,3 Shin-Chang Kuo,1,3 Yi-Wei Yeh,1,3 Serena Chang,1 San-Yuan Huang1,31Department of Psychiatry, 2Department of Neurology, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, 3Graduate Institute of Medical Sciences, National Defense Medical Center, Taipei, Taiwan, Republic of ChinaAbstract: Gerstmann’s syndrome encompasses the tetrad of finger agnosia, agraphia, acalculia, and right-left confusion. An elder...

  7. An angiotensin converting enzyme inhibitor, benazepril can be transformed to an active metabolite, benazeprilat, by the liver of dogs with ascitic pulmonary heartworm disease.

    Science.gov (United States)

    Kitagawa, Hitoshi; Ohba, Yasunori; Kuwahara, Yasuhito; Ohne, Rieko; Kondo, Masahiro; Nakano, Masakazu; Sasaki, Yoshihide; Kitoh, Katsuya

    2003-06-01

    To examine whether an angiotensin converting enzyme (ACE) inhibitor, benazepril, can be transformed to the active metabolite, benazeprilat, by severely injured liver of dogs with ascitic heartworm disease, benazepril hydrochloride was administered orally to dogs once daily for 7 consecutive days at a dose rate of 0.29 mg/kg to 0.63 mg/kg of body weight, and plasma benazepril and benazeprilat concentrations were determined on the 1st and 7th administration days. In 7 dogs with ascitic pulmonary heartworm disease, plasma benazeprilat concentrations tended to be higher than in 7 control dogs both on the 1st and 7th administration days. The peak concentration and area under the concentration-time curve tended to be greater in dogs of the ascites group than in control dogs, but the statistics could not detect significant differences in the time to peak concentration and t(1/2) between the control and ascites groups. Plasma ACE activities decreased after administration of benazepril. In dogs with ascitic heartworm disease, benazepril was readily transformed to benazeprilat by the liver, and was effective for suppression of plasma ACE activity.

  8. Acute pancreatitis

    Directory of Open Access Journals (Sweden)

    Bo-Guang Fan

    2010-01-01

    Full Text Available Background : Acute pancreatitis continues to be a serious illness, and the patients with acute pancreatitis are at risk to develop different complications from ongoing pancreatic inflammation. Aims : The present review is to highlight the classification, treatment and prognosis of acute pancreatitis. Material & Methods : We reviewed the English-language literature (Medline addressing pancreatitis. Results : Acute pancreatitis is frequently caused by gallstone disease or excess alcohol ingestion. There are a number of important issues regarding clinical highlights in the classification, treatment and prognosis of acute pancreatitis, and treatment options for complications of acute pancreatitis including pancreatic pseudocysts. Conclusions : Multidisciplinary approach should be used for the management of the patient with acute pancreatitis.

  9. Acute pancreatitis

    Directory of Open Access Journals (Sweden)

    Bo-Guang Fan

    2010-05-01

    Full Text Available Background: Acute pancreatitis continues to be a serious illness, and the patients with acute pancreatitis are at risk to develop different complications from ongoing pancreatic inflammation. Aims: The present review is to highlight the classification, treatment and prognosis of acute pancreatitis. Material & Methods: We reviewed the English-language literature (Medline addressing pancreatitis. Results: Acute pancreatitis is frequently caused by gallstone disease or excess alcohol ingestion. There are a number of important issues regarding clinical highlights in the classification, treatment and prognosis of acute pancreatitis, and treatment options for complications of acute pancreatitis including pancreatic pseudocysts. Conclusions: Multidisciplinary approach should be used for the management of the patient with acute pancreatitis.

  10. Elevated troponin levels and typical chest pain: Is always acute coronary syndrome?

    Directory of Open Access Journals (Sweden)

    Altug Osken

    2016-01-01

    Full Text Available Aortic dissection is a fatal disease that must be considered in the differential diagnosis of chest pain. If the diagnosis cannot be made in early period, mortality is very high. Here, we present a case of aortic dissection, clinically mimicking acute coronary syndrome.

  11. Prognosis of Acute Kidney Injury and Hepatorenal Syndrome in Patients with Cirrhosis: A Prospective Cohort Study

    Directory of Open Access Journals (Sweden)

    Andrew S. Allegretti

    2015-01-01

    Full Text Available Background/Aims. Acute kidney injury is a common problem for patients with cirrhosis and is associated with poor survival. We aimed to examine the association between type of acute kidney injury and 90-day mortality. Methods. Prospective cohort study at a major US liver transplant center. A nephrologist’s review of the urinary sediment was used in conjunction with the 2007 Ascites Club Criteria to stratify acute kidney injury into four groups: prerenal azotemia, hepatorenal syndrome, acute tubular necrosis, or other. Results. 120 participants with cirrhosis and acute kidney injury were analyzed. Ninety-day mortality was 14/40 (35% with prerenal azotemia, 20/35 (57% with hepatorenal syndrome, 21/36 (58% with acute tubular necrosis, and 1/9 (11% with other (p=0.04 overall. Mortality was the same in hepatorenal syndrome compared to acute tubular necrosis (p=0.99. Mortality was lower in prerenal azotemia compared to hepatorenal syndrome (p=0.05 and acute tubular necrosis (p=0.04. Ten participants (22% were reclassified from hepatorenal syndrome to acute tubular necrosis because of granular casts on urinary sediment. Conclusions. Hepatorenal syndrome and acute tubular necrosis result in similar 90-day mortality. Review of urinary sediment may add important diagnostic information to this population. Multicenter studies are needed to validate these findings and better guide management.

  12. Differential diagnosis of cervical lymphadenitis mimicking malignancy due to tularemia: Our experiences

    Directory of Open Access Journals (Sweden)

    Vedat Turhan

    2013-01-01

    Full Text Available Background: Tularemia is a disease caused by a Gram-negative coccobacillus Francisella tularensis. This bacterium may cause different types of clinical pictures owing to acquisition route and entrance site, such as ulceroglandular, oropharyngeal, glandular, pneumonic, typhoid and ocular forms. Oropharyngeal tularemia (OPT is the most common form of tularemia in some regions. OPT may cause tonsillopharyngitis followed by cervical lymphadenopathies (LAPs. Without treatment LAP may persist for several months and may mimic other diseases causing cervical LAPs. Materials and Methods: A total of six cases of OPT, five male and one female, between 21 and 31 years old, diagnosed serologically and clinically recorded in GATA Haydarpasa Training Hospital were included in this study. Detailed story including the region they lived for last 6 months, their occupation, family and neighborhood story with similar complaints were obtained. Patient data were also obtained from manually written patients files and electronical patient file system. Formalin fixed paraffin embedded tissue blocks of all biopsy material were submitted for polymerase chain reaction (PCR study for F. tularensis. Results: A total of six cases with head and neck mass following a story of tonsillopharyngitis admitted to different clinics including infectious diseases, ear-nose-throat and internal medicine in our tertiary care hospital. Physical examination revealed immobile, hard, conglomerated unilateral cervical lymphadenopathy in all cases. Histopathological examination revealed granulomatous inflammation in four cases. Acute suppurative inflammatory changes were also seen in two cases. Large necrotic areas mimicking casseifying necrosis were seen in two cases. PCR amplification of F. tularensis genom from isolated deoxyribonucleic acids was successful in five cases. Conclusion: Tularemia should be kept in mind in patients with tonsillopharyngitis not responding to penicillins and beta

  13. Growth inhibition and pro-apoptotic activity of violacein in Ehrlich ascites tumor.

    Science.gov (United States)

    Bromberg, Natália; Dreyfuss, Juliana L; Regatieri, Caio V; Palladino, Marcelly V; Durán, Nelson; Nader, Helena B; Haun, Marcela; Justo, Giselle Z

    2010-06-07

    The continuing threat to biodiversity lends urgency to the need of identification of sustainable source of natural products. This is not so much trouble if there is a microbial source of the compound. Herein, violacein, a natural indolic pigment extracted from Chromobacterium violaceum, was evaluated for its antitumoral potential against the Ehrlich ascites tumor (EAT) in vivo and in vitro. Evaluation of violacein cytotoxicity using different endpoints indicated that EAT cells were twofold (IC(50)=5.0 microM) more sensitive to the compound than normal human peripheral blood lymphocytes. In vitro studies indicated that violacein cytotoxicity to EAT cells is mediated by a rapid (8-12h) production of reactive oxygen species (ROS) and a decrease in intracellular GSH levels, probably due to oxidative stress. Additionally, apoptosis was primarily induced, as demonstrated by an increase in Annexin-V positive cells, concurrently with increased levels of DNA fragmentation and increased caspase-2, caspase-9 and caspase-3 activities up to 4.5-, 6.0- and 5.5-fold, respectively, after 72 h of treatment. Moreover, doses of 0.1 and 1.0 microg kg(-1) violacein, administered intraperitoneally (i.p.) to EAT-bearing mice throughout the lifespan of the animals significantly inhibited tumor growth and increased survival of mice. In view of these results, a 35-day toxicity study was conducted in vivo. Complete hematology, biochemistry (ALT, AST and creatinine levels) and histopathological analysis of liver and kidney indicated that daily doses of violacein up to 1000 microg kg(-1) for 35 days are well tolerated and did not cause hematotoxicity nor renal or hepatotoxicity when administered i.p. to mice. Altogether, these results indicate that violacein causes oxidative stress and an imbalance in the antioxidant defense machinery of cells culminating in apoptotic cell death. Furthermore, this is the first report of its antitumor activity in vivo, which occurs in the absence of toxicity to

  14. Anti-tumour effects of Egyptian propolis on Ehrlich ascites carcinoma

    Directory of Open Access Journals (Sweden)

    Hager T.H. Ismail

    2011-09-01

    Full Text Available A total of 150 female Swiss mice were used to study the ability of water soluble propolis derivatives (WSPD of Egyptian propolis to inhibit the proliferation and growth of Ehrlich ascites carcinoma (EAC cells in mice. The mice were divided equally into three groups: the first was kept as a negative control group, the second received an intraperitoneal injection of 2.5 × 10(6 EAC and was kept as a positive control group and the third an intraperitoneal injection of 2.5 × 10(6 EAC and treated with propolis (50 mg/kg body weight administered by gastric intubations 2 h prior to the intraperitoneal injection of EAC. The propolis was administered daily for 11 successive days. An examination of EAC cells revealed a reduction in the volume, total cell count, viable percentage and increase in the percentage of dead cells in the treated group with an increasing mean survival time (MST, increasing life span (ILS percentage and treated vs positive control (T/C percentage. Immunological studies revealed a significant increase in the lymphocyte transformation rate (LTR, phagocytic activity and killing power in the group treated with propolis. A haematological study of the parameters revealed leucocytosis in cancer-bearing mice and propolis-treated groups with granulocytosis and monocytosis. The erythrogram revealed a significant reduction in red blood cell (RBC count in group 2. The result showed that the implantation of EAC in Swiss mice without treatment resulted in a significant decrease in total protein and albumin levels without a change in globulin level and a significant increase in creatinine level, while the third group that received propolis showed an improvement in these biochemical parameters compared to the normal control group.

  15. Ca2+ transport by mitochondria from L1210 mouse ascites tumor cells.

    Science.gov (United States)

    Reynafarje, B; Lehninger, A L

    1973-06-01

    Mitochondria isolated from the ascites form of L1210 mouse leukemia cells readily accumulate Ca(2+) from the suspending medium and eject H(+) during oxidation of succinate in the presence of phosphate and Mg(2+), with normal stoichiometry between Ca(2+) uptake and electron transport. Ca(2+) loads up to 1600 ng-atoms per mg of protein are attained. As is the case in mitochondria from normal tissues, Ca(2+) uptake takes precedence over oxidative phosphorylation. However, Ca(2+) transport by the L-1210 mitochondria is unusual in other respects, which may possibly have general significance in tumor cells. The apparent affinity of the L1210 mitochondria for Ca(2+) in stimulation of oxygen uptake is about 3-fold greater than in normal liver mitochondria; moreover, the maximal rate of Ca(2+) transport is also considerably higher. Furthermore, when Ca(2+) pulses are added to L1210 mitochondria in the absence of phosphate or other permeant anions, much larger amounts of Ca(2+) are bound and H(+) ejected per atom of oxygen consumed than in the presence of phosphate; up to 7 Ca(2+) ions are bound per pair of electrons passing each energy-conserving site of the electron-transport chain. Such "superstoichiometry" of Ca(2+) uptake can be accounted for by two distinct types of respiration-dependent interaction of Ca(2+) with the L1210 mitochondria. One is the stimulation of oxygen consumption, which is achieved by relatively low concentrations of Ca(2+) (K(m) congruent with 8 muM) and is accompanied by binding of Ca(2+) up to 40 ng-atoms per mg of protein. The second process, also dependent on electron transport, is the binding of further Ca(2+) from the medium in exchange with previously stored membrane-bound protons, in which the affinity for Ca(2+) is much lower (K(m) congruent with 120 muM).

  16. Altered adrenergic response and specificity of the receptors in rat ascites hepatoma AH130.

    Science.gov (United States)

    Sanae, F; Miyamoto, K; Koshiura, R

    1989-11-15

    Adenylate cyclase activation through adrenergic receptors in rat ascites hepatoma (AH) 130 cells in response to adrenergic drugs was studied, and receptor binding and displacement were compared with those of normal rat hepatocytes. Epinephrine (Epi) and norepinephrine (NE) activated AH130 adenylate cyclase about half as much as isoproterenol (IPN) but equaled IPN after treatment with the alpha-antagonist phentolamine or islet-activating protein (IAP). The three catecholamines in hepatocytes were similar regardless of phentolamine or IAP. These catecholamines activated adenylate cyclase in order of IPN greater than NE greater than Epi in AH130 cells but IPN greater than Epi greater than NE in hepatocytes. We then used the alpha 1-selective ligand [3H]prazosin, the alpha 2-selective ligand [3H]clonidine, and the beta-ligand [125I]iodocyanopindolol [( 125I]ICYP), and found that AH130 cells had few prazosin-binding sites, about eight times as many clonidine-binding sites with high affinity, and many more ICYP-binding sites than in hepatocytes. The dissociation constant (Ki) of the beta 1-selective drug metoprolol by Hofstee plots for AH130 cells was lower than that for hepatocytes. The inhibition of specific ICYP binding by the beta 2-selective agonist salbutamol for AH130 cells gave only one Ki value which was much higher than both high and low Ki values of the drug for hepatocytes. These findings indicate that the alpha- and beta-adrenergic receptors in hepatocytes are predominantly alpha 1-type and beta 2-type, but that those in AH130 cells are predominantly alpha 2-type and beta 1-type, and the low adrenergic response of AH130 cells is due to the dominant appearance of alpha 2-adrenergic receptors, linked with the inhibitory guanine-nucleotide binding regulatory protein, instead of alpha 1-adrenergic receptors, and beta 1-adrenergic receptors with low affinity for the hormone.

  17. Forskolin inhibits the Gs-stimulated adenylate cyclase in rat ascites hepatoma AH66F cells.

    Science.gov (United States)

    Miyamoto, K; Sanae, F; Koshiura, R; Matsunaga, T; Hasegawa, T; Takagi, K; Satake, T

    1989-09-01

    Forskolin increased intracellular cyclic AMP and augmented cyclic AMP formation by prostaglandin E1 (PGE1) in normal rat hepatocytes and ascites hepatoma AH66 cells. However, in AH66F cells which were derived from the AH66 cell line, the diterpene only slightly increased the cyclic AMP level, and dose-dependently inhibited the accumulation caused by PGE1. Forskolin dose-dependently activated adenylate cyclase in these membranes, and the magnitude of activation by forskolin was largest in the following order: hepatocytes, AH66 cells, and AH66F cells. This difference may be based on the number of forskolin-binding sites. The binding affinity of forskolin for each cell membrane was similar. The number and affinity of forskolin-binding sites in these cells were not influenced by 5'-guanylylimidodiphosphate [Gpp(NH)p]. In hepatocytes and AH66 cells, forskolin and other adenylate cyclase activators such as PGE1, GTP, Gpp(NH)p, F-, and Mn2+ synergistically increased the enzyme activity. In AH66F cells, the forskolin-stimulated activity was hardly influenced by the GTP analog, and forskolin diminished the activities induced by the GTP analog in a manner similar to that of diterpene alone. Forskolin (10 microM) also significantly inhibited the activities induced by PGE1, GTP, and F-. The effect of forskolin with Mn2+ was additive in AH66F cells. The data suggest that forskolin promotes the interaction between the stimulatory guanine nucleotide-binding protein and the catalytic unit in the membrane of normal hepatocytes and AH66 cells, but it interferes with the coupling in AH66F cells.

  18. Kabuki syndrome as a cause of non-immune fetal hydrops/ascites.

    Science.gov (United States)

    Long, Ashleigh; Sinkovskaya, Elena S; Edmondson, Andrew C; Zackai, Elaine; Schrier Vergano, Samantha A

    2016-12-01

    Kabuki syndrome (MIM 147920) is a well-described, multiple congenital anomaly syndrome characterized by growth and developmental delay, cardiac, renal, and vertebral anomalies, as well as persistent fetal finger pads and distinct facial features. Facies are characterized by long palpebral fissures with eversion of lateral third of the lower eyelid, resembling the "Kabuki make-up" theatre genre after which the syndrome is named. Kabuki syndrome is estimated to affect 1/32,000 births, with 55-80% of patients showing nonsense or frameshift mutations in the KMT2D (MLL2) gene, which encodes a histone transferase located on chromosome 12q. Additionally, owing to the heterogeneous nature of Kabuki syndrome, a smaller number of diagnosed patients have been identified with mutations or deletions in KDM6A (a component of the same transcriptional complex as KMT2D) with no mutations in KMT2D, or as those diagnosed with Kabuki syndrome and without alterations in either KMT2D or KDM6A. Diagnosis of the syndrome in newborns and infants is difficult, as the facial features are not as evident as in toddler- or childhood. There are no known "tell-tale" signs of Kabuki syndrome prenatally, and there are no reports of common, specific findings in fetuses that might suggest the diagnosis. We present here two infants who presented with prenatal hydrops/ascites, who were subsequently diagnosed with Kabuki syndrome. Although relatively non-specific, we suggest that Kabuki syndrome be added to the list of genetic syndromes that are suspected in cases of prenatal hydrops, review the molecular etiology of Kabuki syndrome, and broaden the phenotype of this well-described disorder. © 2016 Wiley Periodicals, Inc.

  19. Antitumor activity of Aponogeton undulatus against Ehrilich ascites carcinoma in Swiss albino mice

    Institute of Scientific and Technical Information of China (English)

    Md Reyazul Islam; Md BadrulAlam; UmmeTamima; Shayla Islam Jenny

    2015-01-01

    Objective:To investigate in vitro antioxidant and in vivo antitumor activity of the crude methanolic extract of Aponogeton undulatus (MAU) along with its various organic fractions. Methods:Aponogeton undulatus leaves were successively extracted using methanol (MAU) and then fractionated by chloroform, ethyl acetate (EAU) and water. The total antioxidant capacity, lipid peroxidation inhibition assay, 1, 1-diphenyl-2-picrylhydrazyl (DPPH) free radical scavenging assay and ferrous reducing power assessment were used to evaluate the antioxidant potential of the crude extract and its organic fractions. The in vivo antitumor activity is evaluated against Ehrlich ascites carcinoma (EAC) cell bearing in Swiss albino mice. Results:EAU showed the highest antioxidant capacity as (175.80±0.41) mg/g, IC50 value of DPPH scavenging activity was (38.84±0.02)μg/mL and also exhibited maximum lipid peroxidation inhibition activity with the IC50 value of (42.52±0.32)μg/mL than other fractions. The results demonstrate that reducing power of the extract was concentration dependent. In addition, EAU was administered at 50, 100 and 200 mg/kg body weight respectively to EAC cell bearing mice and a significant (P<0.05) decrease in tumor volume, packed cell volume and viable cell count and also increased the life span (17.52%, 42.53%and 62.05%). Hematological profiles were restored to normal levels in MAU treated mice as compared to EAC control mice. Conclusions:The results were found to be significant and confirmed that the Aponogeton undulatus has remarkable antitumor activity with antioxidant potential.

  20. Action of the antitumor and antispermatogenic agent lonidamine on electron transport in Ehrlich ascites tumor mitochondria.

    Science.gov (United States)

    Floridi, A; Lehninger, A L

    1983-10-01

    The effect of lonidamine, an antispermatogenic and antitumor drug, on the oxygen consumption, ATPase activity, and redox state of the electron carriers of Ehrlich ascites tumor mitochondria has been studied. Lonidamine inhibits ADP- and uncoupler-stimulated respiration on various NAD- and FAD-linked substrates, but does not affect state 4 respiration. Experiments to determine its site of action showed that lonidamine does not significantly inhibit electron flow through cytochrome oxidase. Electron flow through site 2, the ubiquinone-cytochrome b-cytochrome c1 complex, also was unaffected by lonidamine, which failed to inhibit the oxidation of duroquinol. Moreover, inhibition of electron flow through site 2 was also excluded because of the inability of the N,N,N',N'-tetramethyl-p-phenylenediamine bypass to relieve the lonidamine inhibition of the oxidation of pyruvate + malate. The F0F1ATPase activity and vectorial H+ ejection are also unaffected by lonidamine. The inhibition of succinate oxidation by lonidamine was found to take place at a point between succinate and iron-sulfur center S3. Spectroscopic experiments demonstrated that lonidamine inhibits the reduction of mitochondrial NAD+ by pyruvate + malate and other NAD-linked substrates in the transition from state 1 to state 4. However, lonidamine does not inhibit reduction of added NAD+ by submitochondrial vesicles or by soluble purified NAD-linked dehydrogenases. These observations, together with other evidence, suggest that electron transport in tumor mitochondria is inhibited by lonidamine at the dehydrogenase-coenzyme level, particularly when the electron carriers are in a relatively oxidized state and/or when the inner membrane-matrix compartment is in the condensed state. The action of lonidamine in several respects resembles the selective inhibition of electron transport in tumor cells produced by cytotoxic macrophages (D. L. Granger and A. L. Lehninger (1982) J. Cell Biol. 95, 527).

  1. Acute diverticulitis of the terminal ileum: ultrasonography and CT findings

    Directory of Open Access Journals (Sweden)

    Jewon Jeong

    2015-01-01

    Full Text Available We describe a rare case of terminal ileal diverticulitis in a 68-year-old female with a day of history Epub ahead of print of right lower quadrant pain and tenderness, mimicking acute appendicitis. Ultrasonography revealed small sac-like out-pouching lesions with increased echogenicity of surrounding fat in thickened terminal ileum, suggesting inflamed diverticula. We diagnosed terminal ileal diverticulitis primarily by ultrasonography. The diagnosis was confirmed by subsequent computed tomography.

  2. Acute diverticulitis of the terminal ileum: ultrasonography and CT findings

    Energy Technology Data Exchange (ETDEWEB)

    Jeong, Jewon; Hong, Seong Sook; Hwang, Ji Young; Kim, Hyun Joo; Chang, Yun Woo [Dept. of Radiology, Soonchunhyang University Seoul Hospital, Soonchunhyang University College of Medicine, Seoul (Korea, Republic of)

    2015-01-15

    We describe a rare case of terminal ileal diverticulitis in a 68-year-old female with a day of history Epub ahead of print of right lower quadrant pain and tenderness, mimicking acute appendicitis. Ultrasonography revealed small sac-like out-pouching lesions with increased echogenicity of surrounding fat in thickened terminal ileum, suggesting inflamed diverticula. We diagnosed terminal ileal diverticulitis primarily by ultrasonography. The diagnosis was confirmed by subsequent computed tomography.

  3. Takotsubo cardiomyopathy after acute myocardial infarction: An unusual case of possible association.

    Science.gov (United States)

    Ferrara, Francesco; Baldi, Cesare; Malinconico, Marisa; Acri, Edvige; Cirillo, Annapaola; Citro, Rodolfo; Bossone, Eduardo

    2016-04-01

    Takotsubo cardiomyopathy is an acute reversible clinical condition mimicking an acute myocardial infarction. Although a normal coronary artery tree is frequently detected, the concurrence of coronary artery disease is a common finding in a substantial proportion of patients. We report an unusual case of takotsubo cardiomyopathy in post-menopausal women after emotional stress, occurring after inferior ST-segment elevation myocardial infarction. The possible association between takotsubo cardiomyopathy and coronary artery disease is discussed.

  4. Ascaris lumbricoides-Induced Acute Pancreatitis: Diagnosis during EUS for a Suspected Small Pancreatic Tumor

    OpenAIRE

    Benedetto Mangiavillano; Silvia Carrara; Maria Chiara Petrone; Paolo Giorgio Arcidiacono; Pier Alberto Testoni

    2009-01-01

    Context Ascaris lumbricoides is the second most common intestinal parasite world-wide and, although the infection can be asymptomatic, in some cases it can present with complications, such as acute pancreatitis. Case report We describe the case of a 37- year-old man, with a history of travelling in Eastern countries who presented with Ascaris lumbricoides-induced acute pancreatitis mimicking a small pancreatic cancer, diagnosed during an upper EUS. The endoscopy revealeda roundworm floating i...

  5. Tax mimicking and yardstick competition among local governments in the Netherlands

    NARCIS (Netherlands)

    Allers, MA; Elhorst, JP

    2005-01-01

    This paper provides a spatial-econometric analysis of the setting of property tax rates by Dutch municipalities. We find evidence of tax mimicking: a ten percent higher property tax rate in neighboring municipalities leads to a 3.5 percent higher tax rate. Mimicking is less pronounced in municipalit

  6. The Acute-Phase Proteins Serum Amyloid A and C Reactive Protein in Transudates and Exudates

    Science.gov (United States)

    Okino, Alessandra M.; Bürger, Cristiani; Cardoso, Jefferson R.; Lavado, Edson L.; Lotufo, Paulo A.; Campa, Ana

    2006-01-01

    The distinction between exudates and transudates is very important in the patient management. Here we evaluate whether the acute-phase protein serum amyloid A (SAA), in comparison with C reactive protein (CRP) and total protein (TP), can be useful in this discrimination. CRP, SAA, and TP were determined in 36 exudate samples (27 pleural and 9 ascitic) and in 12 transudates (9 pleural and 3 ascitic). CRP, SAA, and TP were measured. SAA present in the exudate corresponded to 10% of the amount found in serum, that is, the exudate/serum ratio (E/S) was 0.10 ± 0.13. For comparison, the exudate/serum ratio for CRP and TP was 0.39 ± 0.37 and 0.68 ± 0.15, respectively. There was a strong positive correlation between serum and exudate SAA concentration (r = 0.764;p < 0.0001). The concentration of SAA in transudates was low and did not overlap with that found in exudates (0.02-0.21 versus 0.8–360.5 g/mL). SAA in pleural and ascitic exudates results mainly from leakage of the serum protein via the inflamed membrane. A comparison of the E/S ratio of SAA and CRP points SAA as a very good marker in discriminating between exudates and transudates. PMID:16864904

  7. Outcomes in culture positive and culture negative ascitic fluid infection in patients with viral cirrhosis: cohort study

    Directory of Open Access Journals (Sweden)

    Ali Ailia W

    2008-12-01

    Full Text Available Abstract Background Ascitic fluid infection (AFI in cirrhotic patients has a high morbidity and mortality. It has two variants namely, spontaneous bacterial peritonitis (SBP and culture negative neutrocytic ascites (CNNA. The aim of this study was to determine the outcome in cirrhotic patients with culture positive (SBP and culture negative neutrocytic ascites. Methods We analyzed 675 consecutive hepatitis B and/or C related cirrhosis patients with ascites admitted in our hospital from November 2005 to December 2007. Of these, 187 patients had AFI; clinical and laboratory parameters of these patients including causes of cirrhosis, Child Turcotte Pugh (CTP score were recorded. Results Out of 187 patients with AFI, 44 (23.5% had SBP while 143 (76.4% had CNNA. Hepatitis C virus (HCV infection was the most common cause of cirrhosis in 139 (74.3% patients. Patients with SBP had high CTP score as compared to CNNA (12.52 ± 1.45 vs. 11.44 ± 1.66; p 9/L as compared to CNNA (132 ± 91 × 109/L, p = 0.005. We found a high creatinine (mg/dl (1.95 ± 1.0 vs. 1.44 ± 0.85, (p = 0.003 and high prothrombin time (PT in seconds (24.8 ± 6.6 vs. 22.4 ± 7.2 (p = 0.04 in SBP as compared to CNNA. More patients with SBP (14/44; 31.8% had blood culture positivity as compare to CNNA (14/143; 9.8%, p = 0.002. Escherichia. Coli was the commonest organism in blood culture in 15/28 (53.5% patients. SBP group had a higher mortality (11/44; 25% as compared to CNNA (12/143; 8.4%, p = 0.003. On multiple logistic regression analysis, creatinine >1.1 mg/dl and positive blood culture were the independent predictors of mortality in patients with SBP. Conclusion Patients with SBP have a higher mortality than CNNA. Independent predictors of mortality in SBP are raised serum creatinine and a positive blood culture.

  8. Characterisation of a cell swelling-activated K+-selective conductance of Ehrlich mouse ascites tumour cells

    DEFF Research Database (Denmark)

    Niemeyer, María Isabel; Hougaard, Charlotte; Hoffmann, Else Kay

    2000-01-01

    1.  The K+ and Cl- currents activated by hypotonic cell swelling were studied in Ehrlich ascites tumour cells using the whole-cell recording mode of the patch-clamp technique. 2.  Currents were measured in the absence of added intracellular Ca2+ and with strong buffering of Ca2+. K+ current...... activated by cell swelling was measured as outward current at the Cl- equilibrium potential (ECl) under quasi-physiological gradients. It could be abolished by replacing extracellular Na+ with K+, thereby cancelling the driving force. Replacement with other cations suggested a selectivity sequence of K...

  9. Chylous Ascites: A Rare Adverse Effect of Methimazole Treatment for Grave's Disease—A Case Report and Review of the Literature

    Science.gov (United States)

    Khoury, Tawfik; Schneider, Ronen

    2015-01-01

    A 40-year-old woman was admitted due to an urticarial rash that was attributed to recent onset of methimazole treatment for a diagnosis of Grave's disease. The patient had no prior significant medical history and used no medications, including over-the-counter or herbal medications. Her sister had Grave's disease. On admission, the patient received corticosteroids with improvement in her rash. On the second day of the hospitalization, the patient complained of abdominal discomfort. Abdominal ultrasound revealed a large amount of new onset ascites. Peritoneal tap yielded a milky fluid with high triglyceride level (12.2 mmol/L or 1080 mg/dL), consistent with chylous ascites. After discontinuation of the methimazole, the ascites disappeared. The patient later underwent therapeutic thyroidectomy, after which all features of thyrotoxicosis had improved. PMID:26366308

  10. 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.

  11. Branched-chain amino acid supplements reduced ascites and increased the quality of life in a patient with liver cirrhosis: A case report.

    Science.gov (United States)

    Itou, Minoru; Kawaguchi, Takumi; Taniguchi, Eitaro; Oku, Yuichiro; Fukushima, Nobuyoshi; Ando, Eiji; Oriishi, Tetsuharu; Uchida, Yuki; Otsuka, Momoka; Tanaka, Suiko; Iwasaki, Shoko; Torii, Mari; Yoshida, Kiyomi; Adachi, Yuko; Suga, Mariko; Yoshiyama, Manami; Ibi, Ryoko; Akiyama, Yoshiko; Takakura, Machiko; Mitsuyama, Keiichi; Tsuruta, Osamu; Sata, Michio

    2009-01-01

    Liver cirrhosis is frequently accompanied by malnutrition and hypoalbuminemia, which in turn commonly induces ascites in patients with liver cirrhosis. Ascites leads to abdominal distention and appetite loss, resulting in a deteriorated quality of life (QOL). Administration of branched-chain amino acid (BCAA)-rich supplements reduces hepatic encephalopathy and malnutrition. In addition, BCAAs by themselves up-regulate albumin synthesis through an increase in Fisher's ratio. Thus, in patients with liver cirrhosis, BCAA-rich supplements seem to be effective at reducing ascites and improving the QOL. Here, we report the case of a 58-year-old Japanese man with liver cirrhosis with severe ascites and peripheral edema. The hepatic function of the patient was classified as Child-Pugh grade C. To reduce protein-energy malnutrition, BCAA-rich supplements were administered as a late evening snack as part of a regimen including 2000 kcal/day (32.5 kcal/kg/day) of total energy and 83.5 g/day (1.3 g/kg/day) of total protein intake. Eight weeks after admission, ascites and edema had decreased. Nutritional status also improved from the time of admission to discharge; the serum BCAA level increased from 365.4 to 450.2 µmol/l. Furthermore, the ratio of BCAAs to tyrosine (BTR) increased from 1.70 to 3.65. We also evaluated the effects of nutritional therapy on the patient's QOL using the Medical Outcomes Study 36-Item Short-Form Health Survey upon admission and at discharge. All subscores showed marked improvement and reached a level greater than the Japanese norm with nutritional treatment. In conclusion, BCAA supplementation not only reduced ascites, but also improved the QOL in a patient with liver cirrhosis.

  12. Tunable Transmission-Line Metamaterials Mimicking Electromagnetically Induced Transparency

    Science.gov (United States)

    Feng, T. H.; Han, H. P.

    2016-11-01

    Tunable transmission-line (TL) metamaterials mimicking electromagnetically induced transparency (EIT) have been studied. Firstly, two types of tunable TL EIT-like metamaterial, based on the double split-ring resonator (DSRR) and single split-ring resonator (SSRR), were fabricated and their transmission properties carefully compared. The results showed that the transmittance maximum was almost invariable with shift of the transparency window for the tunable DSRR-based TL EIT-like metamaterial, but for the tunable SSRR-based TL EIT-like metamaterial, the transmittance maximum gradually diminished with shift of the transparency window toward the center of the absorption band. Moreover, the reason for these different transmission properties was explored, revealing that the reduction of the transmittance maximum of the transparency window for the tunable SSRR-based TL EIT-like metamaterial is mainly due to energy loss caused by the resistance of the loaded varactor diodes.

  13. Oral manifestion of Langerhans cell histiocytosis mimicking inflammation

    Directory of Open Access Journals (Sweden)

    K S Divya

    2014-01-01

    Full Text Available Langerhans cell histiocytosis (LCH is a rare idiopathic disease characterized by the clonal proliferation of Langerhans cells. LCH affects five children per million population. The peak incidence is from 1 to 4 years of age. LCH involves the head and neck region quite commonly. Oral soft tissue lesions are also common. The differential diagnosis of oral LCH includes leukemia, neutropenia, prepubertal periodontitis, hypophosphatasia, fibrous dysplasia, and Papillon-Lefevre syndrome. The prognosis of LCH depends on early detection and appropriate management. Surgical management alone is used in 50% of cases with an additional 23% of the lesions being treated with both surgery and radiation therapy. A case of LCH in a 6-year-old girl involving the mid root level of developing first permanent molar with a floating developing tooth bud of permanent second molar mimicking an inflammation is reported.

  14. Granulomatous prostatitis after intravesical immunotherapy mimicking prostate cancer.

    Science.gov (United States)

    Białek, Waldemar; Rudzki, Sławomir; Iberszer, Paweł; Wronecki, Lech

    2016-12-01

    Intravesical immunotherapy with attenuated strains of Mycobacterium bovis is a widely used therapeutic option in patients with non-muscle-invasive transitional cell carcinoma of the bladder. A rare complication of intravesical therapy with the Bacillus Calmette-Guérin vaccine is granulomatous prostatitis, which due to increasing levels of prostate-specific antigen and abnormalities found in transrectal examination of the prostate may suggest concomitant prostate cancer. A case of extensive granulomatous prostatitis in a 61-year-old patient which occurred after the first course of a well-tolerated Bacillus Calmette-Guérin therapy is presented. Due to abnormalities found in rectal examination and an abnormal transrectal ultrasound image of the prostate with extensive infiltration mimicking neoplastic hyperplasia a core biopsy of the prostate was performed. Histopathological examination revealed inflammatory infiltration sites of tuberculosis origin.

  15. An Adolescent Patient with Scabies Mimicking Gottron Papules

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    Eiji Yoshinaga

    2009-01-01

    Full Text Available Atypical features of scabies occur in infants and children and patients with prolonged use of corticosteroids or immunosuppression. We report a non-immunosuppressed 15-year-old female case of scabies showing scaly reddish papules over the proximal interphalangeal joints mimicking Gottron papules in classic dermatomyositis. Periungal erythema was also seen. Four months’ topical corticosteroids from previous clinics had been used. Dermoscopic findings were consistent with typical pictures of scabies. Scraping of hand crusts demonstrated scabies mites and ova. Skin lesions of the patient were cured with oral ivermectin and topical 10% crotamiton. This case suggests that a lesion resembling Gottron papules may be added to the panel of unusual presentations of scabies.

  16. Enterobiasis in Ectopic Locations Mimicking Tumor-Like Lesions

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    Silvio Pampiglione

    2009-01-01

    Full Text Available Both the clinical and the histopathological diagnostic difficulties of oxyuriasis in unusual sites and their importance from a clinical point of view are pointed out. The authors report two ectoptic cases of enterobiasis observed in Northern Italy, one located in a fallopian tube of a 57-year-old woman and the other in a perianal subcutaneous tissue of a 59-year-old man, mimicking tumor-like lesions. The authors take advantage of the occasion to focus the attention of the medical world on this subject, lamenting the scarce importance given to this parasitosis in university courses of medical schools and in medical textbooks as it is incorrectly considered “out-of-fashion.”

  17. Enterobiasis in ectopic locations mimicking tumor-like lesions.

    Science.gov (United States)

    Pampiglione, Silvio; Rivasi, Francesco

    2009-01-01

    Both the clinical and the histopathological diagnostic difficulties of oxyuriasis in unusual sites and their importance from a clinical point of view are pointed out. The authors report two ectoptic cases of enterobiasis observed in Northern Italy, one located in a fallopian tube of a 57-year-old woman and the other in a perianal subcutaneous tissue of a 59-year-old man, mimicking tumor-like lesions. The authors take advantage of the occasion to focus the attention of the medical world on this subject, lamenting the scarce importance given to this parasitosis in university courses of medical schools and in medical textbooks as it is incorrectly considered "out-of-fashion."

  18. Verrucous tumor mimicking squamous cell carcinoma in immunocompetent patient.

    Science.gov (United States)

    Ruiz-Villaverde, Ricardo; Sanchez-Cano, Daniel; Martinez-Peinado, Carmen M; Galan-Gutierrez, Manuel

    2016-02-17

    Mycobacteria cause a range of diseases in both immunocompetent and immunosuppressed individuals. An increase in non-tuberculous mycobacterial (NTM) infections targeting skin has been described. Many hypotheses have been developed in order to explain it: the increasing burden of immunocompromised individuals, immigration from endemic countries, improved laboratory identification techniques, and changes inhuman behavior that expose individuals to this NTM. Mycobacterium mucogenicum group comprises M. mucogenicum, Mycobacterium aubagnense, and Mycobacterium phocaicum. This group of organisms was first named Mycobacterium chelonae-like organism in 1982. Most clinically significant cases of those organisms involved catheter-related infections. Nevertheless, we report an interesting patient with a cutaneous infection produced by M. mucogenicum mimicking a squamous cell carcinoma; an excellent response to combined therapy with rifampicin and clarythromicin was observed.

  19. Mimicking unfolding motion of a beetle hind wing

    Institute of Scientific and Technical Information of China (English)

    MUHAMMAD Azhar; PARK Hoon C; HWANG Do Y; BYUN Doyoung; GOO Nam S

    2009-01-01

    This paper presents an experimental research aiming to realize an artificial hind wing that can mimic the wing unfolding motion of Allomyrina dichotoma, an insect in coleopteran order. Based on the understanding of working principles of beetle wing folding/unfolding mechanisms, the hind wing unfolding motion is mimicked by a combination of creative ideas and state-of-art artificial muscle actuator. In this work, we devise two types of artificial wings and the successfully demonstrate that they can be unfolded by actuation of shape memory alloy wires to provide actuation force at the wing base and along the leading edge vein. The folding/unfolding mechanisms may provide an insight for portable nano/micro air vehicles with morphing wings.

  20. Adenoid Cystic Carcinoma Mimicking an Oroantral Fistula: A Case Report

    Science.gov (United States)

    Monteiro, Bárbara Vanessa de Brito; Grempel, Rafael Grotta; Gomes, Daliana Queiroga de Castro; Godoy, Gustavo Pina; Miguel, Márcia Cristina da Costa

    2013-01-01

    Introduction Adenoid cystic carcinoma (ACC) is one of the most frequent malignant salivary gland tumors, which commonly affects the minor salivary glands of the mouth and is rare in the nose and paranasal sinuses. In the maxillary sinus, ACC can mimic inflammatory diseases and has a poor prognosis. Objective To report a case of a 50-year-old man with ACC of the maxillary sinus whose clinical findings in the alveolar ridge mimicked an oroantral fistula. Case Report An excisional biopsy was performed and histopathologic analysis revealed ACC. Lung metastases and residual tumor in the maxillary sinus were detected by imaging methods. In view of the poor general health of the patient, no new surgical intervention was performed and he was only treated by radiotherapy and follow-up. Conclusion Although rare in the maxillary sinus, ACC should be included in the differential diagnosis of lesions affecting this site. PMID:25992095