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PubMed2001

Body fluid osmolality and tonicity in preterm infants.

In adult patients, a recent physiological approach for the osmoregulatory system based on body fluid tonicity (the so-called effective osmolality) seems to provide better information on water movements than does the classical body fluid osmolality. To evaluate whether plasma or urinary tonicities could give a better assessment of osmoregulation than plasma and urine osmolalities in sick preterm infants cared for in a NICU. A prospective study was conducted in 30 preterm infants (BW=1284+/-377 g; GA=28.8+/-1.7 weeks). Fifteen consecutive 8-h urine collections were performed for each infant from the 8th h of life (450 periods). A plasma sample was obtained at the end of each urine collection. Sodium, potassium, creatinine, osmolality and tonicity were measured or calculated in urine and blood samples as often as possible. Hypernatremia (PNa=146-149 mmol/l) was observed in seven infants (23.3%) and in 5.9% of the periods. Fifty-three percent of the infants and 20.4% of the periods presented with plasma hyperosmolality (>300 mosmol/kg H2O). The relationship between Posm and PNa was significant, but the clinical relevance was weak (r(2)=0.411; P<0.001). Plasma osmolality (Posm) positively correlated with urine osmolality (Uosm), but did not correlate significantly with CH2O/100 ml GFR. Plasma tonicity (2x(PNa+PK)) positively correlated with both urine tonicity (2x(UNa+UK)) and effective water clearance (EWC/100 ml GFR). On an individual basis, the linear relationship between urine and plasma osmolalities was significantly weaker than the relationship between urine and plasma tonicities. This study suggests that the calculation of plasma and urine tonicities allows a better assessment of water movements in body fluid compartments than plasma and urine osmolalities.

Blood↗
PubMed1992

AUR Memorial Award 1992. Quantification of amino acids in human body fluids by 1H magnetic resonance spectroscopy. A specific test for the identification of abscess.

RATIONALE AND OBJECTIVES: When polymorphonucleocytes are incubated in proteinaceous fluid, they cause extensive protein degradation, which leads to accumulation of free amino acids. The authors tested whether these free amino acids, particularly valine and leucine, also accumulate in human abscess fluids, but not in other body fluids, and thus could be a specific and distinguishing marker for the presence of an abscess. METHODS: Thirty fluids, obtained by percutaneous drainage from 28 patients, were lyophilized and reconstituted in 2H2O before in vitro 1H magnetic resonance (MR) spectroscopy. Concentrations of valine and leucine were determined by comparison of spectra before and after addition of known amounts of valine and leucine. Two chart reviewers, blinded to the spectroscopic results, categorized cases as abscess (n = 14), non-abscess (n = 15), or infection but not abscess (n = 1). RESULTS: The concentration of valine and leucine was significantly higher in the abscess fluids, 2.57 +/- 1.90 mM than in the non-abscess fluids, 0.25 +/- 0.33 mM (P < .001). The one infected fluid which was not an abscess had no amino acids. Using 0.8 mM as the threshold concentration of valine and leucine necessary for the diagnosis of abscess resulted in a sensitivity rate of 86% and a specificity rate of 94%. CONCLUSION: The authors conclude that identification of high concentrations of valine and leucine by 1H MR spectroscopy may be a specific test for the diagnosis of abscess. This technique merits further investigation in vivo.

Abscess↗
PubMed1989

Exposure to and precautions for blood and body fluids among workers in the funeral home franchises of Fort Worth, Texas.

In 1982 the Centers for Disease Control published a set of recommendations and measures to protect persons working in health care settings or performing mortician services from possible exposure to the human immunodeficiency virus. This study of a number of funeral homes in the Fort Worth area was designed to determine the level of exposure of funeral home workers to blood and other body fluids and also to assess existing protective measures and practices in the industry. Workers in 22 funeral home franchises were surveyed with a predesigned questionnaire. Eighty-five responses from 20 of the 22 establishments were received. All 85 respondents admitted exposure of varying degrees to blood and body fluids. Sixty persons (70%) admitted heavy exposure, that is, frequent splashes. Analysis of the responses showed that 81 of 85 (95.3%) persons consistently wore gloves while performing tasks that might expose them to blood or other body fluids. Of the 60 persons who were heavily exposed, 43 wore long-sleeved gowns, 27 wore waterproof aprons, 17 surgical masks, and 15 goggles. The study further revealed that 52.9% (45/85) of the respondents had sustained accidental cuts or puncture wounds on the job. In light of these findings it is important to target educational efforts to persons in this industry to help them minimize their risks of infection with blood and body fluid borne infections.

Acquired Immunodeficiency Syndrome↗
PubMed2004

Cold-water acclimation does not modify whole-body fluid regulation during subsequent cold-water immersion.

We investigated the impact of cold-water acclimation on whole-body fluid regulation using tracer-dilution methods to differentiate between the intracellular and extracellular fluid compartments. Seven euhydrated males [age 24.7 (8.7) years, mass 74.4 (6.4) kg, height 176.8 (7.8) cm, sum of eight skinfolds 107.4 (20.4) mm; mean (SD)] participated in a 14-day cold-water acclimation protocol, with 60-min resting cold-water stress tests [CWST; 18.1 (0.1) degrees C] on days 1, 8 and 15, and 90-min resting cold-water immersions [18.4 (0.4) degrees C] on intervening days. Subjects were immersed to the 4th intercostal space. Intracellular and extracellular fluid compartments, and plasma protein, electrolyte and hormone concentrations were investigated. During the first CWST, the intracellular fluid (5.5%) and plasma volumes were reduced (6.1%), while the interstitial fluid volume was simultaneously expanded (5.4%). This pattern was replicated on days 8 and 15, but did not differ significantly among test days. Acclimation did not produce significant changes in the pre-immersion distribution of total body water, or changes in plasma osmolality, total protein, electrolyte, atrial natriuretic peptide or aldosterone concentrations. Furthermore, a 14-day cold-water acclimation regimen did not elicit significant changes in body-fluid distribution, urine production, or the concentrations of plasma protein, electrolytes or the fluid-regulatory hormones. While acclimation trends were not evident, we have confirmed that fluid from extravascular cells is displaced into the interstitium during acute cold-water immersion, both before and after cold acclimation.

Acclimatization↗
PubMed1991

Thoracic impedance as an index of body fluid balance during cardiac surgery.

Thoracic impedance at 2.5 (TI2.5) and 100 kHz (TI100), central venous pressure (CVP), and body fluid balance were recorded together with rectal temperature and arterial haematocrit in 15 consecutive patients subjected to coronary artery bypass grafting. I.v. fluid and blood were administered in an excess of 3.18 (1.38-9.35) 1 during the operation. TI2.5 decreased from 51.7 (39.2-66.4) to 34.9 (21.1-45.7) ohm (P = 0.001), while TI100 decreased from 41.9 (31.4-55.0) to 30.3 (18.3-40.8) ohm (P = 0.002). CVP, 6 (3-11) mmHg [0.8 (0.4-1.5) kPa], was the same before and after surgery. Temperature decreased during cardiopulmonary bypass from 35.4 (34.1-36.6) to 26.7 (22.9-31.0) degrees C and haematocrit from 39 (34-46)% to a lowest value of 27 (23-32)% (P = 0.0001). A close linear correlation between TI and body fluid balance was observed (TI2.5: r = -0.96, TI100: r = -0.95, P = 0.0001). Corrections of TI for temperature and/or haematocrit improved the correlation between TI and fluid balance to 0.99 (TI2.5) and 0.98 (TI100). The data indicate that changes in thoracic impedance can be used to monitor body fluid balance during cardiac surgery.

Aged↗
PubMed1995

Deoxyribonuclease II (DNase II) activity in mouse tissues and body fluids.

The distribution of deoxyribonuclease II (DNase II) in tissues and body fluids was examined in 12-week-old C3H/He mice. Activity was observed in most tissues and body fluids except erythrocytes and serum, but their levels were quite different among tissues. Activity was high in the spleen, salivary gland, and preputial gland, moderate in the liver, kidney, thymus, lung, heart, pancreas, seminal vesicle, coagulating gland and prostate and low in the brain, testis and muscles. Sex difference, males having a significantly higher DNase II activity level than females, was observed in salivary gland, kidney and urine.

Animals↗
PubMed1995

Humoral defense of the nematode Ascaris suum: antibacterial, bacteriolytic and agglutinating activities in the body fluid.

Three humoral defense activities (antibacterial, bacteriolytic and agglutinating) were detected in the body fluid of the nematode Ascaris suum. Gram-positive bacteria (Staphylococcus aureus and Bacillus subtilis) were more sensitive to the antibacterial activity than the Gram-negative bacteria (Escherichia coli). The antibacterial activity was heat stable and was lost by trypsin digestion. The molecular mass of the factor responsible for antibacterial activity was estimated as 6 kDa. The bacteriolytic activity against dried Micrococcus luteus was also detected. The bacteriolytic factor was 6-9 kDa in molecular mass, heat sensitive and trypsin sensitive. Both E. coli and glutaraldehyde-fixed trypsin-treated human A-type red blood cells were agglutinated in the body fluid. An analytical gel permeation HPLC revealed the agglutinating activity consists of at least two factors. Activities of both agglutinating factors were lost by heat treatment or trypsin digestion. The molecular masses estimated for the two agglutinating factors were 500 kDa and 25 kDa. Under experimental conditions, microbe-injection was not a prerequisite for the appearance of these defense activities.

Agglutination↗
PubMed2005

Pharmacokinetics of difloxacin and its concentration in body fluids and endometrial tissues of mares after repeated intragastric administration.

Pharmacokinetics of difloxacin and its distribution within the body fluids and endometrium of 6 mares were studied after intragastric (IG) administration of 5 individual doses. Difloxacin concentrations were serially measured in serum, urine, peritoneal fluid, synovial fluid, cerebrospinal fluid, and endometrium over 120 h. Bacterial susceptibility to difloxacin was determined for 174 equine pathogens over a 7-month period. Maximum serum concentration (Cmax) was 2.25 +/- 0.70 microg/mL at 3.12 +/- 2.63 h and Cmax after the 5th dose was 2.41 +/- 0.86 microg/mL at 97.86 +/- 1.45 h. The mean elimination half-life (t(1/2)) was 8.75 +/- 2.77 h and area under the serum concentration versus time curve (AUC) was 25.13 +/- 8.79 microg h/mL. Highest mean synovial fluid concentration was 1.26 +/- 0.49 microg/mL at 100 h. Highest mean peritoneal fluid concentration was 1.50 +/- 0.56 microg/mL at 98 h. Highest mean endometrial concentration was 0.78 +/- 0.48 microg/g at 97.5 h. Mean cerebrospinal fluid concentration was 0.87 +/- 0.52 microg/mL at 99 h. Highest mean urine concentration was 92.05 +/- 30.35 microg/mL at 104 h. All isolates of Salmonella spp. and Pasteurella spp. were susceptible. In general, gram-negative organisms were more susceptible than gram-positives. Difloxacin appears to be safe, adequately absorbed, and well distributed to body fluids and endometrial tissues of mares and may be useful in the treatment of susceptible bacterial infections in adult horses.

Animals↗
PubMed1990

Evaluation of isolator system and large-volume centrifugation method for culturing body fluids.

The Isolator system was compared with the large-volume centrifugation method for processing and recovering organisms from body fluids other than blood, cerebrospinal fluid, and urine. A total of 155 body fluid samples were processed for the recovery of clinically significant organisms. Of the 55 positive cultures, Isolator detected 94% and the large-volume centrifugation method detected 64%. The time necessary to indicate positivity was not significantly different in the two methods; however, in five cases, the Isolator system yielded clinically significant organisms 24 h sooner than the conventional method. The Isolator system was found to be a more sensitive alternative than the conventional large-volume centrifugation method.

Bacteria↗
PubMed1980

Body fluid and hematologic adjustments during resting heat acclimation in rhesus monkey.

The purpose of this study was to examine body fluid adjustments during prolonged resting heat exposure in primates. Rhesus monkeys were acclimated for 35 days at 35 degrees C and 30% rh. Red cell mass, extracellular fluid volume (ECF), and total body water (TBW) were determined with 51Cr, 35SO4, and 3H2O, respectively, prior to and at intervals during heat exposure. Heat acclimation was characterized by a fluid shift from the interstitial compartment. In relation to TBW, interstitial fluid volume and ECF decreased 10.3 and 8.3%, respectively, while plasma volume (PV) and intracellular fluid were increased an average of 5.8 and 3.8%. TBW increased 4.8% during heat exposure. Hematocrit and hemoglobin decreased significantly on day 3 (7.9 and 6.5%) followed by a return toward control values. PV in relation to TBW remained elevated throughout the exposure. An increased drinking (25.0%) was associated with a decrease in caloric intake (30.7%) during heat acclimation. This study has provided a complete body fluid compartment analysis during resting heat acclimation in the rhesus monkey. Our results are consistent with the hypothesis that heat acclimation in primates is characterized by a protein and fluid shift from the interstitial fluid compartment to the cardiovascular system and to the intracellular compartment.

Adaptation, Physiological↗
PubMed1985

Approach to the analysis of body fluids for the detection of infection.

Sterile body fluids represent an important source for the diagnosis of infectious diseases because they can be sampled by sterile methods that bypass the normal bacterial flora so heavily colonizing the body surface. Thus when these specimens are received, full advantage should be taken to perform complete microscopic and cultural tests for viral, bacterial, mycobacterial, fungal, and parasitic diseases. In many cases the evaluation can be tailored to the types of organisms that are likely to infect particular body cavities. Ideally, the workup could also be based on the history, clinical presentation, and preliminary examination of the patient, but under most circumstances it may be more appropriate for the laboratory to proceed with a more complete workup of these vital specimens than physicians request. Specimens should be transported promptly to the laboratory and should be viewed quickly by Gram's or acridine orange stain and, in selected situations, also by acid-fast stain, direct fluorescence for legionellosis, and direct wet mount for parasites. Results of these studies should be called in without delay to the responsible physician. Cultures should also be inoculated as soon as possible. Nonspecific tests, including the cell count and protein, glucose, lactic acid, and LDH levels, may provide valuable clues to the presence of infection. Direct antigen detection does not replace traditional microscopic and cultural evaluation of these specimens but may have supplemental value.

Amniotic Fluid↗
PubMed1990

Relationship between anesthetic procedure and contact of anesthesia personnel with patient body fluids.

We recorded the frequency with which anesthesia personnel came in contact with patient body fluids in order to provide an empirical basis for the recommendation of relevant precautions. Anesthesia personnel completed a questionnaire when performing a range of standardized procedures. The rate of contact with blood was as follows: catheterization of peripheral vein, 18%; insertion of central venous catheter, 87%; arterial puncture, 38%; lumbar puncture, 23%; catheterization of the extradural space, 34%; tracheal intubation, 4%; tracheal extubation, 9%; suction of oral cavity, pharynx, or trachea, 13%; intramuscular injection of drug, 8%; and establishment or discontinuation of drip for blood transfusion, 43%. By using protective gloves, 98% of contacts with patient blood would have been prevented. Blood contact was more frequent in the emergency ward than in the operating room (P less than 0.05). Health care workers were not able to predict when a specific procedure would imply that contact with patient blood would occur. We recommend that specific precautions be adopted for the various procedures and discuss precautions that could have prevented contact with body fluid.

Anesthesiology↗
PubMedDate not supplied

Development of an immunomagnetic assay system for rapid detection of bacteria and leukocytes in body fluids.

Immunomagnetic (IM) separation and concentration of specific target ligands or particles, such as bacteria or leukocytes, from complex mixtures, such as bone marrow, blood and other body fluids, is now a widely accepted technique. IM methodologies require high affinity antibodies or other receptors, but are potentially as effective as density gradient separations. Thus, a computer-controlled first-generation immunomagnetic assay system (IMAS) biodetector is being developed for clinical diagnostics. This system is fully automated and affords the advantage of rapid flow-through capture of all types of magnetic beads (MBs) and obviates operator contact with body fluid samples during the collection and analysis phases. In the present work, biotinylated capture antibodies were bound to streptavidin-coated MBs for capture of E. coli O157:H7, T cells and T cell subsets. Samples were automatically vortex mixed with antibody-coated MBs, stained with an acridine dye or fluorescent antibody and collected in a specially designed flow cell containing multiple steel pins, which concentrate external magnetic field lines. IM complexes were rapidly (within minutes), separated from their media in the magnetic field. Magnetically captured particles were automatically rinsed in the flow cell to remove unwanted materials and detection was achieved via a flow-through fluorimeter. Samples can be subsequently captured on a microbiological filter for microscopic visualization and image analysis. Preliminary results demonstrate that rapid detection of target bacteria and leukocytes at low concentrations in body fluids is possible with a total assay time under 1 h. This IM technology has many other potential clinical, industrial and environmental monitoring applications.

Animals↗
PubMed1986

Influence of high-dose methotrexate on the distribution of body fluid volumes in the dog.

We studied the influence of high-dose methotrexate (HDMTX) on body fluid volumes in the dog, using indicator dilution techniques. In six healthy mongrel dogs total body water volume (TBW), extracellular water volume (ECW), body mass, and plasma osmolality were measured before and after infusion of both saline and HDMTX. TBW and ECW were determined simultaneously, using a double-indicator (D2O/ferrocyanide), single injection technique. In vitro experiments confirmed the reliability of ferrocyanide as an indicator for ECW, also in the presence of methotrexate. Results showed an increase in ECW after HDMTX (P = 0.029, paired Student's t-test), while TBW remained constant. Infusion of the same volume of isotonic saline in the control experiments did not result in any demonstrable change in either TBW or ECW. Therefore, infusion of HDMTX appears to cause a water shift from the intracellular to the extracellular compartment. Such a change in body water volumes may have implications for estimates of body composition and for pharmacokinetic studies in cancer patients receiving HDMTX.

Animals↗
PubMed1989

[Gonadotropin, as a tumor marker, in body fluid and tumor tissues of germ cell tumors].

The value of gonadotropin in the body fluids of germ cell tumor patients is its usefulness as a tumor marker. It is also used for differential diagnosis and/or judgement of therapeutic effects. In order to clarify the most effective value of gonadotropin as a tumor marker in the body fluids, we compared the value in serum, liquor and urine with one another. The liquor contained highest (1650 IU/l) value of gonadotropin in the primary intracranial germ cell tumors, mostly in choriocarcinoma. But the gonadotropin value was highest (3050 IU/l) in the serum of secondary intracranial choriocarcinoma. Chiasmal germ cell tumor, except choriocarcinoma, which does frequently secrete gonadotropin (alpha, beta) showed moderate or very high values in the liquor. However, pineal germ cell tumors rarely secrete gonadotropin and sometimes mild high value are obtained in the serum without gonadotropin secretion immunohistochemically. In such cases, the gonadotropin may be increased by indirect mechanism of gonadotropin-secretion following pineal disorder. In most of such cases, the gonadotropin was not human chorionic gonadotropin (HCG) but lutein hormone (LH). Because alpha-subunit of such gonadotropin has the same structure, their antibodies show immunologic cross reaction. So, a count of beta-subunit gonadotropin in the serum or liquor is the best way for differential diagnosis or judgement of therapeutic effects. From our results, it is considered that the tumor secretes HCG if the serum beta-HCG value was higher than 30 IU/l, and that it doesn't secrete HCG if beta-HCG value was lower than 10 IU/l or non calculable. The mild increased HCG may be caused by hypothalamo-diencephalic disorder such as pineal tumor.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1996

[Experience with and prospects for emergency Ippan kensa (urinalysis, fecal tests and body fluid tests].

Ippan Kensa (defined as urinalysis, fecal tests, and tests of cerebrospinal fluid, pleural fluid, ascites, and other body fluids) are done of fresh samples, as a rule, and such samples should be tested as soon as possible. Even for tests not ordered in an emergency, rapid results are desirable. In these two senses, all tests are somewhat urgent. Along with the rest of the hospital, our section moved into a new hospital complex in 1993, and that time, an order-entry and reporting system was implemented. Urinalysis was totally systematized from the start with two automated analyzers connected to an automated transportation system, and other tests were gradually automated and computerized. Time and labor were saved without decreased quality. Most routine tests are now done within 2.5 hours of sampling. Emergency tests are not handled by a special, formally established procedure in our laboratory, but at the request of a physician, any test can be done rapidly when necessary, because the system allows interruption at any time for testing of samples out of order. Our experience with this system suggests that automation and computerization are essential if emergency and urgent tests are to be done rapidly by a small staff. Further improvements in the high-quality automated analyzers already available, speeding results but allowing fewer false-positives and false-negatives can be expected.

Automation↗