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Changes in haemodynamics and body fluid volume due to enalapril in patients with essential hypertension on chronic diuretic therapy.

In 12 patients with essential hypertension who remained hypertensive despite chronic chlorthalidone treatment, the effect of 2 weeks of additional therapy with the converting enzyme inhibitor (CEI) enalapril on blood pressure and body fluid volumes has been evaluated. The objective was to examine the influence of a diuretic-stimulated renin-angiotensin-aldosterone system (RAAS) on haemodynamics and body fluid volume. Mean arterial pressure (MAP -21%), total peripheral resistance index (TPRI -22%) and plasma aldosterone concentration (PAC -39%) were decreased, and plasma renin activity (PRA 660%) was increased. The average heart rate (HR), cardiac index (CI), plasma volume (PV), blood volume (BV), extracellular fluid volume (ECFV) and body weight (BW) remained unchanged. A negative correlation was found between the per cent changes in ECFV and PAC. Thus, body fluid volumes during chronic diuretic treatment are well preserved even when the RAAS with its sodium retaining properties is suppressed by CEI. Possible mechanisms are a volume (not angiotensin II) - dependent stimulation of aldosterone and a fall in blood pressure.

Body Fluids

[Body fluids during 120-day anti-orthostatic hypokinesia].

Body fluid variations were examined during 120-day antiorthostatic (-5 degrees) hypokinesia in 21 test subjects, 9 of which comprised a control group (Group 1). The remaining 12 subjects formed three groups (four subjects each) who received drugs to normalize mineral and lipid metabolism (Group 2), or performed specially developed exercises (Group 3), or were on the combined treatment (Group 4). Total body water (TBW), intracellular fluid volume (IFV), extracellular fluid volume (EFV), and EFV composition were measured by nuclear physical methods. Measurements were taken prior to exposure, on head-down tilt days 1, 60 and 120, and on recovery day 15. Body composition and K40 content were investigated before and after head-down tilt. The controls showed body dehydration that began on tilt day 1 at the expense of vascular fluid and continued by day 60 at the expense of interstitial fluid and by day 120 at the expense of IFV. Group 2 subjects exhibited variations that were similar to those of controls. Group 3 subjects were in better shape due to the beneficial effect of exercise which diminished as head-down tilt continued. In the recovery period the above changes regressed.

Blood Volume

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

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

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

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

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

[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

An approach to the measurement of body fluid compartment volumes in non-steady conditions in the rat.

A method has been developed by which body fluid volume changes can be assessed frequently after only one initial injection of the appropriate radioactive tracers. This method is based on the assumptions that, 1. following their intravenous injection, the temporal behaviour of tritiated water or radio-sodium can be adequately modelled by the kinetic behaviour of an open, interconnected two-compartment system; 2. known amounts of tracer are added to or irreversibly removed from the system only via the first compartment. In the measurement of body fluid volume changes in rats after isotonic blood volume expansion, the rapid urinary tracer excretion was treated as a series of negative tracer "injections" made instantaneously into the first tracer compartment at the mid point of each short urine collection period. The effect of these "injections" on the first compartment was regarded as diminishing with time in accordance with the steady state rate constants. The vaolues for non steady state changes in total body water volume and functional extracellular fluid volume obtained by such a mathematical treatment, agreed closely with directly measured changes where such direct comparisons could be made.

Animals

Body fluid responses of heat-tolerant and intolerant men to work in a hot wet environment.

Acclimatization to heat before proceeding underground is a requirement for each South African mine laborer. Certain individuals among this large population cannot be acclimatized to heat (33.3 degrees C db, 31.7 degrees C wb) and are classified as heat intolerant. In this study certain body fluid responses to heat and work were compared between a group of 19 heat-tolerant (HT) and of 15 heat-intolerant (HI) subjects. To the factors known to affect heat tolerance such as age, weight, and oxygen consumption must now be added differences in body fluid responses. The HI group of subjects failed to hemodilute to the same degree as the HT group though working at the same relative work loads (30% and 50% VO2 max). As the 4-h work period (33.3 degrees C db, 31.7 degrees C wb) continued, the HI group did not maintain hemodilution in spite of the lower absolute work loads, sweat rates, and water deficits suffered by this group. From analysis of blood constituent changes it was suggested that the reason for the differences noted in body fluid dynamics concerned plasma protein equilibrium across capillary walls as well as the protein population of interstitial spaces.

Acclimatization

Quantitative analysis of trifluoroacetic acid in body fluids of patients treated with halothane.

A simple procedure for the quantitative analysis of trifluoroacetic acid (TFA) in urine and serum from patients narcotized with halothane is described. This involves addition of sodium hydroxide to the body fluid, evaporation of the aqueous phase and esterification of TFA in concentrated sulphuric acid with 2,2,2-trichloroethanol. The gaseous phases above the reaction mixture were then analyzed by gas chromatography with a nickel-63 electron-capture detector. The detection limit was 1 microgram of TFA per mililitre of body fluid (200 microgram of body fluid are analysed) and the relative standard deviation was +/-6%. Patients treated with ethrane, another commercial anaesthetic, did not produce any detectable TFA.

Anesthesia

Suppression of glucose utilization of murine peritoneal exudate macrophages by body fluids from cancer patients and identification of the susceptible enzyme.

The glucose consumption of cultured murine (C57BL/6N) peritoneal exudate macrophages is suppressed by pleural effusions, ascitic fluids, and sera from patients with advanced primary lung and gastric cancers. Analysis for the generation of 14C-labeled CO2 after [14C]glucose metabolism revealed the glycolysis pathway to be more susceptible to cancerous body fluids than was the hexose monophosphate shunt. Enzymatic analysis showed that the enzyme susceptible to the cancerous body fluids was D-fructose-6-phosphate 1-phosphotransferase (PFK), the rate-limiting key enzyme in the glycolysis pathway. Other enzymes participating in glycolysis were insensitive to the cancerous body fluids. Suppression of PFK may represent a new tumor marker.

Animals

Freezing avoidance and the distribution of antifreeze glycopeptides in body fluids and tissues of Antarctic fish.

The distribution of antifreeze glycopeptides (AFGPs) in the body fluids and tissues of antarctic notothenioid fish was determined. In Dissostichus mawsoni (Norman), the peritoneal, pericardial and extradural fluid, like the blood, contained all eight AFGPs and in concentrations sufficient to depress freezing points below that of sea water (-1.9 degree C). Secreted fluids including urine, endolymph and aqueous and vitreous humour either lack all AFGPs or have very low concentrations of only the low molecular weight forms and have freezing points of about -1.0 degree C, and are therefore undercooled with respect to environmental temperature. Fluids with high concentrations of AFGPs also contain high levels of proteins similar to plasma proteins. Systemic administration of tritiated AFGPs in the closely related species Trematomus bernacchii (Boulenger) yielded a distribution pattern similar to that of the native AFGPs in D. mawsoni. This suggests passive distribution of AFGPs into the various fluid compartments following secretion from the liver; a pattern typical of secreted blood proteins. Tissue distribution of AFGPs was determined by comparison with that of the extracellular space marker [14C]polyethylene glycol. AFGPs were found in the interstitial fluid of all body tissues examined except brain tissue. No tissue showed any intracellular accumulation of tritiated AFGPs from the blood.

Animals

Deoxyribonucleic acid (DNA) analysis by restriction fragment length polymorphisms of blood and other body fluid stains subjected to contamination and environmental insults.

Deoxyribonucleic acid (DNA) restriction fragment length polymorphism (RFLP) profile results were obtained from bloodstains and other body fluid stains subjected to mixture with other body fluids, environmental insults (sunlight and temperature), different substrates (cotton, nylon, blue denim, glass, aluminum, and wood), and contaminants (gasoline, bleach, sodium hydroxide, soil, motor oil, detergent, phosphate salt, glacial acetic acid, and microorganisms). Of the samples that produced profile results, all had profiles that were consistent with those of untreated control samples.

Blood Stains

"Endogenous" benzodiazepine activity in body fluids of patients with hepatic encephalopathy.

Body fluids from patients with hepatic encephalopathy and from controls with no renal or hepatic disease were assayed for benzodiazepine immunoreactivity and benzodiazepine-receptor-binding activity. The subjects had taken no synthetic benzodiazepines for at least 3 months. Benzodiazepine receptor binding in cerebrospinal fluid was significantly higher in hepatic encephalopathy patients than in controls (210 [SE 50.2] vs 40.7 [7.3] oxazepam equivalents [ng/ml]). The severity of hepatic encephalopathy was directly and significantly correlated with the level of benzodiazepine activity by radioreceptor assay or radioimmunoassay in urine and in plasma. Benzodiazepine activity equivalent to levels of more than 900 ng/ml was found in patients with advanced encephalopathy. Although the chemical identity and source of this substance (or substances) are still unknown, its properties and the estimated levels of activity suggest it may have a role in the pathogenesis of the neural inhibition seen in hepatic encephalopathy.

Benzodiazepines

Specific capture of ABH blood group antigens of the red cell or body fluids by double antibody sandwich-ELISA.

A double antibody sandwich-ELISA method for the detection of the ABH blood group of each constituent of mixed stains is described. Extracts from mixed stains were applied to microtitration plates coated with rabbit polyclonal antisera to red cells or body fluids. ABH antigens in body fluid stains which were captured by the polyclonal antibodies were detected by monoclonal anti-A and -B and enzyme-conjugated anti-mouse immunoglobulin. By this procedure, ABH antigens of only saliva, semen or red cells could be detected from mixed stains, but no ABH antigen capture activity was observed using anti-sweat, -milk, -vaginal secretion, -erythrocyte membrane and -band 3 antibodies.

ABO Blood-Group System

Comparison of Papanicolaou's and Wright-Giemsa stains in the examination of body fluids for Hodgkin's disease.

We reviewed 36 body fluid specimens from 18 patients with Hodgkin's disease (HD) to characterize the cytologic features of HD as seen in Wright-Giemsa (WG)-stained cytocentrifuge preparations, and to compare diagnostic agreement between WG- and Papanicolaou-stained samples. Slides were examined independently by two pathologists without knowledge of the original diagnosis, and were classified as either positive, inconclusive, or negative for malignant cells. There was diagnostic agreement between both methods in 35 (97%) of 36 samples. Features in cytocentrifuged WG-stained specimens that were most helpful in recognizing HD included mirror image nuclei in typical Reed-Sternberg cells and an axis of symmetry in polylobate Reed-Sternberg variants, with even distribution of the nuclear material within the cytoplasm.

Adult