Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “ASCITES”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 1,315 records · Page 73Linked to original sources
PubMed1998

Renal effects of a urodilatin infusion in patients with liver cirrhosis, with and without ascites.

This study reports the effects of a short-term (60 min) low-dose (20 ng x kg(-1) x min(-1)) infusion of synthetic urodilatin (URO) in patients with liver cirrhosis. URO is a natriuretic peptide. A total of 15 cirrhotic patients with ascites and nine without ascites participated in a randomized, double-blind, placebo-controlled study in a crossover design. Renal hemodynamics were estimated by a clearance technique using radioactive tracers, and tubular handling of sodium was evaluated by the lithium clearance method. The renal effects of URO were characterized by a significant increase in urine sodium excretion rate (UNa) and urine flow rate (V) in the cirrhotic patients without ascites (UNa: 173%; V: 94%) and with ascites (UNa: 219%, P < 0.01; V: 42%, P < 0.01) when compared with placebo infusions. Fractional excretion of sodium increased significantly, indicating a tubular effect of URO on sodium handling. Filtration fraction, lithium clearance (a marker of end-proximal fluid delivery), and fractional excretion of lithium increased, fractional proximal tubular sodium reabsorption decreased, and absolute proximal tubular sodium reabsorption remained unchanged, suggesting increased delivery of isotonic fluid from the proximal tubule during URO infusion. In addition, a significant decrease in fractional distal tubular sodium reabsorption contributed to the natriuresis. In conclusion, URO improved sodium and urine output in cirrhotic patients with and without ascites by enhancing fluid delivery from the proximal tubules in addition to inhibiting fractional sodium reabsorption in the distal nephron.

Adult↗
PubMed1992

Gross ascites as a first manifestation of primary hypothyroidism due to post-treatment of radioiodine therapy for Graves' disease.

We report herein a case with myxedema (primary hypothyroidism) associated with marked ascites that was found during the course of examination for a suspected decompensated state of liver cirrhosis or malignant disease. Aspirated ascitic fluid was found to have the characteristics of the exudate. Thyroid hormone replacement resulted in rapid clinical improvement with resolution of the ascites. This case is an unusual association of hypothyroidism as a cause of ascites. In all the cases with ascites of unknown etiology, the differential diagnosis requires consideration of myxedema.

Ascites↗
PubMed1987

Lymphangiomyomatosis associated with chylous ascites and high serum CA-125 levels: a case report.

A case of lymphangiomyomatosis with marked chylous ascites and persistently elevated CA-125 levels is presented. A 30-year-old woman revealed milky urine, milky ascites and exertional dyspnea about one year after the normal delivery of her second child. The lungs showed bilateral diffuse reticular shadows. No pleural effusion was observed. Pulmonary function tests revealed hypoxemia and obstructive changes of the respiratory tract. The levels of CA-125 in blood and ascites were continuously more than 200 U/ml. The inguinal lymph node biopsy and open lung biopsy confirmed the diagnosis of lymphangiomyomatosis. The patient was first treated with progesterone without effect. Oophorectomy was then performed, resulting in the improvement of respiratory distress, although ascites continued. With addition of Le Veen's peritoneojugular shunt the patient improved with reduction of ascites.

Adult↗
PubMed1995

The role of imaging in patients with ascites.

Imaging plays a significant role in patients with ascites for assessing the size and the causes of ascitic fluid, for assisting sampling or draining of ascitic fluid, for selecting candidates for TIPS placement, and for surveilling and detecting complications after TIPS placement. Sonography and CT are primary imaging tools, and MR imaging is used in selected cases such as demonstration of peritoneal or ascitic fluid enhancement, particularly in patients with compromised renal function. Interventional procedures combined with CT and sonography play a major role in the assessment of patients considered for TIPS placement because of refractory esophageal bleeding or ascites. Before the TIPS procedure, these procedures are used to exclude contraindications such as polycystic liver disease, hypervascular hepatic tumors, and portal vein thrombosis. After the TIPS procedure, sonography combined with interventional procedures is used to detect immediate complications such as hemorrhage or intractable shunt-induced encephalopathy due to excessive portosystemic diversion and to detect and treat mid- to long-term complications such as shunt stenosis and occlusion through a routine surveillance program.

Ascites↗
PubMed1983

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

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

Aged↗
PubMed1984

Cerebrospinal fluid ascites complicating ventriculoperitoneal shunting. Report of four cases.

Four cases of cerebrospinal fluid (CSF) ascites secondary to ventriculoperitoneal shunting are described. It is possible to differentiate CSF ascites from a CSF-filled pseudocyst by the characteristic bowel gas pattern on films of the abdomen and by the presence of shifting dullness. Two of the patients had active shunt infections, and had ascitic fluid with a protein level greater than 3 gm% and a white blood cell (WBC) count greater than 1000/cu mm. Both were treated successfully with antibiotics and removal of the shunt from the peritoneum. Two other patients had no evidence of infection, protein levels of less than 2 gm%, and WBC count less than 100 cu mm. These disorders resolved spontaneously. A review of 18 cases reported in the literature shows that the etiology of CSF ascites in the absence of shunt infection is multifactorial, and no features are consistently present in all cases. Ascites without infection may resolve spontaneously without surgical intervention.

Adult↗
PubMed1995

Growth of broiler chickens in response to feed restriction regimens to reduce ascites.

A trial was conducted to investigate the impact of early feed restriction on ascites induced by cold temperatures and the subsequent effect on the whole body and breast muscle growth of broilers. Two feed restriction regimens were tested, consisting of limiting daily feed intake of the birds to 75% of the ME required for normal growth from either 4 to 11 d or from 7 to 14 d. At 21 d, half of the birds were moved to a cold house (17.8 C) to induce ascites. Five birds from each pen were killed for the breast muscle growth, Pectoralis major and Pectoralis minor, and heart and abdominal fat pad weights at 4, 7, 11, 14, 21, 35, and 49 d of the experiment. Birds in the cold house were heavier and had better feed conversion than birds in the control house at 49 d of age. This could be attributed to the high ambient temperatures (27 to 33 C) in the control house. The ad libitum birds had a significantly greater percentage of P. major than the feed-restricted birds. Exposure to cold temperatures caused significantly higher percentage of ascites from 21 to 49 d. Cold temperatures also increased the percentage of total heart and the right ventricle weight relative to total heart weight ratio at 35 and 49 d of age, suggesting that the surviving birds were more likely to develop ascites. Although catch-up growth was observed, the final body weight of feed-restricted birds was not the same as ad libitum birds. Early feed restriction reduced the incidence of ascites, but at the cost of breast muscle growth.

Age Factors↗
PubMed1996

Hematocrit values and mortality from ascites in cold-stressed broilers from parents selected by hematocrit.

A hypothesis that the relative hematocrit value of broilers is inherited and can serve as an indicator of partial resistance to the ascites syndrome in cold-stressed broilers was shown to be valid in a field trial. Hematocrits were determined for male and female grandparent breeding stocks. Matings were then made between low (LL), low-medium (LM), medium-high (MH), and high (HH) hematocrit parents: LL x LL, LM x LM, MH x MH, and HH x HH. The progeny of HH parents had higher hematocrit values than the progeny of lower hematocrit parents (P < 0.0001). Exposure of the progeny from all the parental groups to an ascites-predisposing cold environment caused higher losses from ascites in the progeny of the HH parents (P < 0.0001). The progeny of LH parents had an increased mortality from causes other than ascites (P < 0.0001). This work suggests that elimination of birds with HH in broiler breeding programs may be desirable where cold-induced ascites is an important problem.

Age Factors↗
PubMed2006

Clinical research on navel application of Shehuang Paste combined with Chinese herbal colon dialysis in treatment of refractory cirrhotic ascites complicated with azotemia.

AIM: To explore the efficacy and mechanism of a novel therapeutic method of traditional Chinese medicine in patients with refractory cirrhotic ascites complicated with azotemia. METHODS: Seventy-five cases of refractory cirrhotic ascites complicated with azotemia were randomly divided into 3 groups: comprehensive treatment (n = 29), simple treatment (n = 24), and control (n = 22). The basic treatment methods were the same in all groups, including liver protecting medicines, diuretics and supportive drugs. The control group underwent only the basic treatment. Shehuang Paste (SHP) was applied to the navels of the two treatment groups once a day for 30 d. Colon dialysis with Chinese herbs was administered to the comprehensive treatment group once every two days. Before and after treatment, we measured abdominal circumference, BUN, Cr, serum Na+, urine Na+/K+, liver function, endotoxin content, NO, and ET-1. Color Doppler ultrasonography was conducted to measure the portal vein blood flow. RESULTS: The total effective rate for ascites was 72.4% in the comprehensive treatment group, 45.8% in the simple treatment, contrasting with 18.2% in the controls. Between the two treatment groups and the controls, there were significant differences in the effective rates (P < 0.01, and P < 0.05). There was also a significant difference (P < 0.05) between the two treatment groups. Measurements of Cr and BUN showed higher values for the treatment groups, with the comprehensive better than the simple group (P < 0.05). Sera Na, urine Na/K were different, P < 0.01 between pre- and post-treatment in the comprehensive group, and P < 0.05 in the simple group. The treatment groups' endotoxin content was also significantly reduced (P < 0.01, and P < 0.05), with the comprehensive group better than the simple group (P < 0.05). Portal vein blood flow and NO content significantly reduced (P < 0.05), as did ET-1 content (P < 0.01). There were no significant changes in the control group (P > 0.05). The comprehensive treatment group's pre- and post-treatment portal vein and splenic vein blood flows showed a positive correlation to NO, ET-1 and endotoxin contents. CONCLUSION: When treating refractory cirrhotic ascites complicated with azotemia, Shehuang Paste combined with Chinese herbal dialysis is better than Shehuang Paste alone for ascites resolution, azotemia, and endotoxin elimination. However, both methods on their own were also effective for reducing portal and splenic vein blood flow, and lowering the contents of NO, ET-1 in the two treatment groups.

Administration, Topical↗
PubMed2003

[Detection of soluble Apo-1/Fas in plasma, pleural and ascites fluid of malignant tumor patients and its clinical significance].

OBJECTIVE: To study the changes of soluble Apo-1/Fas levels in plasma, pleural and ascites fluid of malignant tumor patients and to evaluate their clinical significance. METHODS: The soluble Apo-1/Fas levels were measured by enzyme-linked immunosorbent assay (ELISA) in the plasma of 157 malignant tumor patients and 25 normal controls as well as in the pleural and ascite fluids of 129 patients with various diseases. RESULT: The plasma soluble Apo-1/Fas levels in acute and chronic leukemia and multiple myeloma were significantly higher than those in normal controls (P <0.05). The plasma soluble Apo-1/Fas levels in chronic myeloid leukemia and chronic lymphocytic leukemia were significantly higher than those in acute myeloid leukemia and acute lymphocytic leukemia, respectively (P <0.05). After chemotherapy, the plasma soluble Apo-1/Fas levels in complete remission group were distinctly decreased(P <0.05),whereas the levels in no remission and recurrence groups remained high. Compared with normal controls, the plasma soluble Apo-1/Fas levels in solid tumors were significantly increased (P <0.01), and the levels in metastasis cancers were significantly higher than those in non-metastasis cancer (P <0.0 1). Simultaneously the levels in remission cancer patients after operation and radiotherapy were distinctly lower than those before treatment(P <0.01), but were significantly increased in recurrence cancer patients (P <0.01). The soluble Apo-1/Fas levels in pleural and ascites fluid of malignant tumors were significantly higher than those in tuberculous effusions and transudates. CONCLUSION: The soluble Apo-1/Fas levels in plasma, pleural and ascites fluid of malignant tumor patients are markedly increased, which might be associated with the progress of cancers. The changes of soluble Apo-1/Fas levels may be useful for understanding the pathologic process of cancers and to differential diagnosis of various pleural and ascites fluids.

Adolescent↗
PubMed1998

Thrombomodulin, a receptor for the serine protease thrombin, is decreased in primary tumors and metastases but increased in ascitic fluids of patients with advanced ovarian cancer FIGO IIIc.

The human ovarian cancer cell line OV-MZ-19, established from a patient with cystadenocarcinoma of the ovary, expressing thrombomodulin (TM), a cell surface receptor for the serine protease thrombin, interacts with monoclonal and polyclonal antibodies having different specificity for TM. These antibodies detect TM antigen by means of flow cytofluorometry, laser scanning microscopy, immunocytochemistry, and ELISA. Therefore a highly sensitive ELISA for TM antigen was established using two different monoclonal antibodies to quantify TM in tissue extracts and biological fluids, e.g. peritoneal malignant ascites. Primary malignant ovarian tumors and metastases of the omentum and intestine contain TM antigen as determined by ELISA but in significantly lower concentrations than benign ovarian tumors (p=0.0056). In contrast, malignant ascitic fluid of patients with advanced ovarian cancer (FIGO IIIc) contain significantly elevated concentrations of soluble TM than benign peritoneal exudates (p=0.0003). Immunoaffinity purified ascites-derived TM efficiently activates protein C. Protein C activation of ascites-derived TM as well as TM expressed by the tumor cells is inhibited by the monoclonal antibodies. TM abrogates the procoagulant activity of thrombin, reduces pericellular thrombin via internalization, accelerates the thrombin-mediated inactivation of pro-uPA, and the EGF domains of TM exhibit mitogenic activity towards fibroblasts and tumor cells. Both, thrombin and pro-uPA play important roles in tumor invasion and metastasis. Therefore, downregulation and/or release of TM into ascitic fluid may play an important role in the malignant behavior of tumor cells.

Antibodies, Monoclonal↗
PubMed2000

Inhibition of malignant ascites and growth of human ovarian carcinoma by oral administration of a potent inhibitor of the vascular endothelial growth factor receptor tyrosine kinases.

We determined whether inhibition of the catalytic tyrosine kinase activity of the receptors for vascular endothelial growth factor/vascular permeability factor (VEGF/VPF) inhibits the formation of malignant ascites and the progressive growth of human ovarian carcinoma cells implanted into the peritoneal cavity of nude mice. The novel protein tyrosine inhibitor PTK 787 was evaluated in two models of human ovarian cancer: Hey-A8 cells, which express low levels of VEGF/VPF and grow as solid tumor foci on the surface of peritoneal organs, and SKOV3 i.p.1 cells, which express high levels of VEGF/VPF and grow as solid peritoneal tumors and ascites. Treatment of nude mice by daily oral administration of 50 mg/kg PTK 787 was not effective against Hey-A8 tumors. In sharp contrast, it significantly inhibited growth of SKOV3 i.p.1 cells and formation of ascites, significantly increasing survival of mice with the implants. Tumor-induced vascular hyperpermeability in the peritoneum of tumor-bearing mice was inhibited by PTK 787, which accounted for its inhibition of ascites formation. Our results suggest that blockade of the VEGF/VPF receptor may be an efficient strategy to inhibit formation of malignant ascites and growth of VEGF/VPF-dependent human ovarian carcinomas.

Administration, Oral↗
PubMed1978

Carcinoembryonic antigen assay of ascites and detection of malignancy.

Levels of carcinoembryonic antigen (CEA) activity were measured in 105 unselected samples of ascitic fluid submitted for routine cytologic analysis to ascertain whether this assay was useful in the detection of malignancy. The highest CEA level found in the 70 specimens of "benign" ascites was 10 ng/ml. Using values greater than 10 ng/ml as indicating a cancerous effusion, CEA assay successfully detected 14 of the 29 malignant ascites studied. Cytology, on the other hand, detected only 12 of these fluids. Combining the two methods increased the yield to 20. The CEA assay alone thus detected more than one fourth of these malignant fluids. The assay was particularly useful in detecting malignant transudates, nearly half of which had elevated CEA levels despite negative cytologic findings. The CEA assay of ascites thus showed promise as an adjunct to cytology in the detection of malignant ascites when used as part of a complete clinical and laboratory assessment.

Ascitic Fluid↗
PubMed1999

T lymphocytes and cytokine production in ascitic fluid of ovarian malignancies.

The activation status of T lymphocytes and the presence of various cytokines in ascitic fluid were examined to test peritoneal immunity in women with ovarian malignancies. Peripheral blood and peritoneal fluid were collected from 12 patients with primary ovarian cancer with ascites and 27 normal control subjects during laparoscopic examination. Lymphocyte subpopulations and the expression of activation markers on T lymphocytes were analyzed by dual-color flow cytometry. The concentrations of various cytokines and soluble interleukin (IL)-2 receptor-alpha were measured. CD8 T lymphocytes were the main component of peritoneal lymphocytes. CD69 and HLA-DR, but not CD25, were highly expressed on peritoneal T lymphocytes compared to those in peripheral blood. In ascitic fluid of ovarian malignancies, CD4 T lymphocyte concentrations were further decreased, resulting in a decreased CD4/CD8 ratio. Decreased expression of CD69 and CD25 was also noted on T lymphocytes from ascites compared with T lymphocytes in normal peritoneal fluid. IL-1b, tumor necrosis factor-alpha, IL-6, and soluble IL-2 receptor-alpha concentrations were increased significantly in the ascitic fluid of women with ovarian cancer. The decrease in activation markers on T lymphocytes is suggestive of an immunosuppressive state, despite the presence of abundant stimulatory cytokines. The immunosuppression may be multifactorial, attributed, in part, to the increased concentrations of soluble IL-2 receptor-alpha and other inhibitors.

Ascitic Fluid↗
PubMed1999

Malignant ascites in female patients: a seven-year review.

Malignant ascites is common in various types of advanced cancer. Our objective was to determine the primary site and the clinical characteristics of female patients presenting with malignant ascites as well as evaluating the outcome. The authors carried out a retrospective study of 118 cases of malignant ascites diagnosed from January 1986 to December 1992 in female patients. Of the 118 cases, the primary site of the neoplasms was gynecologic in 65 cases (cervix 4, endometrium 6, ovary 52, fallopian tube 3) = 55.1 per cent, non-gynecologic 29 cases (GI 18, lymphoma 8, breast 2, kidney 1) = 24.6 per cent, and unknown 24 cases = 20.3 per cent. The mean age of patients in the gynecologic, non-gynecologic and unknown primary site was 50.4, 45.5 and 59.3 years respectively. Surgery combined with chemotherapy was the main treatment in the gynecologic group, whereas, supportive and symptomatic management was the main treatment in the unknown primary group. Treatments in non-gynecologic group were supportive and symptomatic, surgery and chemotherapy. Survival was longer in gynecologic than in the nongynecologic and the unknown primary groups. The most common primary site of malignant ascites in females was ovarian cancer. In malignant ascites in females caused by gynecologic neoplasms, the prognosis as measured by survival was better than in the non-gynecologic and the unknown primary groups.

Adult↗
PubMedDate not supplied

[Idiopathic ascites associated with hemodialysis. Case report and literature review].

BACKGROUND: Idiopathic dialysis ascites (IDA) is an uncommon disease characterized by the absence of a cause that can explain its presentation. CASE REPORT: Thirty year old female, with diabetic nephropathy under chronic hemodialysis, with massive ascites. Treatment with intensive ultrafiltration was non-successful, and we had poor clinical results with consecutive paracentesis. The study of ascitic fluid was normal. We discarded cardiovascular, hepatic, infectious, neoplastic, and metabolic etiologies and laparoscopy with hepatic and peritoneal biopsies were non-diagnostic. Finally, after renal transplantation, a rapid decrease of the ascites was observed and the diagnosis of IDA was established. DISCUSSION: IDA is a rare entity that does not seem to be related with uremia as it is usually present after the start of hemodialysis. Malnutrition and hypoproteinemia are frequently associated and could be part of the etiology of IDA, which explains the lack of response to ultrafiltration and salt restriction, usual treatment for ascites control. The pathophysiological explanation of the dramatic response of this patients to renal transplantation is unclear.

Adult↗
PubMed1999

[46-year-old patient with polyneuropathy, hepatosplenomegaly, endocrinopathy, M-gradient, skin manifestations, sclerotic bone changes and therapy refractory ascites].

The POEMS syndrome is a rare multisystemic disorder with polyneuropathy, organomegaly, endocrinopathy of various forms, production of monoclonal (M) component, and skin changes. We describe a 46-year-old man who developed ascites one year after the onset of peripheral neuropathy with accompanying muscle atrophies and increasing weakness. Extensive evaluation revealed that the patient had no underlying liver disease, malignancy, infection, or cardiac or renal disease. The ascites initially responded to high-dose corticosteroid therapy. The patient had many clinical features of the described POEMS syndrome including sclerotic bone lesions, a persistent lambda-paraprotein and refractory ascites. In this case ascites was a main presenting feature. Thus, the POEMS syndrome must be added to the list of rare causes of refractory ascites.

Ascites↗
PubMed1999

[Multiple myeloma presenting as massive ascites].

Ascites is a rare complication of multiple myeloma. We report a case of multiple myeloma with peritoneal involvement. An 80-year-old woman was admitted to our hospital because of massive ascites. Laboratory findings included an Hb of 7.8 g/dl, IgA of 2,160 mg/dl, and CA125 of 942 IU/ml. Immunoelectropheresis analysis detected a monoclonal component of IgA lambda in serum, and of BJP lambda in urine. Bone marrow aspirtion revealed normal cellularity with 32.7% atypical plasma cells. The ascites was characterized by an exudate with numerous atypical plasma cells and elevated IgA and CA125 levels. The IL-6 level was 22 pg/ml and 79 pg/ml in serum and ascites, respectively. A diagnosis of IgA lambda multiple myeloma with peritoneal involvement was made. Chemotherapy consisting of melphalan and prednisolone reduced the serum IgA and CA125 levels markedly, and alleviated the patient's ascites.

Aged↗