[Exudates, transudates and the Rivalta reaction (1895). Current status and historical premises].
Explore the source record for details and available documents.
Acetates↗
SEARCH · Search PubMed
Results for “Exudates and Transudates”
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.
Pleural effusion: transudate or exudate.
Explore the source record for details and available documents.
Blood Proteins↗
Cytology of transudates and exudates.
Explore the source record for details and available documents.
Ascitic Fluid↗
Comparative study of penetration of lomefloxacin and ceftriaxone into transudative and exudative pleural effusion.
We investigated the transpleural penetration of lomefloxacin (LFLX) and ceftriaxone (CTRX). LFLX (200 mg) was administered orally to three patients with transudative fluid and four with exudative fluid, and 2 g of CTRX was administered by drip infusion to four patients with transudative fluid and three with exudative fluid. For both groups that received LFLX and CTRX, blood samples were drawn at time zero and 1, 2, and 6 h after drug administration. Thoracocentesis of each group was performed at 6 h after drug administration. The mean ratios of concentrations in pleural fluid/maximum concentrations in serum (P/S max) of LFLX were 66% in patients with transudative fluid and 69% in patients with exudative fluid. The mean ratios of P/S max of CTRX were 9.1% in patients with transudative fluid and 13.5% in patients with exudative fluid. The P/S max ratios for the penetration of LFLX were five to six times higher than those for CTRX. In addition, there was less differentiation in concentrations of LFLX in pleural fluid between the transudative and exudative effusions than there was in the concentrations of CTRX.
Aged↗
[New parameters in the differential diagnosis between pleural exudate and transudate].
Explore the source record for details and available documents.
Diagnosis, Differential↗
Dry up method as a revised Limulus test with a new technique for gelatin inhibitor removing.
To detect endotoxins, Limulus test, especially its tube method, is recently used most widely. But this method has shortcomings considerably, for example, the lack of the objectivity on the judgement, the necessity of long handling time and the requirement of relatively large amount of Limulus lysate. To revise these shortcomings we established a new method. In our method, sample and Limulus lysate are mixed on a silicone coated slide glass and incubated at 37 degrees C for 30 min, then heated to dry up for the judgement. In samples which contain protein, the pretreatments with (NH4)2SO4, dilution and boiling are performed to remove gelation inhibitor. It was proved that this method could be applied to such samples as physiological saline, plasma, urine, transudate, exudate, cerebrospinal fluid (CSF) and suspension of Escherichia coli (E. coli). This method has advantages in its (1) objectivity of the judgement because of the clear difference of the dry up patterns between positive reaction and negative, (2) shortness of the handling time (results can be obtained within 2 hr from sampling), (3) requirement of little amount of sample and of Limulus lysate (a fifth volume of sample and a tenth volume of lysate are needed compared with the conventional method) and (4) sensitivity (0.1 or 0.5 ng/ml of lipopolysaccharide (LPS)).
Adult↗
The value of cells in the pleural fluid in the differential diagnosis.
Fifty samples of pleural fluid, collected from consecutive patients in a thoracic clinic who had diagnostic thoracentesis, were studied prospectively. Pleural fluid protein was of value in differentiating transudates from exudates. Pleural fluid red cell counts, white blood cell counts, and differential white blood cell counts have no specificity and no usefulness in the differential diagnosis of the origin of the effusion. Pleural fluid cytology was positive in 60% of all the malignancies studied in this series; for the group with metastatic breast carcinoma, there was a 78% positive pleural fluid cytology. Differential white cell counts revealed tumor cells in 45% of malignant effusions. In our experience, the finding of tumor cells is the only useful finding in differential cell counts of the pleural fluid.
Blood Cells↗
[Alpha 1-antitrypsin in the blood and pleural effusion fluid].
Alpha-1 antitrypsin levels were determined in 27 pleural effusion liquids classified as transudates and exudates in accordance with the clinical and laboratory data, and in their respective blood samples. Absolute values proved insufficient to distinguish transudates from exudates, though they were capable of signifying and replacing the relative protein value. The relation between liquid: serum alpha-1 AT ratio and the liquid: serum proteins ratio was direct and highly significant. Along with the liquid: serum LAD and liquid: serum proteins ratios, the liquid: serum alpha-1 AT ratio enables transudates and exudates to be differentiated with certainty.
Adult↗
[Significance of lactate dehydrogenase levels in the fluid and serum in the diagnosis of pleural effusions].
Lactic acid dehydrogenase (LAD) levels were determined in 82 pleural effusion liquids and the respective blood samples from 58 patients. Effusions were classed as transudates and exudates on the basis of clinical and laboratory data. The 16 transudates had absolute protein levels of less than 3 g/100 ml and a liquid: serum protein ratio below 0.5. LAD values were below 100 mU/ml and the liquid: serum ratio was less than 0.33, whereas both these levels were exceeded in the case of the 66 exudates. The liquid: serum LAD ratio is better suited for the differentiation of transudates and exudates, particularly if it is related to the liquid: serum protein ratio. Neoplastic effusions have the highest absolute LAD values and liquid: serum LAD ratios. Slighter lower values are noted in TB. Taken in conjunction with other parameters, liquid and serum LAD levels enable a transudate to be distinguished from an exudate and assist in aetiological diagnosis.
Adult↗
Ultrasonic differentiation of types of ascitic fluid.
A review of 65 cases of proven ascites was done to assess the accuracy of ultrasound in distinguishing transudates from exudates. In 10 patients with malignant ascites, ultrasound suggested this in six by showing matted bowel loops, loculation, or hepatic metastasis. In each of the five patients with peritonitis, infected ascites was suggested by observing septations or debris within the fluid. A sonographic diagnosis of exudate was not made in any of the 50 confirmed transudates. The echographic characteristics which may suggest infected or malignant ascites are discussed.
Ascites↗
Erroneous classification of a pleural effusion. The role of a traumatic thoracentesis.
The separation of pleural effusions into exudates and transudates is based on the pleural fluid LDH and protein content compared to the simultaneous serum LDH and protein content. A patient in biventricular failure presented with a right pleural effusion that met the criteria of a transudate. After a traumatic thoracentesis the fluid met the criteria of an exudate.
Aged↗
[Kinin system components, free kinins and proteinase inhibitors in the edematous fluids of nephrotic syndrome patients].
Main components of the kinin system, free kinins, total arginine esterase activity content of alpha 1-antitrypsin and alpha 2-macroglobulin fractions were estimated in various edematous fluids (transduates of different localization, pleural exudates of the inflammatory type) of patients with nephrotic syndrome of various etiology. Noninflammatory edematous fluids (interstitial, abdominal and pleural transudates) were found to contain activated kallikrein and prekallikrein from blood plasma; 3-10 ng/ml of free kinins were present in interstitial edematous fluids and 30-60 ng/ml - in abdominal transudate. Kinins of abdominal transudate were identified with bradikinin by chromatographic properties; a single low-molecular form of kininogene was found, its content did not exceed 10% of the substance occurring in blood plasma of the patients. These edematous fluids practically did not exhibit the kininase activity and contained unsignificant amounts of proteinase inhibitors. Pleural exdates of the inflammatory type were distinctly different from transudates in content of the kinin system components. Depending on the higher content of protein (2.5% as compared with 0.3-0.7% in transudates) the exudates contained high-molecular kininogene and kininase I. Relative content of kallikrein in pleural exudates was lower and that of prekallikrein - higher as compared with transudates; acid kininogenases were not observed. Free kinins (30 ng/ml) were found in three samples of pleural exudates out of five samples studied. The inflammatory type of pleural exudates correlated with the high level of alpha 1-antitrypsin. As shown by comparative analysis of protein fractions from edematous fluids and corresponding samples of blood plasma of patients with nephrotic syndrome, diffusion is the main reason, which determines the course of protein transition from inter-into exovasal space, under conditions of increased vascular permeability. Kallikrein activation and extravasal formation of bradikinin were apparently the long-term affecting factors, supporting the state of increased vascular permeability in nephrotic syndrome; they had an aggravating role in pathogenesis of refractory nephrotic edema, nephrotic crises and cutaneous erythema.
Adolescent↗
Pleural effusions.
Many different conditions result in the accumulation of pleural fluid. A diagnostic thoracentesis should be performed on all patients with pleural effusion from whom pleural fluid can be easily obtained. Empirically we have found that when the pleural effusion is more than 10 mm thick on the lateral decubitus roentgenogram, pleural fluid is easily obtained. At least 30 cc fluid should be obtained and distributed to the various laboratories as outlined in Table 2. The results of these tests will show whether the fluid is a transudate or an exudate. If the fluid is a transudate, no further diagnostic procedures need be directed towards the pleura. If the fluid is an exudate, the diagnosis will frequently be made by these original tests and therapy for the pleural disease can be instituted. If the diagnosis has not been made, the results of these tests should lead to a rational diagnostic attack.
Amylases↗
Decreased heat-labile opsonic activity and complement levels associated with evidence of C3 breakdown products in infected pleural effusions.
Heat-labile opsonic activity was measured simultaneously in serum and pleural fluid of patients with transudates, infectious exudates (with positive or negative bacterial culture) and neoplastic exudates, using two different complement-dependent phagocytic tests: the killing of Staphylococcus aureus Wood 46 variant strain (K50 opsonic titers) and the assessment of ingestion rate of endotoxin-coated paraffin particles (Oil Red 0 uptake test). K50 opsonic titers were lower in culture-positive pleural effusions as compared to culture-negative (P < 0.002) or neoplastic effusions (P < 0.002). These results were corroborated by the Oil Red 0 uptake test. The data obtained with the two assays showed a significant correlation (P < 0.001). The hemolytic activity of complement (CH50) as well as the levels of C3 breakdown product, C3d, were measured in the same sera and pleural fluid samples and in an additional group of patients with pleural effusions of the same etiology. Effusions with positive cultures showed lower CH50 values (P < 0.01) and higher C3d values (P < 0.05) when compared to culture-negative pleural fluids. Finally, evidence for immune complexes in pleural effusions and sera was looked for by determination of Clq binding activity. Levels were higher in culture-positive effusions when compared to culture-negative fluids (P = 0.005).K50 opsonic titers showed a positive correlation with CH50 values (P < 0.001) for all fluids tested. Similarly Clq binding activity correlated with C3d levels in effusions of infectious origin (P = 0.05). Recovery experiments using the various bacterial species isolated from culture-positive pleural effusions showed evidence of complement inactivation upon incubation with pooled sera at concentrations of 10(7)-10(8) microorganisms/ml. These results indicate that one important reason for bacterial persistence in empyema may be decreased opsonization secondary to local consumption of complement.
Adult↗
Human pleural effusions are rich in matrix metalloproteinases.
We identified and characterized type IV collagenase and gelatinase activity in pleural fluid from 32 patients. The capacity to substantially degrade type IV collagen was demonstrated in every pleural sample. Comparable results were also noted for the degradation of a radiolabeled gelatin substrate. Gelatin gel zymography of the pleural fluids revealed two prominent zones of lysis at 66 kDa and 92 kDa. These were identified by specific polyclonal antibodies as human matrix metalloproteinases MMP-2 and MMP-9. The concentration of MMP-2 in pleural fluid, as measured by enzyme-linked immunoassay, averaged 1,622 ng/ml whereas those of MMP-9 were 210 ng/ml. Substrate degradation activity was compared in both serum and pleural fluid from three patients and found to be similar. In serum this enzymatic activity was primarily due to MMP-9 whereas in pleural fluid, the predominant gelatinase was MMP-2. This was confirmed by immunoassay that showed that MMP-2 levels were two to five times higher in pleural fluid than in serum. We conclude that substantial amounts of MMP-2 and, to a lesser degree, MMP-9 are present in pleural effusions. The bioactivity and the immunoactivity of these enzymes did not help to distinguish among pleural fluids characterized as transudates, nonmalignant exudates, or malignant exudates. The differences in the distribution of these enzymes in pleural fluid and blood suggest that their presence is not due simply to the ultrafiltration of plasma, but rather to synthesis by the resident cells at the pleural surfaces.
Biomarkers↗
Nasal glands in nasal allergy.
The entire nasal mucosa from a patient with nasal allergy and hay fever was studied by the whole mount method, and the density of submucous glands was determined. Their density was essentially greater than in normal noses in all parts of the nose, especially on the conchae. This finding indicates that new-abnormal-glands form in the course of the disease, glands which also differ morphologically from the normally occurring glands. As this greatly increases the secretory capacity of the mucous membrane, there is a patho-anatomical basis for assuming that the nasal secretion in allergy is formed exclusively by the existing glands. Other sources of nasal secretion, such as exudation and transudation under normal conditions and in allergy, as well as the mode and causes of gland formation, are discussed.
Adolescent↗
Pleural fluid lysozyme in human disease.
A prospective study was conducted to define the content, significance, and source of lysozyme present in the pleural fluid in human diseases. The pleural fluid lysozyme activity is similar in various malignant and nonmalignant transudates and exudates, and is of limited diagnostic value. The pleural fluid activity correlated well with that of paired serum samples but it had poor correlation with the disease state, the pleural fluid granulocyte counts, and total white blood cell counts. The data suggest that the pleural fluid lysozyme may be derived primarily from the blood and that it is not the product of inflammatory or neoplastic cells in the fluid itself.
Carcinoma↗
[Differential diagnosis of pleural diseases].
Diffuse and circular focal processes are radiologically recognized as possibly pleurally conditioned by the position near to the chest wall. A clarification is possible by means of the diagnostic pneumothorax, the pleuroscopy and the exploratory excision under vision. Callous processes may be of inflammatory and malignant genesis. Transthoracic punctures, punch biopsies and surgical exploration may become necessary for the clarification. The effusion is the most frequent symptom of pleural diseases. The differentiation of transudate and exudate is diagnostically as essential as a functional interpretation of the cell sediments of above all inflammatory effusions. Not all malignant processes are cyto-morphologically to be recognized as such. By means of the determination of the protein coagulation after Weltmann, simultaneously performed in the blood serum and in the effusion into the pleura, we, therefore, try to find additional informations. The colorimetric measuring of the contents of hyaluronic acid of pleura exudates serves the identification of diffuse mesotheliomas.
Biopsy↗