Bacterial culture and identification are both useful in the clinical and forensic fields, although the postmortem changes in human microbiology are poorly understood. This study aimed to identify bacteria that were considered normal flora in postmortem body fluid samples. Bacterial culture and identification testing were performed for 336 body fluid samples (e.g., cardiac blood, peripheral blood, pericardial fluid, pleural fluid, peritoneal fluid, cerebrospinal fluid, and urine) from 129 forensic autopsy cases. Bacteria were identified using both genetic and biochemical methods, and testing for C-reactive protein (CRP) was used to identify the presence of antemortem inflammation. Among the 129 autopsy cases, 79 cases (69.3%) were negative for CRP, and bacterial culture and identification testing were performed for 185 samples from those 79 cases. Bacteria that were considered both normal flora and pathogens were identified in the CRP-negative cases. Therefore, the results from postmortem bacterial culture and identification testing should be interpreted in the context of other postmortem examination, including CRP testing. Furthermore, case selection, postmortem testing, and interpretations of the results should be performed by both clinical bacteriologists and forensic pathologists. To best of our knowledge, this is the first study to examine normal flora in various postmortem body fluid samples form Korean autopsy cases.
Ascitic Fluid ; Autopsy ; Bacteria* ; Body Fluids* ; C-Reactive Protein ; Cerebrospinal Fluid ; Humans ; Inflammation ; Pericardial Fluid ; Postmortem Changes

The maintenance of the osmolality of body fluids within a very narrow physiologic range is possible by water balance mechanisms that control the intake and excretion of water. Main factors of this process are the thirst and antidiuretic hormon arginine vasopressin (AVP), secretion regulated by osmoreceptors in the hypothalamus. Body water is the primary determinant of the osmolality of the extracellular fluid (ECF), disorders of body water homeostasis can be divided into hypo-osmolar disorders, in which there is an excess of body water relative to body solute, and hyperosmolar disorders, in which there is a deficiency of body water relative to body solute. The sodium is the predominant cation in ECF and the volume of ECF is directly proportional to the content of sodium in the body. Disorders of sodium balance, therefore, may be viewed as disorders of ECF volume. This reviews addresses the regulatory mechanisms underlying water and sodium metabolism, the two major determinants of body fluid homeostasis for a good understanding of the pathophysiology and proper management of disorders with disruption of water and sodium balance.
Arginine Vasopressin ; Body Fluids ; Body Water ; Extracellular Fluid ; Homeostasis ; Hypothalamus ; Osmolar Concentration ; Sodium ; Thirst

BACKGROUND: In this study, we evaluated the BACTEC MGIT 960 system (Becton Dickinson Microbiology Systems, Sparks, Md, USA), which is fully automated, noninvasive and nonradiometric fluorescent indicator broth detection system, for the growth and detection of mycobacteria with body fluid specimens. METHODS: Total of 1,891 body fluid specimens were included (pleural fluid 752, ascitic fluid 629, cerebrospinal fluid 214, joint fluid 79, peritozol 54, others 163). Specimens were inoculated into MGIT and solid media (3% ogawa, Japan). Polymerase chain reaction was performed for the discrimination of Mycobacterium tuberculosis from Mycobacterium other than tuberculosis (MOTT). RESULTS: A total of 62 isolates of mycobacteria were recovered from all culture system. With MGIT system, 56 isolates were recovered, compared with solid system recovered 33 isolates. 29 isolates were recovered with MGIT only and 6 isolates recovered with solid media only. Among 62 isolates recovered, 11 isolates were positive in acid fast stain. 10 isolates were recovered with MGIT. One isolate was recovered with solid system. 51 isolates were negative in acid fast stain. Among this, 46 isolates were recovered with MGIT. The mean detection time was 14.2 days with MGIT system, and 38.2 days with solid media. Contamination rate for each system with body fluid specimens were 4.1% for MGIT and 1.7% for solid media. CONCLUSION: In body fluid, the MGIT system has the advantages of improved detection rate and rapid recovery than solid media to recover mycobacteria.
Ascitic Fluid ; Body Fluids* ; Cerebrospinal Fluid ; Discrimination (Psychology) ; Joints ; Mycobacterium ; Mycobacterium tuberculosis ; Polymerase Chain Reaction ; Tuberculosis

BACKGROUND: Many invasive and life-threatening infections are diagnosed by the culture of normally sterile body fluids. Because microorganisms are present in very low concentrations, and these infections are often caused by fastidious or slow-growing microorganisms, they may not be detected by conventional culture methods. The present study was designed to assess the performance of the BacT/Alert blood culture system in order to recover microorganism with standard aerobic and anaerobic bottles and FAN aerobic and anaerobic bottles versus conventional culture methods for culturing normally sterile body fluids other than blood. METHODS: Between February and April 2003, sterile body fluids, such as cerebrospinal fluids (CSF), pleural fluids, peritoneal fluids, continuous ambulatory peritoneal dialysate (CAPD), and other fluids submitted to the microbiology laboratory for culture were entered into the study. Only specimens with a minimum volume of 3.0 mL were included, and the specimens were divided equally among three arms of the study. All BacT/Alert bottles were monitored for up to 5 days. Conventional blood agar plate and thioglycollate broth were incubated for up to 3 days before being discarded as negative, while anaerobic cultures were maintained for a minimum of 5 days. Bacterial identification and antimicrobial susceptibility tests were performed using standard laboratory protocols. RESULTS: A total of 247 specimens (CSF 85, pleural fluids 68, peritoneal fluids 71, CAPD 17, others 6) were included in this study, with 45 isolates recovered from 43 specimens. The recovery rates for each method were standard bottles 65.1% (28/43), FAN bottles 79.1% (34/43), and conventional culture 48.9% (21/43). For CSF and peritoneal fluids, more isolates were recovered from the FAN bottles compared to the conventional culture or standard bottles. The FAN bottles recovered more coagulase negative staphylococci than those from the conventional culture or standard bottles. CONCLUSIONS: Even though the BacT/Alert system using FAN bottles improved the recovery rate for CSF and peritoneal fluids compared to either the standard bottles or conventional culture, coagulase negative staphylococci were also frequently recovered. Therefore, further evaluations are required to assess the clinical usefulness of culturing sterile body fluids using the Bact/Alert blood culture system.
Agar ; Arm ; Ascitic Fluid ; Body Fluids* ; Cerebrospinal Fluid ; Coagulase ; Peritoneal Dialysis, Continuous Ambulatory

PURPOSE: Determination of accurate body fluid is essential for treating hypertension in end stage renal disease patients undergoing dialysis. However, the determination of dry body weight based on clinical assessment has low sensitivity and specificity. This study was done in order to examine the usefulness of bioimpedance analysis in determining the volume of CAPD patients. METHODS: Twenty-four hours ambulatory blood pressure and plasma concentrations of atrial natriuretic peptide (ANP) were measured and peritoneal equilibration test (PET) were obtained from 32 stable CAPD patients. Patients were divided into three groups; patients with normal blood pressure (group A, 11 people), and patients who have hypertension but controlled (under 130/80mmHg) with anti-hypertension medication (group B, 9 people), patients who have high blood pressure (over 130/80 mmHg) with 2 more anti-hypertension medication (group C, 12 people). We measured normalized extracellular fluid (nECF), extracelluar fluid/intracellular fluid ratio (ECF/ICF) and extracellular fluid/total body water (ECF/ TBW) of each group by using bioimpedance analysis (BIA) and compared the results of each group. We also compared the values of nECF, ECF/ICF, ECF/TBW indices from patients with those from normal renal function people. RESULT: Thirteen men and nineteen women participated in this test. Their mean age was 53+/-12 years and mean duration of CAPD was 49+/-38 months. Among three groups, plasma ANP level in group C (53.1+/-13.6 pg/mL) was significantly higher than the level in group A (10.3+/-7.2 pg/mL) and B (13.7+/-8.1 pg/mL) (p<0.05). The values of nECF, ECF/ICF, ECF/TBW that measured by BIA in group C was significant higher than the values in group A and B, but the values in group A and B were not significant different. The values of nECF, ECF/ICF, ECF/TBW from patients with normal kidney function were not different from those of group A and B, but the values were significantly lower than the values in group C (p<0.05). Plasma ANP level was correlated with nECF, ECF/ICF, ECF/TBW (p<0.05) value. Plasma ANP and nECF, ECF/ICF, ECF/TBW was not influenced different PET result. CONCLUSION: BIA is considered as a useful standard to predict the volume status in CAPD patients. In the future, prospective studies are demanded for clinical application.
Atrial Natriuretic Factor ; Blood Pressure ; Blood Volume ; Body Fluids ; Body Water ; Body Weight ; Dialysis ; Electric Impedance ; Extracellular Fluid ; Female ; Humans ; Hypertension ; Kidney ; Kidney Failure, Chronic ; Male ; Peritoneal Dialysis ; Peritoneal Dialysis, Continuous Ambulatory ; Plasma ; Sensitivity and Specificity

The purpose of this report is to explain body fluid redistribution, electrolyte changes and harmful after effects by measuring the blood sugar level before and during intraoperative fluid therapy using 5 percent dextrose in 1/3 saline. Patients were chosen at random, regardless of patients condition, age, sex and anesthetics administered to them in various condition of N.P.O. Patient's blood was drawn on the operating table for blood sugar before intravenous fluid therapy started then a second blood sample for blood sugar was taken after one hour from the time of I.V. fluid administration using 5% dextrose in 1/3 saline which ran at 10 cc/kg body weight. In the group of the first blood sample the level of blood sugar was as low as 40~50 mg per 100 cc of blood in the patients who were on N.P.O. for more than 20 hours. In the group of the second sample taken after in,travenous fluid therapy, blood sugar ranged from 200 to 500 mg volume percent, accompanied by a massive urine output. As a result of this experiment measuring blood sugar before and after I.V. fluid therapy using 5% dextrose in 1/3 saline, there was significant change of blood sugar level depending on the infusion rate which led to body fluid redistribution, accompanied by harmful side effects to the patient. Therefore; 1.The choice of the first I.V. fluid for the surgical patient should be an electrolyte solution which MUST contain 5% dextrose. 2. When intravenous fluid ran at more than 10 cc/kg/hr. for the replacement of body fluid, substitution of a balanced salt solution without 5% dextrose for 5% dextrose in water is strongly recommended to avoid untoward side effects.
Anesthetics ; Blood Glucose* ; Body Fluids ; Body Weight ; Fluid Therapy* ; Glucose* ; Humans ; Operating Tables ; Water

PURPOSE: To investigate the changes of body fluid status after kidney transplantation (KT) and to find out the associated factors. METHODS: Forty-five patients who had received KT were classified into hemodialysis (n=32), peritoneal dialysis (n=5), and preemptive (n=8) groups by dialysis modality. %TBW, %ECF, %ICF, and edema index which were examined by bioelectrical impedance analysis as well as clinical parameters were prospectively measured before KT and 1st month, 3rd month, 6th month after KT. RESULTS: Before KT, there were no significant differences in all of the parameters listed above among the three groups. Mean %TBW and %ICF were not different compared to those of before KT. In contrast, mean %ECF markedly decreased within 1st month (before KT 21.13+/-3.04 L/kg, 1st month 20.03+/-2.37 L/kg, 3rd month 19.61+/-2.18 L/kg, 6th month 18.32+/-5.02 L/kg: p=0.007, p<0.001, p=0.001, respectively). Edema index also decreased from 1st month (1st month 0.354+/-0.014, 3rd month 0.352+/-0.011, 6th month 0.348+/-0.014: p=0.016, p=0.012, respectively). Only edema index was higher at 1st and 3rd month in hemodialysis group. Serum creatinine and 24 hour urine total protein were positively correlated with %ECF at 1st and 3rd month, and with %TBW at 3rd month. CONCLUSION: The recovery of body water distribution after KT starts with reduction of ECF within the 1st month. Serum creatinine and proteinuria are related to the recovery. No significant difference according to dialysis modality was found. Further study with larger sample size is necessary to confirm these findings.
Body Composition ; Body Fluids ; Body Water ; Creatinine ; Dialysis ; Edema ; Electric Impedance ; Extracellular Fluid ; Humans ; Kidney Transplantation ; Peritoneal Dialysis ; Prospective Studies ; Proteinuria ; Renal Dialysis ; Sample Size ; Transplants

BACKGROUND: Distribution and elimination of crystalloid or colloid solutions during inhalational anesthesia have not been adequately investigated. Hemoglobin dilution and fluid kinetic model have been shown to reveal the distribution and elimination of various kinds of fluids. Therefore, we assessed fluid space changes after Hartmann's solution or hydroxyethyl starch solution (HES) infusion during desflurane anesthesia. METHODS: We infused 20 ml/kg of Hartmann's solution, 8.5 ml/kg of Hextend(R) and 8.5 ml/kg of Voluven(R) during 20 min, after anesthesia induction and before surgical incision, and measured the hemoglobin changes. We used mass balance equations and a fluid kinetic model to evaluate the changes of fluid space. In the fluid kinetic model, we used one volume model, which allows estimation of the size of the body fluid space expanded by the fluid (V) and the elimination rate constant (kr). RESULTS: The expanded plasma volume of three different fluids, calculated using mass balance equations, showed a similar degree of expansion during infusion, however, after finishing infusion, the dilution effect of Hartmann's solution decreased rapidly and lasted less than HES. Fluid kinetic model shows the mean size of V of 12.3 +/-5.9 L for Hartmann' solution, 5.2 +/- 1.6 L for Hextend, and 4.5 +/- 1.6 L for Voluven. Corresponding kr values were 263.0 +/- 161.8, 36.5 +/- 31.8, and 34.1 +/- 21.3 ml/min, respectively. CONCLUSIONS: The distribution volume of intravenous fluids analyzed by kinetic model showed that crystalloid fluid has a similar volume distribution compared to extracellular fluid and HES distributed to a volume larger than blood volume. Analysis and simulation of plasma volume expansion using this model provide a helpful tool for anesthesiologists planning fluid therapy.
Anesthesia ; Anesthesia, General ; Blood Volume ; Body Fluids ; Colloids ; Extracellular Fluid ; Fluid Therapy ; Hemoglobins ; Hetastarch ; Isoflurane ; Isotonic Solutions ; Plasma Volume ; Starch

We evaluated the availability of toluidine blue stain in body fluids, such as peritoneal and pleural fluid and urine. Nine hundreds specimens, i.e., 400 pleural and 400 peritoneal fluids and 100 urine samples, respectively, from Jan. 1995 to May 1996 were included. We obtained the result of high sensitivity and high specificity in toluidine blue stained body fluid in comparison with Papanicolaou stained result. Additionally, we found the diagnostically important crystals in chylothorax and some urine samples, which can not be seen in routine Papanicolaou stain. We thought the toluidine blue stain in body fluid is one of very useful diagnostic methods.
Ascitic Fluid ; Body Fluids ; Chylothorax ; Proteinuria* ; Sensitivity and Specificity ; Tolonium Chloride

BACKGROUND: Assessment of body fluid cytology is a useful means of evaluating a metastatic tumor. Liquid-based cytology (LBC) has been developed as a replacement for the conventional Papanicolaou (CP) test. This study was performed to compare CellprepPlus(R) LBC with CP in cytologic diagnosis. METHODS: Body fluid samples (n=188, including 72 peritoneal fluid and 116 pleural fluid samples) were divided equally and analyzed by both CellprepPlus(R) and CP. RESULTS: CellprepPlus(R) revealed distributed thin layers of non-overlapping cells. All CellprepPlus(R) preparations were adequate, while 18 (9.57%) CP preparations were inadequate. The respective diagnostic rates of CellprepPlus(R) and CP were 75.0% and 76.1% negative, 10.6% and 6.38% atypical, 5.85% and 2.66% suspicious, and 8.51% and 5.32% malignant. Of the 58 confirmed cases, the sensitivity of CellprepPlus(R) and CP was 94.4% and 73.3%, respectively, and the negative predictive value was 97.2% and 87.9%, respectively. CONCLUSIONS: CellprepPlus(R) LBC has better sensitivity and negative predictive value, and produces higher quality slide preparations than than CP, making it suitable as in screening of body fluid as a cytologic diagnostic tool.
Ascitic Fluid ; Body Fluids ; Mass Screening ; Neoplasm Metastasis