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

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

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: Most clinical microbiology laboratories in Korea have difficulty in following the recommendations of the clinical procedure handbook for culture of body fluid and wound/abscess specimens. We evaluated the usefulness of MacConkey (MAC) and colistin-nalidixic acid blood agar (CNA) for the isolation of pathogens from these specimens. METHODS: A total of 1,508 clinical specimens [144 peritoneal fluid, 241 body fluids (19 bile, 70 joint fluid, 6 pericardial fluid, 104 pleural fluid, and other fluids in 42 cases) and 1,123 wound/abscess] were inoculated onto basic media [Blood agar plate (BAP), chocolate agar or BAP with streaking of Staphylococcus aureus] and simultaneously inoculated onto MAC and CNA. The pathogens isolated by basic media and by additional use of MAC and/or CNA were compared. RESULTS: With basic media, 885 isolates from 588 specimens were detected, and by additional use of MAC and CNA, an additional 27 isolates from 24 specimens and an additional 128 isolates from 112 specimens were isolated, respectively. Compared to the basic media, by adding MAC, an additional 233.3%, 38.5% and 4.5% of gram-negative bacteria were isolated from peritoneal fluids, body fluid and wound/abscess, respectively, and by adding CNA, an additional 106.7%, 45.0%, and 20.7% of gram-positive bacteria/ yeast were isolated, respectively. The isolates detected by additional use of MAC were mainly Enterobacteriaceae (77.0%), and those detected by CNA were S. aureus (21.1%), Coagulase-negative Staphylococcus spp. (20.3%), Enterococcus spp. (16.4%), Streptococcus spp. (10.2%) and yeasts (16.4%). CONCLUSION: For peritoneal fluid and body fluid specimens, additional use of MAC plus CNA seems necessary for detection of pathogens. For wound/abscess, additional use of CNA will be cost effective.
Agar* ; Ascitic Fluid* ; Bile ; Body Fluids* ; Cacao ; Enterobacteriaceae ; Enterococcus ; Gram-Negative Bacteria ; Joints ; Korea ; Staphylococcus ; Streptococcus ; Yeasts

BACKGROUND: Accurate volume measurement is important in the management of patients with congestive heart failure or renal insufficiency. A bioimpedance analyser can estimate total body water in litres and has been widely used in clinical practice due to its non-invasiveness and ease of results interpretation. To change impedance data to volumetric data, bioimpedance analysers use equations derived from data from healthy subjects, which may not apply to patients with other conditions. Bioelectrical impedance vector analysis (BIVA) was developed to overcome the dependence on those equations by constructing vector plots using raw impedance data. BIVA requires normal reference plots for the proper interpretation of individual vectors. The aim of this study was to construct normal reference vector plots of bioelectrical impedance for Koreans. METHODS: Bioelectrical impedance measurements were collected from apparently healthy subjects screened according to a comprehensive physical examination and medical history performed by trained physicians. Reference vector contours were plotted on the RXc graph using the probability density function of the bivariate normal distribution. We further compared them with those of other ethnic groups. RESULTS: A total of 242 healthy subjects aged 22 to 83 were recruited (137 men and 105 women) between December 2015 and November 2016. The centers of the tolerance ellipses were 306.3 Ω/m and 34.9 Ω/m for men and 425.6 Ω/m and 39.7 Ω/m for women. The ellipses were wider for women than for men. The confidence ellipses for Koreans were located between those for Americans and Spaniards without overlap for both genders. CONCLUSION: This study presented gender-specific normal reference BIVA plots and corresponding tolerance and confidence ellipses on the RXc graph, which is important for the interpretation of BIA-reported volume status in patients with congestive heart failure or renal insufficiency. There were noticeable differences in reference ellipses with regard to gender and ethnic groups.
Adult ; Blood Volume ; Body Fluid Compartments ; Body Water ; Electric Impedance ; Ethnic Groups ; Female ; Healthy Volunteers ; Heart Failure ; Humans ; Male ; Physical Examination ; Renal Insufficiency

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

A cross sectional study on the relation of vaginal fluid secretion syndrome with some risk factors in 340 married women with ages of 15 and older has shown that the rate of vaginal fluid secretion syndrome (VFSS) was 50.6%. There was a relation of VFSS and age when getting married, rounds of pregnancy (3 and above), abortion history, use of unhygienic water and knowledge of women. There was no relation of VFSS with ages, contraceptive method and hygience habit
Fluids and Secretions ; syndrome ; Vagina

BACKGROUND: It is necessary to measure total body water (TBW) in evaluation of the hemodialysis adequacy. Waston's equation has been used clinically. And it is important to measure adequate dry body weight to avoid fluid overloading after hemodialysis. But there was no objective method to measure dry body weight, it was estimated subjectively by clinicians (doctors and nurses). Multi-frequency bioelectrical impedance analysis (MFBIA) has emerged as a clinical tool of the measurement of total body water (TBW) and body fluid compartment (ICW, ECW). The purpose of this study is to investigate the correlation MFBIA-TBW and Watson equation, Then intracellular water (ICW)/extracellular water (ECW) ratio (I/E ratio) usefulness in the evaluation of dry body weight. METHODS: 20 HD patients treated 3 times/week and 21 sex and age adjusted normal control subjects were studied. We measuerd and compared MFBIA-TBW to Waston equation, estimate reproducibility MFBIA-TBW measurement. Then MFBIA-ECW, ICW and I/E ratio were measured and compared dialysis patients both pre- and post dialysis to control group. RESULTS: The correlation between Wastron-TBW and MFBIA-TBW for patients was 0.948 (p<0.001). The closeness of agreement between MFBIA-TBW and Waston-TBW is shown Bland-Altman plots. There was no difference in post-dialysis patient's ICW/ECW ratio compared to control group. CONCLUSION: MFBIA is useful tool for dialysis patients' TBW measurements. Also ICW/ECW ratio measurement by MFBIA may be used to estimate the adequate ultrafiltration.
Body Fluid Compartments ; Body Water* ; Body Weight ; Dialysis ; Electric Impedance* ; Humans ; Renal Dialysis* ; Ultrafiltration

There are several diagnostic findings required for confirming a postmortem diagnosis of drowning. However, postmortem diagnosis of drowning remains challenging for forensic pathologists. In previous reports, several biochemical tests using various body fluids have been studied for their potential use in the postmortem diagnosis of drowning. In this study, the concentration of sodium and chloride was tested in various postmortem body fluids (vitreous humor, sphenoid sinus fluid, pleural fluid, cerebrospinal fluid, etc.) and their results were interpreted for their potential use in postmortem diagnosis of drowning. We examined 67 autopsy cases (freshwater drowning, 12 cases; seawater drowning, 16 cases; control group, 39 cases). The sodium and chloride concentration in the vitreous humor, sphenoid sinus fluid, and pleural fluid significantly correlated with each other. Furthermore, the concentrations of sodium, chloride, and the sum of the concentrations of the two in the various postmortem body fluids were significantly different in the three groups, when compared with each other (generally the concentration being the highest in the seawater drowning group, followed by the control group and the freshwater drowning group). Biochemical tests using various postmortem body fluids may serve as useful indicators for the postmortem diagnosis of drowning and for the differential diagnosis between freshwater and seawater drowning.
Autopsy ; Biochemistry ; Body Fluids ; Cerebrospinal Fluid ; Diagnosis ; Diagnosis, Differential ; Drowning ; Fresh Water ; Seawater ; Sodium ; Sphenoid Sinus ; Vitreous Body

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