The Utility of Lactate Dehydrogenase Isoenzyme Pattern: MATERIAL AND METHODS
A total of 76 patients (43 males and 33 females) with ascites were investigated for their ascitic fluid LDH levels and its isoenzyme activities. Paracentesis were performed to all of the patients to highlight the underlying etiology of ascites. Biochemical, hematological and microbiological investigations were also performed. Complete blood count, biochemical examinations, ultrasonography and cytologic examination of the ascitic fluid were determined:
Group 1—Malignant Ascites
Twenty-one patients (12 males and nine females), aged 52.2 ± 9.1 years formed group 1. The diagnosis of malignancies was based on histopathological examination of liver, omentum or mass. These patients included five ovarian, four hepatoma, three colon, three mesothelioma, two gastric, two breast, one cholangiocellular and one pancreas carcinoma cases. Eight of these patients were detected to have liver metastasis by ultrasonographic biopsy. flomax medication
Group 2—Nonmalignant Ascites
Fifty-five patients (31 males and 24 females), aged 50.9 ± 12.4 years formed group 2. Group 2 included total four subgroups: spontaneous bacterial peritonitis (group 2a), sterile cirrhotic ascites (group 2b), tuberculous ascites (group 2c), and congestive heart failure-related ascites (group 2d).
Group 2a—Spontaneous bacterial peritonitis (SBP). Thirteen patients with SBP (eight males and five females) aged 51.5 ± 10.4 years with a previous history of chronic liver disease formed group 2a. Chronic liver disease was due to hepatitis В in nine cases and hepatitis С in four cases. According to Child-Pugh classification, eight of the patients were group С and five were group B. SBP group was formed of patients either having a positive microbiological culture or having a neutrophil count of >250/mm3 in the ascitic fluid. Ascitic fluid culture positivity was detected in 10 patients (E. coli in seven, enterecocci in three). Going without your pills? Buy cheap dutasteride hair loss online
Group 2b—Chronic liver disease with sterile ascites. Fifteen patients (nine males and six females), aged 54.4 ±11.2 years formed group 2b. Hepatitis В was positive in 10 and hepatitis С was positive in five, and one patient was on alcohol abuser. According to Child-Pugh classification nine patients were group С and six were group B. Malignancy and infections was ruled out in all these patients.
Group 2c—Tuberculous ascites. Forming group 2c were 13 patients (seven males and six females) aged 49.6 ± 12.0 years who were diagnosed by histopathological examination of the peritoneum after diagnostic laparoscopy. cheap phentrimine
Group 2d—Congestive heart failure-related ascites. A total of 14 patients (seven males and seven females) aged 64.2 ± 10.8 years who were diagnosed by echocardiography formed group 2d. Spontaneous bacterial peritonitis, chronic liver disease, tuberculosis and malignancy were ruled out in these patients.
Polypropylene tubes were used for ascitic fluid collection and storage. Biochemical parameters were analyzed by Olympus AU 600 (Olympus, Hamburg, Germany) with Olympus kits. LDH isoenzymes were determined by an LDH isoenzyme electrophoresis kit (Hydradel ISO-LDH, Sebia, PN 4130) and expressed as a percentage of LDH activity. Sebia’s Hyrys densitometer (PN 1010) was used for densitometric measurements. The precision of the analytical method for LDH was assessed by repeated assays of two pools of 10 different nonmalignant ascites fluid. Ascitic fluids (n=10) were stored at -20°C during the experiments. On the other hand, the diagnostic value of ascitic fluid LDH activity was assessed in terms of sensitivity and specificity. buy acomplia
Statistical analysis was performed with SPSS statistical software. Data is presented as the means ± standard deviations. Iiitergroup comparisons were analyzed by Mann-Whitney U and Kruskal-Wallis 1 -Way Anova for nonparametric tests. Spearman test was used for correlation. P<0.05 values were considered to be statistically significant.