Human Peritoneal Cavity Research Articles

Intracellular Survival of Candida albicans in Peritoneal Macrophages From Chronic Peritoneal Dialysis Patients

Candidal peritonitis is a tenacious infection in patients undergoing chronic peritoneal dialysis. Since little is known about host defenses of the human peritoneal cavity against fungi, we investigated the interaction of peritoneal macrophages (PM phi) from uninfected dialysis patients with Candida albicans blastospores. Chemiluminescence (CL) techniques were used to assess the respiratory burst activity of these cells, and candidacidal activity was evaluated with a fluorochrome microassay. In sharp contrast to peripheral blood polymorphonuclear leukocytes (PMNs) from healthy donors, which gave a brisk luminol-enhanced CL response to opsonized blastospores and killed 35% of cell-associated organisms, PM phi produced barely detectable luminol-enhanced CL and killed only 13% of intracellular Candida. These findings appeared to be associated with a decreased level of myeloperoxidase in PM phi. The mechanism of intracellular survival of C albicans also appeared to be related to relatively poor triggering of superoxide production during phagocytosis of viable blastospores. The CL response of PMNs to C albicans was opsonin-dependent, and peritoneal dialysis effluent was devoid of opsonic activity. These studies suggest that local cellular and humoral mechanisms of defense are inadequate for protection of peritoneal dialysis patients against candidal peritonitis.

Respiratory depression with intraperitoneal neomycin.

Respiratory depression was not noted by the authors in more than 100 previous cases where neomycin had been instilled in the human peritoneal cavity (200 ml. of a 1% solution), but tidal volume measurements were not made in these instances.1Pridgen2reported four cases of respiratory arrest in which 0.5 gm. was instilled intraperitoneally in each of two infants and 3 gm. in each of two adults. The infants died. The adults survived after undergoing 3 and 48 hours of respiratory depression, respectively. Poth has noted respiratory arrest in animals and respiratory depression in an infant.3 A fatal adult case is reported in the American Society of Anesthesiologists Newsletter.4This patient received 2 gm. intraperitoneally with respiratory arrest within 10 minutes. Webber5reported a case in which 5 gm. was instilled in the peritoneal cavity, producing respiratory arrest with recovery after 15 hours of artificial

Introduction of blood into the peritoneal cavity; an experimental study.

Intraperitoneal hemorrhage is frequently encountered on an active obstetric and gynecologic service. Therefore, correlation of quantity of free blood with resulting symptoms and with its fate represents information of considerable value to the clinician. For this reason whole blood and other similar materials varying in amounts were introduced at varying rates into the human peritoneal cavity. SUBJECTS Sixteen women about to undergo laparotomy formed the subjects of this study. Twelve were puerperal and awaiting tubal sterilization. Four had noninvasive, or intraepithelial, cervical carcinoma. Preoperative patients were chosen in order to afford opportunity for direct inspection during the subsequent operation. In addition, the protocols of three patients, each with accidental and massive intra-abdominal hemorrhage, were included. Essential data on these 19 patients are presented in the accompanying Table. METHOD Injections were made under local anesthesia through a 16-gauge needle inserted 2 to 4 cm. below the umbilicus and usually in the