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Background Cell-free and concentrated ascites reinfusion therapy (CART) is a strategy for improving various intractable symptoms due to refractory ascites, including hypoalbuminemia. CART has recently been applied in the treatment of cancer patients. This study was performed to assess the safety of CART in a single cancer institute. Methods We retrospectively reviewed 233 CART procedures that were performed for 132 cancer patients in our institute. Results The median weight of ascites before and after concentration was 4,720 g and 490 g (median concentration rate, 10.0-fold), The median amounts of total protein and albumin were 64.0 g and 32.6 g (median recovery rates, 44.9% and 49.0%), respectively. Thirty-three adverse events (AEs) were observed in 22 (9.4%) of 233 procedures; 30 of these events occurred after reinfusion. The most common reinfusion-related AEs were fever (13 events) and chills (10 events). Univariate analyses revealed no significant relationships between the frequency of AEs and age, sex, appearance of ascites, weight of harvested and concentrated ascites, the ascites processing rate (filtration and concentration), weight of saline used for membrane cleaning, amount of calculated total protein for infusion, or prophylaxis against AEs; the reinfusion rate of ≥ 125 mL/h or ≥ 10.9 g/h of total protein affected the frequency of AEs, regardless of the prophylactic use of steroids. Conclusions The observed AEs were mainly mild reactions after reinfusion, which were related to a reinfusion rate of volume ≥ 125 mL/h, a simple indicator in practice, or total protein ≥ 10.9 g/h. Although our study was retrospective in nature and undertaken in a single institute, this information may be helpful for the management of cancer patients with refractory malignant ascites using CART.

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The amount and distribution of ceramide, an intercellular lipid, in the fingernails of three Japanese women in their twenties were examined by high-performance liquid chromatography and antibody staining. In addition, the structural changes of fingernail cross sections were examined after fingernails were immersed in an acetone-based nail polish remover solution. The acetone-treated fingernails had a lower water content and higher water evaporation than the inner forearm skin and healthy fingernails, suggesting that they had compromised moisturizing and barrier functions and were more susceptible to roughness and damage. These results also suggest that, compared to healthy fingernails, rough fingernails are more prone to breakage and damage. Furthermore, it was found that the amount of ceramide decreased when fingernails were immersed in nail polish remover solution. The distribution showed ceramide to be present in the ventral and dorsal regions of the free edge of the fingernail plate. After immersion in nail polish remover, the three-layered structure of the free edge of the plate was intact, but the dorsal distal edge of the plate peeled off. Gaps were observed inside the free edge of the plate, which should have been layered. These results show that the frequent use of nail polish remover may worsen condition of fingernails.

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