The sex peptide of Drosophila melanogaster: female post-mating responses analyzed by using RNA interference

Mating induces profound changes in female insect behavior and physiology. In Drosophila melanogaster, mating causes a reduction in sexual receptivity and an elevation in egg production for at least 5 days. Injection of the seminal fluid sex peptide (SP) induces both responses in virgin females, but only for 1-2 days. The role of SP in eliciting the responses to mating remains to be elucidated. Functional redundancy between seminal fluid components may occur. In addition, mating with spermless males results in brief (1- to 2-day) post-mating responses, indicating either that there is a "sperm effect" or that sperm act as carriers for SP or other seminal fluid components. Here we used RNA interference to suppress SP expression, to determine whether SP is required to elicit full post-mating responses, the magnitude of responses due to other seminal fluid components, and whether SP accounts for the "sperm effect." Receptivity was higher and egg production lower in females mated to SP knock-down males than in controls. Comparison with virgins showed that the responses were brief. SP is therefore required for normal magnitude and persistence of postmating responses. Sperm transfer and use were normal in mates of SP knock-down males, yet their post-mating responses were briefer than after normal matings, and similar to those reported in mates of spermless son-of-tudor males. The prolonged "sperm effect" on female receptivity and egg production is therefore entirely attributable to SP, but sperm are necessary for its occurrence.     

A Field Test of the Sweat Patch

The sweat patch is a new, noninvasive method designed to estimate the ethanol consumption of drinking subjects. It consists of salt-impregnated absorbent pads protected by a plastic chamber with attached water-tight adhesive. The patch reportedly collects transepidermal fluid at a steady rate for up to 10 days. Recent laboratory research has indicated a linear relationship between the concentration of ethanol in transepidermal fluid and mean concentration of ethanol in blood. Levels of ethanol in the sweat patch allowed identification of persons drinking at least 0.5 g of ethanol/kg/day with 100% sensitivity and specificity. The study reported here was conducted to test the field effectiveness of this sweat patch in normal, active research subjects. First, several pretests were conducted to determine the optimal location of the patch on the body and its fluid uptake at various sites. A laboratory experiment using nonalcoholic subjects was conducted to replicate previous work, and methods of measuring ethanol concentration in the patch were refined. A field test of the patch was then carried out. Healthy active volunteers drank a single "moderate" dose of ethanol (0.5 g of ETOH/kg of body weight) and then remained abstinent for the next 3 days. A week later, a "heavy" dose (1.0/kg of body weight) was consumed. Only a trace of ethanol was detected in any of the patches worn in either experiment. The patch did not measure ethanol in the transepidermal fluid under field conditions. Thus, further design modifications and pilot testing are required before the full benefits of this unobtrusive measure of drinking can be realized.     

Maternal tract factors contribute to paternal seminal fluid impact on metabolic phenotype in offspring

Paternal characteristics and exposures influence physiology and disease risks in progeny, but the mechanisms are mostly unknown. Seminal fluid, which affects female reproductive tract gene expression as well as sperm survival and integrity, provides one potential pathway. We evaluated in mice the consequences for offspring of ablating the plasma fraction of seminal fluid by surgical excision of the seminal vesicle gland. Conception was substantially impaired and, when pregnancy did occur, placental hypertrophy was evident in late gestation. After birth, the growth trajectory and metabolic parameters of progeny were altered, most profoundly in males, which exhibited obesity, distorted metabolic hormones, reduced glucose tolerance, and hypertension. Altered offspring phenotype was partly attributable to sperm damage and partly to an effect of seminal fluid deficiency on the female tract, because increased adiposity was also evident in adult male progeny when normal two-cell embryos were transferred to females mated with seminal vesicle-excised males. Moreover, embryos developed in female tracts not exposed to seminal plasma were abnormal from the early cleavage stages, but culture in vitro partly alleviated this. Absence of seminal plasma was accompanied by down-regulation of the embryotrophic factors Lif, Csf2, Il6, and Egf and up-regulation of the apoptosis-inducing factor Trail in the oviduct. These findings show that paternal seminal fluid composition affects the growth and health of male offspring, and reveal that its impact on the periconception environment involves not only sperm protection but also indirect effects on preimplantation embryos via oviduct expression of embryotrophic cytokines.The plasma fraction of seminal fluid contains a complex mix of bioactive proteins and other agents produced by male accessory sex organs, which act after intromission to maximize the chances of successful conception by promoting sperm survival and functional competence (1). Seminal plasma can also affect reproductive events independent of sperm. Seminal fluid regulation of female reproductive physiology is well-known in insects, where effects on female reproductive organs, immune system, and behavioral responses promote fertilization and transmission of the male germ line (2). Rodent, porcine, and human studies show that seminal fluid also exerts a substantial influence on female reproductive tract physiology in vertebrates (3, 4). TGF-β and E-series prostaglandins, produced in the seminal vesicle and other male accessory glands, are major male–female signaling agents in mammalian seminal fluid (5). These factors induce the female reproductive tract to synthesize cytokines and chemokines that in turn influence the immune response to facilitate tolerance of male gametes and the conceptus (3).The periconception phase is a time of developmental plasticity, when the embryo is highly responsive to cues affecting later fetal and postnatal development (6). Greater susceptibility of adult offspring to metabolic disease can result from perturbation at this early time (7). Maternal tract effects at conception are mediated by nutrient availability and other signals to the embryo (6). Embryo sensing of local cytokine and growth factor balance is one underlying mechanism, with oviduct-secreted factors such as granulocyte-macrophage colony-stimulating factor (GM-CSF) and leukemia inhibitory factor (LIF) acting to shape embryo programming of later growth and phenotype characteristics in offspring (8–11).Less is known about the father’s contribution to the conception environment. A pathway of potential influence is seminal fluid regulation of growth factors and cytokines with embryotrophic effects (3). Although it is known that pregnancy can occur without female exposure to seminal plasma, the full physiological role of seminal fluid at conception and its impact on progeny have not been adequately investigated. Here we test the hypothesis that paternal seminal plasma acts at conception to influence the progression of pregnancy and postnatal outcomes in offspring through effects on female reproductive tissues as well as sperm.     

Angiostrongylus cantonensis eosinophilic meningitis.

In the past 50 years, Angiostrongylus cantonensis, the most common cause of eosinophilic meningitis, has spread from Southeast Asia to the South Pacific, Africa, India, the Caribbean, and recently, to Australia and North America, mainly carried by cargo ship rats. Humans are accidental, "dead-end" hosts infected by eating larvae from snails, slugs, or contaminated, uncooked vegetables. These larvae migrate to the brain, spinal cord, and nerve roots, causing eosinophilia in both spinal fluid and peripheral blood. Infected patients present with severe headache, vomiting, paresthesias, weakness, and occasionally visual disturbances and extraocular muscular paralysis. Most patients have a full recovery; however, heavy infections can lead to chronic, disabling disease and even death. There is no proven treatment for this disease. In the authors' experience, corticosteroids have been helpful in severe cases to relieve intracranial pressure as well as neurologic symptoms due to inflammatory responses to migrating and eventually dying worms.     

The significance of pleural fluid cytology in the differential diagnosis of pleurisy showing lymphocyte-predominant pleural effusion

We examined the significance of pleural fluid cytology in differentiation between tuberculous and non-tuberculous pleurisy in patients with lymphocyte-predominant pleural effusion. We divided pleural fluid cytologic findings into two patterns, that is "tuberculous" and "non-tuberculous pattern", according to the report by Spieler, and compared the cytologic pattern with the final clinical diagnosis. Thirteen out of 19 cases (68.4%) with tuberculous pleurisy showed "tuberculous pattern" in the pleural fluid cytology, while four (pleurisy associated with collagen-vascular disease, asbestosis and carcinoma, and idiopathic pleurisy) out of 13 (30.8%) with non-tuberculous pleurisy revealed "tuberculous pattern". The pleural fluid cytology could be used as one of the additional means to differentiate between tuberculous and non-tuberculous pleurisy, though it is impossible to differentiate between them with the pleural fluid cytology alone.     

Testosterone and dihydrotestosterone concentrations in plasma, epididymal tissues, and seminal fluid of adult rats.

The concentration of testosterone (T) and 5alpha-dihydrotestosterone (DHT) in plasma, seminal fluid, and epididymis of male Wistar rats have been determined by radioimmunoassay. The DHT/T ratio rose from 0.1 in blood to 1 in testicular fluid and 4 in epididymal fluid. This ratio is 2 in tissues of "caput" epididymis and 1 in "cauda" epididymis. These data indicate a transformation of T to DHT in the epididymal tissue, particularly at the "caput" level.     

Tumor Necrosis Factor-α, Interleukin-6, and Nitric Oxide in Sterile Ascitic Fluid and Serum from Patients with Cirrhosis Who Subsequently Develop Ascitic Fluid Infection

Ascitic fluid infection probably results from repeated episodes of bacteremia and seeding of ascitic fluid. The outcome of these episodes of colonization is probably a function of serum and ascitic fluid defense mechanisms and the virulence of the organism. Patients who develop spontaneous bacterial peritonitis may have serum and ascitic fluid characteristics that are different from those who do not develop infection. We prospectively collected serum and ascitic fluid specimens at the time of admission from patients with sterile cirrhotic ascites, and tested these specimens for interleukin-6, tumor necrosis factor-, and nitric oxide and compared these results as well as other characteristics of patients who did not develop infection to those who did. An elevated baseline serum tumor necrosis factor- as well as an increased proportion of polymorphonuclear leukocytes in sterile ascitic fluid from patients who subsequently developed infection probably represent a subclinical activation of defense mechanisms from prior silent colonizations with bacteria.     

From the Cover: PNAS Plus: Chloride transport-driven alveolar fluid secretion is a major contributor to cardiogenic lung edema

Alveolar fluid clearance driven by active epithelial Na⁺ and secondary Cl⁻ absorption counteracts edema formation in the intact lung. Recently, we showed that impairment of alveolar fluid clearance because of inhibition of epithelial Na⁺ channels (ENaCs) promotes cardiogenic lung edema. Concomitantly, we observed a reversal of alveolar fluid clearance, suggesting that reversed transepithelial ion transport may promote lung edema by driving active alveolar fluid secretion. We, therefore, hypothesized that alveolar ion and fluid secretion may constitute a pathomechanism in lung edema and aimed to identify underlying molecular pathways. In isolated perfused lungs, alveolar fluid clearance and secretion were determined by a double-indicator dilution technique. Transepithelial Cl⁻ secretion and alveolar Cl⁻ influx were quantified by radionuclide tracing and alveolar Cl⁻ imaging, respectively. Elevated hydrostatic pressure induced ouabain-sensitive alveolar fluid secretion that coincided with transepithelial Cl⁻ secretion and alveolar Cl⁻ influx. Inhibition of either cystic fibrosis transmembrane conductance regulator (CFTR) or Na⁺-K⁺-Cl⁻ cotransporters (NKCC) blocked alveolar fluid secretion, and lungs of CFTR^−/− mice were protected from hydrostatic edema. Inhibition of ENaC by amiloride reproduced alveolar fluid and Cl⁻ secretion that were again CFTR-, NKCC-, and Na⁺-K⁺-ATPase–dependent. Our findings show a reversal of transepithelial Cl⁻ and fluid flux from absorptive to secretory mode at hydrostatic stress. Alveolar Cl⁻ and fluid secretion are triggered by ENaC inhibition and mediated by NKCC and CFTR. Our results characterize an innovative mechanism of cardiogenic edema formation and identify NKCC1 as a unique therapeutic target in cardiogenic lung edema.Traditionally, the formation of cardiogenic pulmonary edema has been attributed to passive fluid filtration across an intact alveolocapillary barrier along an increased hydrostatic pressure gradient. However, recent studies show that cardiogenic edema is critically regulated by active signaling processes. Activation of mechanosensitive endothelial ion channels increases lung vascular permeability (1), whereas alveolar epithelial cells lose their physiological ability to clear the distal airspaces from excess fluid by their capacity to actively transport ions across the epithelial barrier (2–4).In the intact lung, the predominant force driving alveolar fluid clearance is an active transepithelial Na⁺ transport from the alveolar into the interstitial space. A major portion of the apical Na⁺ entry is mediated by the amiloride-inhibitable epithelial Na⁺ channel (ENaC), with basolateral Na⁺ extrusion through the Na⁺-K⁺-ATPase (5). Cl⁻ and water are considered to follow paracellularly for electroneutrality and osmotic balance. In cardiogenic lung edema, the physiological protection against alveolar flooding provided by an intact alveolar fluid clearance is largely attenuated (3, 4). Previously, we have outlined the signaling events at the alveolocapillary barrier that underlie this inhibition of alveolar fluid clearance by showing that hydrostatic stress increases endothelial NO production in lung capillaries (6), which in turn, blocks alveolar Na⁺ and liquid absorption by a cGMP-dependent inhibition of epithelial ENaC (2).Unexpectedly, however, we observed that increased hydrostatic pressure not only blocks alveolar fluid clearance but reverses transepithelial fluid transport, resulting in effective alveolar fluid secretion that accounts for up to 70% of the total alveolar fluid influx at elevated hydrostatic pressure (2). This effect is not explicable by impaired alveolar fluid clearance and/or passive fluid leakage, and thus, it points to a previously unrecognized and potentially therapeutically exploitable pathomechanism in cardiogenic lung edema, namely alveolar fluid secretion driven by active transepithelial ion transport.Here, we aimed to analyze alveolar fluid secretion and its underlying cellular mechanisms in cardiogenic lung edema. We considered the Cl⁻ channel cystic fibrosis transmembrane conductance regulator (CFTR) as a putative key ion channel in this scenario, because it permits bidirectional permeation of anions under physiologically relevant conditions (7). Hence, the direction of Cl⁻ flux by CFTR may reverse depending on actual electrochemical gradients, thus turning an absorptive into a secretory epithelium or vice versa. This notion is supported by reports describing CFTR as both an absorptive and secretory channel in the regulation of alveolar fluid homeostasis (8, 9). By a combination of indicator dilution, imaging, and radioactive tracer techniques for the measurement of alveolar ion and fluid fluxes in the isolated lung, we show a critical role for CFTR-mediated Cl⁻ secretion in cardiogenic lung edema and identify the Na⁺-K⁺-2Cl⁻ cotransporter 1 (NKCC1) as a therapeutic target in this pathology.     

Increased activity of lysosomal enzymes in the peritoneal fluid of patients with gynecologic cancers and pelvic inflammatory disease

Purpose To investigate whether the activity of lysosomal enzymes is increased in the peritoneal fluid of patients with gynecologic cancers compared to activity in the peritoneal fluid from normal subjects and those with pelvic inflammatory disease, and fluid from benign ovarian cysts.Patients and methods -glucuronidase, -galactosidase, and -mannosidase activity was measured in the peritoneal fluid from patients with gynecologic cancer, pelvic inflammatory disease, and normal subjects, and fluid from benign ovarian cysts.Results The mean±SD of -glucuronidase, -galactosidase, and -mannosidase activity in the gynecologic cancers was 120±50 nmol, 203±86 nmol, and 240±119 nmol 4-methylumbelliferone/ml/h, respectively; in the normal control subjects it was 22±9 nmol, 46±10 nmol, and 80±23 nmol, respectively (P=0.00003, 0.0001, and 0.0001, respectively). The activity was increased even in cases without malignant cells in the peritoneal fluid. In pelvic inflammatory disease it was 148±82 nmol, 278±112 nmol, and 291±140 nmol, respectively. The activity in the fluid of the ovarian cysts was similar to that of the normal peritoneal fluid. There was a significant positive correlation between enzyme activity and stage of cancer, that was stronger for -glucuronidase (r=0.889, P=0.003).Conclusion The increased lysosomal enzyme activity in gynecologic cancers, without overlapping between patients and normal subjects or benign ovarian cyst fluid, indicates that such measurements might be applied for diagnostic purposes.     

Effects of cardiac microstructure on propagating electrical waveforms

Electrical waveforms measured during propagation at microscopic level are considerably affected by normal variations in cardiac microstructure as well as by the superfusing fluid. On the basis of evidence we present in this article, we argue that the anisotropic waveform variations discussed here are explained primarily by the associated variations in different microstructural components of myocardial architecture rather than by the effects of the perfusing bath. The results suggest that different components of myocardial architecture have preferential effects on f1.gif" BORDER="0">(max) and on the shape of the foot of the transmembrane action potential (V(m) foot). Resistive discontinuities primarily affect f1.gif" BORDER="0">(max), and an additional capacitive component in the local circuit due to the capillaries in interstitial space primarily affects V(m) foot. Resistive discontinuities also have an important influence on cardiac conduction. These discontinuities include spatial variations in the size of interstitial space (interstitial resistive discontinuities) and the role of cellular scaling (effects of cell size) when changes occur in the cellular and multicellular distribution of gap junctions during remodeling of normal mature myocardium to proarrhythmic structural substrates. The full text of this article is available at http://www.circresaha.org.     

Perioperative fluid management in major hepatic resection: an integrative review

BACKGROUND: Fluid intervention and vasoactive phar-macological support during hepatic resection depend on the preference of the attending clinician, institutional resources, and practice culture. Evidence-based recommendations to guide perioperative fluid management are currently limited. Therefore, we provide a contemporary clinical integrative overview of the fundamental principles underpinning fluid intervention and hemodynamic optimization for adult pa-tients undergoing major hepatic resection. DATA SOURCES: A literature review was performed of MED-LINE, EMBASE and the Cochrane Central Registry of Con-trolled Trials using the terms "surgery", "anesthesia", "starch","hydroxyethyl starch derivatives", "albumin", "gelatin", "liver re-section", "hepatic resection", "fluids", "fluid therapy", "crystalloid","colloid", "saline", "plasma-Lyte", "plasmalyte", "hartmann's", "ac-etate", and "lactate". Search results for MEDLINE and EMBASE were additionally limited to studies on human populations that included adult age groups and publications in English. RESULTS: A total of 113 articles were included after appro-priate inclusion criteria screening. Perioperative fluid man-agement as it relates to various anesthetic and surgical tech-niques is discussed. CONCLUSIONS: Clinicians should have a fundamental un-derstanding of the surgical phases of the resection, hemody-namic goals, and anesthesia challenges in attempts to individ-ualize therapy to the patient's underlying pathophysiological condition. Therefore, an ideal approach for perioperative flu-id therapy is always individualized. Planning and designing large-scale clinical trials are imperative to define the optimal type and amount of fluid for patients undergoing major he-patic resection. Further clinical trials evaluating different in-traoperative goal-directed strategies are also eagerly awaited.     

Cerebrospinal fluid interleukin 8 concentrations and the subsequent development of postherpetic neuralgia

PURPOSE: Other than age, the risk factors for postherpetic neuralgia are not well established. We studied whether the concentration of interleukin 8 in the cerebrospinal fluid is associated with the risk of postherpetic neuralgia. METHODS: We enrolled 170 patients more than 50 years old who had a typical painful and nontrigeminal herpetic rash. Patients were treated with acyclovir; no corticosteroids were given. Cerebrospinal fluid was taken for analysis of interleukin 8 during and at full crusting of the herpetic rash. Age, sex, comorbid conditions, prodromal pain, localization and severity of herpetic rash, number of skin lesions, and degree of pain were recorded. We used multivariate logistic regression modeling to identify significant predictive factors. Receiver operating characteristic (ROC) curves were evaluated to determine the contribution of each factor. RESULTS: Six months after healing, 31 patients (18%) had postherpetic neuralgia; 27 patients still had it after 1 year. Only three variables-age (odds ratio [OR] = 2.7 per 10-year increase; 95% confidence interval [CI]: 1.2 to 6.2), acute pain (OR = 1.8 per unit increase in visual analog scale; 95% CI: 1.2 to 2.8), and interleukin 8 concentration in the cerebrospinal fluid at full crusting of the herpetic rash (OR = 1.6 per 20-microg/L increase; 95% CI: 1.3 to 2.0)-were significant predictors of postherpetic neuralgia at 1 year. Interleukin 8 concentration also had the highest area under the ROC curve at these evaluation points (P <0.001). CONCLUSION: Our results suggest that interleukin 8 concentration in the cerebrospinal fluid at full crusting of herpetic rash may be useful for identifying patients who are likely to develop intractable postherpetic neuralgia.     

Intraperitoneal chemotherapy for treatment and prevention of peritoneal carcinomatosis and sarcomatosis

PURPOSE: The treatment of peritoneal carcinomatosis and sarcomatosis has been associated with long-term disease-free survival. Recently, new intraperitoneal chemotherapy regimens used in patients with small volume peritoneal implants have shown benefits. METHODS: After removal of all but minimal residual disease, the abdominal cavity is flooded with a large volume of fluid containing full systemic doses of chemotherapy. Adenocarcinoma patients receive mitomycin C and 5-fluorouracil; sarcoma patients receive cisplatin and doxirubicin. RESULTS: Long-term disease-free survival is seen in patients with low-grade malignancy, no lymph node or liver metastases, and a complete cytoreduction. CONCLUSIONS: If patients can be treated early when the volume of peritoneal surface cancer is low or if the patient can be made disease free by surgery, then intraperitoneal chemotherapy may be expected to achieve long-term disease-free survival in a majority of selected patients.     

Overnight fluid shifts in subjects with and without obstructive sleep apnea

Objective

To investigate the characteristics of baseline body fluid content and overnight fluid shifts between non-obstructive sleep apnea (non-OSA) and obstructive sleep apnea (OSA) subjects.

Methods

A case-controlled study was performed between February 2013 and January 2014, with 36 (18 OSA and 18 non-OSA) outpatients enrolled in this study. Polysomnographic parameters and results of body fluid were compared between the two groups.

Results

There were no differences in age, weight, and body mass index (BMI) between groups. Compared with the non-OSA group, OSA group had significantly higher neck circumference (NC) and fluid volume shift in the legs. OSA patients had higher left and right leg fluid indices than non-OSA subjects. There were significant correlations between apnoea-hypopnoea index and baseline fluid indices in both legs as well as the reduction in overnight change in both legs fluid volume. The increase in NC was also significantly correlated with the reduction in overnight change in both legs fluid volume, but not with the change in head and neck fluid volume. There were significant correlations between change in NC and increased fluid shifts in head and neck volume.

Conclusions

OSA patients had a higher baseline fluid content in both legs as compared with non-OSA subjects, which may be the basic factor with regards to fluid shifts in OSA patients. The increase in head and neck fluid shift volume did not directly correlate with the severity of OSA.     

Performance of automated multiplex PCR using sonication fluid for diagnosis of periprosthetic joint infection: a prospective cohort

Purpose

Sonication of explanted prostheses improved the microbiological diagnosis of periprosthetic joint infections (PJI). We evaluated the performance of automated multiplex polymerase chain reaction (PCR) using sonication fluid for the microbiological diagnosis of PJI.

Methods

In a prospective cohort using uniform definition criteria for PJI, explanted joint prostheses were investigated by sonication and the resulting sonication fluid was analyzed by culture and multiplex PCR. McNemar’s Chi-squared test was used to compare the performance of diagnostic tests.

Results

Among 111 patients, PJI was diagnosed in 78 (70%) and aseptic failure in 33 (30%). For the diagnosis of PJI, the sensitivity and specificity of periprosthetic tissue culture was 51 and 100%, of sonication fluid culture 58 and 100%, and of sonication fluid PCR 51 and 94%, respectively. Among 70 microorganisms, periprosthetic tissue culture grew 52 (74%), sonication fluid culture grew 50 (71%) and sonication fluid PCR detected 37 pathogens (53%). If only organisms are considered, for which primers are included in the test panel, PCR detected 37 of 58 pathogens (64%). The sonication fluid PCR missed 19 pathogens (predominantly oral streptococci and anaerobes), whereas 7 additional microorganisms were detected only by PCR (including Cutibacterium spp. and coagulase-negative staphylococci).

Conclusions

The performance of multiplex PCR using sonication fluid is comparable to culture of periprosthetic tissue or sonication fluid. The advantages of PCR are short processing time (< 5 h) and fully automated procedure. However, culture technique is still needed due to the low sensitivity and the need of comprehensive susceptibility testing. Modification of primers or inclusion of additional ones may improve the performance of PCR, especially of low-virulent organisms.

     

A PHARMACOKINETIC COMPARISON OF TENOXICAM IN PLASMA AND SYNOVIAL FLUID

In view of the paucity of information on the synovial-fluidpharmacokinetics of nonsteroidal anti-inflammatory drugs witha long half-life, we have compared the pharmacokinetics of tenoxicam(Tilcotil, Mobiflex) in plasma and synovial fluid in six patientswith polyarthritis causing knee effusion. Plasma and synovial-fluidconcentrations of tenoxicam were measured up to 96 h after anoral dose of a single 40 mg tablet. A full pharmacokinetic analysiswas performed. Tenoxicam passed into synovial fluid attaining a peak concentrationsignificantly later than that for plasma. However, the meanhalf-life for synovial fluid (45 h) was not significantly differentfrom that for plasma (42 h). Comparison of area under the curve(AUC) indicated the total exposure of the synovial fluid totenoxicam was consistent in different patients, comprising 50–60%of the corresponding plasma levels in every case. In the case of tenoxicam, synovial fluid exhibits the pharmacokineticproperties of a peripheral ‘tissue’ compartment. KEY WORDS: Tenoxicam, Synovial fluid, Pharmacokinetics     

Synovial fluid and blood monocytes/macrophages in rheumatoid arthritis. Influence on polyclonal activation of autologous B lymphocytes

The regulatory role of synovial fluid monocytes/macrophages from patients with rheumatoid arthritis in terms of B lymphocyte activation was evaluated by a reverse haemolytic plaque-forming cell (PFC) assay. Macrophage-depleted blood mononuclear cells (BMC) failed to respond to pokeweed mitogen (PWM). With autologous synovial fluid macrophages added, the PFC responses of macrophage-depleted BMC increased, and optimal concentration for full restoration of the PFC responses ranged from 8 to 35%. Synovial fluid mononuclear cells (SMC) as well as macrophage-depleted SMC were not able to respond to PWM. Addition of irradiated autologous blood macrophages to SMC did not increase the SMC PFC responses. It is concluded that the regulatory properties of synovial fluid macrophages do not explain the low PFC response of SMC to PWM.     

Ascitic fluid chemical analysis before, during and after spontaneous bacterial peritonitis

A retrospective analysis of 22 patients whose ascitic fluid had been analyzed prior to the onset of spontaneous bacterial peritonitis, during infection and/or after treatment of peritonitis revealed that neither the ascitic fluid total protein nor the absolute ascitic fluid glucose changed during the infection or after treatment of the infection although the ascitic fluid/serum glucose ratio did decrease (p less than 0.001) with infection. The ascitic fluid lactate dehydrogenase increased significantly (p less than 0.05) during infection compared to the baseline value. Contrary to the typical findings in infected body fluids, the total protein content and absolute glucose content of "spontaneously" infected ascitic fluid do not measurably change.     

Synovial fluid characteristics and the lupus erythematosus cell phenomenon in drug-induced lupus. Findings in three patients and review of pertinent literature

The characteristics of synovial fluid obtained from 3 patients with drug-induced lupus erythematosus are described. Two patients had "inflammatory" counts of synovial leukocytes, in the range of 2,500-39,000/mm3, with mononuclear predominance in 1 patient and neutrophil predominance in the other. The third patient had "noninflammatory" fluid, with mononuclear predominance. Lupus erythematosus cells formed in vivo were observed in the synovial fluid of 2 of the patients. Biopsy of the synovium of 1 patient showed nonspecific chronic inflammatory changes. Our findings in these patients with drug-induced lupus are indistinguishable from those previously described in patients with idiopathic lupus erythematosus.     

Development of intelligence in old age

This article attempts to find the structure of a selected spectrum of intelligence. A combination of longitudinal and cross-sectional methods is applied. Two dimensions were found, which can be named as "crystallized" and "fluid" abilities (in the sense of Horn & Cattell). Whereas, the crystallized abilities do not show any systematic variation from age 61 to 83, fluid abilities decline with age. Schaie's three-component-model is not able to describe differences and variations of crystallized intelligence. Within fluid intelligence, age changes are more important than cohort differences. There are hints that structural changes take place.