The human synovial fluid proteome: A key factor in the pathology of joint disease

This review aims to summarise our knowledge to date on the protein complement of the synovial fluid (S F). The tissues, structure and pathophysiology of the synovial joint are briefly described. The salient features of the S F proteome, how it is composed and the influence of arthritic disease are highlighted and discussed. The concentrations of proteins that have been detected and quantified in SF are drawn together from the literature on osteoarthritis, rheumatoid arthritis and juvenile idiopathic arthritis. The measurements are plotted to give a perspective on the dynamic range of protein levels within the SF. Approaches to proteomic analysis of SF to date are discussed along with their findings. From the recent literature reviewed within, it is becoming increasingly clear that analysis of the SF proteome as a whole, could deliver the most valuable differential diagnostic fingerprints of a number of arthritic disorders. Further development of proteomic platforms could characterise prognostic profiles to improve the cliniciads ability to resolve unremitting disease by existing and novel therapeutics.

Preliminary Results of a Prospective Randomized Trial of Restrictive Versus Standard Fluid Regime in Elective Open Abdominal Aortic Aneurysm Repair

Background: Open abdominal aortic aneurysm (AAA) repair is associated with a significant morbidity (primarily respiratory and cardiac complications) and an overall mortality rate of 4% to 10%. We tested the hypothesis that perioperative fluid restriction would reduce complications and improve outcome after elective open AAA repair.

Neurokinin A is the predominant tachykinin in human bronchoalveolar lavage fluid in normal and asthmatic subjects

BACKGROUND—Multiple sensory neuropeptides are present in human airways and may contribute to diseases such as asthma. This study quantified and characterised substance P (SP), neurokinin A (NKA), and calcitonin gene related peptide (CGRP) immunoreactivity in bronchoalveolar lavage fluid in asthmatic and normal subjects.
METHODS—Using specific radioimmunoassay (RIA), SP, NKA and CGRP were measured in bronchoalveolar lavage fluid from asthmatic subjects (n = 5), normal subjects (n = 5), atopic non-asthmatic subjects (n = 6), and asthmatic subjects four hours after allergen challenge (n = 12). Peptide immunoreactivity was characterised using high performance liquid chromatography (HPLC) and RIA.
RESULTS—No SP or CGRP immunoreactivity was detected in any of the fractions from samples after extraction, HPLC, and RIA. Non-specific binding resulted in spurious SP immunoreactivity being detected in bronchoalveolar lavage fluid when no extraction process was employed. NKA was detected in significant amounts in asthmatic (median 550, range 425-625 pg/ml) and normal subjects (median 725, range 350-1425 pg/ml). The level of NKA was significantly higher in the asthmatic subjects after allergen challenge (median 750, range 350-1250 pg/ml) than in unchallenged asthmatic subjects (median 600, range 425-600 pg/ml, p<0.01).
CONCLUSIONS—Extraction and characterisation of peptides from bronchoalveolar lavage fluid must be performed to ensure that the measured immunoreactivity represents target peptide. NKA is present in bronchoalveolar lavage fluid in high concentrations and is the predominant tachykinin. The concentrations of NKA are similar in normal subjects and subjects with mild asthma.

Electronic cell counting to measure total cell numbers in bronchoalveolar lavage fluid

Cell counting of bronchoalveolar lavage (BAL) fluid is performed manually in routine practice. This has both methodological and inherent errors; however, the accuracy and suitability of automated counting devices have been questioned. In this study, a Coulter(R) Counter D Industrial model was calibrated and then used to measure the total cell count in unprocessed bronchoalveolar lavage fluid, and compared to a standard manual method.

Elevated CA-125 and ascites: not always malignancy

Abstract
BACKGROUND: We present two clinical cases from a single institution where a final diagnosis of cardiac failure was made following the initial finding of ascites and an elevated CA 125 level. In both cases gynaecological malignancy was initially suspected.

Numerical simulations of fluid-structure interactions in single-reed mouthpieces

Most single-reed woodwind instrument models rely on a quasistationary approximation to describe the relationship between the volume flow and. the pressure difference across the reed channel. Semiempirical models based on the quasistationary approximation are very useful in explaining the fundamental characteristics of this family of instruments such as self-sustained oscillations and threshold of blowing pressure. However, they fail at explaining more complex phenomena associated with the fluid-structure interaction during dynamic flow regimes, such as the transient and steady-state behavior of the system as a function. of the mouthpiece geometry. Previous studies have discussed the accuracy of the quasistationary approximation but the amount of literature on the subject is sparse, mainly due to the difficulties involved in the measurement of dynamic flows in channels with an oscillating reed. In this paper, a numerical technique based on the lattice Boltzmann method and a finite difference scheme is proposed in order to investigate the characteristics of fully coupled fluid-structure interaction in single-reed mouthpieces with different channel configurations. Results obtained for a stationary simulation with a static reed agree very well with those predicted by the literature based on the quasistationary approximation. However, simulations carried out for a dynamic regime with dn oscillating reed show that the phenomenon associated with flow detachment and reattachment diverges considerably frorn the theoretical assumptions. Furthermore, in the case of long reed channels, the results obtained for the vena contracta factor are in significant disagreement with those predicted by theory. For short channels, the assumption of constant vena contracta was found to be valid for only 40% of the duty cycle. (c) 2007 Acoustical Society of America.

Single-phase fluid flow distribution and heat transfer in microstructured reactors

Single-phase microreactors and micro-heat-exchangers have been widely used in industrial and scientific applications over the last decade. In several cases, operation of microreactors has shown that their expected efficiency cannot be reached either due to non-uniform distribution of reactants between different channels or due to flow maldistribution between individual microreactors working in parallel. The latter problem can result in substantial temperature deviations between different microreactors resulting in thermal run away which could arise from an exothermicreaction. Thus advances in the understanding of heat transfer and fluid flow distribution continue to be crucial in achieving improved performance, efficiency and safety in microstructured reactors used for different applications. This paper presents a review of the experimental and numerical results on fluid flow distribution, heat transfer and combination thereof, available in the open literature. Heat transfer in microchannels can be suitably described by standard theory and correlations, but scaling effects (entrance effects, conjugate heat transfer, viscous heating, and temperature-dependent properties) have often to be accounted for in microsystems. Experiments with single channels are in good agreement with predictions from the published correlations. The accuracy of multichannel experiments is lower due to flow maldistribution. Special attention is devoted to theoretical and experimental studies on the effect of a flow maldistribution on the thermal and conversion response of catalytic microreactors. There view concludes with a set of design recommendations aimed at improving the reactor performance. (C) 2010 Elsevier Ltd. All rights reserved.

Correlation of synovial fluid cytokine levels with histological and clinical parameters of primary and revision total hip and total knee replacements

We retrieved synovial tissue and fluid samples from patients undergoing primary total hip replacement (THR) (n 15), revision of aseptically loose THR (n 12), primary total knee replacement (TKR) (n 13) and revision of aseptically loose TKR (n 6). Several histological parameters were assessed on a relative scale of 1-4. Primary TJRs were clinically evaluated for degree of osteoarthrosis. Revision TJRs were assessed for migration of the implant, gross loosening and the degree of radiolucency. Cytokine levels in synovial fluid were determined with ELISA.

Chronic treatment with a stable obestatin analogue significantly alters plasma triglyceride levels but fails to influence food intake, fluid intake, body weight, or body composition in rats.

Obestatin (OB(1-23) is a 23 amino acid peptide encoded on the preproghrelin gene, originally reported to have metabolic actions related to food intake, gastric emptying and body weight. The biological instability of OB(1-23) has recently been highlighted by studies demonstrating its rapid enzymatic cleavage in a number of biological matrices. We assessed the stability of both OB(1-23) and an N-terminally PEGylated analogue (PEG-OB(1-23)) before conducting chronic in vivo studies. Peptides were incubated in rat liver homogenate and degradation monitored by LC-MS. PEG-OB(1-23) was approximately 3-times more stable than OB(1-23). Following a 14 day infusion of Sprague Dawley rats with 50 mol/kg/day of OB(1-23) or a N-terminally PEGylated analogue (PEG-OB(1-23)), we found no changes in food/fluid intake, body weight and plasma glucose or cholesterol between groups. Furthermore, morphometric liver, muscle and white adipose tissue (WAT) weights and tissue triglyceride concentrations remained unaltered between groups. However, with stabilised PEG-OB(1-23) we observed a 40% reduction in plasma triglycerides. These findings indicate that PEG-OB(1-23) is an OB(1-23) analogue with significantly enhanced stability and suggest that obestatin could play a role in modulating physiological lipid metabolism, although it does not appear to be involved in regulation of food/fluid intake, body weight or fat deposition.

Comparative validation of c-kit exon 11 mutation analysis on cytology samples and corresponding surgical resections of gastrointestinal stromal tumours

Objective: