Submacular fluid after encircling buckle surgery for inferior macula-off retinal detachment in young patients.

PURPOSE: Characterization of persistent diffuse subretinal fluid using optical coherence tomography (OCT) after successful encircling buckle surgery for inferior macula-off retinal detachment in young patients. METHODS: Institutional retrospective review of six young patients (mean age 31 +/- 6 years; five female, one male) with spontaneous inferior rhegmatogenous macula-off retinal detachment. All patients were treated with encircling buckle surgery and five out of six underwent additional external drainage of subretinal fluid. Mean follow-up was 37 +/- 25 months (range 17-75 months) and included complete ophthalmic and OCT examination. RESULTS: At 6 months, 100% of patients showed persistence of subretinal fluid on OCT. Four patients had diffuse fluid accumulation, whereas two patients showed a 'bleb-like' accumulation of fluid. This fluid was present independent of whether or not patients had been treated with external fluid drainage. Subretinal fluid only started to disappear on OCT between 6 and more than 12 months after surgery. CONCLUSION: Young patients with inferior macula-off retinal detachments and a marginally liquefied vitreous may show persisting postoperative subclinical fluid under the macula for longer periods of time than described previously.

Local Renal Circadian Clocks Control Fluid-Electrolyte Homeostasis and BP.

The circadian timing system is critically involved in the maintenance of fluid and electrolyte balance and BP control. However, the role of peripheral circadian clocks in these homeostatic mechanisms remains unknown. We addressed this question in a mouse model carrying a conditional allele of the circadian clock gene Bmal1 and expressing Cre recombinase under the endogenous Renin promoter (Bmal1(lox/lox)/Ren1(d)Cre mice). Analysis of Bmal1(lox/lox)/Ren1(d)Cre mice showed that the floxed Bmal1 allele was excised in the kidney. In the kidney, BMAL1 protein expression was absent in the renin-secreting granular cells of the juxtaglomerular apparatus and the collecting duct. A partial reduction of BMAL1 expression was observed in the medullary thick ascending limb. Functional analyses showed that Bmal1(lox/lox)/Ren1(d)Cre mice exhibited multiple abnormalities, including increased urine volume, changes in the circadian rhythm of urinary sodium excretion, increased GFR, and significantly reduced plasma aldosterone levels. These changes were accompanied by a reduction in BP. These results show that local renal circadian clocks control body fluid and BP homeostasis.

Measurements of seismic attenuation and transient fluid pressure in partially saturated Berea sandstone: Evidence of fluid flow on the mesoscopic scale

A novel laboratory technique is proposed to investigate wave-induced fluid flow on the mesoscopic scale as a mechanism for seismic attenuation in partially saturated rocks. This technique combines measurements of seismic attenuation in the frequency range from 1 to 100?Hz with measurements of transient fluid pressure as a response of a step stress applied on top of the sample. We used a Berea sandstone sample partially saturated with water. The laboratory results suggest that wave-induced fluid flow on the mesoscopic scale is dominant in partially saturated samples. A 3-D numerical model representing the sample was used to verify the experimental results. Biot's equations of consolidation were solved with the finite-element method. Wave-induced fluid flow on the mesoscopic scale was the only attenuation mechanism accounted for in the numerical solution. The numerically calculated transient fluid pressure reproduced the laboratory data. Moreover, the numerically calculated attenuation, superposed to the frequency-independent matrix anelasticity, reproduced the attenuation measured in the laboratory in the partially saturated sample. This experimental?numerical fit demonstrates that wave-induced fluid flow on the mesoscopic scale and matrix anelasticity are the dominant mechanisms for seismic attenuation in partially saturated Berea sandstone.

Do seismic waves and fluid flow sense the same permeability?

We study the discrepancy between the effective flow permeability and the effective seismic permeability, that is, the effective permeability controlling seismic attenuation due to wave-induced fluid flow, in 2D rock samples having mesoscopic heterogeneities and in the presence of strong permeability fluctuations. In order to do so, we employ a numerical oscillatory compressibility test to determine attenuation and velocity dispersion due to wave-induced fluid flow in these kinds of media and compare the responses with those obtained by replacing the heterogeneous permeability field by constant values, including the average permeability as well as the effective flow permeability of the sample. The latter is estimated in a separate upscaling procedure by solving the steady-state flow equation in the rock sample under study. Numerical experiments let us verify that attenuation levels are less significant and the attenuation peak gets broader in the presence of such strong permeability fluctuations. Moreover, we observe that for very low frequencies the effective seismic permeability is similar to the effective flow permeability, while for very high frequencies it approaches the arithmetic average of the permeability field.

Seismic attenuation due to wave-induced fluid flow at microscopic and macroscopic scales

Wave-induced fluid flow at microscopic and mesoscopic scales arguably constitutes the major cause of intrinsic seismic attenuation throughout the exploration seismic and sonic frequency ranges. The quantitative analysis of these phenomena is, however, complicated by the fact that the governing physical processes may be dependent. The reason for this is that the presence of microscopic heterogeneities, such as micro-cracks or broken grain contacts, causes the stiffness of the so-called modified dry frame to be complex-valued and frequency-dependent, which in turn may affect the viscoelastic behaviour in response to fluid flow at mesoscopic scales. In this work, we propose a simple but effective procedure to estimate the seismic attenuation and velocity dispersion behaviour associated with wave-induced fluid flow due to both microscopic and mesoscopic heterogeneities and discuss the results obtained for a range of pertinent scenarios.

Importance of ENaC-mediated sodium transport in alveolar fluid clearance using genetically-engineered mice.

The lung possesses specific transport systems that intra- and extracellularly maintain salt and fluid balance necessary for its function. At birth, the lungs rapidly transform into a fluid (Na(+))-absorbing organ to enable efficient gas exchange. Alveolar fluid clearance, which mainly depends on sodium transport in alveolar epithelial cells, is an important mechanism by which excess water in the alveoli is reabsorbed during the resolution of pulmonary edema. In this review, we will focus and summarize on the role of ENaC in alveolar lung liquid clearance and discuss recent data from mouse models with altered activity of epithelial sodium channel function in the lung, and more specifically in alveolar fluid clearance. Recent data studying mice with hyperactivity of ENaC or mice with reduced ENaC activity clearly illustrate the impaired lung fluid clearance in these adult mice. Further understanding of the physiological role of ENaC and its regulatory proteins implicated in salt and water balance in the alveolar cells may therefore help to develop new therapeutic strategies to improve gas exchange in pulmonary edema.

Fluid evolution at the Variscan front in the vicinity of the Aachen thrust

Quartz-carbonate-chlorite veins were studied in borehole samples of the RWTH-1 well in Aachen. Veins formed in Devonian rocks in the footwall of the Aachen thrust during Variscan deformation and associated fluid flow. Primary fluid inclusions indicate subsolvus unmixing of a homogenous H(2)O-CO(2)-CH(4)-(N(2))-Na-(K)-Cl fluid into a H(2)O-Na-(K)-Cl solution and a vapour-rich CO(2)-(H(2)O, CH(4), N(2)) fluid. The aqueous end-member composition resembles that of metamorphic fluids of the Variscan front zone with salinities ranging from 4 to 7% NaCl equiv. and maximum homogenisation temperatures of close to 400A degrees C. Pressure estimates indicate a burial depth between 4,500 and 8,000 m at geothermal gradients between 50 and 75A degrees C/26 MPa, but pressure decrease to sublithostatic conditions is also indicated, probably as a consequence of fracture opening during episodic seismic activity. A second fluid system, mainly preserved in pseudo-secondary and secondary fluid inclusions, is characterised by fluid temperatures between 200 and 250A degrees C and salinities of < 5% NaCl equiv. Bulk stable isotope analyses of fluids released from vein quartz, calcite, and dolomite by decrepitation yielded delta D(H2O) values from -89 to -113 aEuro degrees, delta(13)C(CH4) from -26.9 to -28.9aEuro degrees (VPDB) and delta(13)C(CO2) from -12.8 to -23.3aEuro degrees (VPDB). The low delta D and delta(13)C range of the fluids is considered to be due to interaction with cracked hydrocarbons. The second fluid influx caused partial isotope exchange and disequilibrium. It is envisaged that an initial short lived flux of hot metamorphic fluids expelled from the epizonal metamorphic domains of the Stavelot-Venn massif. The metamorphic fluid was focused along major thrust faults of the Variscan front zone such as the Aachen thrust. A second fluid influx was introduced from formation waters in the footwall of the Aachen thrust as a consequence of progressive deformation. Mixing of the cooler and lower salinity formation water with the hot metamorphic fluid during episodic fluid trapping resulted in an evolving range of physicochemical fluid inclusion characteristics.

Procalcitonin and C-reactive protein in pericardial fluid for postmortem diagnosis of sepsis.

The aim of this study was to investigate the presence and concentrations of procalcitonin and C-reactive protein in pericardial fluid and compare these levels to those found in the postmortem serum obtained from the femoral blood. Two groups were formed, a sepsis-related fatalities group and a control group. Postmortem native CT scans, autopsies, histology, neuropathology and toxicology as well as other postmortem biochemistry investigations were performed in all cases. Pericardial fluid procalcitonin levels were significantly different between the cases of sepsis-related fatalities and those of the control group. Postmortem serum procalcitonin levels below the detection limit were also reflected in undetectable pericardial fluid levels. Similarly, a large increase in postmortem serum procalcitonin levels was reflected in a large increase of procalcitonin pericardial fluid levels. Based on these findings, pericardial fluid could be an alternative to postmortem serum for the determination of procalcitonin levels in cases where postmortem serum is not available and measurements of procalcitonin are required to circumstantiate the pathogenesis of death.

Magmatic-dominated fluid evolution in the Jurassic Nambija gold skarn deposits (southeastern Ecuador)

The Jurassic (approximately 145 Ma) Nambija oxidized gold skarns are hosted by the Triassic volcanosedimentary Piuntza unit in the sub-Andean zone of southeastern Ecuador. The skarns consist dominantly of granditic garnet (Ad(20-98)) with subordinate pyroxene (Di(46-92)Hd(17-42)Jo(0-19)) and epidote and are spatially associated with porphyritic quartz-diorite to granodiorite intrusions. Endoskarn is developed at the intrusion margins and grades inwards into a potassic alteration zone. Exoskarn has an outer K- and Na-enriched zone in the volcanosedimentary unit. Gold mineralization is associated with the weakly developed retrograde alteration of the exoskarn and occurs mainly in sulfide-poor vugs and milky quartz veins and veinlets in association with hematite. Fluid inclusion data for the main part of the prograde stage indicate the coexistence of high-temperature (500A degrees C to > 600A degrees C), high-salinity (up to 65 wt.% eq. NaCl), and moderate- to low-salinity aqueous-carbonic fluids interpreted to have been trapped at pressures around 100-120 MPa, corresponding to about 4-km depth. Lower-temperature (510-300A degrees C) and moderate- to low-salinity (23-2 wt.% eq. NaCl) aqueous fluids are recorded in garnet and epidote of the end of the prograde stage. The microthermometric data (Th from 513A degrees C to 318A degrees C and salinity from 1.0 to 23 wt.% eq. NaCl) and delta(18)O values between 6.2aEuro degrees and 11.5aEuro degrees for gold-bearing milky quartz from the retrograde stage suggest that the ore-forming fluid was dominantly magmatic. Pressures during the early retrograde stage were in the range of 50-100 MPa, in line with the evidence for CO(2) effervescence and probable local boiling. The dominance of magmatic low-saline to moderately saline oxidizing fluids during the retrograde stage is consistent with the depth of the skarn system, which could have delayed the ingression of external fluids until relatively low temperatures were reached. The resulting low water-to-rock ratios explain the weak retrograde alteration and the compositional variability of chlorite, essentially controlled by host rock compositions. Gold was precipitated at this stage as a result of cooling and pH increase related to CO(2) effervescence, which both result in destabilization of gold-bearing chloride complexes. Significant ingression of external fluids took place after gold deposition only, as recorded by delta(18)O values of 0.4aEuro degrees to 6.2aEuro degrees for fluids depositing quartz (below 350A degrees C) in sulfide-rich barren veins. Low-temperature (< 300A degrees C) meteoric fluids (delta(18)O(water) between -10.0aEuro degrees and -2.0aEuro degrees) are responsible for the precipitation of late comb quartz and calcite in cavities and veins and indicate mixing with cooler fluids of higher salinities (about 100A degrees C and 25 wt.% eq. NaCl). The latter are similar to low-temperature fluids (202-74.5A degrees C) with delta(18)O values of -0.5aEuro degrees to 3.1aEuro degrees and salinities in the range of 21.1 to 17.3 wt.% eq. CaCl(2), trapped in calcite of late veins and interpreted as basinal brines. Nambija represents a deep equivalent of the oxidized gold skarn class, the presence of CO(2) in the fluids being partly a consequence of the relatively deep setting at about 4-km depth. As in other Au-bearing skarn deposits, not only the prograde stage but also the gold-precipitating retrograde stage is dominated by fluids of magmatic origin.

Fluid-rock-strain feedbacks in extensional shear zones

La présence de fluide météorique synchrone à l'activité du détachement (Farmin, 2003 ; Mulch et al., 2007 ; Gébelin et al., 2011), implique que les zones de cisaillement sont des systèmes ouverts avec des cellules de convections à l'échelle crustale et un intense gradient géothermique au sein du détachement (Morrison et Anderson, 1998, Gottardi et al., 2011). De plus, les réactions métamorphiques liées à des infiltrations fluides dans les zones de cisaillement extensionnel peuvent influencer les paramètres rhéologiques du système (White and Knipe, 1978), et impliquer la localisation de la déformation dans la croûte. Dans ce manuscrit, deux zones de cisaillement infiltrées par des fluides météoriques sont étudiées, l'une étant largement quartzitique, et l'autre de nature granitique ; les relations entre déformation, fluides, et roches s'appuient sur des approches structurales, microstructurales, chimiques et isotopiques. L'étude du détachement du Columbia river (WA, USA) met en évidence que la déformation mylonitique se développe en un million d'années. La phase de cisaillement principal s'effectue à 365± 30°C d'après les compositions isotopiques en oxygène du quartz et de la muscovite. Ces minéraux atteignent l'équilibre isotopique lors de leur recristallisation dynamique contemporaine à la déformation. La zone de cisaillement enregistre une baisse de température, remplaçant le mécanisme de glissement par dislocation par celui de dissolution- précipitation dans les derniers stades de l'activité du détachement. La dynamique de circulation fluide bascule d'une circulation pervasive à chenalisée, ce qui engendre localement la rupture des équilibres d'échange isotopiques. La zone de cisaillement de Bitterroot (MT, USA) présente une zone mylonitique de 600m d'épaisseur, progressant des protomylonites aux ultramylonites. L'intensité de la localisation de la déformation se reflète directement sur l'hydratation des feldspaths, réaction métamorphique majeure dite de « rock softening ». Une étude sur roche totale indique des transferts de masse latéraux au sein des mylonites, et d'importantes pertes de volume dans les ultramylonites. La composition isotopique en hydrogène des phyllosilicates met en évidence la présence (1) d'une source magmatique/métamorphique originelle, caractérisée par les granodiorites ayant conservé leur foliation magmatique, jusqu'aux protomylonites, et (2) une source météorique qui tamponne les valeurs des phyllosilicates des fabriques mylonitiques jusqu'aux veines de quartz non-déformées. Les compositions isotopiques en oxygène des minéraux illustrent le tamponnement de la composition du fluide météorique par l'encaissant. Ce phénomène cesse lors du processus de chloritisation de la biotite, puisque les valeurs des chlorites sont extrêmement négatives (-10 per mil). La thermométrie isotopique indique une température d'équilibre isotopique de la granodiorite entre 600-500°C, entre 500-300°C dans les mylonites, et entre 300 et 200°C dans les fabriques cassantes (cataclasites et veines de quartz). Basé sur les résultats issus de ce travail, nous proposons un modèle général d'interactions fluide-roches-déformation dans les zones de détachements infiltrées par des fluides météoriques. Les zones de détachements évoluent rapidement (en quelques millions d'années) au travers de la transition fragile-ductile ; celle-ci étant partiellement contrôlée par l'effet thermique des circulations de fluide météoriques. Les systèmes de détachements sont des lieux où la déformation et les circulations fluides sont couplées ; évoluant rapidement vers une localisation de la déformation, et de ce fait, une exhumation efficace. - The presence of meteoric fluids synchronous with the activity of extensional detachment zones (Famin, 2004; Mulch et al., 2007; Gébelin et al., 2011) implies that extensional systems involve fluid convection at a crustal scale, which results in high geothermal gradients within active detachment zones (Morrison and Anderson, 1998, Gottardi et al., 2011). In addition, the metamorphic reactions related to fluid infiltration in extensional shear zones can influence the rheology of the system (White and Knipe, 1978) and ultimately how strain localizes in the crust. In this thesis, two shear zones that were permeated by meteoric fluids are studied, one quartzite-dominated, and the other of granitic composition; the relations between strain, fluid, and evolving rock composition are addressed using structural, microstructural, and chemical/isotopic measurements. The study of the Columbia River detachment that bounds the Kettle core complex (Washington, USA) demonstrates that the mylonitic fabrics in the 100 m thick quartzite- dominated detachment footwall developed within one million years. The main shearing stage occurred at 365 ± 30°C when oxygen isotopes of quartz and muscovite equilibrated owing to coeval deformation and dynamic recrystallization of these minerals. The detachment shear zone records a decrease in temperature, and dislocation creep during detachment shearing gave way to dissolution-precipitation and fracturing in the later stages of detachment activity. Fluid flow switched from pervasive to channelized, leading to isotopic disequilibrium between different minerals. The Bitterroot shear zone detachment (Montana, USA) developed a 600 m thick mylonite zone, with well-developed transitions from protomylonite to ultramylonite. The localization of deformation relates directly to the intensity of feldspar hydration, a major rock- softening metamorphic reaction. Bulk-rock analyses of the mylonitic series indicate lateral mass transfer in the mylonite (no volume change), and significant volume loss in ultramylonite. The hydrogen isotope composition of phyllosilicates shows (1) the presence of an initial magmatic/metamorphic source characterized by the granodiorite in which a magmatic, and gneissic (protomylonite) foliation developed, and (2) a meteoric source that buffers the values of phyllosilicates in mylonite, ultramylonite, cataclasite, and deformed and undeformed quartz veins. The mineral oxygen isotope compositions were buffered by the host-rock compositions until chloritization of biotite started; the chlorite oxygen isotope values are negative (-10 per mil). Isotope thermometry indicates a temperature of isotopic equilibrium of the granodiorite between 600-500°C, between 500-300°C in the mylonite, and between 300 and 200°C for brittle fabrics (cataclasite and quartz veins). Results from this work suggest a general model for fluid-rock-strain feedbacks in detachment systems that are permeated by meteoric fluids. Phyllosilicates have preserved in their hydrogen isotope values evidence for the interaction between rock and meteoric fluids during mylonite development. Fluid flow generates mass transfer along the tectonic anisotropy, and mylonites do not undergo significant volume change, except locally in ultramylonite zones. Hydration of detachment shear zones attends mechanical grain size reduction and enhances strain softening and localization. Self-exhuming detachment shear zones evolve rapidly (a few million years) through the transition from ductile to brittle, which is partly controlled by the thermal effect of circulating surface fluids. Detachment systems are zones in the crust where strain and fluid flow are coupled; these systems. evolve rapidly toward strain localization and therefore efficient exhumation.

Glial and axonal body fluid biomarkers are related to infarct volume, severity, and outcome.

Body fluid biomarkers of central nervous system damage may help improve the prognostic and diagnostic accuracy in ischemic stroke. We studied 53 patients. Stroke severity and outcome was rated using the National Institutes of Health Stroke Scale and modified Rankin scale. Ferritin, S100B, and NfH were measured in cerebrospinal fluid (CSF) and serum. Infarct volume was calculated from T2W images. CSF S100B (median 1.00 ng/mL) and CSF ferritin (10.0 ng/mL) levels were elevated in patients with stroke compared with control subjects (0.62 ng/mL, P < .0001; 2.34 ng/mL, P < .0001). Serum S100B (0.09 ng/mL) was higher in patients with stroke compared with control subjects (0.01 ng/mL). CSF S100B levels were higher in patients with a cardioembolic stroke (2.88 ng/mL) than in those with small-vessel disease (0.89 ng/mL, P < .05). CSF S100B levels correlated with the National Institutes of Health Stroke Scale score on admission (R = 0.56, P < .01) and the stroke volume (R = 0.44, P = .01). CSF S100B and NfH-SMI35 levels correlated with outcome on the modified Rankin scale. CSF S100B levels were related to stroke severity and infarct volume and highest in cardioembolic stroke.

Multiplex PCR of sonication fluid accurately differentiates between prosthetic joint infection and aseptic failure.

OBJECTIVE: Cultures have limited sensitivity in the diagnosis of prosthetic joint infection (PJI), especially in low-grade infections. We assessed the value of multiplex PCR in differentiating PJI from aseptic failure (AF). METHODS: Included were patients in whom the joint prosthesis was removed and submitted for sonication. The resulting sonication fluid was cultured and investigated by multiplex PCR, and compared with periprosthetic tissue culture. RESULTS: Among 86 explanted prostheses (56 knee, 25 hip, 3 elbow and 2 shoulder prostheses), AF was diagnosed in 62 cases (72%) and PJI in 24 cases (28%). PJI was more common detected by multiplex PCR (n=23, 96%) than by periprosthetic tissue (n=17, 71%, p=0.031) or sonication fluid culture (n=16, 67%, p=0.016). Among 12 patients with PJI who previously received antibiotics, periprosthetic tissue cultures were positive in 8 cases (67%), sonication fluid cultures in 6 cases (50%) and multiplex PCR in 11 cases (92%). In AF cases, periprosthetic tissue grew organisms in 11% and sonication fluid in 10%, whereas multiplex PCR detected no organisms. CONCLUSIONS: Multiplex PCR of sonication fluid demonstrated high sensitivity (96%) and specificity (100%) for diagnosing PJI, providing good discriminative power towards AF, especially in patients previously receiving antibiotics.