Synovial fluid analysis

Synovial fluid analysis Straw colored, slightly cloudy, 5000 to 25,000 WESCs/mm3 (5-25 x 1 09/L), negative if cultured... 

Synovial fluid analysis Yellow, cloudy, decreased viscosity Hand x-rays Soft tissue swelling, joint space narrowing, no evidence of erosions... 

Alkaline phosphatase Arthrocentesis with synovial fluid analysis Arthrography Arthroscopy Bone densitometry Bone scan Bone x-ray Electromyography HLA-B27 antigen Lactate dehydrogenase Magnetic resonance imaging Myoglobin N-telopeptide Rheumatoid factor Spinal x-rays Uric acid... 

Antispermatozoal antibody Arthrocentesis with synovial fluid analysis... 

Moskowitz RW (1982) Synovial fluid analysis. In Moskow-itz RW (ed) Clinical rheumatology. A problem-oriented approach. Lea and Febiger, Philadelphia, p 421... 

One technique to assess lipid peroxidation utilizes second-derivative spectrophotometric analysis of cyclohexane or ethanol-reconstituted extracts to determine the cis-trans and trans-trans isomeric forms of conjugated dienes and oxodiene species within synovial fluid. Using this method, a rise in the synovial fluid concentration of conjugated oxodienes, hydroxydienes and hydroperoxy-dienes was found to follow joint exercise (Merry et al., 1991). 

No specific clinical laboratory abnormalities occur in primary OA. The ESR may be slightly elevated in patients with generalized or erosive inflammatory OA. The rheumatoid factortest is negative. Analysis of the synovial fluid reveals fluid with high viscosity. This fluid demonstrates a mild leukocytosis (less than 2,000 white blood cells/mm3) with predominantly mononuclear cells. 

Figure 7.9. FcyRI expression in blood and synovial-fluid neutrophils. Neutrophils were isolated from the blood (trace ii) and synovial fluid (trace iii) of a patient with rheumatoid arthritis. Expression of CD64 (FcyRI) was then measured by FACS analysis. Trace (i) indicates the fluorescence distribution of a non-immune isotype control monoclonal antibody. Similar results were obtained in 6 out of 11 patients with rheumatoid arthritis.

Ortiz, A.R., Pastor, M., Palomer, A., Cruciani, G., Gago, F., and Wade, R.C. Reliability of comparative molecular field analysis models effects of data scaling and variable selection using a set of human synovial fluid phospholipase A2 inhibitors. /. Med. Chem. 1997, 40, 1136-1148. 

Chemical analysis of Mur levels has proved effective in both clinical and environmental samples, since Mur is not synthesized by eukaryotic cells. For example, it is readily detected in infected human body fluids, for example, synovial fluids from patients with staphylococcal arthritis and spinal fluids from those with pneumococcal pneumonia [7,16]. However, the most widely used method for its analysis, as an alditol acetate, is time consuming. A large number of derivatives have been tested in order to develop a simpler alternative. Unfortunately the limit of detection for these alternative approaches has not been optimal [17,18]. 

Proteome analysis of synovial fluid. See Dasuri, K., Antonovici, M., Chen, K. et al.. 

The bioanalyst can be required to analyse most biofluids although the most common are urine and the aqueous phase of blood, i.e. plasma or serum. Other samples may be cell and tissue extracts, synovial fluid, cerebrospinal fluid (CSF) and saliva. In the case of urine and CSF with their very low protein content it might be possible to directly inject the sample into an HPLC column. With most silica-based packing materials, direct injection of blood proteins will rapidly lead to column deterioration. HPLC columns are expensive and their efficiency is easily lost so correct preparation of samples will not only improve column life but also improve the results. At its simplest it is only necessary to remove particulate matter from samples to prevent clogging of the column and frits. Modern HPLC packings are very susceptible to contamination by proteins, fats and other macromolecules from biological samples and it is necessary to remove these (except of course for protein analysis). 

Investigations of biotransformation pathways in vivo require the collection and analysis of appropriate biologic samples. The types of sample collected include urine, feces, expired air, blood and/or plasma, bile, milk, saliva, synovial fluid, and tissues. These samples can be divided into two groups 1) those requiring complete collection (e.g., urine and feces) in order to provide quantitative as well as qualitative information on the excretion of the drug and its metabolites and 2) those such as blood and milk that are subsampled at specific times to yield information on the identity and time-related concentrations of the drug and its metabolites that contribute to systemic exposure. Samples of the above types can be obtained from all the common laboratory animals used in biomedical research. In addition, with the exception of bile and tissues, similar samples can usually be obtained from humans without great difficulty. 

De Clerck, L.S., Struyf, N.J., Bridts, C.H. and Stevens, W.J. (1991). Activation of inflammatory cells by immune complexes containing IgE in serum and synovial fluid of patients with rheumatoid arthritis a study using flow cytometric analysis. Ann. Rheum. Dis. 50, 379-382. 

For intracellular cytokine detection by flow cytometry, PBMCs are often used, but to have a more specific analysis, it may be necessary to use cells from other biological fluids (e.g., synovial fluid, cerebrospinal fluid, and bronchoalveo-lar lavage fluid) or to separate cells according to functional characteristics or expression of membrane antigens (e.g., CD3, CD4, CDS, and CD56). 

Paper chromatographic methods have been devised to determine cephalothin and its micro-biologically active metabolite deacetylcephalothin in body fluids. Miller developed a method that is satisfactory for analysis of urine samples. Hoehn e t al. odescribed a method that affords quantitative disassocia-tion of cephalothin from plasma proteins, and developed a chromatographic technique to measure low levels of cephalothin and its metabolite in urine, plasma, synovial fluid, and cerebrospinal fluid. 

The NMR method is not only applicable for the characterization of the solutions of isolated HA, but also for the analysis of human body fluids, e.g. the synovial fluids from patients suffering from RA [71] subsequently to y-irradia-tion, increased N-acetyl intensities could be monitored [72]. Concomitantly, the intensity of formate at 8.44 ppm increased. It is one considerable advantage of NMR that both, high- and low-molar-mass compounds can be simultaneously detected. Of course, NMR also offers another additional advantage that even completely unexpected metabolites can be monitored [73]. The contribution of... 

Baere SD, Pille P, Croubels S, et al. High-performance liquid chromatographic-UV detection analysis of ceftiofur and its active metabolite desfuroylceftiofur in horse plasma and synovial fluid after regional intravenous perfusion and systemic intravenous injection of ceftiofur sodium. Anal ChimActa. 2004 512 75-84. 

Measurements Normal load, cartilage deformation, friction cartilage wear and damage, biochemical analysis of cartilage specimens, synovial fluid, and wear debris sub-surface changes... 

Flow Cytometric Analysis of Neutrophils in Synovial Fluid or Synovial Tissue... 

Figure 4 Analysis of neutrophils in synovial fluid by flow cytometry. Synovial fluid was obtained from a control mouse and a mouse with established arthritis (days 7 after K/BxN serum injection). Cells were stained with Ly-6G antibody and analyzed by flow cytometry. Left panel green line indicates synovial fluid neutrophils from a mouse with established arthritis, red line shows synovial fluid neutrophils from control mouse, and black line reveals staining of established arthritis using an isotype control. The arthritic synovial fluid contains a large population of Ly-6G positive neutrophils while this population was absent in the synovial fluid of a control mouse. Right panel quantitation of the number of Ly-6G positive cells in control and arthritic joints (control mice n=2, arthritic mice n = 2). Data are the meaniSEM P<0.05 versus control mice.

Two studies have suggested that the IR spectra of synovial fluid specimens provide the basis to diagnose arthritis and to differentiate among its variants.A NIR study demonstrated that osteoarthritis, rheumatoid arthritis, and spondyloarthropathy could be distinguished on the basis of the synovial fluid absorption patterns in the range 2000-2400 nm.< In that case, the pool of synovial fluid spectra was subject to principal component analysis, and eight principal component scores for each spectrum were employed as the basis for linear discriminant analysis (LDA). On that basis, the optimal LDA classifier matched 105 of the 109 spectra to the correct clinical designation (see Table 7). 

The IR-based diagnoses are from principal component analysis and LDA of synovial fluid NIR spectra (see text) SA = spondyloarthropathy RA = rheumatoid arthritis OA = osteoarthritis. The table indicates, for example, that of the 29 spectra corresponding to patients with osteoarthritis, 27 were classified correctly but two were misdassified as rheumatoid arthritis, (see Shaw et al. ). 

H.H. Eysel, M. Jackson, A. Nikulin, R.L. Somoqai, G.T.D. Thomson, H.H. Mantsch, A Novel Diagnostic Test for Arthritis Multivariate Analysis of Infrared Spectra of Synovial Fluid , Biospectroscopy, 3, 161-167 (1997). 

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