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1.
Sci Total Environ ; 946: 174314, 2024 Jun 27.
Article in English | MEDLINE | ID: mdl-38944305

ABSTRACT

Shipping activity can be a substantial source of pollution and impact on the environment, including air, water and ecosystems, as well as adverse health and climatic effects. Due to the distribution of maritime transport activity routes in the EU, a large portion of the population is exposed to shipping pollution throughout Europe. The ongoing European project EMERGE aims to investigate and quantify these impacts over Europe, and in more detail, in specific case studies regions. The Aveiro lagoon region in Portugal is one of these case studies. This region is a Natura 2000 area, and also includes a medium-sized port. Both air quality and water modelling tools were applied to assess the impact of the emissions and discharges from shipping (to air and water) in the region in 2018. Additionally, ecotoxicological impacts were determined by bioassays to evaluate the impact of scrubber-water discharges on the most sensitive stages of marine invertebrates, and on the post-exposure feeding inhibition of crustacean and bivalve species. The results show that there was a substantial increase in atmospheric pollutant concentrations due to emissions attributed to shipping, which was most relevant for NOx and SO2 (up to a 30 % shipping contribution). There was no significant degradation of the water quality, mainly as the ships operating in this area did not have scrubber equipment. The ecotoxicological tests were performed with three samples of scrubber water, including one artificial sample and two samples collected on-board ships. If scrubber water would have been discharged in this area, the results indicated that the majority of the tested species would be exposed to lowest observed effect concentration (LOEC) for the different scrubber-water samples, as well as to substantial concentrations of metals, PAHs, and alkylated PAHs.

2.
Environ Int ; 36(1): 36-45, 2010 Jan.
Article in English | MEDLINE | ID: mdl-19878999

ABSTRACT

People are exposed to air pollution from a range of indoor and outdoor sources. Concentrations of nitrogen dioxide (NO(2)), which is hazardous to health, can be significant in both types of environments. This paper reports on the measurement and analysis of indoor and outdoor NO(2) concentrations and their comparison with measured personal exposure in various microenvironments during winter and summer seasons. Furthermore, the relationship between NO(2) personal exposure in various microenvironments and including activities patterns were also studied. Personal, indoor microenvironments and outdoor measurements of NO(2) levels were conducted using Palmes tubes for 60 subjects. The results showed significant differences in indoor and outdoor NO(2) concentrations in winter but not for summer. In winter, indoor NO(2) concentrations were found to be strongly correlated with personal exposure levels. NO(2) concentration in houses using a gas cooker was higher in all rooms than those with an electric cooker during the winter campaign, whereas there was no significant difference noticed in summer. The average NO(2) levels in kitchens with a gas cooker were twice as high as those with an electric cooker, with no significant difference in the summer period. A time-weighted average personal exposure was calculated and compared with measured personal exposures in various indoor microenvironments (e.g. front doors, bedroom, living room and kitchen); including non-smokers, passive smokers and smoker. The estimated results were closely correlated, but showed some underestimation of the measured personal exposures to NO(2) concentrations. Interestingly, for our particular study higher NO(2) personal exposure levels were found during summer (14.0+/-1.5) than winter (9.5+/-2.4).


Subject(s)
Air Pollutants/analysis , Air Pollution, Indoor/analysis , Atmosphere/chemistry , Environmental Exposure/analysis , Nitrogen Dioxide/analysis , Environmental Monitoring , Human Activities/statistics & numerical data , Surveys and Questionnaires , United Kingdom
3.
Am J Physiol Gastrointest Liver Physiol ; 279(4): G815-26, 2000 Oct.
Article in English | MEDLINE | ID: mdl-11005770

ABSTRACT

Cell transplantation into hepatic sinusoids, which is necessary for liver repopulation, could cause hepatic ischemia. To examine the effects of cell transplantation on host hepatocytes, we transplanted Fisher 344 rat hepatocytes into syngeneic dipeptidyl peptidase IV-deficient rats. Within 24 h of cell transplantation, areas of ischemic necrosis, along with transient disruption of gap junctions, appeared in the liver. Moreover, host hepatocytes expressed gamma-glutamyl transpeptidase (GGT) extensively, which was observed even 2 years after cell transplantation. GGT expression was not associated with alpha-fetoprotein activation, which is present in progenitor cells. Increased GGT expression was apparent after transplantation of nonparenchymal cells and latex beads but not after injection of saline, fragmented hepatocytes, hepatocyte growth factor, or turpentine. Some host hepatocytes exhibited apoptosis, as well as DNA synthesis, between 24 and 48 h after cell transplantation. Changes in gap junctions, GGT expression, DNA synthesis, and apoptosis after cell transplantation were prevented by vasodilators. The findings indicated the onset of ischemic liver injury after cell transplantation. These hepatic perturbations must be considered when transplanted cells are utilized as reporters for biological studies.


Subject(s)
Cell Transplantation , Gap Junctions/physiology , Gene Expression Regulation, Enzymologic , Hepatocytes/cytology , Liver/cytology , Transplantation, Homologous/physiology , gamma-Glutamyltransferase/genetics , Animals , Cells, Cultured , Kinetics , Liver/enzymology , Liver/physiology , Male , Rats , Rats, Inbred F344
4.
Am J Physiol Gastrointest Liver Physiol ; 279(3): G631-40, 2000 Sep.
Article in English | MEDLINE | ID: mdl-10960364

ABSTRACT

Transplanted hepatocytes integrate in the liver parenchyma and exhibit gene expression patterns that are similar to adjacent host hepatocytes. To determine the fate of genetically marked hepatocytes in the context of hepatocellular proliferation throughout the rodent life span, we transplanted Fischer 344 (F344) rat hepatocytes into syngeneic dipeptidyl peptidase IV-deficient rats. The proliferative activity in transplanted hepatocytes was studied in animals ranging in age from a few days to 2 yr. Transplanted hepatocytes proliferated during liver development between 1 and 6 wk of age, each dividing an estimated two to five times. DNA synthesis in occasional cells was demonstrated by localizing bromodeoxyuridine incorporation. There was no evidence for transplanted cell proliferation between 6 wk and 1 yr of age. Subsequently, transplanted cells proliferated again, with increased sizes of transplanted cell clusters at 18 and 24 mo of age. The proliferative activity of transplanted cells was greater in rats entering senescence compared with during postnatal liver development. In old rats, some liver lobules were composed entirely of transplanted cells. We conclude that hepatocyte proliferation in the livers of very young and old F344 rats is regulated in a temporally determined, biphasic manner. The findings will be relevant to mechanisms concerning liver development, senescence, and oncogenesis, as well as to cell and gene therapy.


Subject(s)
Cell Transplantation , Cellular Senescence/physiology , Dipeptidyl Peptidase 4/analysis , Liver/cytology , Liver/enzymology , Age Factors , Animals , Animals, Suckling , Antimetabolites/pharmacokinetics , Biomarkers , Bromodeoxyuridine/pharmacokinetics , Cell Division/physiology , Cytological Techniques , Liver Regeneration , Male , Rats , Rats, Inbred F344
5.
Mol Ther ; 1(4): 358-65, 2000 Apr.
Article in English | MEDLINE | ID: mdl-10933954

ABSTRACT

Hepatic overexpression of Mad1 with an adenoviral vector, AdMad, induced liver toxicity in immunodeficient mice. Transduction of cultured hepatocytes with AdMad inhibited cellular DNA synthesis and cell cycling, along with increased lactate dehydrogenase release, indicating cytotoxicity. When dipeptidyl peptidase IV-deficient F344 rat hepatocytes were transplanted into the liver of immunodeficient mice after treatment with AdMad, significant portions of the liver were repopulated. This was in agreement with corresponding losses of host hepatocytes, which showed increased apoptosis rates. Mortality in mice following AdMad treatment decreased significantly when animals were subjected to hepatocyte transplantation. The findings indicated that Mad1 overexpression perturbed hepatocyte survival. Investigation of pathophysiological mechanisms concerning specific cell cycle regulators in acute liver toxicity will thus be appropriate. Cell therapy has potential for treating acute liver injury under suitable circumstances.


Subject(s)
Carrier Proteins , Cell Transplantation , Liver Failure, Acute/therapy , Liver Transplantation , Nuclear Proteins , Phosphoproteins/genetics , Repressor Proteins/genetics , Adenoviridae/genetics , Animals , Cell Cycle Proteins , Gene Expression , Humans , Lac Operon , Liver/metabolism , Liver Failure, Acute/etiology , Liver Failure, Acute/pathology , Mice , Phosphoproteins/metabolism , Rats , Rats, Inbred F344 , Repressor Proteins/metabolism
6.
Pathobiology ; 68(2): 76-86, 2000.
Article in English | MEDLINE | ID: mdl-10878504

ABSTRACT

The monoclonal antibody designated mAb Das-1, which was generated against a colon epithelial protein, reacts with the normal biliary epithelium and keratinocytes, which are among targets of tissue injury in ulcerative colitis. Moreover, mAb Das-1 reacts with abnormal cells in Barrett's esophagus and chronic cystitis profunda, as well as so-called 'oval cells' in the adult liver, which are considered oncogenic progenitor cells. To establish ontogenic regulation of mAb Das-1 reactivity, we studied 7- to 24-week-old human fetuses by immunohistochemistry. In liver, mAb Das-1 reactivity was further correlated with glycogen, dipeptidyl peptidase IV, glucose-6-phosphatase and gamma-glutamyl transpeptidase expression. mAb Das-1 reacted with cells in organs arising from the pharyngeal cleft (thymus), primitive gut (oral cavity, pharynx, lung, esophagus, stomach, biliary tree, pancreas, liver, colon), ureteric bud (renal tubules, collecting duct), mesonephros (kidney, testis), mesoderm (muscle) and elsewhere (skin, adrenal cortex). In distinction from the adult liver, mAb Das-1 staining was more pronounced in hepatoblasts compared with biliary cells. In adult tissues, however, mAb Das-1 reactivity was restricted to the colon, biliary epithelium, keratinocytes, and ciliary body. These data indicated that the mAb Das-1 recognized epitopes in fetal cells of diverse ectodermal, mesodermal and endodermal origin, compatible with sharing of lineage mechanisms in tissues. Reactivation of mAb Das-1 staining in epithelial precancerous conditions, including carcinomas arising in these organs, is compatible with oncofetal regulation of the antigen, which will facilitate analysis of cell subpopulations during organ development, regeneration and oncogenesis.


Subject(s)
Antibodies, Monoclonal/immunology , Antigen-Antibody Reactions/immunology , Autoantigens/immunology , Intestinal Mucosa/immunology , Liver/immunology , Adult , Cell Lineage/physiology , Dipeptidyl Peptidase 4/metabolism , Embryonic and Fetal Development/physiology , Fetus , Gestational Age , Glucose-6-Phosphatase/metabolism , Glycogen/metabolism , Humans , Immunoenzyme Techniques , Intestinal Mucosa/metabolism , Liver/embryology , Liver/metabolism , Tissue Distribution , gamma-Glutamyltransferase/metabolism
7.
J Pathol ; 191(1): 78-85, 2000 May.
Article in English | MEDLINE | ID: mdl-10767723

ABSTRACT

Repopulation of the cirrhotic liver with disease-resistant hepatocytes could offer novel therapies, as well as systems for biological studies. Establishing whether transplanted hepatocytes can engraft, survive, and proliferate in the cirrhotic liver is a critical demonstration. Dipeptidyl peptidase IV-deficient F344 rats were used to localize transplanted hepatocytes isolated from the liver of syngeneic normal F344 rats. Cirrhosis was induced by administration of carbon tetrachloride with phenobarbitone and these drugs were withdrawn prior to cell transplantation. Cirrhotic rats showed characteristic hepatic histology, as well as significant portosystemic shunting. When hepatocytes were transplanted via the spleen, cells were distributed immediately in periportal areas, fibrous septa, and regenerative nodules of the cirrhotic liver. Although some transplanted cells translocated into pulmonary capillaries, this was not deleterious. At 1 week, transplanted cells were fully integrated in the liver parenchyma, along with expression of glucose-6-phosphatase and glycogen as reporters of hepatic function. Transplanted cells proliferated in the liver of cirrhotic animals and survived indefinitely. At 1 year, transplanted hepatocytes formed large clusters containing several-fold more cells than normal control animals, which was in agreement with increased cell turnover in the cirrhotic rat liver. The findings indicate that the cirrhotic liver can be repopulated with functionally intact hepatocytes that are capable of proliferating. Liver repopulation using disease-resistant hepatocytes will be applicable in chronic conditions, such as viral hepatitis or Wilson's disease.


Subject(s)
Cell Transplantation , Liver Cirrhosis, Experimental/therapy , Liver Transplantation/pathology , Liver/cytology , Animals , Carbon Tetrachloride , Cell Division , Cell Survival , Graft Survival , Humans , Liver Cirrhosis, Experimental/chemically induced , Liver Cirrhosis, Experimental/pathology , Liver Regeneration , Rats , Rats, Inbred F344
8.
Cancer Res ; 59(23): 5871-4, 1999 Dec 01.
Article in English | MEDLINE | ID: mdl-10606225

ABSTRACT

Hepatic tumors often recur in the liver after surgical resection. Postoperative radiotherapy (RT) could improve survival, but curative RT may induce delayed life-threatening radiation-induced liver damage. Because RT inhibits liver regeneration, we hypothesized that unirradiated, transplanted hepatocytes would proliferate preferentially in a partially resected and irradiated liver, providing metabolic support. We subjected F344 rats to hepatic RT and partial hepatectomy with/without a single intrasplenic, syngeneic hepatocyte transplantation. Hepatocyte transplantation ameliorated radiation-induced liver damage and improved survival of rats receiving RT after partial hepatectomy. We further demonstrated that transplanted hepatocytes extensively repopulate and function in a heavily irradiated rat liver.


Subject(s)
Cell Transplantation , Liver Regeneration , Liver/cytology , Liver/radiation effects , Animals , Hepatectomy , Liver/pathology , Male , Rats , Rats, Inbred F344 , Spleen , Transplantation, Heterologous , Transplantation, Isogeneic
9.
Gene Ther ; 6(5): 729-36, 1999 May.
Article in English | MEDLINE | ID: mdl-10505095

ABSTRACT

To distinguish between transduced cell clearance and transgene regulation following adenoviral gene transfer, we infected F344 rat hepatocytes with an E-1-deleted adenovirus (Ad beta gal) and studied cell survival in the liver of dipeptidyl peptidase IV-deficient (DPPIV-) F344 rats. Transplanted cells were localized with histochemical staining for DPPIV and transgene expression localized with staining for beta-galactosidase (lacZ). The transgene was expressed in 90-100% hepatocytes without impairment in cell viability in vitro, although transplanted cells were cleared mostly within 1 day by infiltrates containing activated macrophages, CD4+ or CD8+ lymphocytes, and phagocytes. When Ad beta gal-transduced hepatocytes were transplanted repeatedly at 14-day intervals, transplanted cells were cleared rapidly each time. LacZ expression following Ad beta gal administration to intact animals was associated with apoptosis and unscheduled DNA synthesis in the liver. To determine whether adenoviral antigen expression activated consequential MHC-restricted liver injury, we transplanted Ad beta gal-hepatocytes followed subsequently by transplantation of nontransduced hepatocytes. Transplanted cells expressing Ad beta gal were rapidly cleared as before, whereas nontransduced hepatocytes engrafted with progressive liver repopulation. The findings indicated that adenovirally transduced cells are cleared early in the host liver. Use of ex vivo strategies will facilitate analysis of modified adenoviral vectors in the context of immunoregulatory, cellular and viral mechanisms.


Subject(s)
Adenoviridae/genetics , Genetic Therapy/methods , Genetic Vectors/administration & dosage , Liver Transplantation/immunology , Transfection/methods , Animals , Apoptosis , Host vs Graft Reaction , Immunohistochemistry , Rats , Rats, Inbred F344 , Transplantation, Isogeneic
10.
J Pathol ; 187(3): 365-73, 1999 Feb.
Article in English | MEDLINE | ID: mdl-10398093

ABSTRACT

To establish the differentiation potential of progenitor cells, non-parenchymal epithelial cells from the F344 rat liver (FNRL cells) were studied. These cells reacted with the OV-6 antibody marker of oval cells, but were negative for hepatocyte markers (albumin, transferrin, glycogen, glucose-6-phosphatase, H4 antigen), biliary markers (gamma glutamyl transpeptidase, cytokeratin-19), and alpha-fetoprotein, although exposure to sodium butyrate induced nascent albumin and alpha-fetoprotein mRNA transcription. When stably transduced, FNRL cells expressed a retroviral promotor-driven lacZ reporter in vitro, similar to transgene expression in hepatocyte-derived HepG2 cells. However, lacZ expression in FNRL cells was rapidly extinguished in intact animals, whereas the reporter remained active in HepG2 cells. Transplanted FNRL cells showed copious glucose-6-phosphatase expression; however, the cell differentiation programme remained incomplete, despite two-thirds partial hepatectomy, D-galactosamine treatment or bile duct ligation. Interestingly, lacZ expression resumed in cultures of FNRL cells explanted from recipients. Moreover, lacZ expression was down-regulated by gamma-interferon in FNRL cells, without affecting lacZ activity in HepG2 cells. The data indicate that although subpopulations of oval cells may not fully differentiate into mature hepatocytes, these cells might serve critical functions, such as glucose utilization, and help survival after liver injury. Also, introduced genes may be regulated in progenitor cells at multiple levels, including by interactions between regulatory sequences, differentiation-specific cellular factors, and extracellular signals; in vivo studies are thus especially important for analysing gene regulation in progenitor cells.


Subject(s)
Epithelial Cells/cytology , Gene Expression Regulation , Liver/cytology , Transgenes , Animals , Biomarkers/analysis , Cell Line , Diploidy , Interferon-gamma/pharmacology , Lac Operon , Male , Rats , Rats, Inbred F344 , Stem Cells/cytology
11.
Am J Physiol ; 276(5): G1260-72, 1999 05.
Article in English | MEDLINE | ID: mdl-10330018

ABSTRACT

In understanding mechanisms of liver repopulation with transplanted hepatocytes, we studied the consequences of hepatic polyploidization in the two-thirds partial hepatectomy model of liver regeneration. Liver repopulation studies using genetically marked rodent hepatocytes showed that the number of previously transplanted hepatocytes did not increase in the liver with subsequential partial hepatectomy. In contrast, recipients undergoing partial hepatectomy before cells were transplanted showed proliferation in transplanted hepatocytes, with kinetics of DNA synthesis differing in transplanted and host hepatocytes. Also, partial hepatectomy caused multiple changes in the rat liver, including accumulation of polyploid hepatocytes along with prolonged depletion of diploid hepatocytes, as well as increased senescence-associated beta-galactosidase and p21 expression. Remnant hepatocytes in the partially hepatectomized liver showed increased autofluorescence and cytoplasmic complexity on flow cytometry, which are associated with lipofuscin accumulation during cell aging, and underwent apoptosis more frequently. Moreover, hepatocytes from the partially hepatectomized liver showed attenuated proliferative capacity in cell culture. These findings were compatible with decreased proliferative potential of hepatocytes experiencing partial hepatectomy compared with hepatocytes from the unperturbed liver. Attenuation of proliferative capacity and other changes in hepatocytes experiencing partial hepatectomy offer novel perspectives concerning liver regeneration in the context of cell ploidy.


Subject(s)
Cell Division , Cellular Senescence , Hepatectomy , Liver/cytology , Polyploidy , Animals , Cell Transplantation , DNA/analysis , DNA/biosynthesis , Dipeptidyl Peptidase 4/genetics , Flow Cytometry , Kinetics , Liver Regeneration , Male , Mice , Mice, Inbred C57BL , Mice, Transgenic , Rats , Rats, Inbred F344
12.
Hepatology ; 29(2): 509-19, 1999 Feb.
Article in English | MEDLINE | ID: mdl-9918929

ABSTRACT

To establish the process by which transplanted cells integrate into the liver parenchyma, we used dipeptidyl peptidase IV-deficient F344 rats as hosts. On intrasplenic injection, transplanted hepatocytes immediately entered liver sinusoids, along with attenuation of portal vein radicles on angiography. However, a large fraction of transplanted cells (>70%) was rapidly cleared from portal spaces by phagocyte/macrophage responses. On the other hand, transplanted hepatocytes entering the hepatic sinusoids showed superior survival. These cells translocated from sinusoids into liver plates between 16 and 20 hours after transplantation, during which electron microscopy showed disruption of the sinusoidal endothelium. Interestingly, production of vascular endothelial growth factor was observed in hepatocytes before endothelial disruptions. Portal hypertension and angiographic changes resulting from cell transplantation resolved promptly. Integration of transplanted hepatocytes in the liver parenchyma required cell membrane regenesis, with hybrid gap junctions and bile canaliculi forming over 3 to 7 days after cell transplantation. We propose that strategies to deposit cells into distal hepatic sinusoids, to disrupt sinusoidal endothelium for facilitating cell entry into liver plates, and to accelerate cell integrations into liver parenchyma will advance applications of hepatocyte transplantation.


Subject(s)
Cell Transplantation , Endothelium, Vascular/physiology , Liver/cytology , Animals , Bile Canaliculi/ultrastructure , Cell Membrane/ultrastructure , Cell Survival , Cells, Cultured , Dipeptidyl Peptidase 4/analysis , Endothelial Growth Factors/analysis , Gap Junctions/ultrastructure , Hemodynamics , Immunohistochemistry , Kinetics , Liver/blood supply , Liver/enzymology , Lymphokines/analysis , Microscopy, Electron , Portal Vein/cytology , Portal Vein/diagnostic imaging , Radiography , Rats , Rats, Inbred F344 , Vascular Endothelial Growth Factor A , Vascular Endothelial Growth Factors
13.
J Biol Chem ; 274(4): 2157-65, 1999 Jan 22.
Article in English | MEDLINE | ID: mdl-9890978

ABSTRACT

Mechanisms directing position-specific liver gene regulation are incompletely understood. To establish whether this aspect of hepatic gene expression is an inveterate phenomenon, we used transplanted hepatocytes as reporters in dipeptidyl peptidase IV-deficient F344 rats. After integration in liver parenchyma, the position of transplanted cells was shifted from periportal to perivenous areas by targeted hepatic ablations with carbon tetrachloride. In controls, transplanted cells showed greater glucose-6-phosphatase and lesser glycogen content in periportal areas. This pattern was reversed when transplanted cells shifted from periportal to perivenous areas. Transplanted hepatocytes in perivenous areas exhibited inducible cytochrome P450 activity, which was deficient in periportal hepatocytes. Moreover, cytochrome P450 activity was rapidly extinguished in activated hepatocytes when these cells were transplanted into the nonpermissive liver of suckling rat pups. In cells isolated from the normal F344 rat liver, cytochrome P450 inducibility was originally greater in perivenous hepatocytes; however, periportal cells rapidly acquired this facility in culture conditions. These findings indicate that the liver microenvironment exerts supremacy over prior differentiation state of cells in directing position-specific gene expression. Therefore, persistence of specialized hepatocellular function will require interactions with regulatory signals and substrate availability, which bears upon further analysis of liver gene regulation, including in progenitor and/or stem cells.


Subject(s)
Cell Differentiation , Gene Expression Regulation , Liver/metabolism , Animals , Cell Transplantation , Cytochrome P-450 Enzyme System/metabolism , Liver/cytology , Liver/enzymology , Rats , Rats, Inbred F344
14.
J Rheumatol ; 21(7): 1192-6, 1994 Jul.
Article in English | MEDLINE | ID: mdl-7966056

ABSTRACT

OBJECTIVE: To independently confirm previous probe drug findings that patients with rheumatoid arthritis (RA) have defective oxidation of cysteine derivatives. METHODS: Measurement of cysteine dioxygenase substrate (cysteine) and product (sulfate) under controlled conditions, with elemental assessment by proton induced x-ray emission (PIXE). RESULTS: Plasma inorganic sulfate was significantly depressed in patients with rheumatoid arthritis (RA) compared to both controls and non-RA disease, 85 +/- 36 nm/ml vs 267 +/- 146 and 604 +/- 412 (mean +/- SD. RA patients vs non-RA disease p < 0.001). Fasting cysteine levels were significantly raised compared to controls (59 +/- 20 nm/ml vs 17 +/- 81 nm/ml p < 0.001). Synovial fluid (SF) sulfate was also significantly reduced in patients with RA compared to non-RA controls (202 +/- 117 nm vs 1041 +/- 700 p < 0.001). PIXE data confirmed the low sulfate levels in serum and SF while showing no reduction in the levels of other elements analyzed. CONCLUSIONS: These cysteine/sulfate findings confirm the validity of the previous probe drug abnormalities and the importance of defective cysteine dioxygenase activity in RA.


Subject(s)
Arthritis, Rheumatoid/metabolism , Sulfates/metabolism , Adult , Aged , Arthritis, Rheumatoid/physiopathology , Female , Humans , Male , Middle Aged , Reference Values , Spectrometry, X-Ray Emission , Sulfates/blood , Sulfoxides/metabolism , Sulfur/blood , Synovial Fluid/metabolism
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