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The cutaneous response to intradermal injection of monosodium urate crystals was investigated in 97 Urate crystal suspensions were injected intradermally into the flexor surface of the nonBarnes, S Yurdakul, S Atasoy, A Akcasu, dominant forearm. An equal volume of normal saline was injected into the opposite forearm. The pathergy test was also performed on the non-dominant forearm.4 The erythema which developed at each site was measured by weighing a paper template (using standard paper throughout) of the area at 24 and 48 hours after injection.9 The erythema was thus recorded as the weight of the paper in milligrams. Some patients and controls had erythrocyte sedimentation rate, total and differential leucocyte count, C reactive protein, and prealbumin concentrations estimated before and 24 and 48 hours after the urate injections. Body temperature was also recorded. STUDIES IN ENGLANDThe urate crystals were prepared by a similar method in Professor Dieppe's laboratory (Bristol, UK), and the same clinical methods were used. No haematological or biochemical tests were performed. ResultsNinety seven Turkish and 14 English patients with Behcet's syndrome, and 170 normal or diseased controls who gave informed consent to the investigation were studied. Table 1 shows the different quantities of urate crystals given by intradermal injection. STUDIES IN TURKEYInitially, 10 mg of urate crystals was injected intradermally into the forearm of 25 patients with Behcet's syndrome and 31 healthy controls. It was noted that at 48 hours the mean area of erythema in the patients was significantly greater than in controls (t=2 75, p<0-01), whereas they had been similar at 24 hours (figure). It was also found that the C reactive protein and erythrocyte sedimentation rate values before and after injection were significantly raised and the prealbumin concentrations depressed in patients compared with controls. Urate crystal injection was not associated with alterations in C reactive protein concentrations, erythrocyte sedimentation rate, white blood cell counts, or body temperature. Prealbumin concentrations both in female patients and female controls were affected at 24 hours, however. The mean (SD) baseline prealbumin concentrations of 185-0 (50-1)

The effects of intravenous (iv) administration of the synthetic opioid analgesic meperidine in conscious dogs and their relation to histamine stored in mast cells were studied in comparison with those induced by compound 48/80, potent mast cell degranulator. When 48/80 (0.5 mg/ kg) and meperidine (10 mg/kg) were injected iv into conscious dogs, an acute brief period of yelling, flare reaction, scratching, hypersalivation, urination, defecation, and tachypnea occurred after a latency of 30-35 sec. In addition, meperidine-treated dogs showed marked sedation. Dogs whose histamine stores were depleted by 48/80 manifested none of those effects induced by meperidine except sedation. Likewise, pretreatment with meperidine prevented the effects of a subsequent injection of 48/80. Sedation appeared to be independent of the histamine-releasing effect of meperidine, whereas other effects elicited by its intravenous injection of the drug were suppressed by 48/80 and thus were probably mediated via released histamine. We concluded that the peripheral effects of meperidine show histamine dependency and mast cells are a potential important site for the peripheral actions of meperidine as well.