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ID PMID Title PublicationDate abstract
7976741 [Clinical and radiological results with the spherical Mecring as acetabulum prosthesis in 1994 Aug The recent experiences which the university hospital in Heidelberg has made with the spherical Mecring must be valued positively. Clinical, radiological and subjective dates from 147 patients were worked up retrospectively. Indeed, the positive results must be considered as relative because of the short respectively medium-term period of control. Nevertheless, the repeated improvement in the second group after a period of postexamination on a average of 3.05 years lets hope for positive long-term results. In the period between 1985 and 1990 three sockets had to be changed. The reasons that the sockets loosened were not specific for the screwing but depending on the individual patients or on the implantations and technical circumstances. The negative results achieved by Engh et al. 1990 could not be recognized (8). He measured a radiological instability of 18% and a technical instability of 28%. What Engh did was measuring simple review photographs and extracting valuable material from them while using geometrical methods. This method shows various measuring mistakes. Therefore Engh's conclusion that the screwing should not be used for implantation because of its displacement in the bones is doubtful. The doubts seem to be supported by the results of our comparison of two series of X-ray photographs with defined different pelvis positions of the same patient. The screwing seemed to be significantly displaced in cranio-medial direction. This was proved by experimental photographs with a pelvis raised to 6 cm in contralateral direction. But the results were a matter of radiological illusion. Radiological migration of the screwing is only provable by complicated X-ray analyses steered with the computer. These big X-ray series are not accessible at the time.
8197755 [Determination of serum pepsinogen I and II for assessment of gastroduodenal tolerance of 1994 Therapy with non-steroidal anti-inflammatory drugs often causes gastroduodenal side effects. Changes in the gastric mucosa were studied by determination of serum pepsinogen I and pepsinogen II by the means of radioimmunoassay. 41 patients with degenerative rheumatic diseases were divided into two groups, 21 patients receiving 600 mg S(+) ibuprofen daily (3 x 200mg) and 20 patients receiving 900 mg S(+) ibuprofen daily (3 x 300 mg) over a 14-day period. No significant increase occurred in mean and median values of pepsinogen I and II. Indeed, no changes in serum pepsinogen I and II were noted in 80% of the patients in the higher dosage group and in more than 90% of the lower dosage group. None of the gastroduodenal side effects frequently reported during therapy with non-steroidal anti-rheumatic drugs occurred.
1417122 Action of sodium aurothiomalate on erythrocyte membrane. 1992 Aug The number of sulphydryl groups on the erythrocyte membrane has been assessed as a function of nutritional status for two groups of patients, one receiving non-steroidal anti-inflammatory drugs (NSAIDs) and the other receiving sodium aurothiomalate (Myocrisin). The patients receiving NSAIDs had a significantly higher number of sulphydryl groups in both the glucose depleted and glucose activated states than the patients receiving sodium aurothiomalate. The study focuses on the hexose transport protein where there is a specific binding site for gold using the two sulphydryl residues on helices 11 and 12 of the protein. The data suggest that the strong binding of gold to the erythrocyte membrane occurs via thiol pairs rather than by isolated sulphydryl groups and that there are possibly two further binding sites for gold on the membrane, the identities of which are still unclear.
1448746 Correlative histologic and arthroscopic evaluation in rheumatoid knee joints. 1992 Nov The correlation between arthroscopic observations and histologic changes in rheumatoid arthritis is still controversial. Synovial samples of 21 knee joints in rheumatoid arthritis patients were comparatively investigated by endoscopy and histology. Biopsies were scored by an endoscopist and subsequently dissected. Different histochemical and immunocytochemical staining techniques were used to define inflammatory activity. Arthroscopic and histological values were compared by rating scales and variance analysis. Our study indicates that synovial biopsy is of diagnostic value in rheumatoid arthritis. However, its usefulness depends on the histochemical methods used. The results revealed highly significant correlations of endoscopic features with the number of neutrophilic granulocytes, intravascular leukocytes, and peroxidase-positive macrophages. However, no relationship was found between the detection of lymphocytes or resident macrophages and inflammatory scores. The close correlation between endoscopic and histological findings suggests that arthroscopic evaluation allows a valuable classification of the inflammatory activity in rheumatoid synovitis.
8849387 Methotrexate-associated lymphoma in patients with rheumatoid arthritis: report of two case 1996 Feb This report describes 2 patients with longstanding seropositive rheumatoid arthritis (RA) treated with oral methotrexate (MTX) who developed large cell lymphoma of B cell phenotype. In situ hybridization studies showed nuclear staining for Epstein-Barr virus (EBV) within the malignant lymphoid cells. In both cases, the lymphoma was undetectable several weeks after diagnostic biopsy followed by discontinuation of MTX. These observations suggest that, in patients with RA who develop an EBV-associated lymphoproliferative disorder, a trial of discontinuation of immunosuppressive agents may be warranted before chemotherapy is considered. In addition, there is a need for a heightened awareness of the development of lymphoma in this patient population.
8610219 Relationships between measurements of impairment, disability, pain, and disease activity i 1995 Relationships between the results from shoulder movement impairment assessments, a shoulder-arm disability questionnaire, the disability indices Health Assessment Questionnaire (HAQ), Sickness Impact Profile (SIP) and Functional Status Questionnaire (FSQ), shoulder pain, and disease activity (ESR and the number of swollen joints) were analysed in a study evaluation outcome measurements to rheumatoid arthritis patients with shoulder problems. Sixty-seven women aged 24-82 years (mean 59.3) average disease duration 13 years were involved. The associations between shoulder movement impairment and HAQ, SIP physical and overall, FSQ and shoulder-arm disability questionnaire factor 1 were statistically significant, but of moderate magnitude (0.45 < or = r < or = 0.55, p or = 0.001). Shoulder pain correlated significantly but moderately to shoulder impairment and to FSQ (0.44 < or = r < or = 0.49, p < or = 0.001). Disease activity did not correlate to shoulder impairment, disability or shoulder pain. Despite some overlapping, impairment, disability, pain, and disease activity represent different areas and must be measured separately.
8778953 Differential expression of cytokine genes in CD27-positive and -negative CD4 lymphocyte su 1996 Immunofluorescence analysis of CD27 expression by CD4 lymphocytes from the peripheral blood of healthy humans or rheumatoid arthritis (RA) patients and from the synovial fluid (SF) of RA patients was carried out, along with the estimation of cytokine gene [interleukin (IL) 2, IL-3, IL-4, IL-5, IL-6, IL-6R, IL-10 and interferon-gamma (IFN-gamma)] expression in these lymphocyte subsets by RT-PCR. Although no differences in CD27-positive and -negative peripheral blood CD4 cell subset distribution were revealed, marked differences in IL-3, IL-4, IL-5 and IFN-gamma mRNA expression were detected between these lymphocyte subsets and between control and disease states. These results showed that phenotyping of different cell subsets in disease cannot provide adequate information about lymphocyte functional status. To estimate differences in cytokine gene expression, CD4 lymphocytes from the peripheral blood and SF of RA patients were compared. In both cases, mRNAs for IL-2, IL-4, IL-10 and IFN-gamma were detected, but CD4 cells from SF failed to express detectable levels of IL-5 mRNA despite our findings of a CD27-cell accumulation within the synovial population of CD4 lymphocytes. These are the first data to demonstrate that expression of the IL-5 gene in RA SF CD27- lymphocytes is down-regulated and that IL-5 disregulation in RA cannot be ruled out.
7537827 Immunologic assessment during treatment of rheumatoid arthritis with anti-CD5 immunoconjug 1995 Feb OBJECTIVE: To determine if sustained immunologic effects occurred after treatment of patients with rheumatoid arthritis (RA) with an immunoconjugate of murine anti-CD5 monoclonal antibody with ricin A chain (anti-CD5). METHODS: We measured lymphocyte populations, mitogen induced peripheral blood mononuclear cell (PBMC) stimulation, cytokine levels, immunoglobulin levels, in vivo immune function, and clinical outcomes in 9 patients with RA treated with anti-CD5. RESULTS: The treatment of patients with RA with anti-CD5 was associated with marked acute depletion of peripheral blood lymphocytes (p < 0.01) during and immediately after treatment. A sustained decrease in the number of CD3, CD4, CD5, and CD8 bearing lymphocytes persisted for 2 months after treatment (p < 0.05). After 3 months a mild decrease in the number of these lymphocyte populations persisted, but when compared to baseline values, the differences were not found to be statistically significant. Phytohemagglutinin induced PBMC proliferation was decreased at the 3-month followup (p < 0.05). Evaluations of mitogen induced cytokine and immunoglobulin production, immunoglobulin level, autoantibody, and in vivo antibody response to tetanus toxoid did not show any consistent change from baseline. CONCLUSION: Anti-CD5 treatment of RA appears to be associated with a decrease in the population of cells bearing CD5, but does not appear to induce any persistent immunologic abnormalities.
8907069 Cyclosporine, FK-506, rapamycin, and other immunomodulators. 1996 Feb Immunomodulatory agents represent a unique group of therapies that are not biologics and have relatively specific, noncytotoxic effects on the immune system. Cyclosporine has been the most widely tested of the immunomodulatory agents and shown efficacy in a variety of autoimmune diseases as well as monotherapy in established rheumatoid arthritis. FK-506 and rapamycin, agents similar to cyclosporine, are being tested in human transplantation, with only arthritis studies having been done in animals. Tilomisole, imuthiol, and mycophenolate mofetil have been studied in limited rheumatoid arthritis trials with positive effects. Although more specific and with manageable short-term side effects, this group of therapies requires more studies to establish their efficacy and long-term safety.
7489532 Spontaneous pericardial tamponade during PTCA. 1995 Nov A case of acute hemorrhagic pericardial tamponade complicating a successful percutaneous transluminal coronary angioplasty (PTCA) is described, in the setting of rheumatoid arthritis (with no evidence of prior or concomitant pericarditis), large doses of intravenous heparin administration and a relatively high activated clotting time. There was no evidence of coronary artery rupture and there was no recent use of other anticoagulants or thrombolytic agents. Successful treatment comprised emergency pericardial drainage and intravenous protamine sulphate. The authors believe this to be the first reported case of acute hemorrhagic pericardial tamponade due solely to heparin administration. The possibility of acute hemorrhage of a rheumatoid nodule was considered but subsequent magnetic resonance imaging scan with contrast gadolinium was normal.
8239453 [The role of MRI of the knee]. 1993 Imaging of the knee is one of the main indications of MRI in musculo-skeletal diseases. Some of the most recent papers dealing with MR imaging of the knee are discussed in this review article. Abnormal conditions reviewed are meniscal injuries including those occurring in previously operated menisci, osteochondral fractures, osteochondritis dissecans and rheumatoid arthritis.
8096419 Rheumatoid arthritis: a risk factor for sulphasalazine toxicity? A meta-analysis. 1993 Apr The disease RA itself is assumed to be a risk factor for the occurrence of adverse drug reactions during sulphasalazine therapy. A meta-analysis comparing treatment termination because of toxicity among RA, inflammatory bowel disease and seronegative spondylarthropathy patients was conducted. It is shown that RA itself does not appear to predispose to treatment discontinuation because of adverse reactions. Differences found in the incidence of side effects among the various disease groups can probably be explained by patient selection, particularly with respect to age, proportion treated for the first time with sulphasalazine, and dosage used. The side effect profiles in the three groups studied are not different. However, a trend towards greater haematological and hepatic toxicity in rheumatic patients is noticed.
8461240 A novel sustained-release formulation of ibuprofen provides effective once-daily therapy i 1993 Jan The efficacy and safety of a novel sustained-release formulation of ibuprofen given once-daily was compared with conventional-release ibuprofen tablets 400 mg given four times daily, in a single-blind, parallel-group study. This study was conducted at 84 general practice centres throughout the UK among patients with osteoarthritis or rheumatoid arthritis. An unequal randomisation in the ratio of 4:1 was carried out, with 463 patients who received sustained-release and 115 who received conventional-release ibuprofen providing evaluable data. In this study sustained-release ibuprofen was shown to be a more effective alternative to conventional ibuprofen therapy for the treatment of arthritic diseases in general practice, offering the convenience of once-daily dosing and the associated potential benefit of improved patient compliance.
8877917 Interleukin 1 (IL-1) receptor antagonist, soluble tumor necrosis factor receptors, IL-1 be 1996 Sep OBJECTIVE: To examine circulating levels of cytokines and cytokine inhibitors and their production by blood mononuclear cells (MNC) in patients with active rheumatoid arthritis (RA) before treatment with methotrexate (MTX) and inactive disease upon treatment as well as healthy control individuals. METHODS: Interleukin-1 receptor antagonist (IL-1ra), soluble tumor necrosis factor receptors p55 and p75 (sTNFr; p55 and p75), interleukin-1 beta (IL-1 beta), tumor necrosis factor alpha (TNF-alpha), interleukin-8 (IL-8), and monocyte chemoattractant protein 1 (MCP-1) were assessed by immunoassays in sera and MNC culture supernatants of 27 patients with RA with active disease before and 14 patients with inactive disease during MTX treatment, and 10 healthy controls. RESULTS: Levels of circulating IL-1ra, sTNFr p55 and p75 were higher in patients with active RA compared to those with inactive disease or controls. At the cellular level, resting MNC of patients with active RA released more IL-1 beta and IL-8, but less IL-1ra, and showed a lower ratio of IL-1ra:IL-1 beta than MNC of patients without inflammatory symptoms or healthy controls. In addition, unstimulated and in vitro lipopolysaccharide stimulated MNC cultures of patients with inactive RA released higher amounts of sTNFr p75 than MNC of patients with active RA. CONCLUSION: Circulating levels of IL-1ra and sTNFr as well as IL-1 beta, IL-8, and sTNFr p75 release from MNC and the ratio of IL-1ra:IL-1 beta production by these cells serve as markers to assess complete disease remission in patients with RA during MTX treatment.
7895392 Growth factor activity of IL-6 in the synovial fluid of patients with rheumatoid arthritis 1994 Nov OBJECTIVE: We set out to determine whether the ability of synovial fluids (SF) in patients with rheumatoid arthritis (RA) to facilitate the proliferation of synovial tissue-derived fibroblastic cell lines was related to the presence of growth factors and/or cytokines. METHODS: The growth factor activity of 20 RA SF was measured by their ability to induce anchorage-independent growth of the rat NRK-49F (49F) fibroblastic strain. The presence of transforming growth factor-beta (TGF-beta) and platelet-derived growth factor (PDGF) was also assessed using neutralising anti-TGF-beta or anti-PDGF-AB mAbs. Cytokines were measured by functional assays or ELISA: RESULTS: We observed a correlation between growth factor activity and the IL-6 levels in SF. Both were correlated to the erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) levels in SF and serum. IL-6 (at concentrations above 10(4) U/ml), synergized with growth factors in the induction of the anchorage independent (AI) growth of 49F cells. Pretreatment of SF with a neutralising anti-IL-6 mAb substantially reduced the capacity of these SF to induce AI growth of 49F cells, confirming the growth factor activity of IL-6 in this test. In contrast, IL-6 alone or in association with PDGF, epidermal growth factor (EGF) or TGF-beta had no effect on the anchored growth of synovial tissue-derived fibroblasts, and treatment of SF with a neutralising anti-IL-6 mAb did not affect their ability to increase the growth rate of synovial tissue-derived fibroblasts. CONCLUSIONS: These results strongly suggest that IL-6 is responsible for the observed correlation between the growth factor activity of SF and inflammatory indexes such as ESR and CRP. However, neither IL-6 nor PDGF were responsible for the observed positive effect of SF on synovial fibroblastic cell lines.
7857664 Oligonucleotide genotyping of HLA-DRB1 04 and HLA-DQB1 03 among Russians in west Siberia s 1994 To determine the HLA-DRB1 04 and HLA-DQB1 03 variants associated with rheumatoid arthritis (RA) among Russians who live in West Siberia, we studied patients with RA using the polymerase chain reaction and dot-blot hybridization with oligonucleotide probes. A significant increase was seen only for DRB1 0404/08, although the predominant variant in DR4+ RA patients was DRB1 0401. We found no significant difference in the DQB1 03 variants in RA cases when compared with controls. The results suggest that in the Russian-Siberian population RA is primarily associated with several DRB1 04 variants that share sequence identity in the third hypervariable region.
8975278 [Primary chronic polyarthritis of the knee joint]. 1996 Aug Rheumatoid arthritis is a chronic, multisystemic disease. The characteristic feature is persistent inflammatory synovitis. The knee joint is commonly involved with synovial hypertrophy, chronic effusion, and frequently ligamentous laxity. Pain and swelling behind the knee may be caused by extension of inflamed synovium into the popliteal space (Baker's cyst). Plain radiographs of the knee joint remain the basic radiological procedure, although early in the disease they might not provide significant changes. Sonography sufficiently reveals synovial fluid and Baker cysts, but cannot be recommended for evaluation of synovial proliferations or pannus formation. Computer tomography has only limited indications and may be used for the evaluation of subtle erosive lesions or the quantitation of osteoporotic changes. Magnetic resonance imaging has shown excellent visualization of cartilage, fluid, synovium and soft tissues and is the method of choice for the demonstration of early affection and the evaluation of pannus activity and therapy control. With administration of contrast agents (gadolinium), dynamic studies may demonstrate inflammatory activity. Modern MR sequences, such as T1 SE "fat sat" or magnetization transfer, further improve the discrimination of cartilage, pannus and synovial fluid.
7588815 NMR studies of the action of hypochlorous acid on native pig articular cartilage. 1995 Oct 15 The action of sodium hypochlorite on pig articular cartilage was studied by 1H-NMR spectroscopy to model some aspects of degradation processes of cartilage during rheumatoid arthritis. Two effects of NaOCl on cartilage polysaccharides have been observed. Hypochlorous acid causes an enhanced release of oligomeric polysaccharides from cartilage. The second effect concerns the degradation of N-acetyl side chains of carbohydrates to acetate via a chlorinated transient product. Signal intensities for N-acetyl groups (approximately 2.0 ppm) increase during the first 2 h of incubation of cartilage with NaOCl. Then they decrease again. However, acetate (1.90 ppm) as the final product of degradation of N-acetyl side chains increases continuously over the period of incubation with NaOCl. In addition to polysaccharides, effects of NaOCl were only observed in cartilage samples on amino acids like alanine. The alanine resonance disappeared already at NaOCl concentrations where only small effects on cartilage polysaccharides have been observed.
8871839 Association of methotrexate and corticosteroids in the treatment of patients with rheumato 1996 Jul OBJECTIVE: To investigate whether the association of methotrexate (MTX) and corticosteroids introduced concomitantly is more effective than MTX alone in patients with rheumatoid arthritis (RA). METHODS: Twenty-eight RA patients (group 1) were treated with MTX (mean dose: 10 +/- 1.4 mg/week) and corticosteroids (mean dose: 14.9 +/- 5.6 mg/day, range: 5-25) introduced concomitantly, and were compared to 251 RA patients (group 2) treated with MTX alone (mean dose: 9.8 +/-1.5 mg/week). Variations in the clinical (number of swollen and painful joints, morning stiffness, Ritchie's articular index), biological (ESR, CRP), and radiological parameters were studied. Remission was defined according to Pinals' criteria. At baseline, there were no significant differences between the two groups, except for a greater number of swollen and painful joints in group 1 (p = 0.03 and p = 0.01, respectively). The total MTX dose and the duration of treatment (26 +/- 21.8 months in group 1 versus 33.5 +/- 27.2) months in group 2) did not differ between the two groups. RESULTS: We noted a more marked reduction in the number of swollen and the number of painful joints in group 1 (p = 0.03). No differences were noted for the other clinical and biological parameters. The proportion of patients fulfilling Pinals' remission criteria was higher in group 1 (25% versus 10.1% in group 2, p = 0.04). The steroid dosage could be significantly reduced in group 1 (-3.4 +/- 6.1 mg/day, p = 0.05) and corticosteroids were stopped in 11 patients. The frequency and type of side effects, as well as the frequency and reasons leading to MTX withdrawal, did not significantly differ between the two groups. CONCLUSION: The association of MTX and corticosteroids seems to bring about a greater improvement in the different clinical activity parameters of RA than MTX alone, without any significant increase in the frequency of side effects. These results need to be confirmed in larger scale prospective studies.
1491485 [Pharmacokinetics of oral alminoprofen (Minalfen) in elderly patients with rheumatoid arth 1992 Nov The pharmacokinetics of oral Alminoprofen, a nonsteroidal anti-inflammatory drug, were studied in five elderly patients with rheumatoid arthritis and spondylosis deformans after 200 mg (three times a day) repeated dose for 5 days. The pharmacokinetic parameters after oral administration of Alminoprofen were analyzed by the one-compartment open model method. The maximum plasma concentrations (Cmax) were 16.1 +/- 2.5 micrograms/ml, after dosing on day 1, 25.2 +/- 1.6 micrograms/ml on day 3 and 21.6 +/- 2.7 micrograms/ml on day 5. The maximum time (Tmax) were about 2 hours after the medication in al cases. The area under the curve in drug concentration in plasma versus time (AUC) were 58.5 +/- 6.3 micrograms hr/ml on day 1, 58.5 +/- 3.1 micrograms hr/ml on day 3 and 58.1 +/- 8.5 micrograms hr/ml on day 5. The biological half-lives (t1/2) were 2.45 +/- 0.35, 2.09 +/- 0.82 and 2.49 +/- 0.63 hours, after dosing on day 1, day 3 and day 5, respectively. The analysis of moment in pharmacokinetics revealed that the mean residence time (MRT) on day 1, day 3 and day 5 observed were 2.31 +/- 0.03, 2.15 +/- 0.09 and 2.15 +/- 0.07 hours, respectively. The variance residence times (VRT) observed were 0.95 +/- 0.05 hour2 on day 1, 0.88 +/- 0.09 hour2 on day 3 and 1.06 +/- 0.07 hour2 on day 5. The ratios of accumulation calculated were 1.16 +/- 0.05 in both the morning medication on day 3 day 5, and it therefore appears that the steady-state equilibrium is established within 3 days after commencement of dosage.(ABSTRACT TRUNCATED AT 250 WORDS)