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ID PMID Title PublicationDate abstract
8283115 [Measurement of bone mineral density of metacarpal and phalangeal bones of the hand by dua 1993 Nov Bone mineral density (BMD) of the metacarpal and phalangeal bones of the hand was evaluated using dual X-ray absorptiometry (DXA) in 104 healthy subjects, 35 patients with rheumatoid arthritis (RA) and 6 young male volunteers with a short arm cast. BMD was positively correlated with the bone volume of metacarpal and phalangeal bones in skeletal specimens. In healthy subjects, the mean values for BMD of metacarpals of the index and middle fingers were significantly higher than those of the ring and little fingers (p < 0.001). The BMD of the middle proximal phalanx was the highest among the proximal phalanges. The BMD of the middle phalanges was the same pattern as in the proximal phalanges. There was no significant difference in the BMD of the distal phalanges between the fingers. In 62 healthy women aged from 22 to 82 years, BMD was at its peak in the metacarpal and proximal phalangeal bones in their thirties, and in the distal phalanges in their forties. Thereafter, BMD decreased linearly with age. In contrast, age-related changes in BMD were not shown in 42 healthy men aged from 22 to 76 years. BMD of the metacarpal and phalangeal bones in RA markedly decreased with disease stage. Four-week immobilization of the hand by a short arm cast affected BMD of the metacarpal bones in 6 healthy volunteers. The mean change in BMD was -4.1% after 4 weeks of immobilization, followed by a return to the initial value in 12 weeks after removal of the plaster. We concluded that the bone mineral measurement of metacarpal and phalangeal bones could be useful for evaluation of age-related bone loss and the deterioration of bone in metabolic disorders.
8741010 Augmented plasma and tissue kallikrein like activity in synovial fluid of patients with in 1996 Apr We studied some of the components of the kininogen-kallikrein-kinin system, simultaneously, in plasma and synovial effusions of patients with inflammatory articular diseases. Plasma and tissue kallikrein like activity and kininogen levels were evaluated. Active plasma and tissue kallikreins in plasma and synovial fluid were detected by their amidase activity upon specific chromogenic substrates. Kininogen levels were determined by a bioassay. Both specific amidase activity of plasma and tissue kallikreins were augmented in synovial effusions in relation to their own plasma activity. Kininogen levels in synovial fluid tended to be diminished in relation to plasma, however statistical significance was not reached. The consumption of kininogen is probably related to kinin production. This finding together with increased activities of plasma and tissue kallikreins reinforce the involvement of kinins in pathogenesis of inflammatory articular diseases.
1563144 Long-term results of the Manchester knee. Surface arthroplasty of the tibiofemoral joint. 1992 May Unicompartmental knee replacement is increasing in popularity. Long-term analysis of an early bi-compartment variety, the Manchester knee, therefore has relevance. One hundred fifty-six consecutive Manchester knee replacements were observed, 47 for longer than ten years. Using survivorship tables, the authors found that the annual failure rate did not increase during the ten-year period. The cumulative success rate was 73% for all knees and 69% for the osteoarthritic ones. The main cause of failure was subsidence. Correction of mechanical axis had no effect on the outcome. Polyethylene wear was not significant clinically or on measurement of retrieved specimens.
1396965 Evidence for oligoclonality of T cell receptor delta chain transcripts expressed in rheuma 1992 Oct The inflamed synovium of rheumatoid arthritis (RA) patients contains gamma/delta T cells which express predominantly T cell receptor (TcR) variable (V) delta 1 and V delta 2 chains. Such T cells may contribute to the pathogenesis of RA. To assess the extent of clonality among these T cell populations we sequenced the junctional regions of rearranged TcR V delta 1-C delta and V delta 2-C delta chain cDNA, after using the polymerase chain reaction (PCR) to amplify TcR delta chain transcripts isolated from synovial membrane mononuclear cells (SMC) of five RA patients. The sequences of these delta chain transcripts were compared with those found in peripheral blood mononuclear cells (PBMC) of the same patients and in PBMC of four healthy controls. In contrast to control PBMC, V delta 1 chain cDNA derived from PBMC of three patients showed a strong bias towards usage of the same V-joining (J) combination and junctional region sequences, although the specific sequences were unique in each patient. However, oligoclonality of the V delta 1 chain was less marked in SMC of two of these patients and absent in SMC of the other patients. For V delta 2, oligoclonality was detected in PBMC of two patients. In SMC of a single patient, a dominant V delta 2 transcript was detected that utilized the J delta 2 segment, which was rarely expressed in the normal TcR repertoire. These results indicate in vivo clonal expansion of V delta 1- and V delta 2-expressing gamma/delta T cells in the peripheral blood of RA patients and a synovial T cell infiltrate which consists largely of polyclonally expanded gamma/delta T cells, but shows clonal dominance in some patients. Our data strongly support a role for V delta 1+ and V delta 2+ gamma/delta T cells in the pathogenesis of RA, and, although the nature of the antigen(s) recognized by these cells remains elusive, this report suggests the potential involvement of antigen(s) specific for the V region and V-J junction.
1401808 Salvage for failed implant arthroplasty of the wrist. 1992 Sep We have had to revise 19 wrist arthroplasties--seven silicone implants and 12 metal-on-plastic total wrist arthroplasties. Each of the seven silicone implants was successfully revised in one operation; the four fusions and three total wrist implants were functioning 6 or more years after surgery. Nineteen operations were needed to revise the total wrist implants. Four had failed because of loosening, six had become unbalanced, and two had become infected. All of the loose prostheses eventually required fusion. Four of the unbalanced wrists were rebalanced, but two of these patients have pain; the other two cases required fusion. One infected wrist required fusion, and one is stable with an implant.
1433017 Association of methotrexate, rheumatoid arthritis and lymphoma: report of 2 cases and lite 1992 Sep We describe 2 Caucasian men with rheumatoid arthritis (RA) who developed non-Hodgkin's lymphoma of identical histological type during treatment with low dose oral weekly methotrexate (MTX). Both patients had longstanding RA and had been treated with MTX for over 2 years at time of tumor diagnosis; neither had secondary Sjögren's syndrome. The oncogenic potential of MTX and RA arthritis is reviewed.
1481577 [Aging of the immune system and sequelae for rheumatic diseases]. 1992 Nov Immunoreactivity is impaired in old individuals. This is due especially to a loss of signals as well as to a loss of corresponding receptors. Moreover, the regulation of the immune response is reduced. This causes an increase of infectious diseases and of autoimmunopathies. With regard to rheumatic diseases there is a significant decline of reactive states in contrast to the manifestation of autoimmune arthritis. However, this is modified by nonimmunological factors such as hormones, which explains the predominance of females.
1588759 [Felty's syndrome]. 1992 Mar Felty's syndrome is a variant of rheumatoid arthritis with a triad of leukopenia, splenomegaly and typical rheumatoid arthritis, and often accompanies the other extraarticular symptoms, such as subcutaneous nodules, lymphadenopathy, anemia, thrombocytopenia, leg ulcers, fever and weight loss. In addition to the decreased number of leukocyte, impaired functions of leukocytes were also revealed. These changes were considered as the cause of repeated infections, which was the major cause of death in Felty's syndrome. Splenectomy is not fully effective for leukopenia and for the repeated infection. Glucocorticoid therapy can increase leukocyte count, at least tentatively. It has been reported that gold was effective for leukopenia, repeated infection and skin ulcer. However, the definitive way of treatment of this syndrome based on the pathogenesis of this syndrome, remains to be established.
9110393 Quality of life in users of non-steroidal anti-inflammatory drugs. 1996 In clinical practice, non-steroidal anti-inflammatory drugs are used for a wide variety of painful conditions, in many of which inflammation is not a fundamental feature. Despite this they are favourably perceived by patients and limited data suggest that when used for relatively 'minor' conditions they are probably more effective than paracetamol. However, some patients develop life-threatening complications from these drugs. Assessment of Quality of Life (QOL) in NSAID users represents a balance between the adverse effects of the underlying condition, the QOL disturbance from side effects from NSAID use and the benefits and side effects of drugs used as prophylaxis against NSAID complications. The Health Assessment Questionnaire (HAQ) is a well-established scale measuring QOL in patients with rheumatoid arthritis, but there are fewer established instruments for use in patients using NSAIDs for other conditions.
8738592 Quantification of hemostatic proteins and activation products in synovial fluids from arth 1996 May Synovial fluids drawn from joints of patients suffering from rheumatoid arthritis were investigated for their concentrations of proteins and activation markers of the complement, coagulation and fibrinolytic systems. A broad spectrum of plasmatic inhibitors and other hemostatic proteins were detectable by immunologic assays. Compared to normal plasma concentration ranges, levels of alpha 2-antiplasmin, antithrombin III, heparin-cofactor II, factor H, alpha 2-macroglobulin, inter-alpha-trypsin inhibitor, fibrinogen and particularly high molecular weight kininogen were found to be decreased when corrected for total protein content. However, highly elevated levels of C-reactive protein, factor XIII, PMN-elastase, prothrombin fragment F1+2, thrombin-antithrombin III, plasmin-antiplasmin and terminal complement-complexes as well as C5a were determined. Eight and 24 hours after induction of chemical synoviorthesis, a general increase in most of the parameters was observed. Statistically significant alterations were found for C1-inhibitor, factor H, alpha 1-antitrypsin, inter-alpha-trypsin inhibitor, factor XIII, protein C, thrombin-antithrombin III complexes and C5a.
8316765 Human monoclonal IgG rheumatoid factors from the synovial tissue of patients with rheumato 1993 Jun We have established IgG rheumatoid factor (RF)-secreting hybridoma cell lines from the synovial tissues of two patients (TS and SJ) with rheumatoid arthritis (RA) and one (KL) with the polyarticular form of juvenile rheumatoid arthritis (JRA). The IgG RF bind human and rabbit IgG and all except one form intracellular complement-fixing complexes indicative of a self-association process. The possibility of IgG RF for self association and immune complex formation is a feature thought to be important for the inflammatory processes in RA. Of the IgG RF-secreting cell lines established, three clones from patient SJ and one from patient KL are of the IgG1 kappa isotype while five clones from patient TS are of the IgG2 lambda isotype.
10780895 Study of eosinophil-endothelial adhesion, production of oxygen radicals and release of eos 1993 Oct Beside lymphocytes and neutrophils, eosinophils are also involved in the inflammatory reaction in rheumatoid arthritis (RA). In this study, adhesion characteristics of peripheral blood eosinophils were studied in 43 RA patients and 19 controls, together with the expression of the beta2-integrin Mac-1 (CD11b/CD18). In addition, the production of oxygen radicals of isolated peripheral blood eosinophils and serum levels of eosinophil cationic protein (ECP) were measured in order to evaluate eosinophil activation. Adhesion of eosinophils to unstimulated human vascular endothelium was significantly higher in RA patients with active disease (n = 4) compared with controls (n = 14) (P < 0.005) and compared with patients with less active RA (n = 16) (P < 0.05). Nevertheless, the expression of the adhesion molecule Mac-1 (CD11b/CD18) was not increased in RA patients. ECP levels were higher in RA patients with active disease (P < 0.01). Release of oxygen radicals in response to phorbol stimulation was significantly elevated in active RA compared with controls (P < 0.05) and to less active RA (P < 0.05). We conclude that eosinophils of RA patients, especially those with active disease, are activated or at least primed and are involved in the inflammatory process in RA, analogous to the inflammation in asthma. The higher adhesion to inflamed endothelium is indicative of a higher infiltration in the joints, where tissue damage can be caused by toxic oxygen radicals and by granular proteins, such as ECP.
7812020 Subjective weighting of disability: an approach to quality of life assessment in rehabilit 1994 Oct The impact of various disabilities may differ greatly from individual to individual. Therefore, for a full assessment of a rehabilitee, objective aspects of disability should be supplemented with disability perception. The purpose of this study was to construct a self-administered questionnaire of 39 abilities/activities based on the ICIDH D-code, with parallel questions about '(dis)ability' and 'impact'. The instrument was used to obtain data from 60 disabled people. Fifty forms (83%) were returned from 25 patients with spinal cord injury and 25 patients with rheumatoid arthritis. Mean time to fill out the questionnaire was 24 minutes. A first attempt to validate the 'weighted score' with an open question about the most negative aspects of the disease showed a (very) good correspondence in 74%. An information gain as a result of the impact question was noted in 44%. This instrument has attractive properties for clinical use and research purposes in rehabilitation medicine. It was developed for the identification of needs of individual patients. The 'weighted scores' allow the setting of priorities in an individually tailored rehabilitation programme. Future applications might include monitoring the progress of a rehabilitee and identification of group needs.
8052828 [Cyclosporin in autoimmune diseases]. 1994 Jul 12 At a symposium held in Zurich in November 1993, a series of presentations covered the optimal use of cyclosporin A (CsA) in autoimmune diseases. Besides its immunosuppressive effects in organ transplantation, CsA appears to be active in a variety of autoimmune disorders. Its most pronounced and beneficial clinical effects are seen in patients with severe rheumatoid arthritis. New clinical studies include the nephrotic syndrome in children and patients with systemic lupus erythematodes. The main concern remains CsA induced nephrotoxicity. For the treatment of autoimmune disorders CsA can be used at lower doses (< or = 5 mg/kg per day) than in transplantation medicine. Thus, monitoring of CsA blood concentrations is not usually necessary. The galenics of CsA has been optimized recently, an achievement which will further improve the clinical use of CsA. Due to increased knowledge of intracellular CsA binding proteins and of effects of CsA on T-lymphocytes and cytokine production, it can be expected that novel immunosuppressive compounds will be developed.
8396184 [TNF and TNF receptors: structure, mechanism of action, role in disease and therapy]. 1993 Jul In this article, the topics on TNF and TNF receptors presented in the 4th International Conference on Tumor Necrosis Factor and Related Cytokines (Netherlands, May, 1992) are briefly summarized in Japanese, based on Dr. Benjamin Bonavida's report (Cancer Update, supplement 8, 1992) with permission. Following categorized themes were discussed in the meeting: 1) regulation of TNF synthesis, especially at the transcriptional level, 2) TNF receptors, including type I (55 kd), type II (75 kd) and soluble forms, 3) TNF cytotoxicity and immunomodulation with considerations for mechanisms, 4) TNF and infectious diseases such as Plasmodium falciparum infection, 5) TNF and inflammatory diseases such as rheumatoid arthritis and 6) TNF and cancer, in attempts to overcome drug resistance and TNF toxicity.
1296163 [Soluble interleukin-2 receptor assay is unhelpful in chronic inflammatory rheumatism]. 1992 Nov The level of soluble interleukin-2 receptors (SIL2-R), which reflects lymphocyte activation, is often described as a useful parameter for evaluating disease activity and progression in patients with inflammatory conditions. Serum SIL2-R was assayed using a sandwich ELISA method in 98 subjects including 38 controls (C), 36 patients with ankylosing spondylarthropathy (AS) and 24 patients with rheumatoid arthritis (RA). SIL2-R levels were higher in RA patients than in controls and AS patients (p < 10(-4)), whereas the difference between AS patients and controls was small (p = 0.02). In RA patients, SIL2-R levels were not correlated with any of the clinical or biological parameters studied and remained unchanged during clinical improvements. In the AS group, SIL2-R levels showed no correlations with inflammation parameters (CRP, IgA) and was similar in patients with and without HLA B27 or appendicular joint involvement. This study failed to provide any evidence that SIL2-R levels are helpful for monitoring patients with inflammatory joint disease.
8240665 Selection of T lymphocytes in two rheumatoid arthritis patients defines different T-cell r 1993 Oct To study the selective pressures responsible for the expansion of T cells in rheumatoid arthritis, we constructed cDNA mini-libraries from purified CD4+ and CD8+ T cells prepared from peripheral blood and from synovial fluids of two rheumatoid arthritis patients. Comparison of these libraries by hybridization with specific probes indicated that V beta 2 and V beta 8 transcripts are selectively enriched in the CD4+ synovial fluid lymphocyte population, while V beta 4 was over-represented among both the CD4+ and CD8+ subsets. The enrichment of V beta 14 and V beta 17 observed in synovial fluid T cells of one patient was, however, selectively confined to the CD8+ T-cell subpopulation. Sequence analysis of several V beta 2, V beta 4 and V beta 8 clones, derived from CD4+ cells, revealed a high degree of heterogeneity in the V beta-D beta-J beta junctions, while a more biased utilization of J segments and a more restricted junctional heterogeneity were observed in V beta 4, V beta 14 and V beta 17 clones derived from CD8+ cells. These data suggest that the disease may be induced by the initial activation of a rather heterogeneous population of T-helper cells that are later responsible for the expansion of a more restricted pool of highly specific effector lymphocytes.
8617987 Human CD4-internal antigen anti-idiotypic monoclonal antibody: induction of a CD4-specific 1996 May 1 We previously showed that anti-idiotypic mAb (mAb2) F16-16D7 (16D7) to the paratope (or paratope-related idiotope) of the anti-CD4 mAb HP2/6 induces anti-CD4 Abs in BALB/c mice. In view of the potential ability of 16D7 to induce anti-CD4 Ab in humans and the potential benefits of anti-CD4 Abs in the treatment of autoimmune diseases, we evaluated the immunologic response to and assessed the safety of four 2-mg 16D7 s.c. injections in one patient with systemic lupus erythematosus (SLE) and one with rheumatoid arthritis (RA). 16D7 induced anti-isotypic and anti-anti-idiotypic Abs (Ab3), which were almost exclusively of the IgG isotype. Ab3 specifically reacted with 16D7 as they inhibited its binding to mAb HP2/6. Although Ab3 did not react with cellular or recombinant CD4 (rCD4), single-cell enzyme-linked immunospot assays of anti-CD4 Ab production revealed many more spot-forming cells in rCD4- and 16D7-coated wells than in wells coated with BSA or 16D7 isotype-matched MK2-23. Spot-forming anti-CD4 Abs were specifically induced by 16D7, since rCD4-dependent spot formation 1) was not observed with PBL from one patient with SLE, one with mixed connective tissue disease, and one with melanoma immunized with MK2-23; and 2) was inhibited by 16D7 and not by MK2-23. Spot-forming anti-CD4 Abs recognize a CD4 epitope identical (or closely related) to that seen by HP2/6, since this specifically inhibited spot formation. A substantial, although transient, CD4+ T cell depletion was only observed in the RA patient. Local and/or general toxicity and laboratory and/or clinical signs indicative of immunodepression or diseases relapse were not observed during an 18-month follow-up.
8517073 [Use of an improved transmission ultrasound camera for diagnosis of rheumatic joint diseas 1993 Mar Transmission (TM) sonography allows a reliable and fast imaging of soft tissues like joint capsules and tendons, especially of hands and feet. Bony structures appear blurred, but serve as landmarks for easy orientation on the ultrasonic images. The quality of imaging allows a reproducible measurement of joint capsule parameters. Inflammatory alterations of joints are recognized earlier than with conventional x-rays. TM sonography contributes to the diagnostic panel for rheumatic diseases, which involve soft tissues and joints of hands and feet. Today, TM sonography cannot compete with conventional reflex sonography in general arthrosonography, but it is an interesting addition. Follow-up studies will show whether objective joint parameters available by TM sonography may help to both indicate disease progression and to monitor therapeutic interventions in rheumatic diseases.
1605539 [Secondary bronchogenic pulmonary hydatidosis]. 1992 Secondary bronchogenic hydatid disease is a rare and little known complication of primary hydatid cyst of the lung, which is even refuted by some authors. We report 7 cases of secondary bronchogenic hydatid after surgical cure of a hydatid cyst which had ruptured into the bronchi, while the last case concerned a young girl who was treated by corticosteroids for rheumatoid arthritis and who developed secondary bronchogenic hydatid from a cyst rupturing into the bronchi in the absence of surgery. Hydatid dissemination was ipsilateral to the primary cyst in 5 cases, controlateral in one case and bilateral in one case. Five patients underwent radical surgery. The patient with bilateral dissemination was operated on one side and a large number of residual cysts were eliminated by vomica, as for the last patient; these two patients are still under surveillance. The operation and general anaesthesia played a predisposing role in the pathogenesis of this complication and inhibition of immune mechanisms could also play a role. Prevention is necessary when treating a hydatid cyst of the lung which has ruptured into the bronchi. Treatment is surgical, bearing in mind that a large number of secondary cysts can be eliminated by vomica or may involute spontaneously.