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ID PMID Title PublicationDate abstract
8569606 Salivary gland scintigraphy in patients with primary Sjögren's syndrome. 1993 Methodology, interpretation and results of salivary gland scintigraphy in 33 patients with primary Sjögren's syndrome (pSs) are presented. Patients were divided in two groups: 14 patients with isolated pSs and 19 patients with pSs and extraglandulary manifestations. There was no correlation between scintigraphic findings and duration of disease, and between scintigraphic findings and presence of recurrent swelling of parotid glands. The damage of salivary glands, detected by scintigraphy, was more marked in patients with pSs and extraglandulary manifestations than in patients with isolated pSs.
1617905 Cerebral involvement in adult onset Still's disease. 1992 Jun Still's disease was diagnosed in a 40-year-old patient as a cause of psycho-organic syndrome with complete disorientation and stupor, sensory and motor aphasia. There were no signs of a tumour, cerebrovascular accident, bacterial or viral infection. The patient recovered quickly from the cerebral disturbances under treatment with corticosteroids. Similar symptoms in adult patients with Still's disease are seldom found in the literature.
7497658 Evolution of the quadriceps snip. 1995 Dec Between May 1990 and December 1992, the quadriceps snip was used to assist in the surgical exposure of the knee in 16 patients (4 women and 12 men) who underwent knee surgery at the average age of 65 years (range, 50-73 years). The original diagnoses included osteoarthritis (12 patients), traumatic arthritis (2 patients), rheumatoid arthritis (1 patient), and psoriatic arthritis (1 patient). The surgical exposure was done in the treatment of aseptic loosening of a total knee prosthesis in 8 patients, septic loosening in 2 patients, and primary knee arthroplasty in 6 patients with fibrous ankylosis. Using the Hospital for Special Surgery Scoring System, the authors rated the knees of 10 patients as excellent and those of 6 patients as good at postoperative evaluation. The range of motion was improved in all knees by an average of 30 degrees. Cybex testing revealed significant weakness of the knee in extension when compared with the contralateral normal side at test speeds of 60 degrees and 180 degrees per second but no difference compared with the opposite knee that had been replaced. In the authors' experience, the surgical technique of a quadriceps snip has been safe and simple, has not required special equipment, and postoperatively the patient's physical therapy has not had to be altered. Clinically, the quadriceps strength was very good, although weaker than that of a contralateral normal leg when measured by Cybex testing.
8271326 Ankle arthrodesis. 1993 Sep As a fused ankle provides a painless ankle joint with limited functional disability, ankle arthrodesis is still the treatment of choice for most disabling ankle arthritis. From January 1987 to December 1990, 45 cases of ankle arthrodesis were performed, including 27 male and 18 female patients, aged from 18 to 70 years with an average of 41.9 years. The causes leading to arthrodesis included 19 cases of post-traumatic arthritis, 3 rheumatoid arthritis, 7 osteoarthritis, 9 ankle infections (4 pyogenic and 5 tuberculosis), 4 ankle deformities, 2 avascular necrosis of the talus and 1 cases of Charcot joint. The methods included modified Blair's ankle arthrodesis (34 cases), compression arthrodesis (7 cases) either by Hoffman external fixation or triangular compression device, and intra articular arthrodesis by staple fixation (4 cases). The follow up period ranged from 17 Ms to 52 Ms with an average of 28.6 Ms. There were 2 cases who ultimately required amputation due to uncontrollable infection, and 2 cases of nonunion and one of them received refusion. There were 11 cases of delayed union (union time more than 6 Ms). The average union time was 5.6 Ms, ranging from 2 Ms to 10 Ms. Excluding the cases of amputation and nonunion, all patients had improvement in the ankle functional scale evaluation and 85.3% of the patients were satisfied with their present condition. The modified Blair's method of ankle arthrodesis has proven to be an effective method for treating ankle arthritis no matter what the cause. However, for cases of infection, compression arthrodesis with an external fixational device is superior.(ABSTRACT TRUNCATED AT 250 WORDS)
8555022 Impaired sweating as an exocrine manifestation in Sjögren's syndrome. 1995 Nov To examine the prevalence of hypohidrosis and to quantitate sweating as an exocrinopathy in Sjögren's syndrome (SS), 49 patients with SS (primary form, 38; secondary form, 11) were studied. Sweating was induced by mental stimulation such as deep breathing or hand grasping. Statistically significant reductions of sweat volume were seen in SS (P < 0.005). Patients under 50 years old showed impaired sweat function compared with normal controls (P < 0.0005). In a control study, only haemodialysis patients showed impairment of sweating and this was greater than in patients with SS aged under 50 years. These results suggest that patients with SS develop impaired sweating as an exocrine manifestation in addition to the known symptoms of xerostomia and xerophthalmus.
8385717 [Reassessment of usefulness of salivary scintigraphy in diagnosis of Sjögren's syndrome]. 1993 Feb Dynamic salivary scintigraphy using 99mTcO4- was performed in 95 patients (a total of 366 glands) suspected of Sjögren's syndrome (SjS) and the results were compared with SjS diagnostic criteria by the Japanese Welfare Ministry. Time-activity curve of ROI created over each salivary gland was classified into four patterns, that is, N, M1, M2, F pattern, depending upon trapping, accumulation and secretion response to the tartaric acid. In definite SjS patients, most of the patients had different patterns in the four glands, and classical F (flat) pattern in all of the four glands was uncommon (3/38, 8%). F and/or M2 (no response to secretary stimulation) patterns were seen in 68.5% (98/143) of the all glands. Provided that F and/or M2 patterns in 2 or more glands is scintigraphic criteria for diagnosis of SjS, sensitivity, specificity and accuracy were 82.9%, 59.5%, 70.8%, respectively. As for salivary uptake of 99mTcO4-, there is a significant difference between the patients with definite SjS and control subjects (parotis p < 0.05, submandibular gland p < 0.01), but there is no significant difference among the patients with definite SjS, suspected SjS and chronic sialoadenitis. In conclusion, the four patterns classification may have potential in screening patients with SjS.
1357863 Significance of tubuloreticular structures in infants with neonatal lupus erythematosus an 1992 Four infants with neonatal lupus erythematosus who had annular erythema on the trunk and face reacted positively to tests for anti-Ro(SS-A)/La(SS-B) antibodies. Electron microscopic examination of vascular endothelial cells in the annular erythema revealed the presence of tubuloreticular structures. Once anti-Ro(SS-A)/La(SS-B) antibodies had turned negative, these tubuloreticular structures were no longer evident in the vascular endothelial cells in the same area where annular erythema had been present. Mothers of these 4 infants reacted positively to anti-Ro(SS-A)/La(SS-B) antibodies, but had no sicca syndrome. A biopsy taken from the minor salivary gland of the lip of each mother revealed marked periductal mononuclear cell infiltration. Primary subclinical Sjögren's syndrome was confirmed. Tubuloreticular structures were also observed in the vascular endothelial cells in the region of the minor salivary gland. These findings suggest that the presence of tubuloreticular structures may be related to anti-Ro(SS-A)/La (SS-B) antibodies.
8064769 Drug management of arthritis in the elderly. 1994 Rheumatic disorders are common in the ageing population requiring the use of DMARDs and immunosuppressive therapy as with younger patients. Indications for therapy are approximately the same in both groups, but toxic side-effects are probably more common in the elderly necessitating close supervision of indications and drug requirements. Local injection techniques The practice of local injection of corticosteroid in musculo-skeletal disorders is widespread. The literature on comparative efficacy between different preparations is scanty. These techniques can give significant relief in rheumatoid arthritis, osteoarthritis, sero negative arthropathies, crystal induced arthritis and many soft tissue lesions. Severe joint and soft tissue lesions are common in the elderly. In these patients even a small loss of physical function may have a markedly detrimental effect on independence. Such lesions should therefore be actively sought and vigorously treated. Often a simple, rapidly acting, local corticosteroid injection is preferable to a prolonged course of either NSAIDs or physiotherapy. In general, such injections should not be used if the diagnosis is uncertain, or there is any suspicion of infection, or if there has been a previous severe local reaction. Injections that are becoming too regular mean that the technique has not proved successful and other therapies should be sought. In performing the injections, antisepsis should be scrupulous and a 'no-touch' technique used. Accuracy of needle placement is necessary for good results. Injections should not be given against pressure as this generally means incorrect sitting. Some systemic absorption does occur.(ABSTRACT TRUNCATED AT 250 WORDS)
8424834 Production of monocyte chemotactic protein-1 in human type B synoviocytes. Synergistic eff 1993 Jan OBJECTIVE: Since local secretion of chemotactic factors could contribute substantially to the homing of monocytes to the rheumatoid synovium, we investigated the ability of type B, or "fibroblast-like," synoviocytes isolated from the synovial tissue of patients with rheumatoid arthritis to synthesize and secrete the novel cytokine monocyte chemotactic protein 1 (MCP-1). METHODS: Synthesis and secretion of MCP-1 was determined by immunoprecipitation following metabolic labeling of MCP-1 with 35S-cysteine. MCP-1 gene regulation was assessed by Northern blot analysis. RESULTS: Unstimulated type B synoviocytes released little or no MCP-1, although low levels of MCP-1 messenger RNA (mRNA) were detected. However, incubation of these cells with tumor necrosis factor alpha (TNF alpha) resulted in a time- and dose-dependent release of MCP-1 into the supernatant, and expression of MCP-1 mRNA. Use of cycloheximide and actinomycin D confirmed that TNF alpha was inducing MCP-1 expression at both the transcriptional and translational levels. Treatment of the synoviocytes with interferon-gamma (IFN gamma) also stimulated an increase in both the steady-state levels of MCP-1 mRNA, as well as MCP-1 protein synthesis and secretion. In addition, TNF alpha and IFN gamma in combination exerted a synergistic effect on both MCP-1 mRNA accumulation and protein secretion. CONCLUSION: These studies demonstrate that the MCP-1 gene is regulated by TNF alpha and IFN gamma in type B synoviocytes and indicate that these cells may play an important role in the recruitment of inflammatory cells to the rheumatoid synovial environment, via the production of novel chemotactic cytokines such as MCP-1.
7955604 Cartilage contribution to gender differences in joint disease progression. A study with ra 1994 Jul OBJECTIVE: Rheumatoid arthritis is associated with a worse prognosis in females and is influenced by sex hormone changes. Similar observations in osteoarthritis support the hypothesis that gender differences in cartilage make a hitherto unrecognized contribution to gender differences in arthritis. The aim of the present study was to investigate potential gender differences in articular cartilage biochemistry, metabolism and response to inflammatory mediators. METHODS: Femoral head cartilages from age-matched male and female Wistar rats were analysed for the water, glycosaminoglycan, hydroxyproline and collagen crosslink contents. Proteoglycan loss and synthesis were assessed in vitro, and in the presence and absence of serum and interleukin-1. An in vivo model of inflammation-induced cartilage degradation was employed to investigate gender differences in cartilage susceptibility to erosion caused by granulomatous tissue. RESULTS: Articular cartilage from male Wistar rats presented higher levels of both proteoglycan and collagen and showed a lower spontaneous glycosaminoglycan loss and higher proteoglycan synthesis in vitro than cartilage from females. Proteoglycan synthesis from female, but not male, cartilage was significantly stimulated by foetal calf serum. Female cartilage was more sensitive to IL-1 inhibition of proteoglycan synthesis while the opposite was observed in IL-1-induced proteoglycan loss. Female cartilage was more susceptible to granuloma-induced degradation than male when implanted into female mice, but no differences were observed between male and female cartilage implanted in male mice. CONCLUSION: These results demonstrate important gender differences in cartilage biochemistry, metabolism and susceptibility to inflammatory mediators which may have important consequences for the joint destruction in arthritis and support a role for hormone therapy.
8301522 Evaluation of autoantibodies to brain proteins in patients with AIDS dementia complex. 1994 Feb A high frequency of autoantibodies to brain proteins has been reported in HIV-1-positive patients. However, the specificity of this response has not been characterized. Using homogenized tissue from three normal brains, the presence of autoantibodies to human brain proteins was analyzed in 16 HIV-1-positive patients with AIDS dementia complex (ADC), 10 HIV-1-positive patients without ADC, 10 patients with multiple sclerosis, 10 patients with juvenile rheumatoid arthritis, and 10 normal controls. Although antibodies to various brain proteins were detected in sera from one-third HIV-1-infected individuals with or without ADC, the proteins recognized were different among different brains. Only one ADC patient had consistent seroreactivity to a 50-kDa brain-specific protein. Our results indicate that autoantibodies to brain proteins are infrequently present in patients with ADC.
8871846 Incidence of chronic juvenile rheumatic diseases in Finland during 1980-1990. 1996 Jul OBJECTIVE: To study trends in the incidence of juvenile rheumatoid arthritis (JRA) and to obtain information on the incidence of other juvenile rheumatic diseases in Finland. METHODS: The present study covered those subjects entitled under the nationwide sickness insurance scheme to receive specially reimbursed medication for juvenile rheumatic diseases in 5/21 central hospital districts in Finland (population base about 270,000 children < 16 years of age) in 1980, 1985 and 1990. RESULTS: A total of 114 incident cases (34 boys, 80 girls) satisfied the criteria for JRA during the three study years: 1980, 1985 and 1990. Seven of the patients had systemic-onset disease. The incidence of JRA remained similar (14/100,000 in the population < 16 years of age). The female: male ratio was 2.4: 1. Only one case of juvenile spondyloarthropathy was found. Seven patients had juvenile systemic lupus erythematosus and four had juvenile dermato/polymyositis. The corresponding annual incidence rates were 0.1, 0.9 and 0.5/100,000, respectively, in this population. CONCLUSION: The present study provides population-based figures on the occurrence of various chronic arthritic syndromes in childhood using a unified data base. The incidence of JRA remained quite similar for the three study years. The incidence figures for systemic rheumatic and connective tissue diseases were slightly higher than those reported in previous studies.
7980680 Deficiency of the beta subunit of the eighth component of complement presenting as arthrit 1994 Nov A 13-year-old boy presented with juvenile chronic arthritis of 6 months' duration. Antinuclear antibodies, anti-double-stranded DNA antibodies, and rheumatoid factor were not detected. Western blotting showed a deficiency of the beta subunit of the eighth component of complement. The same deficiency was present in the patient's sister. C8 beta deficiency is usually detected in individuals who survive meningococcal disease. There was no such history in this family. Juvenile chronic arthritis has not previously been described in patients with C8 beta deficiency.
7562749 Lipopolysaccharide binding protein as a marker of inflammation in synovial fluid of patien 1995 Jul OBJECTIVE: To determine levels of lipopolysaccharide binding protein (LBP) in serum and in synovial fluid (SF) of patients presenting with various articular disorders [degenerative arthritis, rheumatoid arthritis (RA), reactive arthritis (ReA)] and to correlate these levels with C-reactive protein (CRP) and interleukin 6 (IL-6), 2 markers of the acute phase response. METHODS: LBP was measured by a radioimmunoassay made up of lipopolysaccharide (LPS) to capture LBP and radiolabelled anti-LBP antibodies to detect LBP. LBP was also measured for its ability to present fluorescein isothiocyanate LPS (FITC-LPS) to human monocytes. CRP was measured by nephelometry and IL-6 bioassay. RESULTS: Levels of LBP in serum and in SF were significantly higher in patients with RA and ReA than in the control group of degenerative arthropathies. In the latter group, LBP values were similar to those found in controls. Serum LBP values correlated positively with SF LBP values. LBP values also correlated with CRP and IL-6 levels measured in SF. Functionally, LBP was found to be active and able to present LPS to monocytes, resulting in tumor necrosis factor-alpha (TNF-alpha) release upon LPS challenge. CONCLUSION: These in vitro data support the observation that LBP could play a major role in local joint disorders. Our results also strengthen the view that LBP may be a new marker of synovial inflammation.
8446416 [Serum keratan sulfate studies and their significance in the evaluation of cartilage degra 1993 Feb 28 Fragments of high density cartilage proteoglycan (aggrecan) are released during either the normal or pathological turnover of cartilage proteoglycans, which fragments diffuse into the synovial fluids and then appear in the serum. The keratan sulphate (KS; a glycosaminoglycan side chain of aggrecan) is resistant to enzymatic degradation, it has a relatively low clearance and has a "standard" serum level indicating the actual level of cartilage (proteoglycan) breakdown. Using anti-KS monoclonal antibody in ELISA (enzyme-linked immunosorbent assay), we measured serum KS levels in patients with different joint diseases. The highest KS content (595 ng/ml) was measured in the sera of patients with articular chondrocalcinosis (calcium pyrophosphate crystal deposition disease/pseudogout). Slightly lower KS levels were determined in osteoarthrosis (OA; 578 ng/ml) and much less in rheumatoid arthritis (RA; 421 ng/ml). All these patient groups (either with degenerative or inflammatory joint diseases) expressed slightly higher KS levels compared to control blood donors (295 ng/ml). However, there were remarkable variations between these diseased groups, i. e., KS levels in patients with RA were significantly lower than in patients with OA (p < 0.001) and this difference was more pronounced in rheumatoid patients with I-II Steinbrocker stage (370 ng/ml) or in those treated with non-steroid anti-inflammatory drugs (NSAIDs) (382 ng/ml). Keratan sulphate levels in RA patients chronically treated with corticosteroid (460 ng/ml) or auro-thiomalat (473 ng/ml) indicate that these drugs may influence the cartilage metabolism more effectively than the NSAIDs.(ABSTRACT TRUNCATED AT 250 WORDS)
8823714 Propionibacterium acnes isolated from sternal osteitis in a patient with SAPHO syndrome. 1996 Jul A woman presented with palmar pustulosis and deep chest pain in association with osteitic lesions in the lower part of the sternum. Propionibacterium acnes was isolated and grew in pure culture from 6 surgically obtained bone specimens. The patient received clindamycin treatment for 6 months. Synovitis in both her wrists persisted and, based on a clinical suspicion of seronegative rheumatoid arthritis, she was treated with intramuscular gold and methotrexate with no apparent benefit. Subsequently, she was diagnosed with SAPHO syndrome (synovitis, acne, pustulosis, hyperostosis, and osteomyelitis). Our patient provides further data on the potential association between P. acnes and SAPHO syndrome.
8688665 The immunopathology of psoriasis. 1996 Jul Psoriasis affects approximately 2% of the population in Western countries. Although clinically rather monomorphic, the disease presents with a number of phenotypically distinct and heterogeneous subgroups showing differences in their pathogenetic pathways. Patients with type I (early onset) psoriasis demonstrate inflammatory lesions with epidermal hyperproliferation and the presence of activated T cells as well as intraepidermal polymorphs as principal features. In contrast to pustular types of psoriasis, these patients show genetic susceptibility and strong association with MHC class I and class-I haplotypes. There is evidence for a T-cell-mediated pathomechanism leading to a large spectrum of regulatory mediators including cytokines and growth factors as well as lipid mediators which are abnormally expressed. Pathogenetically psoriasis shows features in common with chronic relapsing T-cell-mediated diseases including Crohn's disease, rheumatoid arthritis and others.
8650624 [Vision disorders in inflammatory-rheumatic diseases]. 1996 Jan The association of visual disturbances and rheumatic disease has been known for centuries. This review provides a synopsis of the ocular conditions that are associated with inflammatory rheumatic disease. The major ophthalmic manifestations of the rheumatic diseases include keratoconjunctivitis sicca, ulcerative keratitis, scleritis, uveitis, retinal vascular disease, and neuro-ophthalmic lesions. Each of these ocular conditions is most characteristically associated with a few, but not all, of the rheumatic disorders. Scleritis, for example, is most often seen with rheumatoid arthritis or with vasculitis. Acute anterior uveitis is most often seen with the seronegative spondylarthropathies. Retinal vascular and neuro-ophthalmic lesions are seen with disorders having either a vaso-occlusive component, such as systemic lupus erythematosus, or with one of the vasculitides. Important considerations for a successful collaboration between ophthalmologists and physicians/rheumatologists are discussed.
8620682 Cutaneous amyloidosis in patients with progressive systemic sclerosis. 1996 Jan It is rarely reported that amyloidosis occurs as a complication of progressive systematic sclerosis (PSS), in comparison with rheumatoid arthritis (RA). We observed pigmentation on the upper back of six of sixty-six patients with PSS (9 percent), and recognized amyloid deposits in the skin on histochemical and electron microscopic examinations. These amyloid deposits were localized cutaneous type, according to results of morphologic and immunologic studies. Patients' levels of serum amyloid A were normal or moderately elevated. Two of the six patients had Barnett type I disease and four had Barnett type II; none had severe visceral involvement with PSS.
8534309 The arthroscopic appearance of lipoma arborescens of the knee. 1995 Oct Lipoma arborescens is a rare intra-articular lesion consisting of a villous lipomatous proliferation of the synovial lining. This case report draws attention to the history, physical findings, and arthroscopic appearance of lipoma arborescens, a rare lesion of the synovial lining of the knee. Arthroscopically, the lesion appears as a synovial lesion with numerous fatty-appearing globules and villous projections. In addition, magnetic resonance imaging is a valuable tool to differentiate the lesion from rheumatoid arthritis, pigmented villonodular synovitis, and synovial chondromatosis in those patients who present with a chronic, swollen, and painful joint.