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ID PMID Title PublicationDate abstract
7806929 Partial radiocarpal arthrodesis. 1994 Oct Eight patients underwent partial radiocarpal arthrodesis for various wrist disorders. There were 5 men and 3 women, whose age at operation ranged from 33 to 59 years with an average of 44 years. The indications for operation included post-traumatic changes secondary to distal radius fracture in 5 cases, Kienböck's disease in 1, Madelung's deformity in 1, and rheumatoid arthritis in 1. Arthrodesis was performed at the radiolunate joint in 5 cases, and at the radioscapholunate joint in 3 cases. In all cases, bone union was obtained within 3 months postoperatively. Postoperative wrist pain disappeared in 6 cases, and decreased in 2 cases. The average postoperative flexion-extension arc of motion was 35 degrees in the radioscapholunate arthrodesis group, and 85 degrees in the radiolunate arthrodesis group. The postoperative grip strength compared with the unaffected hand averaged 51% in the radioscapholunate arthrodesis group, and 68% in the radiolunate arthrodesis group. One patient showed a deterioration in the osteoarthritic change in the midcarpal joint.
7806792 Simultaneous proximal row carpectomy and radius to distal carpal row arthrodesis. 1994 Sep We assessed the functional results of simultaneous proximal carpal carpectomy and radius to distal carpal row arthrodesis. A retrospective review of patients undergoing wrist arthrodesis for degenerative joint disease was performed. Patients with rheumatoid arthritis or spastic hemiplegia were excluded. Simultaneous proximal row carpectomy and radius to distal carpal row arthrodesis was performed in 38 patients using AO plates and 3.5 mm diameter screws. The mean follow-up time was 16 months, the fusion rate was 100%, and the average grip strength was 24 kg force or 79% of the contralateral hand measured at 10 degrees wrist extension. Patients with three or more screws placed in the metacarpal had significantly more plate-related complications and a higher rate of plate removal than those with two screws distally. Simultaneous proximal row carpectomy and radius to distal carpal row arthrodesis did not decrease the postoperative grip strength.
7933582 [Histopathological and immunohistochemical diagnosis of intractable vasculitis syndromes]. 1994 Aug Vasculitis has a simple definition--primary inflammation of the blood vessels, often with necrosis and occlusive changes--but its clinical manifestations are diverse and complex. In the absence of pathognomonic clinical features and laboratory tests, the diagnosis of vasculitis relies heavily on the correct interpretation of histologic changes but these too may not be specific in any given case. A positive biopsy is always helpful whereas a negative biopsy does not exclude the disease under consideration because the vasculitis may be focal and segmental in distribution, as in polyarteritis nodosa. Pathologic and immunohistochemical characteristics of some of the major categories of systemic vasculitis were described; 1) polyarteritis nodosa; 2) Churg-Strauss syndrome; 3) hypersensitivity vasculitis; 4) Wegener's granulomatosis; 5) Kawasaki disease; 6) malignant rheumatoid arthritis; 7) systemic lupus erythematosus; 8) scleroderma; 9) polymyositis-dermatomyositis; 10) mixed connective tissue disease; 11) polyangiitis overlap syndrome; 12) giant cell arteritis; 13) Takayasu arteritis; 14) Behçet disease; 15) Buerger disease; and 16) inflammatory aortic aneurysm. Each of these major vasculitic syndromes has its own unique histopathologic features, but overlap still occurs.
8045480 Nutrition and health aspects of free radicals and antioxidants. 1994 Jul Although the role of free radicals has continued to capture the imagination of scientists, the interest in nutritional aspects of free radicals is relatively recent. Oxidative stress, which often arises as a result of the imbalance in the human antioxidant status, has been implicated in ageing and in a number of human diseases such as cancer, atherosclerosis, malaria and in rheumatoid arthritis. This review discusses the current status of free radicals in nutrition and dietary antioxidants and considers the possibility that use of a range of antioxidants, which have been carefully evaluated, combined with methods for measuring oxidant generation, would help to delineate the contribution of nutrients to the modulation of the consequences of free radicals in the human body.
7966067 Clinical utility and serological connections of anti-RA33 antibodies in systemic lupus ery 1994 Jul OBJECTIVE: To determine whether the autoantibody anti-RA33, first identified in patients with rheumatoid arthritis, could define a subset of patients with lupus. METHODS: Sera from 30 patients with systemic lupus erythematosus (SLE), including serial bleeds from 8 patients were tested for anti-RA33 antibodies by immunoblotting. The results were compared to a wide range of SLE clinical features using the British Isles Lupus Assessment Group system and serological abnormalities. RESULTS: 12 of the 30 patients had RA33 antibodies. Their presence was associated with erosive arthropathy, and a lack of dermatological involvement in patients less likely to be Caucasian. CONCLUSION: The presence of anti-RA33 antibodies appears to identify a subset of patients with SLE.
8000057 Antispermatogenic effect of Tripterygium wilfordii and tripchlorolide (T4) on rat gametoge 1994 Jun The multiglycosides of Tripterygium wilfordii (TII), a ready-made Chinese herbal medicine used for the treatment of rheumatoid arthritis, have been shown to cause oligospermia in patients. In the present study, the antifertility effects of TII and tripchlorolide (T4, isolated from TII) were observed in male rats. In rats fed with TII at a dose of 10 mg.kg.d for 7 weeks, the seminiferous tubules were essentially not influenced. However, most of the sperm heads along the surface of the tubular lumen were transformed from the normal sickle-shaped to round shaped, suggesting a possible mutagenic action. There was minimal testicular change but prominent epididymal spermatozoa damage in all rats treated with T4 (0.05 mg.kg.d) for 7 weeks. The epididymal spermatozoa showed various structural abnormalities, including disrupted connecting pieces and cracked midpieces, and more than 80% of the spermatozoa were decapitated. No significant changes were seen in the main visceral organs. The data suggest that T4 may have good prospects as a male contraceptive.
8307913 Patterns of rheumatic diseases and antirheumatic drug usage in 11931 Indian patients. 1993 Sep Patterns of rheumatic diseases and antirheumatic drug usage in different regions of India were analysed. The data was collected from a post-marketing surveillance of diclofenac sodium (Voveran) in 11931 patients. The common conditions were-rheumatoid arthritis (RA) 28.1%, osteoarthrosis (OA) 24.8%, soft-tissue rheumatism 12.4%, cervical spondylosis 6%, ankylosing spondylitis (AS) 3.5%, gout 2%. East zone had a significantly lower proportion of osteoarthritis (20.9%). The age distribution and sex ratios of RA, OA and AS were in line with literature reports. The severity of illness was moderate in 62% and duration was more than 6 months in 50.2%. Data on NSAID usage showed a preponderance of combinations and ibuprofen. There were no significant differences in NSAID usage across diseases or regions.
1566161 Atlantoaxial arthrodesis using interlaminar clamps. An improved technique. 1992 Mar The atlantoaxial articulation is a multiaxial joint with a freedom of motion that presents unique problems in achieving surgical stability. Several methods of atlantoaxial arthrodesis have been established with varying degrees of immediate and sustained stability and safety. This study describes a new, improved method of posterior atlantoaxial arthrodesis, using (Halifax) interlaminar clamps with interposed bone graft, which provides distinct benefits over existing techniques. This method achieved atlantoaxial union within 12 weeks in 80% of the study's patients (20/25). The clamp fixation was revised in two patients, with subsequent fusion. Three other patients required revision surgery for nonunion due to loosening of the clamp. This was usually caused by incomplete tightening of the screws, with subsequent loosening or dislocation of the device. Possible clamp loosening is a potential problem with the currently available system, and may be a result of the clamp design. Techniques to minimize this risk and suggestions for improvement in the device are discussed. Nonunion is more likely to develop in patients with rheumatoid arthritis. If nonunion occurs, the pseudarthrosis is generally between the posterior bone graft and the ring of C1.
9273379 Use of acetabular models in planning complex acetabular reconstructions. 1995 Oct The number of patients requiring revision total hip arthroplasty continues to increase each year. Accurate preoperative planning is a key factor in obtaining a good result. Radiographs provide little information concerning the actual extent of the acetabular defects. Computed tomography-generated models of the acetabulum can provide the surgeon with accurate information concerning the size and location of the defects. Evaluation of radiographs and models in 24 cases showed that radiographs alone failed to detect all 13 anterior wall defects (P < .001), 8 of 18 posterior wall defects (44.4%, P < .001), and 8 of 19 segmental central defects (42%, P < .001), all of which were easily identified with the models. This study showed that preoperative planning based on the foam models accurately predicted the actual implant used in 22 of 24 cases (92%).
1576670 Lobenzarit disodium (CCA) inhibits in vitro immunoglobulin production via direct interacti 1992 Jan The regulatory effects of lobenzarit disodium (CCA), a therapeutic agent for treating rheumatoid arthritis (RA), on polyclonal immunoglobulin production by human lymphocytes were investigated in vitro. CCA inhibited the production of immunoglobulin in all the classes examined at a clinically relevant concentration. Moreover, it inhibited the immunoglobulin production as well as lymphocyte proliferation even when purified B lymphocytes preactivated by Staphylococcus aureus COWAN I were cultured with recombinant lymphokines such as IL2 and IL6. These results suggest that CCA acts directly on B lymphocytes. The analysis at each of two different stages of B lymphocyte activation lineage, i.e., the primary activation stage and a stage of proliferation and differentiation to antibody secreting cells, has indicated that CCA inhibits the proliferation-differentiation stage of B lymphocytes. CCA does not inhibit B lymphocytes at the primary activation stage; actually, it augments them, resulting in the subsequent enhancement of immunoglobulin production.
9213718 [Which patients should be treated with plasma exchange? Indications for plasma exchange th 1996 Nov What is the current opinion on therapeutic plasma exchange, after 20 years of clinical use for numerous patients and disease states? Principles of rational therapy have broken through into the field of therapeutic plasmapheresis during the last decade. Efficacy proven by controlled clinical trials is the prerequisite for determining indications. Superiority of plasma exchange over other therapeutic modalities has been established for only a limited number of rare diseases. Plasma exchange treatment is still actual for plasmatic hyperviscosity syndromes in the course of haematological and rheumatological diseases. Indications for therapeutic plasma exchange in nephrology are narrowed to some forms of Goodpasture's syndrome, rapidly progressive glomerulonephritis with antineutrophil cytoplasmic antibodies and renal insufficiency, and thrombotic thrombocytopenic purpura/haemolytic uraemic syndrome. Plasma exchange therapy is indicated for severe forms of Guillain-Barré syndrome and myasthenia gravis. Therapeutic benefit of plasma exchange was not found by controlled clinical trials in patients with rheumatoid arthritis, systemic lupus erythematosus, polymyositis, dermatomyositis, multiple sclerosis and rejection of kidney allotransplant.
8718920 [Antineutrophil cytoplasmic antibodies (ANCA): study of their presence in diseases not ass 1996 Jun Our study describes the presence of antineutrophil cytoplasmic antibodies (ANCA) in a group of different pathologies comprising 101 patients. Rheumatoid arthritis, systemic lupus erithematosus, idiopatic neutropenia, acute post-streptoccocal glomerulonephritis, minimal change nephrotic syndrome, Downs syndrome, adult periodontitis, tumoral calcinosis, monoartheritis and lipodystrophy were investigated for ANCA, through indirect immunofluorescence and an indirect solid-phase immunoassay (ELISA). Our results show the pattern of distribution of ANCA in the diseases investigated, and allowed us to make the first description of ANCA in diseases such as Downs syndrome, acute post-streptococcal glomerulonephritis and adult periodontitis. The high percentage of reactivity for ANCA detected in adult periodontitis, raise important questions about the possibility of reporting inaccurate percentages of positivity for some diseases, due to the presence of a concurrent disease such as adult periodontitis.
8731781 [Value of cyanoacrylate tissue adhesives in peripheral corneal ulcers of inflammatory orig 1996 PURPOSE: To investigate cyanoacrylate tissue adhesives in ulcerative keratitis. They represent one of the best emergency treatments of corneal descemetoceles, preperforated corneal ulcers, impending corneal perforations and small corneal perforations. METHODS: Nine patients presenting with peripheral ulcerative keratitis were treated by this method between 1990 and 1994. The underlying diseases included Mooren's ulcer (5 eyes), rosacea (2 eyes) and rheumatoid arthritis (2 eyes). RESULTS: Despite the poor prognosis of ulcerative keratitis, good healing and corneal re-epithelialization were obtained in 6 cases (66%) without any relapse. Severe infectious complications occurred in 1 case (11%) and required a therapeutic penetrating keratoplasty. CONCLUSIONS: Cyanoacrylate tissue adhesives are an effective and well tolerated treatment of peripheral ulcerative keratitis associated with ocular inflammatory diseases. Potential infectious complications impose a strict follow-up.
8586896 [A case of itraconazole-induced hypokalemia with pulmonary aspergilloma]. 1995 Dec A case of itraconazole-induced hypokalemia with pulmonary aspergilloma is reported. A 68-year-old female who had been followed for rheumatoid arthritis, gastric ulcer and pulmonary aspergilloma was admitted to our hospital because of a cough, low grade fever and hemosputum. She was treated with itraconazole (100 mg/day) for pulmonary aspergilloma of the left upper lobe. Fifty seven days after starting the treatment, her serum potassium was 2.33 mEq/l. Since there was no history of diarrhea, vomiting or abuse of drugs known to cause hypokalemia, itraconazole- induced hypokalemia was suspected. Thirty one days after the discontinuation of the treatment with itraconazole, her serum potassium increased to 3.57 mEq/l without potassium supplement. The lymphocyte stimulation test for itraconazole was negative. This case suggests that serum potassium should be monitored in the patients treated with itraconazole.
8489373 Geriatric rehabilitation. 3. Mid- and late-life effects of early-life disabilities. 1993 May This self-directed learning module highlights mid- and late-life effects of early-life disabilities. It is part of the chapter on geriatric rehabilitation in the Self-Directed Medical Knowledge Program for practitioners and trainees in physical medicine and rehabilitation. This article contains information on how to evaluate, prevent, and manage late complications seen in adults and older adults with cerebral palsy, spina bifida, spinal cord injury, multiple sclerosis, juvenile rheumatoid arthritis, and early-life amputations, including psychosocial and other quality-of-life issues. New advances in post-polio syndrome are also covered.
1441954 Hyperthermia during occipito-cervical fusion with acrylic cement. Epidural thermometry in 1992 Oct In 22 patients, 23 posterior occipito-cervical fusions using acrylic cement were studied; 18 had seropositive rheumatoid arthritis and 4 traumatic atlanto-axial instability. The mean age was 60 (39-75) years. During the curing of the cement, epidural temperature measurements were performed over the cerebellum and between the foramen magnum and C1. Temperatures up to 69 degrees C were recorded. Cooling with profuse surface irrigation using normal saline solution or precooled 8 degrees C fluid did not influence the maximal temperatures recorded under the cement. Even though no gross neurological damage was noted, the epidural temperatures in occipito-cervical fusion with acrylic cement can be of sufficient degree to be hazardous; surface irrigation does not seem to be an effective way to reduce this risk.
1550369 Incidence of alopecia areata in lupus erythematosus. 1992 Mar BACKGROUND: A small percentage of patients with alopecia areata have connective diseases such as systemic lupus erythematosus, discoid lupus erythematosus, rheumatoid arthritis, and scleroderma. Lupus erythematosus is associated with a number of different types of alopecia, but the incidence of alopecia areata in lupus erythematosus has not been examined. OBSERVATIONS: Of our cohort of 39 patients with lupus erythematosus, alopecia areata developed in 10% (four patients), in contrast to 0.42% of general dermatologic patients. Biopsy specimens of alopecia areata lesions in each of our patients showed continuous granular deposition of IgG at the dermoepidermal junction, a finding usually found in only a minority of alopecia areata cases. Intralesional injections of corticosteroids were effective treatment. CONCLUSIONS: The incidence of alopecia areata in patients with lupus erythematosus is increased. Recognition of this form of alopecia allows for specific therapy with intralesional corticosteroids.
1376864 Acute subdural hematoma in young patient with moyamoya disease--case report. 1992 Feb A 17-year-old boy with known moyamoya disease developed an acute subdural hematoma after a mild head trauma. He had been confined to a wheelchair with contracture in the upper and lower extremities due to juvenile rheumatoid arthritis since age 1 year. He had undergone encephalo-duro-arterio-synangiosis (EDAS) on the right and encephalo-myo-synangiosis (EMS) on the left at 13 years of age. He was admitted with headache, nausea, and vomiting after a fall from his wheelchair at age 17. Computed tomography on admission showed a large acute subdural hematoma in the right fronto-temporal region but no bleeding at the EDAS or EMS sites. Cerebral angiography 12 weeks after the head trauma revealed a remarkable reduction in the spontaneous transdural external-internal carotid anastomoses in the right frontal region. The acute subdural hematoma was probably caused by rupture of the spontaneous transdural anastomoses.
8893375 Autoantibodies and target antigens in antineutrophil cytoplasmic antibody (ANCA)-associate 1996 In this study of antineutrophil cytoplasmic antibody (ANCA)-associated diseases, we determined the prevalence of other autoantibodies and the antigen specificities of ANCA. ANA were common, occurring in 7 of 36 (19%) patients with Wegener's granulomatosis, in 16 of 34 (47%) patients with microscopic polyarteritis, in 6 of 11 (55%) patients with segmental necrotising glomerulonephritis and in 8 of 18 (44%) of those with ANCA-associated systemic vasculitis without renal involvement. ANA were associated more often with pANCA and microscopic polyarteritis than with cANCA (P < 0.05). Patterns were speckled (n = 23), homogeneous (n = 10) or nucleolar (n = 4). Anticardiolipin antibodies were also common, occurring in 10 of 25 (40%) patients with Wegener's granulomatosis, in 8 of 14 (57%) patients with microscopic polyarteritis and in 6 of 18 (33%) of those with a systemic vasculitis. However, anticardiolipin antibodies did not correlate with the presence of ANCA in any of the disease groups. Anti-GBM antibodies were demonstrated in only 2 of 25 (8%) patients with Wegener's granulomatosis, in 1 patient with microscopic polyarteritis (1/14, 7%) and in 1 with segmental necrotising glomerulonephritis (1/11, 9%). All four patients with anti-GBM antibodies had either cANCA or pANCA. In the second part of the study, the target antigens of ANCA were determined in Wegener's granulomatosis, microscopic polyarteritis, systemic vasculitis, inflammatory bowel disease, rheumatoid arthritis and systemic lupus erythematosus (SLE). Of the 19 sera with cANCA, 13 (68%) were directed against proteinase 3; other antigens were myeloperoxidase (1/19, 5%), elastase and lactoferrin together (1/19, 5%), lysozyme (1/19, 5%) or unknown (3/19, 16%). Of the 12 (58%) sera from patients with Wegener's granulomatosis who had cANCA, 7 bound to proteinase 3. Antimyeloperoxidase antibodies were present in 14 of 45 (31%) sera with pANCA; other antigens were proteinase 3 (5/45, 11%), elastase (3/45, 78%), lactoferrin (1/45, 2%), cathepsin G (5/45, 11%) or unknown (17/45, 38%). Antimyeloperoxidase antibodies were common in microscopic polyarteritis (6/14, 43%) and systemic vasculitis (5/16, 31%). However, the majority of target antigens in systemic vasculitis and rheumatoid arthritis with pANCA were not determined. "Atypical" ANCA were present in four patients, one with inflammatory bowel disease (1/8, 13%) and three with SLE (3/15, 20%). The specificities were cathepsin G, cathepsin G plus lactoferrin, or unknown in two sera. A recent report has suggested that bactericidal/permeability-increasing protein may be the target in patients with inflammatory bowel disease.
8726668 Circulating serum levels of IL-1ra in patients with relapsing remitting multiple sclerosis 1996 May Interleukin (IL)-1 receptor antagonist (IL-1ra) is a naturally occurring inhibitor of IL-1 which binds to IL-1 receptors without generating immunologic responses. Evidence has recently been provided that the balance between the production of IL-1 and IL-1ra might influence the course of immunoinflammatory diseases such as inflammatory bowel diseases, rheumatoid arthritis (RA) and Lyme arthritis. To assess whether endogenous IL-1ra may also have a role on the course of multiple sclerosis (MS) we presently studied the fluctuation of the serum levels of IL-1ra in patients with relapsing remitting (RR) MS either during remission or exacerbation. Moreover, to evaluate whether the beneficial effect of IFN-beta on the course of MS might also be mediated by an increased production of IL-1ra, we measured the levels of circulating IL-1ra in MS patients prior to and after 6 months of continuous treatment with natural human IFN-beta (6,000,000 IU three times a week for 6 months). Our results demonstrated that, relative to control subjects, IL-1ra serum levels are "normal' during remitting phases of RR MS but significantly elevated either during exacerbations or in response to IFN-beta treatment.