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ID PMID Title PublicationDate abstract
8997927 Back pain in osteoarthritis of the knee. 1996 Oct OBJECTIVE: To compare patients with knee osteoarthritis (OA) who have and do not have back pain, and evaluate the prevalence, characteristics, and consequences of back pain among knee OA patients. METHODS: During a 3-year period, consecutive patients attending an outpatient rheumatology clinic were evaluated for the presence of back pain, and 368 were found to have OA of the knee. Clinical status was evaluated by the Clinical Health Assessment Questionnaire, radiographs, and joint examinations. RESULTS: Back pain was present in 54.6% of patients with OA of the knee. Almost every clinical status measure was worse among those reporting back pain, including Health Assessment Questionnaire (HAQ) disability, pain, global severity, fatigue, and psychological status. Back pain was more common in women and the obese, but was not associated with age, marital status, formal education, smoking history, or knee radiographic scores. In multivariate analyses the strongest correlates of back pain in knee OA patients were anxiety, night pain, HAQ disability, and global severity. CONCLUSION: Back pain is prevalent among OA clinic patients, more common than in rheumatoid arthritis or population studies, is linked to body mass index, and is associated with clinically significant increases in pain and other measures of clinical distress.
8533525 Epidemiology of interstitial lung disease (ILD) in flanders: registration by pneumologists 1995 Worldwide almost no epidemiologic data are available on the prevalence or incidence of interstitial lung diseases (ILD) in the general population. Therefore, a registration programme of ILD-prevalence was organised by the VRGT (Vereniging voor Respiratoire Gezondheidszorg en Tuberculosebestrijding), among about 100 Flemish pneumologists since 1990. Most categories of the classification by Crystal et al. (1) were included and the diagnostic criteria (histology, laboratory tests, clinic, radiology) were registered. The present paper presents the results of 1992-1994: twenty pneumologists had forwarded the summary files of 237 patients to the central office in 1992 (n = 68), 1993 (n = 90) and 1994 (n = 79). The diagnoses that were most frequently made were: sarcoidosis in 27%, idiopathic pulmonary fibrosis in 20%, hypersensitivity pneumonitis in 14% (of which 68% by birds) and collagen-vascular disease in 10% (of which 54% in rheumatoid arthritis). Less frequent causes were eosinophilic pneumonia (4%), inhalation of inorganic material (4%, anthracosilicosis being excluded), histiocytosis X (3%), drugs (3%), angiitis and granulomatosis (2%), pulmonary hemosiderosis (1%), lymphocytic infiltrative lung disease (1%) and lymphangioleiomyomatosis (1%). The order of relative frequencies of the different categories of diseases was the same in the 3 registration years. In 9% of the patients the diagnosis was confined to "undefined fibrosis". The diagnosis was confirmed by histology in 63% of the cases. The overall male-female ratio was nearly one, with, however, a male preponderance in hypersensitivity pneumonitis (22/12), UIP(8/3) and "undefined fibrosis" (14/7).(ABSTRACT TRUNCATED AT 250 WORDS)
1390947 Aurothioglucose inhibits induced NF-kB and AP-1 activity by acting as an IL-1 functional a 1992 Oct 13 We have designed a series of recombinant CAT genes to study IL-1 signal transduction in murine fibroblast NIH 3T3 cells. We demonstrate that the HSV thymidine kinase (tk) promoter does not respond to IL-1, but that IL-1 induction of this promoter is observed after insertion of either NF-kB or AP-1 binding sites upstream of the HSV tk cap-site. We have studied the effects of indomethacin, dexamethasone and aurothioglucose (which have been used in the treatment of patients affected by rheumatoid arthritis) in the IL-1 inducible CAT assay. We show that aurothioglucose or dexamethasone is able to inhibit IL-1 induced CAT activity whereas a non-steroidal anti-inflammatory drug (indomethacin) is inactive. Order of addition experiments indicate that aurothioglucose, which has disease-modifying activity in treated patients, acts as an IL-1 functional antagonist in this system.
1373621 Isolation and culture of synovial microvascular endothelial cells. Characterization and as 1992 Apr OBJECTIVE: In vitro studies investigating the role of the synovial endothelium in the pathogenesis of rheumatoid arthritis (RA) have, until recently, been performed using cultured endothelial cells of nonsynovial macrovascular origin. In an attempt to more correctly model in vivo conditions, a method for the isolation and culture of synovial microvascular endothelial cells (SMEC) has been developed. METHODS: SMEC were isolated, primarily, by the use of lectin-coated (Ulex europaeus agglutinin type I), magnetizable polystyrene beads. RESULTS: Isolated cells exhibit classic endothelial "cobblestone" morphology, express von Willebrand factor, metabolize acetylated low-density lipoprotein, and exhibit a cytokine (interleukin-1)-mediated expression of endothelial leukocyte adhesion molecule type 1 (ELAM-1) and intercellular adhesion molecule type 1 (ICAM-1). ELAM-1 levels were significantly elevated in SMEC, compared with human umbilical vein endothelial cells, over a range of interleukin-1 concentrations. CONCLUSION: This increased expression of ELAM-1 by SMEC may be a potentiating step in the pathogenesis of RA.
1370417 Specificity and T cell receptor beta chain usage of a human collagen type II-reactive T ce 1992 Jan Collagen type II (CII) is a cartilage-specific matrix compound well known as an inducer of an experimental, T cell-dependent autoimmune arthritis, a disease which shows some similarities to human rheumatoid arthritis. Here we report on an HLA-DR7-restricted human CD4 T cell clone (TC9), which was isolated from a healthy donor and recognizes human CII. After screening CNBr fragments of CII and tryptic fragments derived thereof, the T cell epitope could be mapped to amino acid residues 271-285 of the triple helical region of CII that are located within CNBr fragment 11 [alpha 1 (II) CB11]. This epitope was confirmed by a synthetic peptide stimulatory for TC9. The T cell receptor beta chain of TC9 was cloned using the polymerase chain reaction; it comprises V beta 6.7 and contains besides J beta 2.3 and C beta 2 an as yet undescribed sequence for the D segment.
8969557 [A case of an old woman with Sjögren's syndrome associated with insulin-dependent diabete 1996 Oct Insulin-dependent diabetes mellitus (IDDM) is thought to result from the autoimmune destruction of the insulin-dependent beta cells of the pancreas. Sjögren's syndrome is also an autoimmune disease characterized by the destruction of the lacrimal and salivary glands that leads to keratoconjunctivitis sicca and xerostomia. But it is a very rare case that a patient with Sjögren's syndrome developed IDDM. We present a case of a 65-year old woman with Sjögren's syndrome who developed diabetic ketoacidosis due to IDDM. Recent studies have revealed that there was molecular mimicry between glutamic acid decarboxylase (GAD) and coxsackievirus. Furthermore, some reports have shown that sialadenitis was represented in IDDM model mice. This case shows the possibility that a causal relationship between IDDM and Sjögren's syndrome may exist.
8883435 Parotid gland ultrasonography as a diagnostic tool in primary Sjögren's syndrome. 1996 Oct The diagnostic value of parotid gland ultrasonography (Acuson 128, 7 MHz transducer) was studied in 62 patients with primary Sjögren's syndrome (SS) and in 69 controls of similar age and sex distribution. Different degrees (mild, evident or gross) of parenchymal inhomogeneity (PIH) were the most important sonographic changes in SS; they occurred in 83.9% of the patients. The sonographic results (the presence or absence of PIH) were in accordance with the parotid sialographic and scintigraphic findings and the histology of the minor salivary glands in 87.3, 84.7 and 84.3% of the cases, respectively. Of the degrees of PIH, only evident and gross PIH are thought to be of true diagnostic value for SS. On the basis of the good agreement between the sonographic and sialographic results, consideration of the introduction of parotid sonography as an alternative to sialography is suggested in SS if the latter method cannot be performed.
7496343 Ophthalmological tests in patients with keratoconjunctivitis sicca with and without associ 1995 Sep We compared clinical, laboratory and histological tests in patients with keratoconjuctivities sicca with and without association of primary Sjögren's syndrome. Rosa bengal staining, osmolarity and impression cytology had high specificity and sensitivity for a correct diagnosis of keratoconjunctivitis sicca with and without primary Sjögren's syndrome. Schirmer and breakup time (BUT) tests were not quite as specific or sensitive. Impression cytology was the only ocular test that showed significant differences between the two pathological groups.
8003059 Association of patterns of labial salivary gland inflammation with keratoconjunctivitis si 1994 Jun OBJECTIVE: To determine the association between patterns of inflammation in labial salivary glands (LSG) and the ocular component of Sjögren's syndrome (SS). METHODS: We classified LSG biopsy specimens from 618 patients with suspected SS as showing focal lymphocytic sialadenitis (FLS), other chronic sialadenitis (CS), or other diagnoses. We then determined the association of the other component of primary SS, keratoconjunctivitis sicca (KCS), with FLS, CS, parotid flow rate, and xerostomia. RESULTS: FLS, rather than CS, was associated with a diagnosis of KCS (chi 2 = 191, P < 0.0001). The severity of KCS correlated directly with the severity of FLS (r = 0.52, P < 0.0001), but not of CS, and correlated inversely with parotid flow rate in those patients who had FLS (r = -0.29), but not in those who had CS (r = -0.03). Xerostomia was marginally associated with KCS (chi 2 = 5, P = 0.02). CONCLUSION: The stronger KCS association found in patients whose LSG biopsies show FLS makes FLS the best criterion presently available for diagnosing the salivary component of SS. CS is a common feature of labial salivary glands but is neither associated with SS nor an end stage of primary SS. Histopathologic examination of salivary tissue is currently essential for diagnosing primary SS as well as secondary SS in which KCS is lacking, especially cases to be included in studies of SS.
8170907 [Sjogren's syndrome and the "dry syndrome" in combination with lung diseases]. 1994 Four cases of Sjogren's disease are reported: 2 cases with pulmonary syndrome (fibrosing alveolitis) and 2 cases with respiratory sarcoidosis. The diagnosis was made basing on xerostomia and xerophthalmia. Corticosteroid treatment produced only a partial response. The disease took a chronic course in all the patients. Antibacterial drugs were a failure in all the patients.
7835183 Tear mucus ferning in patients with Sjögren's syndrome. 1994 The purpose of this study is to evaluate the possibility of using the mucus ferning phenomenon of the tears as a diagnostic test for Keratoconjunctivitis sicca in patients with Sjögren's syndrome. Using a polarising light microscope dried samples were tested for ferning phenomenon collected from (1) 36 healthy controls, (2) 21 patients with primary Sjögren's syndrome, and (3) 15 patients with secondary Sjögren's syndrome. Patients with Sjögren's had xerostomia, abnormal salivary gland biopsy and at least two positive tests for Kerato-conjunctivitis sicca. Patterns of mucus crystallization were classified into 5 types according to uniformity, branch spreading and integrity (types I, II normal, types III, IV, V abnormal). Abnormal ferning was found in tear samples of 8 out of 72 normal control eyes, 38 out of 42 with primary Sjögren's syndrome and 25 out of 30 with secondary Sjögren's syndrome. The differences between both primary and secondary Sjögren's syndrome, in comparison to healthy controls, were significant (p < 0.001). The sensitivity of the method was found 90% for primary Sjögren's syndrome and 80% for secondary Sjögren's syndrome. According to our data, tear mucus ferning test is a simple, sensitive and specific test to estimate Keratoconjunctivitis sicca in patients with Sjögren's syndrome.
8108819 [The diagnostic significance of biopsy of the labial salivary glands in Sjögren's disease 1993 Oct Histologic methods were used to examine biopsy specimens of minor (labial) salivary glands obtained to verify Sjogren's disease in 14 patients with this condition, 12 ones with chronic parenchymatous parotitis, and in 4 subjects with chronic interstitial parotitis. Sjogren's disease, chronic parenchymatous parotitis, and, to a lesser degree, chronic interstitial parotitis were found to be associated with development in the minor salivary glands of an immune inflammation with the predominance of features characterizing delayed-type hypersensitivity reaction presenting as mainly lymphoid macrophagal infiltration of tissue first near the ducts and then near the end portions. This or that degree of glandular lymphoid macrophagal infiltration is present during all periods of disease and it therefore cannot be considered as a process secondary in relation to extension of the secretory portion of the gland. These data may be useful in interpretation of morphologic changes in the minor salivary glands in various forms of chronic sialadenitis.
8258247 Interstitial lung disease and adult-onset Still's disease. 1993 Sep Adult-onset Still's disease is an uncommon rheumatological syndrome with a diversity of signs and symptoms. Pulmonary manifestations described are pleuritis and usually transient radiologic infiltrations. The patient presented in this case report had biopsy-proven lung fibrosis when adult-onset Still's disease was diagnosed. Three years after diagnosis, the patient developed clinical signs of the interstitial lung disorder. Radiological and histological progression was observed. Other causes of interstitial lung disorders were excluded. Clinicians should be aware that interstitial lung disease can be a complication of adult-onset Still's disease and can compromise the clinical status of the patient.
8194411 [Clinical application of sialography with the time-pressure curve monitored]. 1993 Sep Sialography with the time-pressure curve monitored in 66 abnormal parotids was compared with the manual injection technique. The results are: 1. The new procedure makes sialogram image superior, avoids gland parenchymal overfilling, finds the causes of failure promptly, and eliminates the pain and other side effects. 2. Shape of the time-pressure curve and the value of the injection may act as an indicator in differential diagnosis. The curve in Sjögren's syndrome is specific and the injection pressure is obviously higher than that in normal (P < 0.01). In Sialosis the injection pressure is much lower than in normal (P < 0.01).
7685194 Long-term correction of neutropenia in Felty's syndrome with granulocyte colony-stimulatin 1993 May Neutropenia in Felty's Syndrome predisposes patients to recurrent bacterial infections. We have treated a patient for more than one year with G-CSF and ascertained that this growth factor can safely correct neutropenia over a long period of time. G-CSF may constitute a new agent for the treatment and prophylaxis of infection in Felty's syndrome.
1418229 [The diagnostic value of nuclear magnetic resonance tomography in Sjögen's disease]. 1992 Oct Sjögren's syndrome is characterised by xerostomia, xerophthalmia and recurrent parotid swelling. There is a high coincidence with rheumatoid diseases. A variety of clinical and laboratory parameters offers important information for diagnosis, but none of them is specific for this disease. 36 patients with clinical diagnosis of Sjögren's syndrome were examined in a prospective study to evaluate the diagnostic significance of this technique. 34 patients showed an inhomogeneous, nodular pattern in the parotid gland. The signal intensity was very high, especially in the T2-weighted sequences. There was a significant correlation of the radiologic changes with the course of the disease. Four patients with the clinical diagnosis of sialadenosis demonstrated bilateral enlarged glands with a homogeneous signal pattern. Patients with acute purulent parotitis demonstrated enlargement of the gland without an alteration in the signal pattern. Patients with chronic recurrent parotitis and patients with radiogenic sialadenitis showed little inhomogeneous increase of signal intensity. Our results indicate that MRI is presently the radiological method of choice in the evaluation of Sjögren's syndrome.
1608349 Lymphoma in Sjogren's syndrome. 1992 Sjogren's syndrome is an autoimmune disease with a known predisposition for lymphoma development. Eight of 120 patients with primary Sjogren's syndrome followed at the University of Ioannina over the past 7 years developed non-Hodgkin's lymphoma diagnosed according to the Kiel classification. The lymphomas differed by location and grading. Six were called low grade (immunocytoma) and two intermediate grade non-Hodgkin's lymphomas. Five of the immunocytomas involved the minor salivary or lacrimal glands. Immunoperoxidase staining for light chains revealed monoclonal populations. Two patients showed spontaneous regression not previously reported in Sjogren's syndrome. Thus, in Sjogren's syndrome, low grade non-Hodgkin's lymphomas and especially immunocytomas are the most common lymphomas. These lymphomas tend to evolve very slowly and may regress spontaneously. Given these facts, a conservative approach to treatment is indicated in those patients with only localized disease.
8891560 Complications of childhood Sjögren syndrome. 1996 Oct Sjögren syndrome (SS) is a common disorder in adults and involves both glandular and extraglandular systems. We report here four cases of childhood SS complicated by chronic thyroiditis, interstitial nephritis or sweat gland inflammation. Additionally, in one of these cases, the central nervous system was involved. All of these complications are common in adult cases. CONCLUSION: Childhood SS is a systemic "ductilitis" or "exocrinopathy" with complications which are commonly observed in adult cases.
7777881 Gold pulmonary toxicity in a patient with a normal chest radiograph. 1995 Jun We report a case of gold pulmonary toxicity in a patient with adult-onset Still's disease with dyspnea on exertion and a normal chest radiograph. Withdrawal of gold therapy resulted in complete resolution of pulmonary toxicity in our patient without the need for additional steroid therapy.
8584859 Serum level of IL-6 in patients with primary and secondary Sjögren's syndrome. 1995 The level of interleukin-6 in the serum of 17 patients suffering from the primary Sjögren's syndrome and of 16 with secondary Sjögren's syndrome were determined by means of ELISA. The mean value of IL-6 in primary and secondary Sjögren's syndrome was 2.41 pg/ml (1.45-3.37 pg/ml) and 3.01 pg/ml (1.63-4.39 pg/ml). The normal serum level of IL-6 was below 3.0 pg/ml. The serum level of IL-6 was not elevated in Sjögren's syndrome patient, there was no significant difference in the serum level of IL-6 between both groups of the patients.