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ID PMID Title PublicationDate abstract
1304634 [Radio-cinematographic study of active elevation of the prosthetic shoulder]. 1992 In order to verify whether it is possible to reproduce the physiologic anterior elevation of the shoulder with a non constrained Neer type prosthesis, the authors have examined the dynamic comportement of 21 total shoulder arthroplasties. Recording of anterior active elevation with video-fluoroscopy and evaluation glenohumeral motion and scapulothoracic motion allowed to distinguish 3 types of biomechanics after total shoulder replacement. A first group of prosthesis (4 cases) had normal biomechanics with conservation of a normal scapulohumeral rythm. This concerned arthroplasties performed for necrosis or osteoarthritis with no cuff tear or loose bone stock and no technical error. A second group of prosthesis (10 cases) had an abnormal biomechanics. There was a superior excursion of the humeral head prosthesis without real glenohumeral motion. A more severe pathology (cuff tear arthropathy, rheumatoid arthritis, old traumas) with bone and/or muscular destruction was sufficient to explain this elevation possible only because of the scapulothoracic motion. Finally, there was a third group of prosthesis (7 cases) which had a reversed scapulohumeral rythm: there was less motion between the prosthetic components but the scapulothoracic motion was unchanged. Three factors can be responsible for this reversed scapulohumeral rythm: 1) The initial pathology, because of the difference in the cuff trophicity. 2) The surgical technic because of the difficulties to respect the position of the joint line and the lever arms. 3) The prosthesis itself, because of the higher degree of conformity and stability between the prosthetic components.
8798544 Functional cloning of the cDNA for a human hyaluronan synthase. 1996 Sep 20 Hyaluronan is a constituent of the extracellular matrix of connective tissue and is actively synthesized during wound healing and tissue repair to provide a framework for ingrowth of blood vessels and fibroblasts. Changes in the serum concentration of hyaluronan are associated with inflammatory and degenerative arthropathies such as rheumatoid arthritis. In addition, hyaluronan has been implicated as an important substrate for migration of adhesion of leukocytes during inflammation. A human hyaluronan synthase (HuHAS1) cDNA was isolated by a functional expression cloning approach. Transfection of CHO cells conferred hyaluronidase-sensitive adhesiveness of a mucosal T cell line via the lymphocyte hyaluronan receptor, CD44, as well as increased hyaluronan levels in the cultures of transfected cells. The HuHAS1 amino acid sequence shows considerable homology to the hasA gene product of Streptococcus pyogenes, a glycosaminoglycan synthetase from Xenopus laevis (DG42), and is the human homolog of a recently described murine hyaluronan synthase.
8816062 [Adherent reaction among activated platelets, polymorphonuclear cells and vascular endothe 1996 Aug Platelet activation in addition to blood coagulation abnormality is regarded as a primary factor of thrombosis by atherosclerotic obstruction. Therefore, the platelet activation on atherosclerosis is considered to correlate with shear stress generated between blood cells and endothelial cells in blood flow. P-selectin on the surface of the platelet membrane is measured by flowcytometry as a marker of platelet activation. Herein, we examined the phenomena of platelet activation and adherent platelets with leukocytes (ad-P.L) on stored platelet concentration (PC) and chronic rheumatoid arthritis (RA), moreover, of the adherent platelets or polymorphonuclear cells (PMN) with endothelial cells (EC) in shear stress by using an apparatus we devised. The rate of platelet activation and ad-P.L increased in PC with storage, and the sensitivity of platelets to thrombin decreased. The rate of platelet activation and ad-P.L increased in RA in vivo. Many adherent platelets with EC were found at a low shear rate on normal EC but at a high shear rate on denatured EC without any specific adherent property. Adherent PMN with EC had several hundred times more denatured EC than normal EC and the relationship with shear rate disappeared on denatured EC. The platelet activation and relationship between platelets or leukocytes and EC as to the cause of thrombosis are important subjects for future studies.
7547098 Lack of photosensitising potential of tenidap, a novel anti-rheumatic agent. 1995 1. The potential of orally administered tenidap sodium, a novel anti-rheumatic agent under investigation for the treatment of rheumatoid arthritis and osteoarthritis, to cause phototoxic reactions was investigated. 2. Twenty-four healthy volunteers entered a randomised, double-blind study in which they received tenidap sodium 40 mg or 120 mg or placebo daily for 7 days. The minimal erythema dose was determined using wavelengths of 305-460 nm for 3 days prior to drug administration and on the last 3 days of dosing. Appropriate clinical and laboratory tests were performed before, during and after the dosing period. 3. Tenidap did not have a statistically significant effect on immediate or delayed photosensitivity. No drug-related side effects were reported and there were no clinically significant adverse findings from the laboratory tests. 4. At the dosage and duration of tenidap sodium used, a photosensitising potential has not been demonstrated.
7993128 [Interferon-alpha, beta, gamma]. 1994 Dec There are three types of interferons (IFN), alpha, beta and gamma. IFN-alpha is produced in the leukocytes infected with virus, while IFN-beta is from fibroblasts infected with virus. IFN-gamma is induced by the stimulation of sensitized lymphocytes with antigen or non-sensitized lymphocytes with mitogens. It is believed that IFN-alpha and beta originated from the same ancestral gene, whereas IFN-gamma did not. IFN has not only an antiviral activity, but also various kinds of biological activities including cell growth inhibition, immunosuppressive effects, enhancement of macrophage, natural killer (NK) cell, killer (K) cell and neutrophil functions, and cell differentiation-inducing activity. IFN also shows the antitumor activity resulting from the integration of the above-mentioned biological activities. IFN is also deeply involved in the pathogenesis of various diseases, e.g., collagen diseases such as SLE and rheumatoid arthritis, insulin-dependent diabetes mellitus, fulminant hepatitis, severe pancreatitis, nephritis, multiple sclerosis, allergic diseases, and atherosclerosis. At present, IFN is clinically used in therapy against virus infections such as hepatitis B and C, and for malignancies such as renal cell carcinoma, multiple myeloma, malignant melanoma, glioblastoma, skin cancers, malignant lymphoma and chronic myelogenous leukemia.
8313681 The mystique of the erythrocyte sedimentation rate. A reappraisal of one of the oldest lab 1993 Dec The ESR is a commonly performed laboratory test with intriguing antecedents extending back to the classical period of Western medicine. Although this background was appreciated by the physicians who popularized the test in the early part of this century, it has been largely forgotten. There has always been a lack of consensus about the role of the ESR as a nonspecific indicator of inflammation and tissue injury. The usefulness of the sedimentation rate has decreased as new methods of evaluating disease have been developed. It remains helpful in monitoring certain inflammatory processes, particularly rheumatoid arthritis, and it is of great value in the diagnosis of temporal arteritis and polymyalgia rheumatica. The use of the ESR as a screening test to identify patients who have significant disease is not supported by the literature. The basic factors influencing the sedimentation rate were understood by the early decades of this century and the most satisfactory method of performing the test was introduced by Westergren in 1921. The complex nature of the factors influencing test outcome have precluded development of a reference method or of an easily implemented quality control program. Current interest in the methodology of the ESR focuses on the development of automated closed systems that allow determination of the sedimentation rate in the collection tube. These methods offer advantages of speed, safety, and uniform specimen handling. Systems utilizing sedimentation columns less than 200 mm in length may be less sensitive to changes at higher ESRs than the Westergren method. Laboratories should consider using a closed or a closed and automated system as their routine method for performing the ESR.
8302140 [The laryngeal mask--news in orthopedic anesthesia]. 1993 May The laryngeal mask airway (LMA) was first used at the Department of Orthopedics, School of Medicine, University of Zagreb on May 8, 1991. Two hundred and three patients were undergoing elective orthopedic surgery during the first year of the LMA use. A size-3 mask was used for women and children weighing over 25 kg (55 lbs) and a size-4 mask for men. Research has been undertaken in 12 patients aged between 30-73 years scheduled for total hip replacement. Blood pressure, heart rate and hemoglobin oxygen saturation were continuously monitored with a noninvasive method. No signs of cardiovascular disorders were noticed 1-min before and 3-min after insertion. Only 2 (16.6%) patients, who suffered no complications, had ventilating pressure higher than 20 cm H2O. The LMA proved to be very useful in anesthesia where endotracheal intubation was difficult or almost impossible. Of 12 examinees, 3 with severe rheumatoid arthritis and 2 with ankylosing spondylitis were successfully anesthetized with the LMA. Awakening from anesthesia was very pleasant. There were no serious complications in terms of laryngo- or bronchospasm, aspiration or insufflation of the stomach. The LMA has been found to be very helpful in solving problems of anesthesia in orthopedic patients. A set of laryngeal mask airways should be an integral part of every anesthetic equipment.
1408055 [Diagnostic value of the determination of serum alpha2-HS-glycoprotein]. 1992 Jun 21 Opsonic glycoprotein, alpha 2-HS-glycoprotein concentration was studied in the serum of 753 patients with various hematological, malignant, immunological, metabolic, endocrine and liver diseases and 68 healthy controls. Decreased serum alpha 2-HS-glycoprotein levels were detected in patients with acute leukemias, chronic granulocyte and myelomonocyte leukemias, lymphomas, myelofibrosis, multiple myeloma, metastatizing solid tumors, systemic lupus erythematosus, rheumatoid arthritis, acute alcoholic hepatitis, fatty liver, chronic active hepatitis, liver cirrhosis, acute and chronic pancreatitis, and Crohn's disease. Elevated levels were measured in patients with B and NANB/C hepatitis. Further decreased levels were observed in some groups with secondary infections. Serum alpha 2-HS-glycoprotein levels are affected by many factors, influencing the synthesis and elimination of the protein. The detection of serum alpha 2-HS-glycoprotein concentration has no specific diagnostic value as a marker for tumors or other diseases, however, its determination can be useful for the assessment of a non-specific regulator of the host defence.
1616366 Joint hypermobility in adults referred to rheumatology clinics. 1992 Jun Joint hypermobility is a rarely recognised aetiology for focal or diffuse musculoskeletal symptoms. To assess the occurrence and importance of joint hypermobility in adult patients referred to a rheumatologist, we prospectively evaluated 130 consecutive new patients for joint hypermobility. Twenty women (15%) had joint hypermobility at three or more locations (greater than or equal to 5 points on a 9 point scale). Most patients with joint hypermobility had common musculoskeletal problems as the reason for referral. Two patients referred with a diagnosis of rheumatoid arthritis were correctly reassigned a diagnosis of hypermobility syndrome. Three patients with systemic lupus erythematosus had diffuse joint hypermobility. There was a statistically significant association between diffuse joint hypermobility and osteoarthritis. Most patients (65%) had first degree family members with a history of joint hypermobility. These results show that joint hypermobility is common, familial, found in association with common rheumatic disorders, and statistically associated with osteoarthritis. The findings support the hypothesis that joint hypermobility predisposes to musculoskeletal disorders, especially osteoarthritis.
1598717 [Use of thermotherapy, ultrasound and laser by practising physiotherapists. Physiotherapis 1992 May 18 The purpose of this examination was to examine the practising physiotherapist's way of treating patients with nine selected diagnoses (fibrosites, osteoarthritis, rheumatoid arthritis, cervical slipped disc, lumbar slipped disc, generalized lumbar/back pain, generalized bursitis, generalized tendinitis, and sprains). In addition, nine different forms of therapy were examined (hot packs, infra-red light, ice packs, short waves, microwaves, diadynamic current, ultrasound, transcutaneous electric nerve stimulation and laser). All in all, 41 clinics with 2,018 treatment confrontations in the examination period, the last week of March 1990, took part in the survey. The majority of therapists were in possession of short wave, hot packs, ultrasound and laser which are also the four forms of therapy most frequently used for treatment. Compared to a Swedish examination from 1979, there is a doubling in ultrasound treatments from 24% to 48%, while the amount of short wave and microwave treatment remained unchanged. There was a remarkable variation in the physiotherapist's choice of therapy in each different diagnosed case. This can be due to the lack of specification of the diagnosis, so that different symptoms, course and stage of illness changed the treatment pattern elected.
1540198 Cyclooxygenase-independent effects of non-steroidal anti-inflammatory drugs on the neutrop 1992 Feb 4 A range of 12 non-steroidal anti-inflammatory drugs (NSAIDs), including members from each of the main chemical groups, were examined for their effects on the oxidative burst induced by the receptor stimulus, platelet-activating factor, and the two post-receptor stimuli, fluoride and dioctanoylglycerol. It was found that the NSAIDs fell into three categories: (1) those that increased the stimulated superoxide (O2-) response, (2) those that had no effect and (3) those that decreased O2- production. All the drugs were without effect in unstimulated cells. The mode of action of those drugs that caused enhancement of the O2- response is unlikely to be due to an inhibition of the cyclooxygenase pathway of arachidonate metabolism as not all NSAIDs caused the enhancement. This data could have clinical implications for the therapy of inflammatory disorders such as rheumatoid arthritis, in that those NSAIDs which cause an increased O2- response, while providing temporary relief of symptoms, could be exacerbating the underlying inflammatory condition and associated tissue damage.
9308336 Immunoglobulin A--alpha-1-antitrypsin complex in rheumatic diseases. 1996 Oct Immunoglobulin A-alpha-1-antitrypsin complex (IgA-AT) is a nonimmune complex formed by disulphide bonding between an active thiol group available on the cysteine residue of alpha heavy chains of IgA and a cysteine in position 232 of alpha l-antitrypsin in single polypeptide chain. The level of the complex can easy be determined using the ELISA method and findings are expressed in arbitrary units. In the healthy adults' sera the IgA-AT complex level is lower than 0.4 arbitrary unit. The elevated levels of the complex were found in a number of rheumatic diseases. In 50% of SLE patients, its levels are increased, particularly in those with current central nervous system involvement. Similarly, in approximately 50% sera derived from RA patients they are also found to be higher. Their presence correlates with anatomical progression of the disease. IGA-AT complex is found in RA (in 90% of cases) but not in the osteoarthritis synovial fluid. Our findings can be applied in clinical praxis in differential diagnosis of early rheumatoid arthritis and osteoarthritis. The IGA-AT complex can be also found in ankylosing spondylitis. The complex has been determined in a relatively large number of IgA myeloma sera. In 30% of the cases its levels were 10-fold higher than the upper limit for healthy adults.
9117192 Chemical toxicity and reactive oxygen species. 1996 Reactive oxygen species (ROS) are cytotoxic, causing inflammatory disease, including tissue necrosis, organ failure, atherosclerosis, infertility, birth defects, premature aging, mutations and malignancy. ROS are produced in the metabolism of drugs and industrial chemicals by (i) one-electron peroxidase oxidations to form cation radicals, (ii) cytochrome P450 metabolism to free radical products, (iii) stabilisation of the ROS-generator, CYP2E1, and (iv) futile cycling of other cytochromes P450. ROS production initiates inflammation which unless quenched may result in chronic inflammatory disease states, e.g. hepatitis, nephritis, myositis, scleroderma, lupus erythematosus, multiple system organ failure. Quenching of ROS is affected by the redox buffer, glutathione (GSH), and the antioxidants, ascorbic acid, tocopherols, retinoids, in conjunction with the redox enzymes, GSH reductase, GSH peroxidase, catalase and superoxide dismutase. Many industrial workers with symptoms of systemic inflammation, resulting from exposure to toxic chemicals, are diagnosed as having rheumatoid arthritis, virus infections, or other microbial lesions, largely because many physicians are unaware that exposure to certain chemicals can initiate inflammatory disease states.
19078097 Diffuse musculoskeletal pain syndromes in pediatric practice. 1996 Dec Diffuse musculoskeletal pains in children and adolescents are common. Females are affected relatively more often. Whereas growing pains and joint hypermobility as possible causes tend to occur in younger children, fibromyalgia syndrome (FMS) appears to be more frequent in adolescents. In growing pains, typically, a) the pains are localized to the thighs, shins, or calves, b) occur in the evening or at night; and c) are usually relieved by massage. Children are otherwise healthy and have normal growth and development. Children with joint hypermobility manifest pain mainly in the knees, ankles, and hips. Symptoms are aggravated by exercise, and mild effusions in the joints can occur. In patients with FMS, pain is generalized, and discrete anatomic points are specifically tender. As in adults with FMS, headaches, abdominal pain, fatigue, and sleep disturbances are usually common. In contrast to the poor outcome of FMS in adults, some data suggest a better prognosis in children. These three syndromes have much in common and might overlap. The diagnosis of any of these diffuse pain syndromes is one of exclusion, and other conditions must be ruled out, including rheumatic disorders such as juvenile rheumatoid arthritis and systemic lupus erythematosus, psychogenic or somatoform disorders, child abuse, sexual abuse, and malignancies. Management is usually conservative and symptomatic; a multidisciplinary team approach may be helpful.
8908437 Uveitis in children. 1996 Jul Uveitis is diagnosed more often in adults than in children but in children the prevalence of chronic inflammation and the difficulty of an early diagnosis may worsen the visual prognosis. The different incidence of the presumed or defined etiologies in the various ages is probably responsible for the better classification of uveitis in childhood (71% versus 55% in adult patients). Juvenile rheumatoid arthritis is the most common identifiable etiology of pediatric anterior uveitis (28%). However, its long-term prognosis is not satisfactory and ophthalmic surveillance protocols are necessary especially for ANA and HLA DR11 positive girls with the pauci articular form of the disease. Intermediate uveitis is idiopathic in 98% of the cases and accounts for 20-26% of all pediatric uveitis; cystoid macular edema in these patients is the leading cause of visual impairment. Toxoplasmosis is the most frequent cause of posterior uveitis (43%) and of uveitis in childhood (12%); involvement is bilateral in 50-60% of cases. Diffuse uveitis forms are uncommon in children, but their course is particularly severe. They may either be the natural evolution of a posterior uveitis or the presenting sign of a systemic disease typical of the third decade of life, such as sarcoidosis, Behçet's disease, Vogt-Koyanagi-Harada's disease. Masquerade syndromes including retinoblastoma, leukemia and lymphoma, intraocular foreign body, retinitis pigmentosa may contribute to confusion in the differential diagnosis of inflammatory disease of the uveal tract in childhood.
8612624 A factor derived from polymorphonuclear leukocytes enhances interleukin-1-induced synovial 1996 Mar 1 We found that short-term culture medium and homogenate of casein-induced rat peritoneal polymorphonuclear leukocytes (PMN) markedly induced collagenase and prostaglandin E2 (PGE2) production by normal rat synovial cells and these effects were abrogated by anti-(rat interleukin-1 alpha) (IL-1 alpha) polyclonal antibodies. However, collagenase activity and PGE2 induced by recombinant rat IL-1 alpha were less than those induced by rat PMN culture medium. It was also proved by radioimmunoassay that rat PMN culture medium contains a relatively small amount of IL-1 alpha. The introduction of IL-1 alpha-deleted PMN culture medium and recombinant rat IL-1 alpha together into the synovial cell culture system revealed that IL-1 alpha deleted PMN culture medium has a significant enhancing activity on IL-1 alpha-induced synovial cell collagenase and PGE2 production. This new factor, which was shown to be a negatively charged protein of about 80 kDa, may have important roles in connective tissue destruction and chronic inflammation in diseases such as rheumatoid arthritis.
8835505 Molecular mimicry: the geographical distribution of immune responses to Klebsiella in anky 1996 Jan The discovery that HLA-B27 is linked to ankylosing spondylitis (AS) and HLA-DR1/DR4 to rheumatoid arthritis (RA) has provided new approaches to the study of the possible causation of these diseases. Several theories have been proposed to explain these associations but only one, namely "molecular mimicry", has provided a specific aetiological agent for each of these diseases. Molecular mimicry between HLA-B27 and two molecules in Klebsiella microbes: nitrogenase and pullulanase D has been reported whilst in Proteus microbes, the haemolysin molecule shows sterochemical similarity to HLA-DR1/DR4. Elevated immune responses to Klebsiella microbes have been demonstrated in AS patients from 10 different countries and this wide geographical distribution suggests that the same aetiological agent is probably acting in producing this condition. Furthermore RA patients show similar immune responses to Proteus microbes. Whether AS or RA are caused by these bacteria can only be resolved by tissue typing all rheumatological patients early, in the course of their disease and then assessing their response to antibiotic chemotherapy in longitudinal studies involving double-blind crossover trials. It is possible that in the future, the course of AS or even RA could be modified by adequate antibiotic chemotherapy or even diets which affect the substrates on which these bacteria grow.
8536794 Mycophenolic acid suppresses protein N-linked glycosylation in human monocytes and their a 1996 Jan Mycophenolic acid (MPA) is the active part of the corresponding morpholinoethyl ester pro-drug Mycophenolate Mofetil. MPA, an inhibitor of IMP dehydrogenase, depletes GTP and thereby suppresses transfer of mannose and fucose to proteins. Treatment of human monocytes with a clinically attainable concentration of MPA (10 microM) decreases their attachment to endothelial cells and to laminin, but not to type I collagen or fibronectin. Our results not only elucidate a major role of mannose/fucose residues in homing of monocytes on activated endothelium but also explain in part the beneficial effects of MPA in rheumatoid arthritis and organ graft rejection.
7482502 Comparative analysis of HLA polymorphism at the serologic and molecular level in Moroccan 1995 Aug The Jewish people comprise two major groups, one encompassing the Jews of Ashkenazi (Central and Eastern European) origin and the other including those of Sephardic (Middle Eastern and North African) descent. To the latter belong the Jews of Moroccan stock, who form the largest Jewish subgroup among the non-Ashkenazi population living in Israel. As the members of each of these groups differ in physiognomy and life style, it was of interest to investigate whether these differences are also reflected in their respective HLA compositions. To this end, 132 subjects of Ashkenazi and 113 individuals of Moroccan origin residing in Israel were tested and the results compared with data for other populations made available by the 11th International Histocompatibility Workshop. Comparison between their HLA profiles and those of non-Jews revealed that the Jewish groups in some aspects resembled one another but in others showed disparities. The dissimilarities between the various groups are expressed in terms of gene and haplotype frequencies, as well as in HLA-disease associations (as for example rheumatoid arthritis, erosive lichen planus, primary Sjögren's syndrome, pemphigus vulgaris). However, both Jewish groups shared some unique features with respect to HLA class II allelic frequencies, pointing to a common ancestry.
7760258 The measurement structure of the Center for Epidemiologic Studies Depression Scale. 1995 Jun This study examined the temporal stability of the measurement structure of the Center for Epidemiologic Studies Depression Scale (CES-D; Radloff, 1977) in 813 individuals with rheumatoid arthritis. Participants completed the CES-D (Radloff, 1977) on three occasions 1 year apart. Structural equation models and polyserial correlations were used to address methodological limitations of previous studies. Four competing measurement structures were tested with one factor, three factors, four factors, and a single second-order factor underlying the four-factor model. The four-factor and the second-order-factor models provided the best fit at Time 1. When cross-validated at Times 2 and 3, the four-factor and the second-order-factor models remained invariant. Researchers can now more confidently use the CES-D to examine how distress changes in chronic physical disorders.