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PMID	Title	PublicationDate	abstract
623699	Susceptibility of rheumatoid and nonrheumatoid synovial cells to antibody-dependent cell-m	1978 Jan	Fibroblastic cells derived from rheumatoid (RA) and nonrheumatoid (N-RA) synovial tissue (synovial cells) were used as targets in assays of antibody-dependent cell-mediated cytotoxicity (ADCC). Synovial cells that had been pretreated with human alloantisera were rapidly lysed by normal human blood mononuclear cells. RA and N-RA synovial cells were equally susceptible to ADCC under these assay conditions. Antibody to autologous synovial cells was not detected in sera from 10 patients with RA by this method of assay.
139861	Bus use by disabled arthritics: functional requirements.	1977 May	Twenty-five rheumatoid arthritic patients were studied to determine the extent of independence and functional requirements necessary to use public bus transportation in Philadelphia. To measure the extent of independence, a functional assessment scale was developed that evaluates 19 bus activities, each according to a four-point scale. Of the 11 subjects who stated that they used the public bus prior to admission, only 4 were found to be able to use the public bus independently at the time of evaluation. Ascending, descending and motion activities provided considerable difficulty for the sample population. Functional requirements of boarding and disembarking the bus are described in detail.
6433140	Feasibility of willingness-to-pay measurement in chronic arthritis.	1984	Quantification of nonmonetary aspects of disease is a major challenge for economic analysts. Using the amounts of money recipients are willing to pay for nonmonetary benefits has theoretical appeal, but it has proven difficult to implement. Difficulties encountered include noncomprehension by subjects, misrepresentation of preferences, extraneous determinants of answers, and ethical concerns. In a preliminary exploration of feasibility, 184 patients with osteoarthritis and rheumatoid arthritis were asked their willingness to pay (WTP) for hypothetical complete cure. With minimal pressure put on the patients to respond, 27 percent gave plausible answers. People with more schooling, with paid employment, or who were having more treatments for their arthritis were more likely to respond. Patients were willing on average to pay 17 percent of family income for arthritis cure. Methods for measuring WTP are being strengthened and may soon play an important role in health services research.
6607819	Piroxicam versus naproxen in rheumatoid arthritis.	1983	Forty-five patients with definite or classical rheumatoid arthritis were randomly allocated into two groups and treated with piroxicam 20 mg once daily or naproxen 250 mg twice daily in a 3-month, double-blind study. The results were available in 38 patients (21 in the piroxicam group and 17 in the naproxen group). Both drugs showed significant effects on the majority of clinical parameters compared to baseline. However, piroxicam was significantly superior to naproxen in reducing the grade of swollen joints. Moreover, piroxicam had better efficacy as shown by the number of patients who preferred it to previous therapy; 13 (62% of the patients entered) compared to 8 patients (47%) who preferred naproxen. Tolerance of the two drugs was similar. Two patients in each group dropped out due to side-effects.
7292020	Advances in the use of therapeutic pheresis for the management of rheumatic diseases.	1980 Nov	Twenty-two patients with rheumatoid arthritis, 3 with seronegative juvenile rheumatoid arthritis, 4 with systemic lupus erythematosus, and 4 with psoriatic arthritis have undergone therapeutic pheresis at our institution over the last 3 yr. Lymphoplasmapheresis appears to be the most effective form of pheresis in treating rheumatoid arthritis. After achieving a remission with 20 treatments performed in 11 wk, a flare may be preventable by pheresing patients 3 times a week every 6 wk provided the patient is on a concomitant, long-acting agent. Therapeutic pheresis has been disappointing in seronegative juvenile rheumatoid arthritis. Life-threatening complications of systemic lupus erythematosus may respond dramatically to pheresis. In treating less severe disease on a long-term basis, pheresis has demonstrated excellent steroid sparing properties. Nonspondylytic psoriatic arthritis responds slowly to pheresis, but arthritic remissions may be prolonged, even though skin response is variable. Experience in the use of pheresis for treating these diseases has allowed for the development of criteria for deciding whether to institute such therapy as an adjunct to more standard modes of treatment for individual patients. Also, a variety of "technical" factors can influence the outcome of therapy, and these must be managed appropriately. Therapeutic pheresis is a promising tool for investigating and treating rheumatic diseases.
710991	The use of the Flatt hinge prosthesis in the rheumatoid thumb.	1978 Feb	Nine patients with marked destruction in both the metacarpophalangeal and interphalangeal joints of the thumb, were treated with fusion of the interphalangeal joint and insertion of the Flatt hinged metal prosthesis into the metacarpophalangeal joint. Of the nine thumbs treated in this manner, eight had good to excellent results. One prosthesis was removed after it became infected, leaving both joints fused.
4342958	A collagenolytic system produced by primary cultures of rheumatoid nodule tissue.	1972 Nov	A collagenase and a neutral protease have been insolated and characterized from primary cultures obtained from rheumatoid subcutaneous nodules. Release of both active enzymes was maximal between the 3rd and 7th days of culture and was stimulated by the presence of small amounts of colchicine (0.1 mug/ml) added to the culture medium. Both the protease and the collagenase from nodule tissue were active at physiologic pH and were inhibited by chelating agents, sulfhydryl compounds, and 1:40 dilutions of human serum. Both enzymes appeared to have a molcular size equivalent to similar enzymes found in cultures of rheumatoid synovium. The nodule collagenase was purified by chromatography on molecular sieve columns followed by affinity chromatography. The pure enzyme cleaved collagen in solution at 24 degrees C at the locus common for mammalian collagenases to act: three quarters of the distance from the amino-terminus. Under the same conditions the purified enzyme cleaved gelatin (denatured collagen) at the same locus. It is likely therefore that the collagenase in rheumatoid connective tissues functions to produce the initial cleavage of collagen and that after the initial reaction products are denatured, proteases digest them into smaller polypeptides more rapidly than does the collagenase itself. Since rheumatoid nodules grow centrifugally at the expense of the palisading fibroblast layer it seems possible that the central necrotic areas are caused by release of collagenase and protease from the highly cellular palisading zone resulting in the destruction of the extracellular collagen matrix.
779025	Igg rheumatoid factor in serum of rheumatoid arthritis patients.	1976	The ability of isolated IgG and F(ab)2 fragments to agglutinate IgG-coated latex particles was used as a test of IgG-RF activity. No definite differences could be proved between controls and RF-negative RA patients, whereas the latex titres of IgG and F(ab)2 of sero-positive RA patients were higher. The IgG latex activity was recovered in the fractions between the 19S and 7S after gradient centrifugation of serum or isolated IgG at pH 7.2 and within the 7S fraction after centrifugation at pH 4.1. The dissociated IgG complexes reformed after neutralization, thus indicating a self-association of the IgG molecules.
6405834	A comparison of conventional and low dose sodium aurothiomalate treatment in rheumatoid ar	1983 May	Forty-one patients were given sodium aurothiomalate either in the conventional dose of 50 mg weekly for five months or in a small dose of 10 mg weekly for the same period. Monthly maintenance injections of 50 mg and 20 mg, respectively, were continued for a further seven months. A high incidence of toxicity and the subsequent withdrawal of 15 patients from the study prevented any analysis of results beyond five months. Statistically significant clinical improvements occurred with both treatment regimes. Although there were no significant differences between the clinical measurements of the treatment groups at any stage, a significant reduction of ESR and serum IgM occurred only with the higher dose. Side-effects were more frequent and occurred earlier with conventional treatment. However, severe toxicity, demanding withdrawal from the study, was slightly more common in the low-dose group. Thus, at least in the short term, conventional- and low-dose regimes appeared equally effective. A small dose did not lesson the hazards of toxicity.
104649	Distribution of gold in blood during chrysotherapy.	1978 Nov	Measurements have been made using electrophoresis and neutron activation analysis of the distribution of gold in the blood of four patients who have responded well to chrysotherapy for rheumatoid arthritis. It has been shown that in these patients there is litte, if any, binding to the fibrinogen. The majority of protein-bound gold is associated with the albumin but significant amounts are bound to the other proteins. There is a small amount of gold associated with the blood cells.
675112	[Lysis of the odontoid process in rheumatoid polyarthritis].	1978 Apr	The authors report 9 cases of partial or total lysis of the odontoid peg in rheumatoid arthritis. Retrospective study of 100 cases of rheumatoid arthritis and the data from the literature demonstrate the rarity of these lesions, the last stage of the odontoid erosions which are much commoner. The therapeutic approach is usually nuero-surgical.
7220097	Synovial fluid lactic acid levels in septic arthritis.	1981 Jan	Synovial fluid lactic acid estimations were carried out on 50 samples by gas liquid chromatography. Specimens from 4 patients with bacteria arthritis, other than gonococcal, had a mean lactic acid concentration of 215 mg/dl. One patient with gonococcal arthritis had a synovial fluid lactic acid of 30 mg/dl. Forty-one patients with inflammatory arthritis and 4 patients with degenerative arthritis had mean synovial fluid lactic acid levels of 27 and 23 mg/dl respectively. The estimation of synovial fluid lactic acid is reliable in differentiating septic arthritis from inflammatory and degenerative arthritis except when the infecting organism is NEisseria gonorrhoeae.
954180	The effects of anti-rheumatoid drugs on the in vitro activity of human serum hyaluronidase	1976 Aug	Fourteen antirheumatoid drugs were tested for their effects on the in vitro hyaluronidase activity of normal human serum. Four drugs produced significant changes in enzyme activity. Different results were obtained with ovine testicular hyaluronidase when diluted with either saline or inactivated human serum. No increase in serum hyaluronidase activity was found in patients with rheumatoid arthritis. There was no evidence for the existence of tissue specific isoenzymes of hyaluronidase in the serum of either normal subjects or patients with rheumatoid arthritis.
3877605	Delayed skin hypersensitivity as indicator of T-cell function in three population groups.	1985 Sep	Immunological differences between a rural under-developed black population with a low incidence of rheumatoid arthritis, and living according to old traditional ways have been compared with an urban black and urban Caucasian population with a high incidence of the disease. A delayed skin hypersensitivity test for cell-mediated immunity with seven antigens and control was used. The rural group showed a statistically significant inhibition of cell-mediated immunity with 37% showing an anergic response. A matched Caucasian group showed a more marked response while an urban black group occupied an intermediate position. The 37% anergic response in our rural group was seen despite the fact that they were very healthy and their immune systems resisted multiple parasitic and infective onslaughts. From this data interpretation of an anergic response to multiple skin antigen tests in peoples from under-developed populations must be approached with great caution. Whether this altered cell-mediated immunity plays a role in the low incidence of rheumatoid arthritis in under-developed peoples is still speculative.
6430141	Proteinuria in gold-treated rheumatoid arthritis.	1984 Aug	Treatment records of 1800 patients with rheumatoid arthritis who were included in the clinical trials of auranofin in the United States were examined for data on development of proteinuria. Three percent (41) of 1283 auranofin-treated patients had an abnormal 24-hour urine protein level: 15 had mild (0.15 to 1 g/d), 17 had moderate (1 to 3.5 g/d), and 9 had heavy (greater than 3.5 g/d) proteinuria. Permanent renal impairment did not occur, and proteinuria did not persist beyond 12 months in most patients. Seven of eight patients who were rechallenged when the proteinuria had cleared were able to continue treatment without relapse. No clinically discernible risk factors were found. Biopsy specimens from 4 patients showed membranous glomerulonephritis, which indicates an underlying immunopathologic mechanism. In similar groups of patients, the risk of developing proteinuria with auranofin therapy is significantly less than that with parenteral gold therapy (p less than 0.05) and similar to that with background therapy with nonsteroidal antiinflammatory drugs (p = 0.92). The lower incidence and relatively benign nature of proteinuria seen in this review support previous findings that auranofin is better tolerated than injectable gold.
140527	[Glycosaminoglycans in blood serum of patients with rheumatoid arthritis].	1976 May	Serum glycosaminoglycans were studied in patients with rheumatoid arthritis by means of electrophoresis. Dismucopolysaccharidemia, which was observed in these patients, was manifested in alteration in the ratio of hyaluronic acid and chondroitin-4-sulphate and also in occurrence of heparin associated with protein and chondroitin-6-sulphate in blood serum. The latter fractions of glycosaminoglycans are not usually found in blood of healthy persons. The alteration in the ratio of fractions of glycosaminoglycans was accompanied by a decrease in content of hyaluronic acid in synovial tissue of the joints impaired, by an increased excretion of the substance with urine and also by the increased activity of hyaluronidase in blood serum, articular fluid and in synovial tissue. The alterations in the composition of blood glycosaminoglycans, which correlated with the clinical manifestations of the disease, suggest that impairments of metabolism of the carbohydrate-containing biopolymers are involved in the genesis of rheumatoid arthritis.
6718949	An electron microscopic study of the synovial-bone junction in rheumatoid arthritis.	1984	The cellular characteristics of the rheumatoid synovial-bone junction (SBJ) were examined in the electron microscope. Large numbers of mononuclear inflammatory cells along the bone suggested the advance of the rheumatoid inflammatory lesion into bone tissue. The SBJ contained macrophage-rich and osteoclast-rich areas. The presence of the macrophage as a predominant cell type and the marked collagenolysis of the eroded bone matrix suggested that collagenase released by macrophages was responsible for a major portion of the bone erosion. The observation of osteoclasts with ruffled borders, containing free bone crystals in close contact with the bone, indicated that these osteoclasts were stimulated by the rheumatoid synovium. It seems likely that articular bone resorption depends upon the local host response to the macrophage and osteoclast in the rheumatoid joint.
7280485	The dynamic vertical force distribution during level walking under normal and rheumatic fe	1981 May	Normal subjects and patients with rheumatoid arthritis and varying degrees of foot involvement have been studied using an apparatus which measures the dynamic force distribution under the foot during walking. There was a significant change in the walking pattern of the patients, expressed in slowing the speed of walking, lowering the heel-strike and push-off impacts, increasing the double-support period and reducing the amount of impulse taken by the forefoot. As a result, the localized peak loads and impulses were not higher than those of the control group, but moved from the medial side of the foot towards the centre, and the ratio of peak to average load (force concentration factor) at this region increased.
641093	Simultaneous and staged bilateral total knee arthroplasty.	1978 Mar	Bilateral total knee arthroplasties were performed in twenty-six patients with severe rheumatoid arthritis and osteoarthritis. Twelve had simultaneous operations bilaterally and fourteen had separate, staged procedures. The improvement in the two groups of patients was statistically comparable to the relief of pain and the over-all restoration of function. There were no intraoperative complications. The postoperative morbidity was minimum and was not predominant in either group. Costs were greatly increased with the staged procedure.
7034594	Inhibition of polymorphonuclear leukocyte migration by sera of patients with rheumatoid ar	1982 Jan	The migration of peripheral polymorphonclear leukocytes (PMN) of patients with rheumatoid arthritis (RA) and normal controls was studied using autologous sera and homologous rheumatoid positive and negative sera. A significant inhibition of cells from RA patients was observed using autologous or homologous rheumatoid sera in contrast to patients' PMN exposed to control sera in which no significant migration inhibition was detected. Negative results were observed when rheumatoid sera were used with PMN from normal controls. No correlation was found between the degree of PMN migration inhibition and the titer of rheumatoid factor. The results of these studies indicate that mononuclear cells in rheumatoid patients have varying degrees of sensitization to certain factor(s) in rheumatoid sera.