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ID PMID Title PublicationDate abstract
17986957 Reconstruction of large defects of the roof of the hip joint using solid cortical spongy b 2001 Jan Background. A favorable outcome following revision hip arthroplasty is the result of several factors. One of the basic conditions is stable fixation of the endoprosthetic acetabulum in the physiological site with full bone support. It is difficult to meet this condition, however, in cases of upward migration of the primary endoprosthetic acetabular graft. This requires the supplementation of defects of various sizes present within the roof of the acetabulum during the revision procedure.
Material. The author presents long-term results from the reconstruction of the roof of the hip joint using solid corticalspongy bone grafts in 36 operated patients.
Results. Features of graft healing and full bone remodeling were found within 12 months in 21 operated patients, in whom solid bony autografts taken from the iliac ala had been used to fill the defects. The healing process in 13 patients, in whom solid frozen grafts taken from the bone bank had been used for plastic reconstruction of the roof of the hip joint, lasted 22 months. Unfavorable bony graft healing was observed in 2 patients, in whom full osteolysis of the graft had occurred, resulting in loosening of the acetabulum. Both patients were administered high doses of Encorton due to rheumatoid arthritis in the pre- and post-operation period.
11759380 [The mosaic of pemphigus]. 2001 Nov Pemphigus is an autoimmune blistering disease of skin and mucous membranes. The classic types of pemphigus are pemphigus vulgaris and pemphigus foliaceus. In this review we summarize recent advancement in the etiology and the pathogenesis of pemphigus. Desmogleins--transmembrane glycoproteins involved in intracellular adhesion--were recognized as targets of pemphigus antibodies. It was found that the distribution and the expression of desmogleins can explain the difference in the localization of lesions in pemphigus vulgaris and pemphigus foliaceus. Pemphigus develops in a two-step process. The first step leads to the presence of a low titer of autoantibody, the second step results in a significant increase in the antibody titer which causes the clinical stage of the disease. Selective presentation of self peptides can explain the Major Histocompatibility Complex (MHC)--linked susceptibility to autoimmune diseases including pemphigus and rheumatoid arthritis. Peptides selective for the disease-associated molecules can be identified and used to search for microbiologic factors that can take part in the pathogenesis of pemphigus.
11731028 Drug targeting to hypoxic tissue using self-inactivating bioreductive delivery systems. 2001 Dec 17 Hypoxia is a characteristic feature of a number of diseases including some cancers, rheumatoid arthritis and diabetes. Hypoxic tissue facilitates the use of bioreductive drug targeting systems as oxygen suppresses the release of the active drug. This review focuses on bioreductive delivery where accompanying intramolecular cyclisation negates adduct formation between the bioreductive and macromolecules such as DNA. To date, three systems have been reported. In the quinone lactonization system, reduction of the quinone facilitates through bond cyclisation and concomitant release of the drug. In the self-alkylating system, a nucleophile is built into the bioreductive structure to favour intramolecular cyclisation over nucleophilic attack from DNA moieties. The final system is based on vitamin E which undergoes redox mediated cyclisation between its oxidised (tocopherol quionone) and reduced (tocopherol) forms. Self-inactivating bioreductive delivery systems represent a powerful tool for extending bioreductive-based drug delivery to non-cancerous hypoxic tissues.
11709116 Clinical evidence for osteoarthritis as an inflammatory disease. 2001 Dec Osteoarthritis (OA) is not a simple consequence of "wear and tear" or aging--the presence of cytokines suggests a role for inflammation. OA is polyarticular in most patients, with metabolic and differential risk factors for prevalence and severity. Odds ratios for the prevalence of OA according to formal education levels are similar to those seen for dysregulatory diseases such as hypertension, diabetes, and rheumatoid arthritis. Clinical survey data indicate significant patient preference for nonsteroidal anti-inflammatory drugs (NSAIDs) compared with acetaminophen. A recent crossover clinical trial indicated significantly greater efficacy of the NSAID, diclofenac/misoprostol, versus acetaminophen for most patients with OA.
11701549 Bone Marrow Transplantation for Non-Malignant Disease. 2000 This article reviews the experience in hematopoietic stem cell transplantation (HSCT) for non-malignant disease. HSCT has long been applied as treatment of life-threatening congenital immunodeficiency and metabolic diseases. In Section I, Dr. Parkman reviews that experience for severe combined immunodeficiency, Wiscott-Aldrich syndrome, hyper IGM syndrome, Chédiak-Higashi disease and hereditary lymphohistiocytosis. The value of HSCT in genetic metabolic diseases such as osteopetrosis, osteogenesis imperfecta and the storage diseases are reviewed. In Section II, Dr. Walters reviews the experience over the last decade with allogeneic stem cell transplantation in patients with thalassemia major and sickle cell disease. In Section III, Dr. Sullivan reviews the more recent investigations using stem cell transplantation in patients with advanced autoimmune diseases such as systemic sclerosis, systemic lupus erythematosus, multiple sclerosis and juvenile rheumatoid arthritis. The pathogenesis and outcome with conventional care of these patients, the selection criteria and current results for HSCT, and the future directions in clinical research and patient care using this modality are addressed.
11584192 The concept and application of antisense oligonucleotides. 2001 Sep Since the identification of the double-stranded DNA helix by Watson and Crick in 1953, the knowledge of nucleotide structure and function has been an important potential tool in the study and therapy of disease. There is recent clinical evidence that antisense oligonucleotides may be important therapeutic compounds in the clinical therapy of a range of diseases, including infection (viruses and bacteria), oncology, and inflammation. Our laboratory-based understanding of antisense oligonucleotide activity has provided a foundation for their use in several human diseases. Potentially relevant applications include inflammatory bowel disease therapy, psoriasis, transplantation, rheumatoid arthritis, cytomegalovirus retinitis, hepatitis C, and solid tumor therapy. Here we will outline these applications as well as our ongoing clinical trials for Crohn's disease.
11506245 Silica and renal diseases: no longer a problem in the 21st century? 2001 Jul Silicosis and other occupational diseases are still important even in the most developed countries. In fact, at present, silica exposure may be a risk factor for human health not only for workers but also for consumers. Furthermore, this exposure is associated with many other different disorders besides pulmonary silicosis, such as progressive systemic sclerosis, systemic lupus erythematosus, rheumatoid arthritis, dermatomyositis, glomerulonephritis and vasculitis. The relationships between these silica-related diseases need to be clarified, but pathogenic responses to silica are likely to be mediated by interaction of silica particles with the immune system, mainly by activation of macrophages. As regards renal pathology, there is no single specific clinical or laboratory finding of silica-induced nephropathy: renal involvement may occur as a toxic effect or in a context of autoimmune disease, and silica damage may act as an additive factor on an existing, well-established renal disease. An occupational history must be obtained for all renal patients, checking particularly for exposure to silica, heavy metals, and solvents.
11425292 Monoamine oxidase inhibitors for IgA nephropathy. 2001 Feb IgA nephropathy (IgAN), characterized by renal mesangial deposits of antibodies (of the IgA subtype), is the most common glomerulonephritis worldwide. The cause of IgAN is not known. IgAN can often lead to end stage renal disease (ESRD), and there is no known treatment proven to prevent ESRD in IgAN. Long term use of steroids or other immunosuppressant drugs carry severe toxicities and other risks. IgAN patients have high serum levels of tumor necrosis factor-alpha (TNF). Increased monoamine levels, via increased cellular cyclic AMP, can decrease TNF elaboration. Monoamine oxidase inhibitors (MAO-Is) have been found effective in case studies for a number of diseases, e.g. rheumatoid arthritis and Crohn's disease, characterized by high TNF levels. Here I suggest that MAO-Is might be of utility in IgAN by decreasing TNF levels.
11114845 Estrogen receptor alpha dinucleotide repeat polymorphism in Japanese patients with autoimm 2000 BACKGROUND: The autoimmune thyroid diseases (AITDs), comprising Graves' disease (GD) and Hashimoto's thyroiditis (HT), appear to develop as a result of complex interactions between predisposing genes and environmental triggers. Susceptibility to AITDs is conferred by genes in the human leukocyte antigen (HLA) and genes unlinked to HLA, including the CTLA-4 gene. Recently, an association to some estrogen receptor (ER)alpha genotypes with breast cancer, hypertension, osteoporosis, generalized osteoarthritis, and some autoimmune diseases such as rheumatoid arthritis has been reported. We have analyzed a dinucleotide (TA)n repeat polymorphism lying upstream of the human ERalpha gene in patients with AITDs and in normal subjects. RESULTS: Seventeen different alleles were found in 130 patients with GD, 93 patients with HT, and 190 control subjects. There was no significant difference in the distributions of ERalpha alleles between patients and controls. CONCLUSIONS: The present results do not support an association between the ERalpha gene and AITD in the Japanese population.
10929353 Total knee arthroplasty in femorotibial instability. 2000 Jun Regarding the reasons for failure of conventional knee arthroplasty a lot of work has be done on loosening and polyethylene wear, often leading to recurrent deformation and osteolysis. But there are only few reports concerning femorotibial instability. This instability is related to failure of the collateral ligaments which can often be found in cases of important frontal deformity both in the varus and valgus knee or in rheumatoid arthritis. Femorotibial instability has been reported in the literature as reason of failure of knee replacement in 10 to 30% of all cases. This complication may be avoided by a precise preoperative analysis including unipodal standing view and stress X-Rays. Encouraged by the good long-term results published by the Endo-Klinik we started to use the ENDO-Model rotational knee system in patients with suspected femorotibial instability in order to resolve the problems of resurfacing the patella restoring mobility correcting the deformity stabilising the knee In fact, the rotating or hinge prosthesis is actually transforming the anatomical joint in a mechanical joint in which the pivot is acting as a ligament should act.
10684171 [Biology of heat shock proteins]. 1999 Hsp (Heat shock proteins) are a family of constitutive proteins of all pro and eukariotic cells that play different physiological roles: they promote the folding (acquisition of tertiary structure) assembly, translocation and secretion of newly synthesized polypeptides and participate in the removal or repairing of denatured proteins acting as molecular chaperons. This family of proteins is composed by numerous members grouped according to their molecular weight. When cells are subjected to different stresses such as hyperthermic shock, radiation, toxins, viral infections, etc., Hsp are overexpressed. In this way, they exert a cytoprotective effect, making the cells resistant to apoptosis. In humans, Hsp are overexpressed in cancer cells from ovary, endometrium, breast, prostate, digestive tract, etc. In some cases, overexpression is correlated with an unfavorable outcome because these proteins could favour metastatic disease. Some authors associate them not only with proliferation but also with differentiation of the neoplastic tissue. Recent studies show their influence in resistance to chemotherapeutic drugs. In autoimmune diseases like rheumatoid arthritis, Hsp can suppress the inflammatory response. Nevertheless, their role in the immune system has not been well established.
10583061 Pneumocystis carinii pneumonia in patients receiving immunosuppressive drugs for dermatolo 1999 Sep In recent years, Pneumocystis carinii pneumonia (PCP) has been increasingly reported in patients without human immunodeficiency virus (HIV) infection. The increased occurrence of PCP in non-HIV-immunocompromised subjects has been attributed to several factors: use of stronger immunosuppressive regimens, higher awareness of PCP, advanced diagnostic technology and nosocomial spread of P. carinii. Appearance of PCP subsequent to the use of immunosuppressive drugs has been noticed in many inflammatory diseases such as rheumatoid arthritis, systemic lupus erythematosus and ulcerative colitis. Dermatologists frequently use immunomodulating agents, but the occurrence of PCP in patients receiving immunosuppressive drugs for skin diseases is largely unknown. We report four cases where PCP appeared following the use of immunosuppressive drugs primarily for cutaneous diseases, namely pemphigus, cutaneous necrotizing vasculitis (two cases) and Behçet's syndrome. These cases were identified in a computerized database study (1979-95) to evaluate the occurrence of PCP among immunocompromised hosts without HIV infection.
10546813 Quantitative zymography of matrix metalloproteinases by measuring hydroxyproline: applicat 1999 Oct Gelatinases A and B are metalloproteinases involved in the degradation of the extracellular matrix. Detection and quantification of these enzymes in physiological and pathological conditions such as rheumatoid arthritis, tumor invasion and metastasis may be clinically useful. Gelatin zymography is an electrophoretic technique specific for gelatinases. It can be used to detect the activity of both the active and latent forms. We have standardized this technique for the active and latent forms of gelatinase A and for the latent form of gelatinase B. We measured the extent of gelatin degradation with an EDC scanning densitometer (Helena). The value recorded was directly proportional to the amount of enzyme. Gelatinase activity was quantified from the gel by assaying hydroxyproline as an index of gelatin breakdown. Gelatin zymography was found to be useful in characterizing gelatinases A and B by their molecular weights and measuring their specific activity by a standardized analysis of the degraded gelatin substrate.
10352133 Deaths due to dementia: An analysis of multiple-cause-of-death data. 1999 This study analyzes multiple-cause-of-death information from over 113,000 death certificates of Canadians aged 65+ and identifies causes that are significantly likely and significantly unlikely to combine with dementia to cause death. For dementia as a mentioned cause and as the underlying cause of death, frequencies and rates of death were calculated. Dementia was mentioned on death certificates 2.4 times as often as it occurred as the underlying cause of death. Among the causes least associated with dementia were some cancers, chronic respiratory diseases and rheumatoid arthritis. Causes of death that rarely occur with dementia should be further investigated in terms of their potential role in preventing or delaying the onset of dementia. In particular, further study of the role of anti-inflammatory drugs and nicotine in reducing the risk of dementia is indicated. Causes positively associated with dementia largely reflect the physical deterioration it confers.
10190250 [Mechanisms and applications of oral tolerance]. 1999 Feb The term oral tolerance (OT) describes the antigen-specific suppression of immune responses following the feeding of the antigen. While some common features with other forms of induction of systemic tolerance have been disclosed, OT can be distinguished by certain immunologic characteristics. Thus, work in experimental animal models revealed the importance of intestinal antigen processing, especially antigen processing in the Peyer's patches, in inducing OT. It has become clear that suppressive T cell cytokines derived from mucosal sites play a major role in mediating OT. The variation of the dose of fed antigen and the modulation of the cytokine milieu both have influences on the underlying immunologic mechanisms active suppression, clonal anergy and clonal deletion following oral antigen uptake. In several animal models of autoimmunity the disease activity can be suppressed by feeding oral autoantigen. Based on these results, recent clinical studies have begun to explore OT as a means to treat autoimmune disorders such as multiple sclerosis, rheumatoid arthritis and diabetes.
10081315 [Pharma-clinics. The drug of the month. Aceclofenac (Biofenac)]. 1999 Jan Aceclofenac, a phenylacetic acid derivative, is a new nonsteroidal anti-inflammatory drug (NSAID). It is indicated in the symptomatic treatment of pain and inflammatory or degenerative arthropathies: osteoarthritis, rheumatoid arthritis, ankylosing spondylitis, abarticular inflammations, posttrauma or postoperative inflammations. The usual oral dosage of aceclofenac is 100 mg twice daily in adults. Its clinical efficacy seems to be similar to that of other NSAIDs, but its safety profile, especially gastro-intestinal tolerance, appears to be better. Finally, in vitro studies suggested that aceclofenac may exert positive effect on cartilage matrix metabolism.
9693188 Pemphigus vulgaris associated with silicosis. 1998 Pemphigus vulgaris has never before been associated with silicosis, although there are many reports of silicosis accompanied by several autoimmune diseases such as progressive systemic sclerosis, systemic lupus erythematosus, dermatomyositis or rheumatoid arthritis. We observed a patient with pemphigus vulgaris accompanied with silicosis. The patient was a 75-year-old man with a 2-month history of repeated oral erosions and blisters on the back, thighs and axillas. Histological examination showed suprabasal cleavage with acantholysis. Immunoblotting analysis demonstrated binding of the patient's serum to the 130-kD pemphigus vulgaris antigen (desmoglein 3) and the 160-kD pemphigus foliaceus antigen (desmoglein 1). The patient has radiographically been diagnosed as having silicosis. An elevated serum IgG, antinuclear antibody, anti-ssDNA, antimicrosomal antibodies and a biologically false-positive reaction to the Wassermann test were also detected. Although the clinical symptoms improved after treatment with systemic steroids, the patient died due to pneumonia. This is the first reported case in which the characteristics of both pemphigus vulgaris and silicosis could be detected.
9606358 Large granular lymphocytic leukemia: an overview. 1998 May 15 Large granular lymphocytes are killer cells that differentiate into natural killer and T-cell types. Neoplastic proliferation of the lineages probably involves different etiologies, producing leukemias with distinct clinical presentations and prognoses. T-large granular lymphocytic leukemia has prominent autoimmune features and may occur in association with other autoimmune diseases, particularly rheumatoid arthritis.
9455962 An evidence-based medicine approach to the diagnosis and management of musculoskeletal com 1997 Dec 29 Evidence-based medicine is an approach to clinical practice and teaching that emphasizes decision-making based on rigorous analysis of clinical research tailored to the individual characteristics of a specific patient. As such, it can be considered the scientifically grounded art of medicine. Through evidence-based guidelines, pathways, and algorithms, the care of populations of patients may also be facilitated by informing individual practitioners of optimal decision-making in specific situations or providing the foundation for comprehensive "disease management" programs. These programs coordinate care for patients with chronic conditions, such as rheumatoid arthritis and osteoarthritis, across time and multiple disciplines. We present an approach to the development of decision-making aids, including guidelines and algorithms, which should be helpful in the care of individual patients and populations for whom physicians and other healthcare practitioners are responsible.
9200945 [Application of oral tolerance to the treatment of autoimmune diseases--active suppression 1997 Jun Oral tolerance is a phenomenon in which an orally ingested antigen induces systemic hyporesponsiveness to the same antigen. If the mechanism can be applied to autoantigens, it could be a promising mode of antigen-specific immunomodulatory treatment for patients with autoimmune diseases. Multiple ingestion of low doses of antigen induces active suppression. Under this condition, suppression of autoimmune attack to target tissues is mediated by anti-inflammatory cytokines such as TGF-beta, which are released from regulatory T cells triggered antigen-specifically. This type of oral tolerance, termed "bystander suppression", has one advantage of needing to know only the major components of the target tissue instead of exact epitopes of autoimmunity. Utilizing this mechanism, clinical trials of oral tolerance therapy are going on among the patients with multiple sclerosis, rheumatoid arthritis, and uveitis.