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ID PMID Title PublicationDate abstract
9768457 Caries and periodontal conditions in patients with primary Sjögren's syndrome. 1998 The present investigation was designed to study caries and periodontal conditions in a selected group of patients with primary Sjögren's syndrome (1oSS). Twenty-one patients, 20 females and 1 male aged 44-75 years (mean 64 years), with recently diagnosed 1oSS constituted the study population. As a control group, 21 patients matched according to sex and age were randomly selected from patients at one clinic in the Public Dental Service. Clinical examinations including registrations of dental caries, restorations, and periodontal conditions were performed. Unstimulated and stimulated salivary secretion rates were recorded. The 1oSS group had a mean number of 16.4 +/- 8.9 and the control group 17.1 +/- 8.4 natural teeth. The 1oSS patients had significantly more DF crown surfaces (63 +/- 25.8 vs 43 +/- 21.3) and more inactive root caries (4.4 +/- 5.4 vs 0.5 +/- 0.9) than did the control patients. No significant differences were found between the groups in the periodontal conditions. The mean value of the unstimulated salivary secretion rate was 0.09 +/- 0.16 ml/15 min in the 1oSS group and 3.33 +/- 2.81 ml/15 min in the control group. The stimulated secretion rate was 0.16 +/- 0.15 ml/min and 1.47 +/- 0.64 ml/min respectively. This study confirms results from other studies that patients with 1oSS face a high risk of developing both coronal and root caries due to xerostomia. The periodontal conditions are similar to those found in patient groups in general dentistry.
9683860 Multiple nodular lesions of the chin and oral mucosa in a patient with Sjögren's syndrome 1998 Jul Sjögren's syndrome is an autoimmune disease characterised by generalised lymphoproliferation. Patients have an increased risk of developing lymphomas which are usually derived from mucosa-associated lymphoid tissue (MALT). We report a low grade, non-Hodgkin's lymphoma of the skin and oral mucosa in a patient with Sjögren's syndrome.
9236670 T-cell receptor in Sjögren's syndrome. 1997 Jun Studies on the TCR repertoire of T cells in several inflamed lesions of SS patients have shown that there exist no unique TCR V family genes, although TCR V gene usage is relatively restricted. Analysis of the clonality of infiltrating T cells shows that some T cells expand clonally in lesions, suggesting that these cells were induced by antigen-driven rather than superantigen-driven stimulation. The restricted usage of the TCRJ beta, V alpha and J alpha genes also supports the notion that all expanded T cells do not accumulate due to superantigen. Junctional sequence analysis has revealed some conserved amino acid sequence motifs in the TCR CDR3 region, which is the antigen-binding site on T cells. These observations strongly suggest that pathogenic T cells in lesions recognize limited epitopes on autoantigens in the context of HLA. These findings are similar to TCR on T cells in rheumatoid synovium, as described elsewhere [51]. Intriguingly, T cells in lacrimal and labial salivary glands recognize common epitopes, but T cells in the kidney react with different autoantigens from those in minor salivary glands. In the future, the peptides recognized by pathogenic autoreactive T cells should be clarified to elucidate the mechanism for the progression of SS. Moreover, we predict that a vaccination with analogue peptides, to induce autoreactive T cells to anergy, might provide a new strategy for the specific treatment of SS.
16972752 Image-injected frameless stereotactic approach to the anterior craniovertebral junction. 1999 Jun 15 Transoral odontoidectomy is often performed in the treatment of cervicomedullary junction disease. The operating microscope is frequently used to improve visualization in this narrow field of view. In the setting of complex anatomy or surgical revision the authors hypothesized that combining frameless stereotactic technique with intraoperative microscopy would improve the ability to visualize and identify intraoperative anatomy. In addition they believed that the ability to visualize the targeted region directly in the operating microscope "image injection" would be of particular interest in this setting, provided that sufficient accuracy for use could be obtained in the registration process. The authors assessed the efficacy of this approach in a cadaveric model and obtained sufficient accuracy to warrant use in the operating room. This technique was applied in the surgical management of a 56-year-old woman with rheumatoid arthritis who had undergone a previous decompressive transoral procedure. Subsequently she suffered progressive deterioration and was found to have residual bony compression of the anterior cervicomedullary junction. The authors performed decompressive surgery and obtained satisfactory results by using the image-injected technique, and the patient experienced subsequent clinical improvement. The authors conclude that the image-injected frameless stereotactic technique is of potential benefit, particularly in the narrow window of approach of the transoral odontoidectomy.
11510206 [Characteristics of hospitalization of patients with rheumatic diseases admitted to a tert 2001 Jun BACKGROUND: The diagnostic profile of patients with rheumatic diseases admitted to a general hospital is variable. AIM: To report the epidemiological profile of patients with rheumatic diseases admitted to a tertiary care hospital. MATERIAL AND METHODS: All admissions to a Medicine ward of a general hospital and seen by the Rheumatology team were prospectively registered during one year in 1999. Patients were classified as primarily admitted for a rheumatic disease or admitted for other cause that required a consultation with the Rheumatology team. RESULTS: One hundred forty five admissions due to rheumatic diseases were registered. Of these, 82 were due to primary rheumatic diseases. Systemic lupus erythematosus, rheumatoid arthritis and vasculitis were the main diagnoses and the mean hospital stay was 18.5 days. Sixty three patients required a consultation with the Rheumatology team specially due to osteoarthritis and crystal induced diseases. CONCLUSIONS: Admissions due to rheumatic diseases are prolonged, correspond to 0.46% of all admissions and the main responsible disease is systemic lupus erythematosus.
11487476 Genetic organization of the human MHC class III region. 2001 Aug 1 The human major histocompatibility complex (MHC), or human leukocyte antigen (HLA) region, encompasses over 4 Mb of DNA on the short arm of chromosome 6 and is traditionally divided into the class I, class II and class III regions. The MHC has now been entirely sequenced and ~220 genes have been defined of which ~62 are in the class III region. It is becoming clear that many of the latter encode proteins that are likely to be involved in the immune and inflammatory responses. The MHC is known to contribute to a large number of immune-related disorders including insulin dependent diabetes mellitus, rheumatoid arthritis, common variable immunodeficiency and IgA deficiency and there is growing evidence that genes within the class III region are important in determining susceptibility to many of these complex conditions. Genes in the class III region have also been implicated in a number of non-immune-related diseases such as congenital adrenal hyperplasia and sialidosis. Now that the full gene content of the class III region is known the stage is set for the identification and characterisation of candidate disease genes, which will allow greater understanding of the causes of many MHC-linked diseases and thus aid the development of improved treatments.
11283456 [Atlanto-axial lateral mass osteoarthritis. Three case reports and review of the literatur 2001 Feb This report describes three cases of symptomatic unilateral C1-C2 mass osteoarthritis. The patients were all female aged 67, 62 and 59 years. One patient had a history of rheumatoid arthritis. Unilateral occipital pain was the main symptom. Neuroradiological work-up included open mouth anteroposterior radiograph, flexion/extension lateral radiograph of the cervical spine, CT scan with coronal and sagittal reconstruction and MRI. Findings allowed differential diagnosis with tumoral or infectious disease of upper cervical spine and ruled out C1-C2 instability. CT scan and MRI permitted precise operative planning by determining the course of vertebral artery in the C1 and C2 vertebrae. Two patients were treated by CT scan guided steroid injection. The third patient was treated by C1-C2 arthodesis after failure of conservative treatment.
11212296 Integrin antagonists. 1999 Oct 30 Integrins are a family of cell surface glycoproteins that mediate numerous cell-cell and cell-matrix interactions and are involved in biological processes such as tissue morphogenesis, leukocyte recirculation and migration, wound healing, blood clotting and immune response. Aberrant cell adhesion has been implicated in the pathogenesis of several diseases, including a number of inflammatory disorders such as rheumatoid arthritis, inflammatory bowel disease and asthma, as well as cancer and coronary heart disease. As such integrins are seen as excellent targets for the development of therapeutic agents. This report begins with an examination of the structure of integrin molecules and their ligands and then goes on to review the current state of development of antiintegrin antagonists.
10752019 Diagnosis and treatment of nonsteroidal anti-inflammatory drug-associated upper gastrointe 2000 Mar Nonsteroidal anti-inflammatory drugs (NSAIDs) are widely prescribed in the United States to treat pain and reduce inflammation from chronic inflammatory disorders such as rheumatoid arthritis and osteoarthritis. Approximately 40% of older Americans take NSAIDs. Chronic NSAID use carries a risk of peptic ulcer and other gastrointestinal disturbances. This article reviews the diagnosis of medication-induced ulcers based on clinical presentation, laboratory tests, and endoscopic findings to assist the clinician in early diagnosis and appropriate therapy. Risk factors for NSAID-induced ulcers include old age, poor medical status, prior ulcer, alcoholism, smoking, high NSAID dosage, prolonged NSAID use, and concomitant use of other drugs that are gastric irritants, such as alendronate, a bone resorption inhibitor prescribed for osteoporosis. Appropriate treatment options for patients with medication-induced ulcers include dosage reduction, medication substitution, medication withdrawal, antiulcer therapy, and discontinuation of other gastrotoxic drugs.
10795877 Total arch replacement with an aortic arch aneurysm due to chronic interstitial pneumonia: 2000 The case of a 66-year-old man who had rheumatoid arthritis, chronic interstitial pneumonia (IP) with honeycomb lung, and an aortic arch aneurysm is described. He complained of left chest pain in April 1998 and chest computed tomography revealed an enlargement of a thoracic aneurysm whose maximum diameter reached 7 cm. He was urgently transferred to our institution to undergo immediate surgery for an impending rupture of the aneurysm. His PaO2 with 80 Torr with oxygen therapy. The operation included a median sternotomy, extracorporeal circulation with selective cerebral perfusion, the use of cold blood cardioplegic solution, and open distal anastomosis. Although an acute exacerbation of IP occurred 2 months after the surgery, he successfully received intensive care including high-dose steroid therapy and artificial ventilation. He was successfully weaned from the ventilator and is now being followed up with medical treatment.
10763370 [Bilateral rupture of the patellar ligament in diabetes mellitus]. 2000 Feb Bilateral ruptures of patellar tendon are a rare event and occur mainly in older patients suffering from systemic diseases like lupus erythematosus, chronic renal failure, rheumatoid arthritis or are taking longterm corticosteroids. Only few cases of spontaneous bilateral rupture of patellar tendon without underlying systemic disease are described in literature up to now. This report provides a patient with bilateral patellar tendon rupture, where in further check up and follow up only a mild diabetes mellitus treated by diet could be detected as systemic disease. In current opinion diabetes mellitus does not belong to the "typical" underlying systemic diseases for tendon ruptures. In literature research diabetes mellitus was only mentioned once together with a bilateral patellar tendon rupture.
10597932 The effect of the additional use of grommets in silicone implant arthroplasty of the metac 1999 Oct After silicone arthroplasty of the metacarpophalangeal (MP) joint there is increasing osteolysis, subsidence and fracture of the implants in the longer postoperative term. In 44 patients with rheumatoid arthritis (54 hands) 151 arthroplasties of the metacarpophalangeal joint were assessed at a mean of 3.9 years postoperatively. In 57 arthroplasties titanium protectors (grommets) were used. There were no significant differences in the clinical outcomes with respect to swelling, correction of ulnar deviation, range of active movement and grip strength. The additional use of grommets in MP joint arthroplasty slightly reduced reactive osteolysis, protected the spacers from breakage and slightly reduced the amount of pain with only a few additional complications in the midterm follow-up.
10466080 CD69 and regulation of the immune function. 1999 Aug CD69, also known as activation inducer molecule, very early activation antigen, MLR-3 and Leu-23, is a member of the natural killer (NK) cell gene complex family of signal transducing receptors. CD69 is as a type II transmembrane glycoprotein with a C-type lectin binding domain in the extracellular portion of the molecule. CD69 expression is induced in vitro on cells of most hematopoietic lineages, including T and B lymphocytes, NK cells, murine macrophages, neutrophils and eosinophils, while it is constitutively expressed on human monocytes, platelets and epidermal Langerhans cells. Although a specific ligand for CD69 has not been identified, its wide cellular distribution and the induction of intracellular signals upon CD69 crosslinking suggest a role for the receptor in the biology of hematopoietic cells. Moreover, certain results indicate that CD69 may be involved in the pathogenesis of such diseases as rheumatoid arthritis, chronic inflammatory liver diseases, mild asthma, and acquired immunodeficiency syndrome.
10423543 Identification of aggrecanase activity in medium of cartilage culture. 1999 Aug Erosion of cartilage is a major feature of joint diseases, i.e., osteoarthritis and rheumatoid arthritis, which leads with time to a loss of joint function. Proteolytic cleavage of the aggrecan core protein is a key event in the progress of these joint diseases. Aggrecan degradation has been believed to be mediated by a putative proteinase, aggrecanase. We identified aggrecanase activity in conditioned medium from explant culture of bovine nasal cartilage stimulated by retinoic acid. The activity was partially purified more than 10,000-fold. The enzyme cleaves at the aggrecanase site (Glu(373)-Ala(374)) but not at the MMP site (Asn(341)-Phe(342)) in the interglobular domain of the aggrecan. It also cleaves at Glu(1971)-Leu(1972), which is located in the gap region in the chondroitin sulfate attachment region prior to the aggrecanase site. The enzyme is a typical Ca(2+)-dependent metalloproteinase with a unique salt-dependency and is inhibited by several hydroxamate-based inhibitors for matrix metalloproteinases. Heparin and chondroitin sulfate inhibited the enzyme in a dose-dependent manner, suggesting that the large carbohydorate in aggrecan is important for substrate recognition by aggrecanase.
9918266 The responsiveness of generic quality of life instruments in rheumatic diseases. A systema 1999 Jan To review the available evidence that has used generic instruments alone or in comparison with disease specific instruments. A systematic review was carried out using the methods recommended by the Cochrane Collaboration. We used MEDLINE and EMBASE searches and we performed a hand search of the abstracts listed under "quality of life" at American College of Rheumatology (ACR) meetings. Selection was limited to randomized controlled trials (RCT) using generic instruments in populations older than 18 years with any of the following diseases: rheumatoid arthritis, fibromyalgia, osteoporosis, osteoarthritis, systemic lupus erythematosus, and ankylosing spondylitis. Language was restricted to English papers. Studies using only disease-specific instruments were excluded. From 488 articles retrieved, 13 reports of 10 randomized controlled trials were selected. There were 101 abstracts on quality of life in ACR abstract books; 78 abstracts contained data on generic instruments, and of these, 9 described their use in RCT. Despite a substantial increase in the number of papers and abstracts addressing different aspects of generic questionnaires, the majority of the papers were descriptive. The evidence is not yet available to document that any of the generic instruments pass the requirements of the OMERACT Filter.
9788509 Measurements of zeta potentials of particulate biomaterials in protein-rich hyaluronan sol 1998 Dec 5 This study was undertaken to determine the zeta potentials of particulate biomaterials in three types of protein-rich hyaluronan solution with changes in pH; a microelectrophoretic method was used. For the purpose of determining the pH value of synovial fluid in various inflammatory conditions, we collected synovial fluid samples from joints with osteoarthritis (OA), rheumatoid arthritis (RA), and those undergoing revisions arthroplasties. The mean values of the pH in the synovial fluid from joints with OA, RA, and revision arthroplasty were shown to be 7.9, 7.5, and 8.1, respectively. The pH-zeta potential curves obtained differed, depending on the biomaterial and the medium. Addition of gamma-globulin to the medium reduced the absolute value of the zeta potentials of some of the biomaterials. The findings of this study suggest that the electrophoretic behaviors of the particulate biomaterials tested in this study are affected by the protein constituents of and pH changes in protein-rich synovial fluid. The values we obtained will be useful as reference standards and will also aid in the study of the surface phenomena of biomaterials.
9769999 [Bronchiolitis obliterans with organizing pneumonia. Retrospective study of 19 cases]. 1998 Jul We report a series of 19 cases of bronchiolitis obliterans with organized pneumonitis (BOOP) observed in two pneumology units at the Strasbourg University Hospital between July 1987 and June 1997. Mean patient age was 60 years. Clinical features included dry cough, exercise-induced dyspnea, and a flu-like syndrome in three-quarters of the cases. Standard chest x-ray showed a diffuse non-systemized alveolar syndrome with a air bronchogram in 18 cases and an interstitial syndrome in one-third of the cases. computed tomography of the thorax visualized bronchial dilatations by traction of the alveolar syndrome in one-third of the cases. Pulmonary function tests showed moderate restriction. Lymphocytes predominated in bronchio-alveolar lavage fluid. Pathology examination of surgical lung specimens (5 cases), transbronchial biopsies (5 cases) and scan-guided transparietal punctures (4 cases) provided the diagnosis. In 5 cases the diagnosis was based on the radiological and clinical presentation and favorable course on corticosteroid therapy. Recurrence was observed at corticosteroid withdrawal or dose reduction in 7 cases. In this series, bronchiolitis obliterans with organized pneumonitis was probably secondary to rheumatoid arthritis (1 case), breast radiotherapy (3 cases), and drugs (amiodarone: 1 case: sotalol: 2 cases: betaxolol: 1 case). An association with betaxolol has not been previously reported in the literature.
9441573 The pathophysiologic roles of interleukin-6 in human disease. 1998 Jan 15 Interleukin-6, an inflammatory cytokine, is characterized by pleiotropy and redundancy of action. Apart from its hematologic, immune, and hepatic effects, it has many endocrine and metabolic actions. Specifically, it is a potent stimulator of the hypothalamic-pituitary-adrenal axis and is under the tonic negative control of glucocorticoids. It acutely stimulates the secretion of growth hormone, inhibits thyroid-stimulating hormone secretion, and decreases serum lipid concentrations. Furthermore, it is secreted during stress and is positively controlled by catecholamines. Administration of interleukin-6 results in fever, anorexia, and fatigue. Elevated levels of circulating interleukin-6 have been seen in the steroid withdrawal syndrome and in the severe inflammatory, infectious, and traumatic states potentially associated with the inappropriate secretion of vasopressin. Levels of circulating interleukin-6 are also elevated in several inflammatory diseases, such as rheumatoid arthritis. Interleukin-6 is negatively controlled by estrogens and androgens, and it plays a central role in the pathogenesis of the osteoporosis seen in conditions characterized by increased bone resorption, such as sex-steroid deficiency and hyperparathyroidism. Overproduction of interleukin-6 may contribute to illness during aging and chronic stress. Finally, administration of recombinant human interleukin-6 may serve as a stimulation test for the integrity of the hypothalamic-pituitary-adrenal axis.
9122099 Neutrophilic dermatoses: pyoderma gangrenosum and Sweet's syndrome. 1997 Feb Pyoderma gangrenosum and Sweet's syndrome are classified as neutrophilic dermatoses as they exhibit intense dermal inflammatory infiltrates composed of neutrophils with little evidence of a primary vasculitis. They share several characteristics and respond to immunosuppressives. Aetiology is felt to represent a manifestation of altered immunologic reactivity. Patients with both conditions concurrently have been described. Diagnosis is based on clinical and histopathological findings. However, clinically the typical forms of the two conditions are quite distinct: pyoderma showing cutaneous ulceration with a purple undermined border and Sweet's syndrome having tender, erythematous, nonulcerated plaques and nodules. Approximately 50% of cases of pyoderma are associated with a specific systemic disorder. These include inflammatory bowel disease, rheumatoid arthritis, non-Hodgkin's lymphoma and myeloproliferative disorders. Many associations with Sweet's syndrome have been described, including acute myeloid leukaemia, myeloma and adenocarcinomas, and haematological malignancy. There is overlap between the two conditions with lesions categorised as Sweet's syndrome being clinically more characteristic of atypical pyoderma and vice versa. We believe that pyoderma and Sweet's syndrome represent a continuum of spectrum of disease. The reason for the clinical differences between the conditions is unclear and merits further investigation but may be explained by varying levels of intensity and extent of the inflammatory process. This review will describe the pathogenesis, clinical features, diagnosis, associations and treatment of the two conditions.
9044010 Patient satisfaction in a nurse-led rheumatology clinic. 1997 Feb Patient satisfaction with a nurse-led rheumatology clinic was tested using the Leeds Satisfaction Questionnaire (LSQ), which was specially developed and shown to be both reliable (Cronbach's alpha, 0.96) and stable (test-re-test r = 0.83). A total of 70 patients with rheumatoid arthritis, aged 22-75 years were randomly allocated to either a nurse's or a rheumatologist's clinic and seen on six occasions over a year. They completed the LSQ on entry and on completion of the study. At week 0 both groups were satisfied with their care and there were no significant differences between them. By week 48 the medical cohort showed significantly increased satisfaction with access and continuity (P < 0.05) but no change in overall satisfaction. The patients in the nurse-led clinic recorded significant increases in overall satisfaction and in all subscales (P < 0.0001). Between-group comparison at week 48 showed the nurse's patients to be significantly more satisfied than those of the rheumatologist.