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PMID	Title	PublicationDate	abstract
6368064	Fc receptors on granulocytes from patients with rheumatoid arthritis and Felty's syndrome.	1984 Mar	Receptors for the Fc part of IgG on polymorphonuclear cells (FcR) of patients with rheumatoid arthritis (RA), Felty's syndrome (FS) and healthy controls (HC) were studied by means of a rosetting technique with rabbit IgG coated ox erythrocytes. When cold isolated polymorphonuclear cells (PMN) were incubated at room temperature the percentage of rosette forming PMN (RF-PMN) from HC was more than twice that measured directly after isolation at 4 degrees C. The same phenomenon was observed for PMN from patients with RA although the RF-PMN increased by only 1/3. In contrast warming of PMN from patients with FS did not influence the RF-PMN. The presence of surface bound immunoglobulins and intracytoplasmic immunoglobulins was measured by immunofluorescence and appeared to be inversely related to the RF-PMN. A good correlation between the results of the C1q binding assay (C1qBA) and the immunofluorescence score was observed but no correlation existed between the C1qBA and the RF-PMN. These results indicate that the number of PMN expressing FcR in patients with RA and FS is decreased presumably because of the phagocytosis of immune complex like material. The decrease in the availability of FcR may influence the functions of the PMN.
1106425	Identification of immunoglobulins and complement in rheumatoid articular collagenous tissu	1975 Nov	Ninety-three patients with a variety of joint diseases were studied for evidence of immune complexes in articular collagenous tissues. Frozen sections of freshly obtained biopsies of hyaline articular cartilage and menisci were stained with fluoresceinated monospecific antisera for evidence of human immunoglobulins (IgG, IgM,IgA) and the beta1c component of complement. The criterion for the presence of complexes was the staining of two or more immunoglobulins and beta1c in an identical location of sequentially cut sections. Of the 42 patients with rheumatoid arthritis (RA) 83% were positive by this criterion. In those with classic RA the incidence was 92%. Sixteen patients with fresh joint trauma or nonarthritic disease had negative findings. Among 26 patients with noninflammatory disease, 4 of 8 with polyarthritis whose features suggested primary degeneration, 1 of 11 patients with secondary degenerative arthritis, and a single case of synovial osteochondromatosis had positive findings. Among 9 patients with miscellaneous inflammatory arthritides, all of 3 with psoriatic arthritis were negative; however 2 of 6 with other inflammatory arthritides were positive. The findings in classic RA suggest that immune complexes are deposited in the articular collagenous tissues. The persistence of these complexes may play a significant role in the chronicity of the synovitis.
6141832	Sulphasalazine: a 'new' antirheumatic drug.	1984 Feb	Sulphasalazine was first introduced for the treatment of rheumatoid arthritis in 1942. Following initial enthusiasm, interest waned until 1978 when a large open study suggested that it might have a 'second-line effect'. Since then further studies have confirmed this effect and once again rheumatologists are starting to use sulphasalazine in the treatment of rheumatoid arthritis. In this review we examine the pharmacology of sulphasalazine and its metabolites, comment upon the possible modes of action and review the recent literature pertaining to its use in rheumatoid arthritis.
26761	Interaction of cortisol-21-palmitate with liposomes examined by differential scanning calo	1978 Jun	Liposomes have been suggested as carriers for corticosteroids in the local treatment of arthritis by intra-articular injection. The long chain 21-esters of cortisol such as the palmitate or octanoate are taken up and retained by liposomes in higher concentration than cortisol itself. Differential scanning calorimetry has been used to show that the cortisol ester is anchored in the liposome phospholipid bilayer by the acyl side chain. In addition, the limiting concentration of cortisol-21-palmitate which can be incorporated into dipalmitolyl phosphatidylcholine liposomes has been measured by observing changes in the DSC spectrum at different steroid concentrations. Steroid in excess of this concentration limit forms a separate phase which can be identified by nuclear magnetic resonance. For optimum effect, the treatment of arthritis with liposomes must be carried out with liposomes containing steroid below the limiting concentration.
6687339	Protrusio acetabuli: radiographic appearance in arthritis and other conditions.	1983 Dec	Normal radiographic anatomic relationships, as well as distortion of those relationships in protrusio acetabuli, have been described. The occurrence of this deformity in arthropathies is stressed and other entities are mentioned and illustrated. Standard anteroposterior hip or pelvis radiographs readily permit the detection of protrusio acetabuli.
3980503	Successive bilateral total knee replacement.	1985 Apr	We studied the results of 304 posterior stabilized condylar knee arthroplasties, performed over a two and a half-year period, to compare unilateral, bilateral one-stage, and bilateral staged arthroplasty. The minimum length of clinical follow-up was two years. Using The Hospital for Special Surgery rating system, we found the clinical results to be identical for all three groups. The medical complications were similar in each group except that there was a higher incidence of thromboembolism and pulmonary embolism, as seen venographically, in the patients with staged procedures. We concluded that one-stage bilateral knee arthroplasty is preferable in a patient who requires replacement for severely arthritic knees.
1018081	The importance of middle or long finger realignment in ulnar drift.	1976 Sep	Based upon the hypothesis that ulnar drift is the result of a chain reaction starting with a medial shift of the proximal phalanx at the metacarpophalangeal joint and progessing to subluxation of the extensor tendon and finally subluxation of the metacarpophalangeal joint, the author recommends early operative realignment. The extensor tendon is partially divided and a portion passed through the base of the phalanx, the intrinsic tendons are transferred to divided, the junctura tendnium is served, the periosteum is stripped from the neck of the metacarpal, and areas of bony erosions are curetted. In 25 patients with involvement of the middle finger only, alignment was maintained in all over a period of 3 months to 7 years, the average follow-up period being 1.4 years. When deformity was severe and the radical collateral ligament has been disrupted, correction was not always maintained. Early treatment is recommended.
961545	An investigation of the therapeutic value of the 'copper bracelet'-dermal assimilation of	1976 Jul	From over 300 arthritis sufferers, half of whom previously wore 'copper bracelets', three treatment-group-subjects were randomly allocated for a psychological study. This involved wearing 'copper bracelets' and placebo bracelets (amodised aluminum resembling copper) alternately. These groups, as also a control group, answered questionnaires. The copper bracelets were weighed before and after use. Preliminary results show that, to a significant number of subjects, the wearing of the 'copper bracelet' appeared to have some therapeutic value. A study of the components of sweat and the solubility of copper in sweat was carried out. In five sweat samples, the copper concentration was of the order 2 x 10(-5) M and after equilibrating with copper turnings at room temperature for 24 hours the samples turned blue in colour and contained approximately 2 x 10(-3) M copper. The permeability of skin to copper containing solutions has also been discussed. It has also been shown that the wearing of a 'copper bracelet' results in a weight loss in excess of the body's total burden of copper (100-150 mg). A pair of copper bracelets lost 80 mg in 50 days when worn around the ankles and a copper bracelet worn around the wrist also lost about 90 mg in that time.
6860617	Steroid responsiveness in connective tissue diseases.	1983 Jul	Thirty-four patients with connective tissue disease used dexamethasone drops 0.1% in one eye for 6 weeks. There was a higher incidence of positive steroid response than would be expected in a normal population. Most of the male patients were responders. Care should be exercised when prescribing local steroids for these patients. Males should be offered regular screening for glaucoma.
7282108	[Unusual nucleolar types in lymphocytes of inflammatory joint exudates].	1981 Mar	The study of the nucleoli in the lymphocytes of human peripheral blood and articular exudations revealed that the lymphocytes in inflammatory articular exudations possess not only a higher number of compact nucleoli, nucleoli with nucleolonemas and micronucleoli but also a higher number of horseshoe-shaped and bead-shaped nucleoli. Since the horseshoe-shaped and bead-shaped nucleoli are apparently a morphological expression of progressive inhibition of synthesis of nucleolar RNA, their higher number in mature lymphocytes of articular exudations indicates that the inflammatory process in articular exudations is associated with progressive inhibition of nucleolar RNA in mature lymphocytes (11). This observation is added to the previously reported (12) stimulation of transcription of this nucleic acid in activated lymphocytes.
6358365	A simple immunoenzyme batch staining method for the enumeration of peripheral human T lymp	1983 Nov 11	A simple batch method was developed for enumeration of peripheral human T lymphocyte subsets by immunoenzyme staining of stored prefixed preparations of peripheral mononuclear cells on multiple well microscope slides. By this method the monoclonal antibodies Leu 1, Leu 2a and Leu 3a stained the same number of cells as by indirect immunofluorescence on suspended cells.
7062071	Transoral approach to the cervical spine: report of four cases.	1982 Jan	The transoral approach to the upper cervical spine is an established but little used route, offering excellent access with good wound healing, to lesions of the bodies of the atlas, axis and upper part of the third cervical vertebra. The authors report four cases which demonstrate the value of the procedure.
788651	Detection of circulating IgG aggregates and immune complexes using 125I protein A from Sta	1976 Aug	A method for detection of circulating immune complexes by the use of 125I labelled staphylococcal protein A is described. In a polyethylene glycol solution as little as 1-2 mg/l of soluble heat aggregated human IgG could be quantitated. Variables which might influence the assay were examined. Separation of immune complexes in serum from monomeric IgG was essential and achieved by gel chromatography on Sephadex G200. This assay may be suitable for clinical routine for detection and quantitation of immune complexes. A preliminary study on the clinical application of the method is presented. 58% of patients with systemic lupus erythematosus and 42% of patients with rheumatoid arthritis had increased levels of immune aggregates in serum compared to a group of healthy individuals.
6975632	Cytotoxicity of anti-Fab antibodies against B lymphocytes in rheumatoid arthritis.	1981 Oct	Anti-Fab antibody titers were positive in 70% of rheumatoid arthritis patients (54 of 77) and 3% (1 of 35) of healthy donors. Their specificity was examined by inhibition of the radioimmunoassay for anti-Fab antibodies, which demonstrated that they are against the Fd region of the intact immunoglobulin molecule. In addition, anti-Fab antibodies have broad specificities for IgG antigens, shown by inhibition with myeloma IgG. They are cytotoxic against B (20% of B cells from most healthy donors) but not T lymphocytes, with cytotoxicity greater at 5 degrees C than 37 degrees C. These studies show that the anti-Fab antibodies interact with allotypic or idiotypic determinants on subpopulations of B lymphocyte cell surface antigens.
450394	Prosthetic replacement of the patellofemoral joint.	1979 Jan	We are just beginning to fully appreciate the significant role of the patellofemoral joint in total knee replacement surgery. Most of the new generation prostheses have a flanged femoral component. The tendency is to make the flange more anatomic in shape as more attention is paid to patellar tracking. Most systems have an optional polyethylene button to resurface the patellar side of the patellofemoral joint, and indications for its use are increasing. Although pain relief with patellar buttons seems uniform, the potential complications of stress fracture, loosening, and wear must temper our enthusiasm for their use until there is longer follow-up. Vitallium hemiarthroplasty of the patella is available in prostheses with and without the requirement for cement fixation. Most investigators have good results in chondromalacia (as a secondary procedure), but the experience in the literature is small. Results have been poor when the femoral side of the joint has been involved. Metal to plastic isolated patellofemoral prostheses have been designed to treat disease on both sides of the patellofemoral joint or to salvage unflanged total knee replacements with residual patellofemoral symptoms. Short term experience has been promising.
3904437	Adverse effects of isoxicam in relation to age.	1985 Oct 18	The frequencies of adverse reactions in patients younger than 65 years and 65 and older were compared for dosages of isoxicam ranging from 200 to 600 mg per day. Data were collected from the records of 2,184 patients younger than 65 years and 1,059 patients 65 years or older from controlled and open studies of patients with osteoarthritis, rheumatoid arthritis, or musculoskeletal disorders. For both age groups, the most common adverse reactions were gastrointestinal. For other adverse reactions, the frequencies were notably lower than for gastrointestinal reactions. For virtually all adverse reactions, the frequencies were similar for the two age groups. Among patients who received only the recommended dosage of 200 mg per day, the frequencies of all reactions were lower than among the entire population and were similar between the two age groups. On the basis of this study, it appears that isoxicam is equally well tolerated in patients who are younger than 65 and those 65 and older.
6346799	Lack of evidence for granulocyte specific membrane-directed autoantibodies in neutropenic	1983 Feb	With the purpose of detecting granulocyte-specific membrane-directed autoantibodies, IgG was isolated from 14 patients with Felty's syndrome, from 5 patients with rheumatoid arthritis associated with neutropenia, and from 3 rheumatoid factor positive patients with autoimmune neutropenia. By means of indirect immunofluorescence suspensions of leukocytes from healthy controls were tested for their ability to bind whole IgG fractions or F(ab')2 fragments of IgG isolated from the neutropenic patients. By this method, whole IgG preparations from neutropenic patients and normal controls were invariably found to bind to the surface of granulocytes and a minor proportion of lymphocytes. In contrast. F(ab')2 fragments of IgG from the neutropenic patients failed to bind to the surface of granulocytes. Both whole IgG fractions and F(ab')2 fragments displayed displayed antinuclear antibody activity ruling out the possibility of loss of antibody reactivity during the preparation of F(ab')2 fragments. The neutropenia seen in rheumatoid arthritis with or without splenomegaly thus does not seem to be induced by granulocyte-specific membrane-directed IgG autoantibodies, but rather by a non-specific attachment of IgG most probably in immune complex bound form to Fc gamma receptors on neutrophils which thereby acquire surface properties facilitating removal from the circulating blood cell pool.
6134360	Uveitis in connective tissue disorders.	1981 Sep	This paper discusses the various uveal inflammatory signs which can be observed in the course of connective tissue disorders. These diseases can be divided into two groups: (1) Conditions mainly characterized by vasculitis and cardiopulmonary and renal involvement. To this group, in which uveitis is very rare, belong systemic lupus erythematosus, polyarteritis, polymyositis, scleroderma, and their variants. (2) Rheumatic diseases, in which uveitis can be a hall mark, include rheumatoid arthritis, ankylosing spondylitis, and their variants. A description is given of the clinical features of these forms of uveitis, the primary aetiology of which, like that of the systemic disease itself, remains unknown.
6333782	Nonsteroidal anti-inflammatory drugs, arthritis, and gastrointestinal bleeding in elderly	1984 Sep	In a study of 531 consecutive admissions to an acute geriatric admitting unit in England in a four-month period, 33 cases of upper gastro-intestinal (UGI) bleeding were diagnosed. There was a close relationship between UGI bleeding and the use of nonsteroidal anti-inflammatory drugs (NSAIDs), and it is argued that this is a causal link. In view of the dangers of NSAID ingestion by elderly patients, many of whom are using them for analgesic rather than anti-inflammatory reasons, it is suggested that simple analgesics such as paracetamol should be used for maintenance therapy of osteoarthritis in the elderly, with NSAIDs being reserved for treatment of true arthritis in selected patients.
6494972	Synovial calcifications associated with long-term steroid therapy for chronic arthritis.	1984 Nov	Radiologically detected synovial densities may be related to one of several distinct causes. The associated articular appearance may give a clue to the diagnosis. We have described the stippled appearance of innumerable distinct densities in the knees of two patients who had progressive destructive changes associated with long-term steroid therapy. We suggest that prolonged steroid therapy be added to the list of processes associated with diffuse small synovial calcifications.