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PMID	Title	PublicationDate	abstract
942273	Assessment of rheumatoid activity based on clinical features and blood and synovial fluid	1976 Apr	Joint inflammation in rheumatoid arthritis has been assessed, and the most useful guides to disease activity were determined by analysis of synovial fluid and blood together with the history of joint disability. The patient's own evaluation of the amount of pain suffered was the most useful clinical assessment. Differential cell count and glucose estimations were the most helpful guides in the synovial fluid, while C-reactive protein in the serum most accurately reflected disease activity. The effects of systemic steroids on these indices were studied, and the differences between seronegative and seropositive patients noted.
522425	[Immunsuppressive factors in sera and synovial fluids of patients with rheumatoid arthriti	1979 Nov 15	Serum inhibitory factors (SIF) have been demonstrated in several infectious diseases and autoimmune disorders. Most likely, they are caused by an immune reaction, and their persistence indicates a chronic course. Sera and synovial fluids of 31 patients with rheumatoid arthritis and of 33 patients with arthrosis were therefore studied, in order to determine whether immunosuppressive factors exist only in inflammatory diseases and whether their titers correlate with the activity of the disease. PHA-induced stimulation of normal peripheral blood lymphocytes, measured as 3H thymidine uptake, in the presence of patients' serum, was related to lymphocyte stimulation observed in the presence of control sera. Using the MIF-agarose assay, the effect of sera and synovial fluids on the tuberculin-induced migration inhibition was also studied. Sera of 27 of 31 patients with rheumatoid arthritis inhibited mitogen-induced normal lymphocyte thymidine uptake and abolsihed migration inhibition, probably by blocking MIF-production. High titers appeared to predict an unfavourable course. In contrast, sera of all 33 patients with degenerative joint disease failed to exert these effects. Synovial fluids of all patients, irrespective of the nature of the underlying joint disease, did not affect lymphocyte stimulation or leukocyte migration. Other factors, such as immune complexes, cytotoxic antibodies, or drug metabolites could be excluded as potential causes of the observed effects exerted by rheumatoid arthritis sera. These results indicate that the presence of serum factors inhibiting PHA-induced lymphocyte stimulation and leukocyte migration inhibition, respectively, may be used as a diagnostic tool in the differential diagnosis of rheumatoid arthritis.
414343	Measurement of functional capacity with visual analogue scales.	1977 Nov	The value of three visual analogue scales for measuring aspects of functional capacity was assessed in 22 patients with rheumatoid arthritis receiving long-term treatment. A scale in which patients were allowed to choose a function which was a particular problem gave the best results, with more severe initial impairment and greater change with treatment. This scale was as useful as pain in assessing the result of treatment.
458789	Gastrointestinal involvement in rheumatoid arthritis: a biopsy study.	1979 Mar	Gastric, colonic and rectal biopsies were obtained from patients with rheumatoid arthritis. The histologic study demonstrated a greater incidence of pathological findings compared to normal subjects or in patients with gastrointestinal diseases. The histologic changes were characterized by partial or complete loss of superficial epithelium and glanmphocytes, plasma cells, granulocytes, and the presence of vasculitic lesions. These histologic findings suggest that a chronic rheumatoid inflammatory process may affect the gastrointestinal system, in keeping with the concept that rheumatoid arthritis is a systemic disease.
7358758	Total replacement of the rheumatoid elbow with a hingeless prosthesis.	1980 Mar	Twenty-four elbows with rheumatoid arthritis underwent total replacement arthroplasty with insertion of a hingeless surface-replacement prosthesis. These were followed for an average of three years and ten months. Excellent results were seen in fourteen elbows; fair, in seven; and poor, in three. Satisfactory pain relief as well as good stability were obtained in all but one elbow. Two elbows did not regain a useful range of motion. Proximal migration of the humeral component was seen in one elbow, and persistent subluxation with pain and instability was seen in another. No other major complications were encountered. The very low incidence of loosening in this series seems to substantiate the sound principle of the use of this type of hingeless prosthesis.
7463471	Isolation of Bacillus licheniformis var. endoparasiticus from the blood of rheumatoid arth	1981 Feb	Sixty-five samples of blood from patients with rheumatoid arthritis and 94 from control subjects were examined by multiple culture and monthly subculture for periods of up to 33 months to detect the revision stages of Bacillus licheniformis var. endoparasiticus (BLE), which exists as L-forms in blood. Isolation of BLE were obtained more often from the blood of control subjects than from rheumatoid patients during the first 6 months of incubation, when there was clustering of positive cultures within samples. Thereafter, the isolation rate was similar for the two groups and positive cultures were distributed randomly between samples. Isolation of diphtheroid intermediate reversion stages (phase A and B) occurred mainly during the first year of incubation, but isolations of the fully reverted sporing bacillus (phase C) increased in frequency with incubation time, particularly from cultures with a high rate of desiccation during prolonged incubation. The proportion of different phases of BLE amongst the isolates and the distribution of the phases with incubation time were similar for the rheumatoid-arthritis patients and the normal subjects.
6981226	Chemical and immunological features of pleural effusions: comparison between rheumatoid ar	1982 May	The value of determination of pleural fluid glucose, pH, lactic dehydrogenase, IgG, IgA, IgM, C3, C4, anti-IgG antibody, and hydroxyproline in distinguishing between pleural effusions caused by rheumatoid arthritis (RA) and those resulting from other diseases was studied. The series comprised seven patients with RA and 115 patients with other diseases including systemic lupus erythematosus, tuberculosis, malignant disease, empyema, pneumonia, congestive heart failure, and nonspecific pleural effusion. The low glucose concentration, the low pH and the low C4 level in rheumatoid pleural effusion were the most valuable diagnostic findings. The presence of anti-IgG antibody in pleural fluid was not specific for RA. The concentration of hydroxyproline in pleural fluid and the pleural fluid-to-plasma hydroxyproline ratio were significantly higher in RA than in tuberculosis and malignant disease. The results support the view that local metabolic and immunological phenomena as well as a high turnover of collagen occur in the pleural cavity in RA.
6287408	[Is there a relationship between Epstein-Barr virus and rheumatoid arthritis (author's tra	1982 May 29	Antibodies directed against a nuclear antigen of lymphocytes infected by Epstein-Barr virus (RANA antigen) have been detected in the sera of patients with rheumatoid arthritis, where they were present at higher levels than in the sera of controls. In vitro, the T lymphocytes of patients with rheumatoid arthritis seem to be incapable of controlling the multiplication of B lymphocytes induced by Epstein-Barr virus. The stimulated T lymphocytes produce more rheumatoid factors than normal lymphocytes. All this suggests that the Epstein-Barr virus might play a part in the pathogenesis of rheumatoid arthritis--a multifactorial disease which also involves a genetic factor, as shown by the increased prevalence of HLA DR4 antigen.
1218243	[Capacity for in vitro growth and the character of synovial fluid cell transformation in r	1975 Nov	Investigations carried out permitted to detect the in vitro growth of cells in the synovial fluid of patients suffering from rheumatoid arthritis. Five types of cells (macrophages, polykariocytes, fibroblast-like cells histiocytes and lymphocytes) appeared during transformation. It was revealed that the intensity of the cell growth in the culture depended on the activity of the disease; there was also a significant decrease of this intensity (P less than 0.01) in the treatment of the patients. The growth of the fibroblast-like cells up to the formation of colonies pointed to their possible participation in the genesis of inflammatory processes and sclerosing of the vessels. The observed phenomenon of the cytopathic interaction of the lymphocytes and of the fibroblast-like cells served as an index of an autoimmune conflict in the joint and, possibly, one of the mechanisms of automaintenance of the autoimmune process.
3883918	Seatone in rheumatoid arthritis: a six-month placebo-controlled study.	1985 Mar	Thirty-five patients with rheumatoid arthritis were randomly allocated to either Seatone (green-lipped mussel extract) or placebo in order to assess the former's claimed effectiveness in rheumatoid disease. After six months there was no significant improvement in any laboratory or clinical measurement of disease activity in the Seatone group. The patients on active drug fared no better than those on placebo. These results suggest that Seatone is not effective in rheumatoid arthritis.
6150232	Intestinal permeability and inflammation in rheumatoid arthritis: effects of non-steroidal	1984 Nov 24	The suggestion that the intestinal mucosa may be abnormally permeable and a site of absorption of antigens in rheumatoid arthritis was tested by the use of a 51Cr-EDTA (edetic acid) absorption test. 24 patients with rheumatoid arthritis excreted significantly more 51Cr-EDTA than did 34 controls. Intestinal permeability was normal in untreated patients but almost invariably abnormal in patients treated with non-steroidal anti-inflammatory drugs. Studies in patients with osteoarthritis showed that the permeability abnormalities were due to an effect of NSAIDs on both the proximal and the distal intestine and that the effect was systemically mediated. Indium-111-labelled leucocyte scans showed ileocaecal inflammation in 6 of 9 patients on or recently on NSAIDs. Although increased intestinal permeability does not seem to be important in the pathogenesis of rheumatoid arthritis, the administration of NSAIDs may lead to loss of intestinal integrity, thus facilitating antigenic absorption and perhaps contributing to persistence of the disease.
4042433	In vitro stimulation of lymphocytes from patients with rheumatoid arthritis.	1985 Nov	Peripheral blood lymphocytes from patients with rheumatoid arthritis (RA) and from normal controls were compared in 20 microliters droplet cultures following stimulation with phytohemagglutinin or concanavalin A. The dynamics of proliferation were significantly changed in RA. Higher numbers of cells in culture were needed to achieve the same response. This may explain the low proliferative responses of lymphocytes from some patients with RA, and apparent changes of in vitro suppressor effects, reported by other authors. Diurnal variations of lymphocytes in RA patients were also studied. No differences in the response to mitogen of lymphocytes taken at 7 AM and 7 PM were found.
6887162	Alpha EEG sleep and morning symptoms in rheumatoid arthritis.	1983 Jun	We studied the influence of disturbed sleep physiology on morning symptoms in 15 patients with classical rheumatoid arthritis (RA) who were experiencing an acute flare. All were found to have an alpha frequency (7 to 11.5 Hz) EEG sleep anomaly, an overnight increase in tenderness in their peripheral joints and in "fibrositic" regions, as well as increased weakness and diminished energy. One patient experienced remission in symptoms and improvement in sleep physiology. The morning symptoms may relate to a nonrestorative sleep disorder associated with the alpha EEG sleep anomaly.
1099508	Surgical treatment of the boutonniere deformity in rheumatoid arthritis.	1975 Jul	The rheumatoid boutonniere deformity does not limit hand function significantly until it becomes severe. For this reason the surgical procedures used should not risk or sacrifice existing function. For the mild cases one can improve the digital balance by a simple extensor tenotomy combined with dynamic splinting. In more advanced stages with passive correction possible, the deformity can be improved by reconstruction of the extensor mechanism. With fixed deformities one can choose between proximal interphalangeal joint fusion and arthroplasty. The decision is influenced by several factors, including the digit involved and the status of adjacent joints. After a careful evaluation of the patient's capabilities and needs, it is possible to improve these deformities by the methods discussed.
7023411	Lymphocyte populations in rheumatoid arthritis.	1981	The lymphocyte population was studied in 15 patients with rheumatoid arthritis and 15 healthy controls. The early E rosettes, and the B lymphocytes (immunofluorescence) were normal. The late rosettes were lower in rheumatoid arthritis (p less than 0.005). This decrease was correlated with immunosuppressive therapy or the activity of the disease.
3884203	Complement activating rheumatoid factors in rheumatoid arthritis studied by haemolysis in	1985 Jan	Complement (C) activating rheumatoid factors (RF) were measured in 16 patients with rheumatoid arthritis (RA) by a simple haemolysis in gel (HIG) assay. IgM-RF, but not IgG-RF or IgA-RF, measured by an enzyme linked immuno-sorbent assay, were closely correlated with C activating RF (r = 0.86). In neither assay did the concentrations of RF appear to be directly related to C1 activation as expressed by serum concentrations of C1r-C1s-C1 inactivator complexes or of C4. In the sera, C1q binding substances, measured by C1q binding assay, were markedly correlated with C activating RF (r = 0.88), whereas C1q binding substances detected by the C1q deviation test were not. Treatment with podophyllotoxin derivatives for 6 months clearly reduced patients' RF concentrations. The decrease of IgG-RF, IgA-RF and IgM-RF was significantly more pronounced than that of the IgG, IgA and IgM concentrations, respectively.
7138602	Nonreducible rotational head tilt and lateral mass collapse. A prospective study of freque	1982 Nov	Of 126 hospitalized, but otherwise unselected, patients with rheumatoid arthritis, 12 (10%) had a persisting nonreducible rotational head tilt deformity (NRRHT). These 12 were grouped with an additional 12 similar subjects, previously found to have the same condition, and all 24 were compared with the remaining 114 who did not have head tilt. Patients with NRRHT differed significantly from the others in that the former were more likely to have a destructive peripheral arthritis, headache, limited neck motion, and various cervical subluxations. All 24 subjects with NRRHT had predominately unilateral collapse of the lateral masses of the atlas and/or axis, compared with only 2 of the 114 with normal head position. The head always tilted to the side of the lateral mass collapse, which appeared to be the sole or major cause of the abnormal head position.
6326716	Clinical characteristics and prognosis of vasculitic mononeuropathy multiplex.	1984 Jun	The initial appearance and course of 19 patients with mononeuropathy multiplex due to systemic vasculitis were evaluated. Neuropathy first occurred within one year of the onset of systemic vasculitis in all patients and within one year of the onset of rheumatoid arthritis in four of nine patients. Concurrent cutaneous arteritic lesions and elevated ESRs occurred more frequently in patients with rheumatoid arthritis than in those without it. The overall six-month and five-year survival rates were approximately 80% and 60%, respectively. Significant nerve improvement was noted in 86% of surviving patients after one year. There were no factors at initial appearance predictive of outcome.
7141369	[Surgical treatment of the elbow joint in chronic polyarthritis].	1982 Sep 23	Compared to the frequency of manifestation of rheumatoid arthritis in the elbow joint the quota of surgical intervention in this area is low. In most cases pain and disability are only moderate, especially if the reduced range of motion is compensated by maintained function of the equilateral shoulder and wrist joint. Surgical treatment is indicated if instability increases, the independency of the patients in daily life is endangered and inflammation increases acutely. A persistent compression of n. ulnaris has to be operated as soon as possible. Often the preferred early synovectomy is impossible because of priority of other joints. By late synovectomy, however, good results can be expected regarding stability, function and extent of pain. In our cases the joint was opened from radial and ulnar in combination with ventralization of the ulnaris nerve. The replacement of the head of radius by a silastic-spacer seems to reduce the secondary irritation in the radial part of the joint and to increase stability. The own method for resection-arthroplasty in modification of the method of Hass with interposition of the middle part of triceps tendon is described and discussed. Because of imminent loosening prostheses are implanted very rarely.
3977410	Geode development and multiple fractures in rheumatoid arthritis.	1985 Feb	The radiological development from normal bone of geodes and subsequent fractures in phalanges of two adjacent fingers is described in a patient with classical rheumatoid arthritis. Presentation was as a septic, discharging focus, but infection was excluded; the pathology is described.