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PMID	Title	PublicationDate	abstract
3122674	Patterns of gold levels in urine, serum, and saliva in patients with rheumatoid arthritis	1987 Nov	Twenty patients undergoing treatment with aurothiomalate for rheumatoid arthritis (RA) were studied for the presence of gold in all urine specimens passed over four days and for gold in the serum of blood drawn by venous section at 10.00, 16.00, and 22.00 hours on a single day of the study. Specimens of saliva collected at the same times as the blood specimens were also analysed for (total) gold content. Eighteen patients showed rhythmic urinary gold excretion. Variations were observed in the serum levels for total, free, and protein bound gold at different times of the day and night together with similar variations in the salivary total gold levels. It was established that a possible relation exists between urinary gold, serum gold, and salivary gold such that at times of higher urinary gold excretion the serum gold levels (total, free, and protein bound) and the total salivary gold levels were decreased. Conversely, at times of lower urinary gold excretion serum and salivary gold levels were increased.
1838726	[Hyperbaric oxygenation in the comprehensive therapy of patients with rheumatoid arthritis	1991 Sep	For 35 of 50 patients with rheumatoid arthritis traditional drug therapy was a minor success for a long time. Without any modifications of the drug therapy every patient went through a course of hyperbaric oxygenation (HBO): 21 sessions under 1.7 ata for 40 min. Good clinical results both immediate and remote have been obtained. The effect of HBO on the immune system of the patients has intensified the suppressive function of T-lymphocytes (especially with systemic symptoms of the disease), normalized cell-bound immunity and decreased the serum concentration in immune complexes.
3581562	Supracondylar fracture of the femur after total knee arthroplasty.	1987 Jun	In a review of 250 total knee arthroplasties, five patients with rheumatoid arthritis incurred supracondylar fractures of the femur. These fractures may be associated with a surgical encroachment of the anterior femoral cortex during resection of the patellar trochlea. Forty-two percent of patients with excessively deep resections of the patellar trochlea suffered fractures. No fractures occurred in patients without encroachment of the anterior femoral cortex. All patients with fractures also had significant osteoporosis, which may have predisposed them to fracture. A resection of the patellar trochlea that is made too deeply would interrupt the transmission of stresses through the cancellous bony trabeculae of the anterior femoral cortex and could predispose to fracture.
3459117	Rheumatoid disease and related arthropathies. II. Surgical rehabilitation of the temporoma	1986 May	A new classification of four types of TMJ involvement is proposed to help orient and direct the medical and surgical treatment of patients with rheumatoid disease and related arthropathies. Clinical symptoms, radiographic findings, facial deformity features, treatment planning, and results are discussed, with case reports that illustrate each type. Interpositional polymer laminates, a new glenoid fossa prosthesis, and a metallic condyle are introduced for use in selected cases where erosion and destruction of the condyle, meniscus, and fossa area have produced significant TMJ dysfunction and occlusal-facial deformity.
2912612	Vertical settling in rheumatoid arthritis. Diagnostic value of the Ranawat and Redlund-Joh	1989 Feb	The usefulness of the recently developed Ranawat and Redlund-Johnell craniometric methods was compared with that of the conventional McGregor method for diagnosing vertical settling (VS) of the skull and the atlas on the axis in 209 patients with rheumatoid arthritis (RA). Statistical analysis of the values obtained from roentgenograms revealed close correlations among the three methods. The first two methods were superior to the McGregor method because the measuring points could be identified on plain roentgenograms of the cervical spine in virtually all cases. The McGregor value could not be determined in 38 (18%) patients. Since medullary compression could be detected by magnetic resonance imaging in all patients who showed abnormal Redlund-Johnell values, the Redlund-Johnell method may be useful for diagnosing advanced VS. It also detects not only atlantoaxial lesions but also atlantooccipital lesions. Thus, the Redlund-Johnell method appears to be the best method for diagnosing VS in RA patients.
3598994	Questionnaire, walking time and button test measures of functional capacity as predictive	1987 Apr	Mortality over 9 years in rheumatoid arthritis was studied according to baseline demographic, disease, therapy and comorbidity variables, and measures of functional capacity variables. Significant differences between patients who survived and died over the next 9 years were seen for 8 variables: age, joint count, oral corticosteroid use, presence of concurrent heart disease, formal educational level, and 3 quantitative measures of functional capacity, questionnaire responses regarding activities of daily living, modified walking time and the button test. Five-year survivals of 50% or less were seen in patients with severely dysfunctional values for the 3 quantitative measures of functional capacity. Increased relative risk of mortality according to functional capacity measures was not explained by age, sex, duration of disease, smoking history, joint count, hand radiograph score, grip strength, morning stiffness, formal educational level, oral corticosteroid or parenteral gold use, or various comorbidities, and was not expected by a majority of physicians.
2293936	Clinical and histologic observations of monoarthritis. Anticipation of its progression to	1990 Jan	Synovial biopsies were performed on 84 patients with monoarticular synovitis from 1960 to 1984. Twenty-seven (32%) of 84 patients were pathologically differentiated; however, the other patients remained classified as nonspecific monoarthritic. Follow-up studies of nonspecific monoarthritis ranging from five to 25 years (average, 15 years) were carried out in 34 patients. Five patients (15%) disclosed polyarticular involvement and were diagnosed as having classic rheumatoid arthritis (RA) within five years after initial biopsy (RA group). In the remainder (non-RA group), 19 patients recovered completely and nine of ten patients complained of a slight degree of joint involvement. A good prognosis was observed in younger patients and in those who showed minimal histologic changes in the synovium. Initial laboratory examinations, including a white cell count, erythrocyte sedimentation rate, C-reactive protein, and agglutination test, did not show any differences between the RA and the non-RA groups. To determine predicting factors for RA, a comparative histologic study of the initial specimens was performed. Specimens from the RA group showed a predominant appearance of lymphoid aggregates, high endothelial postcapillary venules, and proliferative plasma cell infiltration. These histologic features suggest the future appearance of RA; therefore, careful observation and early treatment should be considered for these patients.
1656176	Collagenase reserves in polymorphonuclear neutrophil leukocytes from synovial fluid and pe	1991 Aug	Degradation of cartilage in rheumatoid arthritis (RA) may be in part due to release of collagenase from specific granules of polymorphonuclear neutrophil leukocytes (PMNs) during degranulation. We decided to study, not synovial fluid (SF) collagenase, but PMN collagenase reserves. PMN were isolated from parallel SF and peripheral blood (PB) samples obtained from 7-arthritis patients. PMNs were stimulated in vitro by tetradecanoyl-phorbol-13-acetate (TPA). Collagenase activity in the supernatant without and with phenylmercuric chloride activation was studied. Compared to PB PMNs, there was no consistent decrease in the total collagenase reserves in the inflammatory SF PMNs. This suggests that the release of collagenase in the inflammatory synovial fluid does not deplete SF PMNs of the collagenase synthesized at the myelocyte stage. The role of PMN collagenase in pathogenesis of cartilage destruction would then seem to be more dependent on local release and autoactivation at cartilage surface by adherent PMNs and not excessive collagenase release from free floating SF PMNs at single cell level. Furthermore, under the experimental conditions used the proportion of collagenase released in active form was higher in SF PMN specimens than in PB PMN specimens (p less than 0.01). The predominant collagenous component of adult cartilage, native type II collagen, was degraded by PMN collagenase as fast as native type I collagen. These findings suggest an important role for this enzyme in destruction of the free cartilage surface in RA.
2654391	OM-8980 in rheumatoid arthritis: a 6-month double blind placebo controlled multicenter stu	1989 Jan	A new immunomodulating drug, OM-8980, was compared to placebo in a 6-month double blind multicenter trial including 107 patients with active rheumatoid arthritis. Ritchie index, number of swollen joints and the pain scale improved significantly more with OM-8980 than with placebo. Grip strength, duration of morning stiffness and erythrocyte sedimentation rate improved more markedly with OM-8980 than with placebo, but the difference did not reach statistical significance. The use of analgesic and antiinflammatory drugs diminished significantly more with OM-8980 than with placebo. Clinical tolerance was good with 7 side effects reported in 3 of the 52 patients included in the OM-8980 group and 11 in 8 patients of the 55 in the placebo group (mostly gastrointestinal troubles and skin reactions). In the overall evaluation by both patients and physicians OM-8980 was significantly superior to placebo.
3493007	Linkage studies of HLA and rheumatoid arthritis in multicase families.	1987 Jan	The linkage of rheumatoid arthritis (RA) to the HLA-DR locus was investigated in 17 families with multiple cases of RA. Log odds scores were computed using the Liped program; sibship associations were examined by 2 methods. The results showed a trend toward linkage which was short of significance. The results were similar for patients with classic or definite RA, with or without the inclusion of probable RA patients. The finding of strong association and weak linkage would suggest that it is DR4, itself, that is important in RA.
2625681	Seropositive rheumatoid arthritis in monozygotic twin sisters carrying HLA-DR4 or DR4 asso	1989 Dec	We have followed 3 pairs of monozygotic twin sisters with seropositive rheumatoid arthritis (RA) since 1966, 1971 and 1975. RA developed in the probands at the age of 25, 39 and 21 years and in the cotwins 37, 8 and 19 years later, respectively. Two pairs, Nos 1 and 3, were discordant when first seen. Only Pair 1 had a family history of RA. Onset of RA was not related to marital status or pregnancy. It was improbable that contagious infections of childhood or seasonal infections could be important triggers of RA. Since the concordance rate for RA in monozygotic twins depends on the duration of the observation period, the previously stated concordance rate of 30% may be questioned.
3205552	Relationship between clinical and radiologic findings of the temporomandibular joint in rh	1988 Dec	The relationship between clinical findings in the craniomandibular system and radiologic findings in the temporomandibular joint was investigated in 101 adults with rheumatoid arthritis. Radiologic changes were correlated with duration and severity of temporomandibular joint symptoms and general joint disease. The radiologic changes were also associated with loss of occlusal support, anterior open bite, and occlusal interferences. Most joints with crepitus exhibited radiologic erosion. Joints with mutilating changes were silent.
1792629	[Hemostatic homeostasis in rheumatoid arthritis patients after "radiosynoviorthesis" with	1991	Six to nine months (7.2 months, on the average) after injection of 198Au into large joints of patients with rheumatoid arthritis there was a decrease of blood thrombophilia characteristics of these patients and refractory to correction with conventional remedies. Functional activity of platelets and fibrinolysis studies were the most sensitive laboratory tests enabling one to reveal the lowering of the patients' blood thrombogenic potential after radionuclide therapy. Comparison of the time-course of changes in these parameters with those of the immunological blood status of the treated patients forms the basis for suggestions that the coagulologic laboratory tests may be used for estimating the efficacy of the treatment carried out.
2778779	Lymphopenia in rheumatoid arthritis.	1989 Aug	Lymphopenia is a recognized but poorly studied feature of rheumatoid arthritis (RA). We set out to establish the prevalence and significance of lymphopenia in RA. A group of 66 RA patients was studied for one year. During this time 10 (15%) had persistent lymphopenia (lymphocyte count less than 1.00 X 10(9)/l) without evidence of Felty's syndrome. A separate study of lymphocyte subsets in 13 lymphopenic RA patients showed marked reduction in T-cell numbers with normal circulating B-cell numbers. The numbers of CD4 and CD8 positive T-cells were equally depressed. Lymphopenia may indicate more severe disease. It was not influenced by changes in disease activity or therapy.
3406935	HLA-linked susceptibility to rheumatoid arthritis in north India.	1988 Apr	Nine multiplex RA families of North Indian origin were tissue typed to determine the segregation of parental haplotypes among sibs. The assortment of haplotypes in 18 affected sibs was not random, with seven sib pairs being HLA identical and two haploidentical with the proband (P = 0.0007). HLA-DR4 occurred in eight out of nine probands (88.8%) and in 11 out of 13 familial RA subjects (84.6%).
2122902	Polymorphism and expression of the galactosyltransferase-associated protein kinase gene in	1990 Nov	We used restriction endonuclease digestion of leukocyte DNA to assess the structural integrity of an N-acetylglucosamine beta 1----4 galactosyltransferase (GalTase)-associated (GTA) protein kinase gene in rheumatoid arthritis (RA) patients. This analysis provides evidence that the gross structure of the GTA protein kinase gene locus remains intact in patients with defective galactosylation and that this gene locus is polymorphic both in normal individuals and in patients with RA, although no polymorphisms unique to RA patients were observed. Initial data on the expression of this gene indicate that comparable levels of GTA protein kinase messenger RNA are present in the lymphocytes of normal individuals and RA patients, irrespective of whether lymphocytes were obtained from patients with decreased or normal levels of galactosylation.
3187458	Upper airway obstruction in patients with rheumatoid arthritis and temporomandibular joint	1988	Among 400 patients with rheumatoid arthritis and measurable ramus height there were 76 patients with mutilating arthritis of the temporomandibular joints. In 30 of these 400 patients, episodes of upper airway obstruction had occurred, mostly when the patient lay supine. Laryngoscopy had been performed in only 7 patients, and in 3 of those a laryngeal arthritis was detected. Upper airway obstruction had occurred significantly more often in patients with arthritis of the temporomandibular joints than in those with normal joints. In 70% of the patients with a severe arthritic destruction of the temporomandibular joints, episodes of airway obstruction had occurred. Upper airway obstruction is assumed to occur in those patients due to a pharyngeal obstruction, as in other patients with micrognathia or sleep apnea syndrome.
2670964	Rheumatoid disease.	1989 Aug	This article documents the developments in surgery for the rheumatoid hand that have been made during the last 40 years and reviews the pertinent literature.
3577727	Cup arthroplasty of the rheumatoid shoulder.	1986 Dec	Hemiarthroplasty of the humeral head, using a stainless steel cup, was performed in 26 shoulders of patients with rheumatoid arthritis who had severe pain and loss of function. All the shoulders were Larsen's radiographic Grade 4 or 5. After 2 (1-5) years, all the shoulders were painless and had satisfactory function. Partial radiolucent zones exceeding 1 mm were seen in three shoulders.
2001072	Increased TNF-alpha secretion by alveolar macrophages from patients with rheumatoid arthri	1991 Mar	Tumor necrosis factor alpha (TNF) and interleukin-1 (IL-1) production by alveolar macrophages (AM) was evaluated in 17 rheumatoid arthritis (RA) patients without interstitial lung disease (ILD, Group 1) and 14 RA patients with clinical ILD (Group 2) in comparison with 10 control subjects. AM after recovery by bronchoalveolar lavage were selected by adherence, and then supernatants were collected after 3 or 24 h of culture. Results showed no modification of IL-1 synthesis in either group of RA patients. Spontaneous TNF production was significantly increased in Group 2 (2.5 +/- 0.5 ng/ml) as well as in Group 1 (2.4 +/- 0.4 ng/ml) compared with control subjects (0.43 +/- 0.1 ng/ml, p less than 0.001). In addition, AM from patients untreated or treated exclusively by nonsteroidal antiinflammatory drugs produced similar levels of TNF, whereas those receiving corticosteroids, second-line drugs (such as sulfasalazine, aurothiomalate, and methotrexate), or the combination of both therapy regimens released significantly less TNF. Interestingly, TNF was not different in both groups, but Group 2 had a markedly increased ratio of local immune complex to albumin in bronchoalveolar lavage fluid (0.47 +/- 0.12 versus 0.07 +/- 0.02 in Group 1; p less than 0.002). TNF thus appears an additional component of RA subclinical alveolitis in RA, but its prognostic value and its precise role in lung damage remain to be determined. Development of ILD requires certainly complex interactions of synergistic factors, possibly including local immune complexes detected in BAL fluids.