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PMID	Title	PublicationDate	abstract
2426542	Evidence for an HLA-DR4-associated immune-response gene for Mycobacterium tuberculosis. A	1986 Aug 9	Antigens of Mycobacterium tuberculosis, M leprae, M scrofulaceum, and M vaccae were injected intradermally in 86 caucasoid leprosy patients, and skin responses (measured in mm of induration at 72 h) were analysed in relation to HLA class II phenotypes. HLA-DR4 was associated with high responsiveness to antigens specific to M tuberculosis but not to antigens shared with other mycobacteria (p = 0.0005). Because DR4 is associated with rheumatoid arthritis (RA) and because a role for M tuberculosis antigens has been suggested both in experimentally induced autoimmune arthritis in rats and in RA, the DR4 associated regulation of the immune response to M tuberculosis may be relevant to the pathogenesis of RA.
3624956	[Osteoporotic changes in rheumatoid arthritis].	1987 Apr	Bone mineral density (BMD) in the distal 1/6 and 1/3 sites of the radius was measured by single photon absorptiometry in 58 female patients with rheumatoid arthritis, not treated with corticosteroids. Half of the patients showed lower values of BMD than those (mean--1SD) of age-matched controls. BMD decreased more significantly with advancement of destructive changes of radiocarpal joint in postmenopausal patients. There was a significant inverse correlation between BMD and duration of the disease. Decreasing rate of BMD was much higher in postmenopausal patients than in premenopausal patients. These results indicated rheumatoid arthritis was not universally associated with osteoporosis. Osteoporosis occurred much more frequently in postmenopausal patients with a long duration of the disease showing marked joint destruction. In premenopausal patients, bone loss was most common in the region of affected joints. But, bone loss in postmenopausal patients occurred not only in the periarticular bone but in the diaphyseal bone.
3665758	[Asbestosis and the rheumatic lung. Medical insurance assessment of combined lung diseases	1987 Oct 23	A fibrosing pulmonary disease, which could not be further classified, was diagnosed in a 76-year-old woman who for 40 years had worked as a seamstress in the textile industry. For the last 16 years she had suffered from progressively increasing shortness of breath. She died three weeks after hospitalization during which she received intensive respiratory and circulatory supportive treatment. At post-mortem examination there was evidence of minimal asbestosis, of pulmonary manifestations of rheumatoid arthritis and of recurrent pulmonary thromboembolism, as well as of the consequences of two weeks of artificial ventilation during the terminal period. This constellation of histopathological findings was assessed in relation to the part played by her occupational disease. She had been previously awarded a pension as a recognized sufferer form asbestosis (50% reduction of earning power). The histopathological findings were not such--in view of the difficult diagnostic constellation while she was alive--as to contradict with a high degree of probability the finding that she had suffered from an occupational disease.
3125797	Effects of chrysotherapy on circulating lymphocyte numbers and subsets.	1988 Jan	In a prospective 24 week study of 25 patients with rheumatoid arthritis (RA) weekly intramuscular (IM) sodium aurothiomalate resulted in a small but significant reduction in the circulating lymphocyte count. Analysis of absolute levels of pan T cells, T4 helper cells, T8 suppressor cells, T4/8 ratio, B cells, and major histocompatibility complex (MHC) class II positive cells showed reductions in these subsets, though these changes did not reach significance. At entry there was no association between circulating lymphocyte counts and subsets and clinical and laboratory indices which reflected disease activity, and during the study gold responders could not be differentiated from non-responders with regard to changes in lymphocyte counts and subsets. Thus this study suggests that weekly IM gold leads to a modest reduction in circulating lymphocyte numbers which involves most subsets. This effect appears to be independent of the clinical efficacy of this drug.
2617230	Influence of auranofin on lymphocyte membrane fluidity in rheumatoid arthritis. A fluoresc	1989	Using the fluorescence polarization of 1.6-diphenyl-1, 3, 5-hexatriene, the membrane fluidity of lymphocytes obtained from rheumatoid arthritis patients was measured during 12 months of auranofin treatment. Significant differences in fluorescence polarization values were observed following auranofin treatment. The correlations shown between fluorescence polarization values and the indices of rheumatoid arthritis activity, such as erythrocyte sedimentation rate, alpha 2-globulins, plasma fibrinogen levels and platelet count suggest that changes in lymphocyte membrane fluidity could be used to monitor the effects of auranofin therapy.
3489973	Circulating human leucocyte elastase in rheumatoid arthritis.	1986	Elastase-inhibitor complex (EIC) levels were determined in EDTA-plasma samples of 40 patients with connective tissue disease by a double antibody immuno-assay technique. In active rheumatoid arthritis (RA) and systemic lupus erythematosus (SLE), EIC levels were significantly higher than in the normal controls (P less than 10(-8) and fell on remission. The mean EIC level in active RA was significantly greater than in inactive disease (P = 0.0001) but there was no statistically significant difference between the EIC levels in the acute and inactive disease states in SLE (P = 0.49). In active RA, there was a positive correlation between EIC levels and white blood cell count (WBC) but not with erythrocyte sedimentation rate (ESR). In SLE there was no significant correlation between EIC levels and ESR or WBC. EIC measurement may be useful in the objective assessment of activity in RA.
1764841	Characterization of anti-endothelial antibodies in patients with rheumatoid arthritis comp	1991 Nov	Anti-endothelial antibodies (AEA) have been described in patients with rheumatoid arthritis (RA) complicated by vasculitis. In this study we made use of an ELISA and immunoblot technique (IBT) to further characterize AEA of the IgG class in serum of patients with rheumatoid vasculitis (RV) and to investigate the relationship between the presence of IgG-AEA and vasculitis. IgG-AEA as measured by ELISA or IBT could be detected in the serum from 20 of the 23 (87%) RV patients, in 2 out of 13 (15%) patients with RA and in one of 15 healthy donors. The IBT revealed reactivity of IgG-AEA against a total of 12 bands of endothelial antigens ranging in size from 16 to 68 kD. IgG-AEA as measured by ELISA and IBT in serum samples of patients followed longitudinally were present more frequently and in higher titres in patients with active RV as compared to patients with vasculitis in remission. A significant correlation was found between the presence of clinical signs of vasculitis and serum IgG-AEA reactivity against an endothelial membrane antigen of 44 kD. These data show that the pattern of IgG-AEA reactivity in the serum of RV patients is heterogeneous and suggest that IgG-AEA against one particular antigen is involved in the pathogenesis of RV.
2772484	Histopathology of femoral head osteonecrosis in rheumatoid arthritis: the relationship bet	1989	To investigate the pathology of osteonecrosis of the femoral head (ON) in patients with rheumatoid arthritis (RA), we examined 26 hips clinically and histologically. In this study, we diagnosed ON by both the radiological evidence of femoral head collapse, with or without narrowing of the joint space, and by histological evidence of extensive areas of bone necrosis with surrounding reparative new bone. Thus 14 hips were diagnosed as ON, and 12 hips were not. All of the patients with ON had a history of steroid medication. The frequency of lipid-containing osteocytes observed in the subchondral area of the femoral head significantly correlated with the occurrence of ON (P less than 0.05). In electron micrographs, these osteocytes showed degenerative features, with their nuclei pressed towards one side of the cell by plump fatty droplets (fatty degeneration). In patients with RA, there was a significant correlation between the appearance of lipid-containing osteocytes and steroid medication (P less than 0.05). No relationship existed between the severity of RA synovitis and the occurrence of ON. These data suggest that ON in rheumatoid hips may relate to the administration of a steroid and the fatty degeneration of osteocytes.
3172098	Rheumatoid vasculitis with intrarenal aneurysm formation.	1988	A 58-year-old male with an 8-year history of seropositive erosive rheumatoid arthritis (RA) presented with acute abdominal pain and syncope; a diagnosis of vasculitis was made arteriographically by finding intrarenal saccular aneurysms. Patients with severe RA and a high titer of rheumatoid factor may develop a diffuse vasculitis, but clinical renal involvement attributable to vasculitis is uncommon. Our case demonstrates the coexistence of RA and renal vasculitis, documented by autopsy findings, and for the first time by arteriographic demonstration of intrarenal aneurysm formation.
2726278	Coping with rheumatoid arthritis pain: catastrophizing as a maladaptive strategy.	1989 Apr	The present study examined catastrophizing in rheumatoid arthritis (RA) patients. Subjects were 223 RA patients who were participants in a longitudinal study. Each patient completed the Catastrophizing scale of the Coping Strategies Questionnaire (CSQ) on 2 occasions separated by 6 months (time 1, time 2). The Catastrophizing scale is designed to measure negative self-statements, castastrophizing thoughts and ideation (sample items = 'I worry all the time about whether it will end,' 'It is awful and I feel that it overwhelms me'). Data analysis revealed that the Catastrophizing scale was internally reliable (alpha = 0.91) and had high test-retest reliability (r = 0.81) over a 6 month period. Correlational analyses revealed that catastrophizing recorded at time 1 was related to pain intensity ratings, functional impairment on the Arthritis Impact Measurement scale (AIMS), and depression at time 2. Predictive findings regarding catastrophizing while modest were obtained after controlling for initial scores on the dependent variables, demographic variables (age, sex, socioeconomic status), duration of pain, and disability support status. Taken together, these findings suggest that catastrophizing is a maladaptive coping strategy in RA patients. Further research is needed to determine whether cognitive-behavioral interventions designed to decrease catastrophizing can reduce pain and improve the physical and psychological functioning of RA patients.
3361318	Tricon-M uncemented total knee arthroplasty. A review of 96 knees followed for longer than	1988	Ninety-six uncemented total knee arthroplasties done using the Tricon-M prosthesis were followed for longer than 2 years. The implant has a multilevel porous surface to facilitate biologic ingrowth and flanged polyethylene pegs for immediate fixation. Each patient was matched for age, body habitus, and diagnosis to a patient with a cemented total knee arthroplasty. There was no statistical difference between the matched pairs as related to pain, eventual range of motion, stability, or patient satisfaction; the uncemented group did as well clinically as the cemented group. Subsidence of the tibial component was noted in cases of obese patients taking systemic corticosteroids and in whom there was inadequate coverage of the cut tibial plateau surface. The mean 2-year Hospital for Special Surgery rating score was 81 in the osteoarthritis group and 83 in the rheumatoid arthritis group.
2730165	Influence of non-steroidal anti-inflammatory drugs and disease activity on serum alkaline	1989 May	The influence of non-steroidal anti-inflammatory drugs (NSAIDs) and of disease activity on the serum alkaline phosphatase concentration was examined in patients with rheumatoid arthritis, osteoarthritis, and polymyalgia rheumatica. Concentrations of serum alkaline phosphatase were similar both in patients with rheumatoid arthritis taking NSAIDs and in those not taking NSAIDs. In patients with osteoarthritis NSAID use was not associated with a significant increase in serum alkaline phosphatase. In rheumatoid arthritis no correlation was found between clinical indices of disease activity and serum alkaline phosphatase concentrations. There was significant correlation with plasma viscosity in rheumatoid arthritis, both in those taking and not taking NSAIDs, and in polymyalgia rheumatica. Serum alkaline phosphatase concentrations are not influenced by NSAIDs. Concentrations correlate with laboratory parameters, but not clinical indices of disease activity.
2584249	The total condylar prosthesis. 10- to 12-year results of a cemented knee replacement.	1989 Nov	Over a two-year period 104 patients had 130 knee arthroplasties performed with the total condylar prosthesis at the Hospital for Special Surgery. At a 10- to 12-year review 58 patients (74 knees) had survived and were available for detailed clinical and radiographic evaluation. Of these, 38 knees (51.3%) were rated as excellent and 27 (36.5%) good. There were three (4.0%) fair and six (8.2%) poor results. Five of the six had had revision operations. The success of this early pattern of prosthesis supports the continued use of methacrylate cement for knee arthroplasties.
2783810	Pre- and postoperative MR imaging of the craniocervical junction in rheumatoid arthritis.	1989 Mar	Ten patients with severe chronic rheumatoid arthritis with atlantoaxial subluxation were examined with conventional radiography and MR imaging of the cervical spine before and at an average of 6 months after posterior occipitocervical fusion. Periodontoid pannus formation was revealed by MR preoperatively in nine patients, all with mobile horizontal atlantoaxial subluxation. Compression of the medulla and/or upper cervical cord, due to subluxation and periodontoid pannus bulging into the spinal canal, was seen in seven patients. After the stabilizing surgery the periodontoid pannus had decreased in size in all patients with preoperative pannus. This reduction in the pannus seems to be the result of the atlantoaxial immobility achieved by the posterior fusion. Postoperatively, three patients had some remaining compression of the medulla and/or cord secondary to immobile subluxation, while the pannus posterior to the odontoid process had disappeared. Artifacts from the surgical stainless steel fixation material were confined to the posterior part of the neck on short TR/short TE MR images and did not interfere with the evaluation of the periodontoid region and the anterior part of the medulla/cervical cord. We found that flexion and extension lateral radiographs, combined with sagittal short TR/short TE MR images in the neutral position, enable preoperative evaluation of patients with rheumatoid arthritis in the cervical spine. Postoperative MR should be performed only if there are residual or new symptoms.
3207384	Relapsing polychondritis mimicking rheumatoid arthritis.	1988 Dec	A woman with relapsing polychondritis presented with progressive and deforming polyarthritis (but always negative for rheumatoid factor) 14 years before the appearance of typical clinical and histological changes of nasal and auricular cartilage destruction.
3075088	Rheumatoid lymphoid dendritic cells--characteristics and functions.	1988	Dendritic cells have been isolated from peripheral blood and inflamed synovial tissue and synovial fluid of patients with rheumatoid arthritis and from normal peripheral blood. Synovial and blood dendritic cells are strongly positive for CD45 and MHC class II antigens, and lack almost all other mononuclear cell markers. Thus, in most respects they have the same characteristics as lymphoid dendritic cells in mice. Synovial and blood dendritic cells are very potent accessory cells for T lymphocyte responses, and much more effective than monocytes. Synovial dendritic cells also spontaneously produce interleukin 1. The accessory function is inhibited by an antibody to interleukin 1. Synovial dendritic cells may thus be critical for starting and perpetuating the chronic inflammation seen in rheumatoid arthritis.
1879087	Raised epidermal phospholipase A2 activity in rheumatoid arthritis.	1991 May	Epidermal phospholipase A2 (PLA2) in RA patients was significantly higher than in normals (p less than 0.0001) but lower than in psoriatic patients (p less than 0.05). No relationship was observed between PLA2 activity and commonly used measures of rheumatoid disease activity in a cross-sectional study. However, in a longitudinal study change in PLA2 activity correlated strongly with changes in disease activity.
3071031	[Personality, stress and rheumatism: methodologic considerations].	1988 Sep	Studies which support the assumption that an "arthritis personality" is a causative factor in the development of rheumatoid arthritis are methodologically inadequate. Some are mere descriptions; others use inappropriate control groups. The investigations also suffer from failure to provide information on patients' characteristics, such as socioeconomic status and disease parameters. Although the quality of investigations concerning the etiological role of stress in the onset of rheumatoid arthritis has also been reduced by theoretical and measuring difficulties, the evidence supports an influence of stressful events. Results of controlled studies mostly refer to a comparison of group means. An own investigation shows that correlation studies are able to describe differences between groups, even if the groups do not differ significantly in their means.
2819352	Exogenous female hormones and rheumatoid arthritis: a methodological view of the contradic	1989	The purpose of this review is not to resolve the contradictory findings that are present in the literature. Rather, it considers a selected number of issues that may pertain to some future understanding of the current controversy. Furthermore, certain issues such as biological plausibility and the absence of a definitive dose, duration, or timing relationships are not discussed. If the association of the use of exogenous female hormones with the prevention of rheumatoid arthritis came to be accepted as likely causal, basic scientists might well unravel the biological processes involved. The dose and duration of exposure to the hormones and the timing of the exposure (current use versus past use) in relation to the preventative effect remains unclear. While clearly a point against a causal relationship the possibility exists that this may result from errors in recall or that prior hormone exposure may 'vaccinate' a woman against the disease. A number of studies have been published only in abstract or are still underway. Reanalysis of existing data sets may also provide some insight into the contradictory findings. The issues raised in this review are of relevance to investigators. They may also be used by readers interested in this topic who wish to attempt to resolve the conflicts in the hormone-rheumatoid arthritis literature for themselves.
3547656	Pulmonary fibrosis in rheumatoid arthritis: a review of clinical features and therapy.	1987 Feb	During the past four decades there has been a growing appreciation of the frequency of pulmonary abnormalities associated with RA. Approximately 30% to 40% of patients with RA demonstrate either radiographic or pulmonary function abnormalities indicative of interstitial fibrosis or restrictive lung disease. The severity of pulmonary fibrosis is not associated with rheumatologic symptoms or the duration of the associated RA, nor is there any clear relation to the extraarticular features of RA or serologic findings. Survival rates in patients with coexisting RA and pulmonary fibrosis are similar to those of patients with idiopathic pulmonary fibrosis. However, the spectrum of disease activity is quite variable. The majority of patients with progressive pulmonary symptomatology, when treated with corticosteroids, will have equivocal results. Some patients appear to respond to immunosuppressive or cytotoxic medications. The role of macrophages may be central to the injury to lung. Recent studies suggest a potential treatment role for cyclosporine, which may be able to interrupt lymphocyte-stimulated macrophage activation, and thus, fibroblast-mediated fibrosis in patients with pulmonary interstitial fibrosis. Bronchoalveolar lavage studies may delineate subgroups of patients who are more likely to respond to immunosuppressive agents, especially when treatment is started early.