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PMID	Title	PublicationDate	abstract
3538767	Experimental study on secondary amyloidosis associated with chronic arthritis.	1986 Sep	Various organs from rabbits immunized with heat-killed E. coli 0:14 to induce chronic polyarthritis resembling rheumatoid arthritis (RA) were examined for amyloid deposition since amyloidosis is a frequent feature of long-standing RA. Amyloids were confirmed mainly by polarizing as well as nonpolarizing light microscopy after Congo red staining and partly by electron microscopy and immunoperoxidase technique. Amyloid deposits after an additional 2 months from the first appearance of arthritis were most frequently found in the spleen and kidneys suggesting secondary amyloidosis. Amyloidosis was observed in 36% of 75 arthritic rabbits. The incidence of amyloidosis was significantly higher in the arthritic rabbits than in the non-arthritic rabbits (p less than 0.05). This suggests that prolonged sensitization with heat-killed E. coli 0:14 containing endotoxic substance participates in the formation of both arthritis and amyloidosis.
3704511	[Tiopronine and rheumatoid polyarthritis].	1986 Jan	This article summarises the authors' experience and the data of the literature concerning Tiopronine, a drug with a thiol function like D-penicillamine, in the treatment of rheumatoid arthritis. Two controlled trials versus placebo and two controlled trials versus D-penicillamine demonstrated the effectiveness of treatment and the identical action of 1 g of Tiopronine and 600 mg of D-penicillamine. The side effects of Tiopronine are very similar to those of D-penicillamine: essentially rash, toxiderma, aguestia, proteinuria, which resolve when treatment is stopped. Patients with a past history of side effects with D-penicillamine have an increased risk of developing side effects with Tiopronine, but this risk is not systematic, which constitutes the principal value of this drug.
1914302	Functional hallux rigidus in the rheumatoid foot.	1991 Oct	Hallux rigidus results from arthritic involvement of the first metatarsophalangeal joint. The authors have observed loss of motion at this joint in patients with rheumatoid arthritis in the absence of hallux valgus or joint destruction. A hyperextension deformity of the interphalangeal joint has also been observed, with a painful callus beneath it. The first metatarsophalangeal joint appears normal on roentgenograms, and passive motion of the joint is normal when it is examined clinically. The loss of first metatarsophalangeal motion is functional, and stems from muscle spasm of the great toe intrinsic muscles in an effort to relieve pressure on the lesser metatarsal heads. The interphalangeal hyperextension may develop secondary to "functional hallux rigidus."
2175662	Combination D-penicillamine and methotrexate therapy: proposal for early and aggressive tr	1990 Fall	We report a retrospective study of 16 patients with seropositive rheumatoid arthritis who were placed on combination D-penicillamine and methotrexate therapy for a period of 5-86 months. Three patients were lost to follow-up, and one patient died of unknown causes at another institution. Among the 12 remaining patients, there was no withdrawal secondary to drug intolerance. All patients demonstrated improvement in functional class correlated with a reduction in joint count, duration of morning stiffness, erythrocyte sedimentation rate, rheumatoid factor, and prednisone requirement. Eight of the 12 patients achieved remission as defined by the American College of Rheumatology criteria. Remission was sustained for a period of 3-72 months. The dosage of D-penicillamine ranged from 250-1000 mg/d (mean = 750 mg); that of methotrexate ranged from 5-15 mg/week (mean = 10 mg). The study indicates that D-penicillamine and methotrexate combination therapy is effective in the treatment of severe rheumatoid arthritis and warrants further prospective investigation.
1953821	Cathepsin B in synovial cells at the site of joint destruction in rheumatoid arthritis.	1991 Nov	Based on the concept that proteolytic enzymes, like cathepsins, are associated with tissue destruction, we investigated the expression of the matrix-degrading cysteine proteinase cathepsin B in synovial tissues from the joints of patients with rheumatoid arthritis. The data indicate an enhanced transcription of cathepsin B in synovial cells when compared with normal fibroblasts, cathepsin B-producing epithelial tumor cells (SW1116), or fibroblasts derived from inflamed tonsils. Immunolocalization of cathepsin B appeared to be restricted mainly to the synovial cells attached to cartilage and bone at sites of rheumatoid joint erosion.
1747704	A preliminary study of magnetic resonance relaxation times (T1 and T2) in inflammatory and	1991 Dec	Multiple synovial fluid samples from 21 patients were analysed using standard synovial analysis techniques and by nuclear magnetic resonance spectroscopy. Significant negative correlations were noted between both T1 (P less than 0.01) and T2 (P less than 0.0006) relaxation times and synovial fluid total protein. No differences in T1 or T2 relaxation times were noted in synovial fluid between 16 patients with inflammatory forms of arthritis and five patients with degenerative arthritis. In a single rheumatoid arthritis patient with concurrent staphylococcal arthritis, T1 and T2 relaxation times did not vary between the active phase and the recovery phase. The lack of any significant differences in the measured relaxation times as a function of joint condition suggest that in vivo magnetic resonance measurements of T1 or T2 for joint analysis may not reveal information of either a diagnostic or pathophysiological nature.
1674382	Facs analysis of myeloid differentiation stages in epiphyseal bone marrow, adjacent to joi	1991	To analyze the differentiation stages of myeloids statistically, we adopted a two-color FACS system and used appropriate monoclonal antibodies belonging to CD15, CD16 and CD11b. By using HL60 treated with DMSO or human bone marrow MNCs from patients with rheumatoid arthritis, it was proved that with this system, myeloids could be clearly separated according to differentiation stages. Furthermore, the number of myeloids at certain stages of differentiation in the epiphyseal bone marrow of patients with RA or OA was measured. Nine of 15 samples from RA patients showed immature and relatively mature myeloids, while none of the 8 OA samples did. When the proportions of myeloids in epiphyseal bone marrow MNCs were compared with the clinical features, disease subsets in RA and the degree of synovitis, seemed to be important factors for abnormal myelopoiesis.
3266030	Radiographic assessment in relation to clinical and biochemical variables in rheumatoid ar	1988	Radiographs of hands and feet were obtained from 125 consecutive patients with rheumatoid arthritis (RA) and the degree of destruction was assessed numerically on a 200-point scale using Larsen's standard radiographs as reference. The method is shown to possess a satisfactory degree of reproducibility. In 96 of these 125 patients, values of another 15 simultaneously determined clinical and biochemical variables were obtained. On applying linear and quadratic multiple regression analysis to this set as well as to the male and female subsets, an 'automatic' selection procedure (stepwise regression) proved duration of disease to be the most important factor relating to the 'Larsen index'. The 96 patients were therefore ranked with respect to duration of disease and divided into 4 subsets of equal magnitude. In the 3 subsets with duration of disease less than 21 years, stepwise regression produced in the final step linear or quadratic combinations not containing duration of disease but correlating quite well with the 'Larsen index' (R = 0.64-0.96). A similar result was obtained upon performing an analogous procedure in the female subset. In all instances, positive contributions of varying degree were obtained from Ritchie's index, ESR, a-antitrypsin (A1-AT), orosomucoid, fibrinogen, and IgM, while negative correlations were associated with ceruloplasmin, IgG, and IgA.
2344242	[Immunostimulating effect of culture filtrates of Yersinia enterocolitica].	1990	Application of sterile culturing supernatant of Yersinia (Y.) enterocolitica (tested serovars were 03 and 08) caused significantly accelerated transplant rejection in mice of various inbreeding strains. Action correlated with dosage (r = -0.92). C57B16 mice were tested for their pregnancy rates in response to the same filtrate (serovar 03), with 5.5 live births per mating being recorded from 47 control matings but only 4.4 from 45 experimental matings (alpha less than 0.0025). The mean gestation period of experimental animals was extended by five percent over that of simultaneous controls (alpha = 0.25). Particular reference is made in this paper to Vesikari et al. (1987) who found Y. enterocolitica to function as interleukin-1 inductor via lipopolysaccharide. The active substance tested in this context, however, proved to be thermolabile, with 30 minutes of heating to 56 degrees C eliminating the action tested before. Y. enterocolitica infections were frequently found to coincide with rheumatoid arthritis, and evidence has been produced to the unspecific stimulating effect of Y. enterocolitica culture filtrates (testing being applied to serovar 03, biovar 4 and serovar 08, biovar 2). It is against the background of these aspects that chronic and other infections by Y. enterocolitica are considered to be of substantive relevance to the etiopathogenesis of autoimmune diseases, above all rheumatoid arthritis.
3406399	Peribursal fat plane of the shoulder: anatomic study and clinical experience.	1988 Sep	A comprehensive anatomic and radiographic analysis of the peribursal fat plane in 12 cadavers confirmed that the fat plane seen on radiographs represents extrasynovial fat lining the subacromial bursa and documented the anatomic relations of the bursa. A three-part retrospective clinical evaluation of rotator cuff tears, calcific tendinitis, and rheumatoid arthritis was performed. Two osteoradiologists blindly graded the appearance of the peribursal fat plane with the shoulder in external versus internal rotation in 21 patients with arthrographically intact rotator cuffs and 21 patients with disrupted rotator cuffs. The peribursal fat plane was seen better with disrupted rotator cuffs. The peribursal fat plane was seen better with the shoulder in internal rotation and was seen in 60% of control subjects but only 21% of patients with rotator cuff tears. Partial or complete obliteration of this fat plane is a sensitive (79%) but less specific (60%) indicator of rotator cuff tears. Obliteration of the peribursal fat plane by inflammatory processes in adjacent tissues, including calcific tendinitis and rheumatoid arthritis, occurred with a high frequency.
3187457	Assessing disability in patients with rheumatoid arthritis. Use of a Swedish version of th	1988	The validity and reliability under Swedish conditions of a translated and slightly modified version of the Stanford Health Assessment Questionnaire (HAQ), referred to here as the ADL questionnaire, was studied. Sixty-four patients with definite/classical rheumatoid arthritis (RA) participated in the major part of the investigation. In addition, inter-observer reliability was studied in the testing of 15 other patients with RA. The questionnaire was filled in by the patients twice (ADL Tests 1 and 2) with a one-week interval between. A physiotherapist or occupational therapist also assessed each of the patients on a sample of ADL functions (ADL Test 3). Joint mobility, grip-strength, pain, Ritchie index and ESR were likewise checked. Results indicated inter-observer reliability to be high for the ADL (r(S) = 0.98), for joint mobility (r(S) = 0.86), and for the Ritchie index (r(S) = 0.83). The test-retest reliability for the ADL questionnaire which the patients filled in (Tests 1 and 2) was high r(S) = 0.91. Results of the ADL questionnaires the patients completed were found to correlate fairly closely with the observations of the therapists, r(S) = 0.71. The validity of the scoring system was found to be sufficient, using Ward's cluster analysis for comparing the original HAQ scores with scores on all the questions included in the questionnaire. Thus, the translated and somewhat modified version of the ADL questionnaire studied here appears to possess a high degree of reliability and validity in assessing patients with RA.
3513771	Food-induced (allergic) arthritis. Inflammatory arthritis exacerbated by milk.	1986 Feb	Suggestive, but largely unproven, observations have associated arthritis with environmental antigens, including foods. We studied a patient with inflammatory arthritis in a prospective, "blinded," controlled fashion to determine whether her symptoms were associated with food sensitivities. This 52-year-old white woman with 11 years of class I, stage I, active disease, had symptomatic exacerbations allegedly associated with meat, milk, and beans. We observed an increase in symptoms following an unblinded food challenge and then studied her in our clinical research unit. On her normal diet for 6 days, she averaged 30 minutes of morning stiffness, 9 tender joints, 3 swollen joints, 87% subjective assessment (100% = best possible), and 89% examiner assessment. While she was fasting (3 days) or taking Vivonex (2 days), we noted no morning stiffness, tender joint score of 1, swollen joint score of 0, and assessments of 100% (P less than 0.05 versus normal diet). She was then nourished with Vivonex for 33 days without difficulty and challenged in a blinded fashion at mealtimes with lyophilized foods placed into opaque capsules. Four milk challenges (equivalent to greater than or equal to 8 ounces per meal) produced up to 30 minutes of morning stiffness, 14 tender joints, 4 swollen joints, subjective assessment of 85%, and objective assessment of 80% (P less than 0.05 versus fasting-Vivonex), peaking 24-48 hours postchallenge. Placebo and other foods (lettuce and carrots) were without effect.(ABSTRACT TRUNCATED AT 250 WORDS)
2785367	Reflection of disease activity in rheumatoid arthritis by indices of activation of the cla	1989 Apr	Levels of C4d, a fragment of C4 generated during activation of the classical complement pathway, were measured in the plasma of 77 patients with rheumatoid arthritis and 30 healthy subjects. Disease activity was judged according to Ritchie's articular index to be mildly active in 31 (group 1), moderately active in 29 (group 2), and severely active in 17 patients (group 3). Plasma levels of C3d, a fragment of C3, and serum levels of C4, C3, and immune complexes were also measured. The ratios C4d/C4 and C3d/C3 were calculated. The C4d/C4 and C3d/C3 ratios and the levels of circulating immune complexes correlated with the degree of disease activity without significantly departing from linear trend and discriminated between patients with different grades of disease activity. C4d, C3d, C4, and C3 also correlated with disease activity but in a non-linear relationship. A significant correlation was found between C4d and C3d, and between C4d/C4 and C3d/C3. C4d and C4d/C4 also correlated with circulating immune complexes. These results indicate that indices of C4 and C3 activation, in particular the ratios C3d/C3 and C4d/C4, provide a sensitive assessment of disease activity in rheumatoid arthritis, and confirm the major part played by the classical complement pathway in the pathogenesis of this disease.
3555359	A controlled trial of nandrolone decanoate in the treatment of rheumatoid arthritis in pos	1987 Mar	To determine whether an anabolic steroid had any benefit in the treatment of rheumatoid arthritis 47 patients entered a parallel group study. Twenty four received nandrolone decanoate 50 mg intramuscularly every third week for two years and 23 patients received no anabolic steroids. Other therapy was unaltered. Patients attended for clinical and biochemical assessments as well as the objective assessments of elementary body composition by in vivo neutron activation analysis and measurement of the mineral content of the distal femur by single photon absorptiometry on five occasions. A modest clinical deterioration (except for grip strength) was seen in both groups. No significant changes in calcium or alkaline phosphatase were seen. There was no significant change in total body calcium, total body phosphorus, body weight, or bone index/bone width measurements in either group. Significant increases occurred in total body nitrogen, total body potassium, haemoglobin, and packed cell volume (by six months) in the group treated with nandrolone decanoate. Comparison of 10 patients in the group treated with nandrolone decanoate also receiving oral steroid therapy with 14 patients in this group not receiving oral steroid therapy showed no significant differences. The main side effect of nandrolone decanoate was hoarseness. No radiological changes were seen. Nandrolone decanoate, in a dose that produces a significant anabolic effect, has no demonstrable action on bone metabolism in rheumatoid arthritis but may improve the chronic anaemia by six months.
1713269	Therapeutic use of monoclonal anti-CD4 antibody in rheumatoid arthritis.	1991 Mar	Ten patients with severe rheumatoid arthritis were treated with a murine monoclonal anti-CD4 (B-F5) antibody in an open study (one with 10 mg/day, 2 with 15 mg/day, 7 with 20 mg/day) for 10 consecutive days. Tolerance was excellent. All patients improved during treatment clinically (Ritchie's index, morning stiffness, pain scale) (p = 0.005), as well as biologically C-reactive protein (p = 0.008) with an average 60% reduction of each of these variables at Day 15, and clinical benefit lasted over 6 months in some patients. No significative depletion was noted in total lymphocyte or CD3, CD4, CD8, CD20, positive cells after treatment. Evidence of murine immunization was found in only 2 patients.
3772918	The effect of low dose chronic intermittent parental methotrexate on delayed type hypersen	1986 Aug	We have shown that a regimen of low dose intermittent methotrexate (MTX), analogous to that used in the treatment of patients with rheumatoid arthritis, does have immunosuppressive effects on the induction of primary delayed type hypersensitivity in normal mice. This occurred even when the last MTX injection was 4 days before immunization. No effect was seen on established delayed type hypersensitivity or on inflammatory responses induced by carrageenan or the Arthus reaction.
2226986	Screening for hydroxychloroquine retinal toxicity: is it necessary?	1990	All the patients (73) in the Rheumatology Department five year study of second line therapy who have taken hydroxychloroquine (Plaquenil) for rheumatoid arthritis for longer than 18 months were reviewed. These patients have their treatment dosage carefully monitored and have been receiving regular ophthalmic examinations. Most patients still taking the drug were assessed with a battery of tests for evidence of retinal toxicity. No retinal toxicity causing visual loss was found. On the basis of these results and a review of the recent literature we no longer routinely screen patients for hydroxychloroquine retinal toxicity in Cardiff.
2754662	Elevated activity of myeloid growth factor in bone marrow adjacent to joints affected by r	1989 May	Myeloid growth activity of rheumatoid arthritis (RA) and normal serum was measured with a newly developed simple method. Abnormally high titers of this activity were found in the bone marrow blood serum adjacent to joints with RA where abnormal myelopoiesis had been found. Maximal activity for myeloid growth was found at a molecular weight of 70 kDa in gel filtration of serum, different from the size of any known factors involved with myelopoiesis.
2075812	[Total knee arthroplasty using a total condylar prosthesis].	1990	The authors studied the cases of 52 patients (56 knees) treated with a total knee prosthesis of the type "total condylar" and "total condylar with posterior stabilization" over a 3-year period. Gonarthrosis (41 cases) and rheumatoid arthritis (12 cases) were the major indications. The analysis of functional results proves the success concerning mobility, pain and ability to negotiate stairs after knee arthroplasty. The postoperative radiological results of 44 knees were reviewed and compared to the literature. Proof of the importance of the postoperative axis and the inclination of the tibial component is provided. Few complications were observed. Review of the literature confirms the good results of this type of total knee prosthesis.
3529372	Sonography and NMR imaging in rheumatoid gonarthritis.	1986	Sonography and NMR imaging of the knee joint make it possible to obtain a visual representation of the thickened synovial membrane occurring in patients with rheumatoid gonarthritis, even before inflammatory deformation is radiologically detectable. Both methods can expose effusions and Baker's cysts. In NMR imaging, an indication of the inflammatory genesis can be obtained from the extended relaxation time T1. Due to the good representation of soft tissues, prognostic evidence may be gained of whether a mainly exudative or proliferative form is present.