bluuebunny/crossref_metadata_2025 huggingface dataset:
Rheumatology manpower in california
Authors: Yelin Edward H. , Henke Curtis J. , Epstein Wallace V.
Published: February 2007

Californian specialists in the treatment of rheumatic diseases were surveyed to determine the spatial distribution of rheumatologic services in the state, the amount of patient care time available for the rheumatic diseases in each county, the physicians' capacity to treat all rheumatic disease patients who seek their care, and their perception of the need for more specialists in their area. The data resulting from the survey are analyzed by four methods to assess the sufficiency of medical manpower resources.
Quantitation of precipitating antibodies to certain soluble nuclear antigens in sle
Authors: Maddison Peter J. , Reichlin Morris
Published: February 2007

Electrophoresis in polyacrylamide gels in the presence of sodium dodecyl sulfate was used to separate and quantitate the components of a washed immune precipitate. Serum was from patients with systemic lupus erythematosus known to have antibodies to soluble nuclear ribonucleoprotein (RNP) or to a soluble nuclear non‐nucleic acid protein (Sm). Amounts of antibody that was predominantly IgG ranged from 0.2 to 8 mg/ml of patients' serum, and in some cases accounted for over 20% of the total serum IgG. Results demonstrate that some patients respond to the disease by producing large amounts of a specific antibody, and that these antibodies can contribute significantly to hypergammaglobulinemia.
Immune complexes and complement catabolism in ankylosing spondylitis
Authors: Gabay R. , Zubler R. H. , Nydegger U. E. , Lambert P. H.
Published: February 2007

In serum samples from 37 patients with ankylosing spondylitis (AS), immune complexes were quantitated by the 125I‐Clq binding test; in paired plasma samples the C3 breakdown product C3d was measured by an immuno‐chemical method. Compared to results in 30 blood donors, the Clq binding activity was significantly ( > 2 SD ), although discretely, increased in 5 of 8 patients with seropositive AS, but not in other AS patients. All C3d levels were within the normal range. In a parallel investigation, increased Clq binding activity and C3d levels were found in 87% and 90%, respectively, of patients with seropositive rheumatoid arthritis.
Association of renal papillary necrosis and ankylosing spondylitis
Authors: Lourie Seth H. , Denman Susan J. , Schroeder Edward T.
Published: February 2007

Three patients with ankylosing spondylitis developed renal papillary necrosis. All had received prosta‐glandin synthetase inhibitors including phenylbutazone, indomethacin, or ibuprofen. One patient had sickle trait. These drugs are not commonly associated with papillary necrosis in man, but may adversely effect renal medullary blood flow. An underlying renal vascular abnormality related to ankylosing spondylitis is also considered. Patients with ankylosing spondylitis who are taking prostaglandin synthetase inhibitors should be routinely screened for hematuria.
Phytomitogen‐induced, lymphokine‐mediated cartilage proteoglycan degradation
Authors: Herman Jerome H. , Musgrave Diane S. , Dennis Marie V.
Published: February 2007

The significance of T‐cell activation in the immunopathogenesis of articular disease has been studied in an in vitro model to assess the capacity of phytomitogen‐induced lymphokines to degrade cartilage matrix proteoglycans. Supernatants derived from T‐cell activation of normal human peripheral blood lymphocytes were shown to contain a monocyte‐dependent, serum‐inhibitable, dialyzable factor or factors capable of inducing significant proteoglycan degradation, as assessed by release of macroprecipitable 35S‐labeled proteoglycan from heterologous cartilage substrates.
Papular mucinosis with myopathy, arthritis, and eosinophilia
Authors: Mcadam Lawrence P. , Pearson Carl M. , Pitts William H. , Sadoff Leonard , Verity M. Anthony
Published: February 2007

A patient with biopsy‐proven papular mucinosis, plus the characteristic IgG lambda light chain para‐proteinemia, also developed a severe proximal myopathy, seronegative inflammatory polyarthritis, and marked eosinophilia. Muscle enzymes were elevated, EMG was compatible with polymyositis, and muscle biopsy revealed an atypical necrotizing vacuolar myopathy. Synovial biopsy revealed an inflammatory synovitis with Class II synovial fluid. No mucin deposition was detectable in muscle or synovium. During 7 years of observation, corticosteroids and various immunosuppressive agents were successively administered with little benefit. Recently, weekly intravenous methotrexate and low‐dose oral corticosteroids have resulted in clinical and laboratory improvement. It is suggested that the pathology in papular mucinosis may include serious rheumatic manifestations in addition to the cutaneous involvement.
Mechanisms Underlying the Suppression of Adjuvant‐Induced Arthritis by 6‐Mercaptopurine
Authors: Chang Yi‐Han
Published: February 2007

Daily oral administration of 6‐mercaptopurine suppressed the development of the secondary (immune) lesions of adjuvant arthritis in a dose‐related manner. The degrees of arthritis suppression corresponded closely to suppressions of concurrent development of the humoral and the cellular immune response to El4 cells. A short course of therapy during the sensitization period (day — 1 to day 5 when the day of adjuvant injection is designated as day 0) appeared to be almost as effective as continued daily dosing (day —1 to day 15). The drug did not influence the development of the primary (nonimmune) lesions of adjuvant arthritis at all dosage levels investigated. Chronic pretreatment with 10 mg/kg/day PO for 17 days had no effect on the development of carrageenin–induced acute inflammation in the rat. The suppression of adjuvant arthritis by 6‐mercaptopurine, unlike suppression by cyclophosphamide, appears to result primarily from its suppressive action on the immune response.
Pneumocystis Carinii Associated with Polyarteritis and Immunosuppressive Therapy
Authors: Bungo Michael W. , Beetham William P.
Published: February 2007

Pneumocystis carinii characteristically causes pneumonia in patients with immunodeficiency disorders. It occurs most often in patients with malignancy or renal transplants whose immune response has been suppressed by corticosteroids or cytotoxic agents. Individuals with connective tissue disease who receive immunosuppressive drugs become susceptible to Pneumocystis. The incidence of Pneumocystis infection in connective tissue disease is low but may increase if immunosuppressive drugs are used more often. Our patient acquired Pneumocystis pneumonia after immunosuppressive therapy for polyarteritis nodosa. Prompt recognition of this condition is essential now that specific therapy is available. Untreated Pneumocystis infection is usually fatal.
Aspirin and Delayed Type Hypersensitivity
Authors: Duncan Matthew W. , Person Donald A. , Rich Robert R. , Sharp John T.
Published: February 2007

The effects of aspirin on delayed hypersensitivity were assessed in 40 healthy subjects who were randomly assigned to two equal groups. In a double‐blind format, the individuals in one group were placed on 4 gm aspirin daily for 5 days, and individuals in the other group were given placebo. Lymphocyte proliferation was measured before and 72 hours after the initiation of drug, by using three mitogens and four antigens. The percentages of T and B lymphocytes were likewise measured before and during therapy. The subjects were skin tested with the same four antigens 72 hours after the initiation of drug, and the skin tests were read 48 hours later. No significant differences between the two groups were detected when skin tests, lymphocyte proliferation, and percentage of T lymphocytes were compared.
Postinjection Nonvasomotor Reactions During Chrysotherapy
Authors: Halla James T. , Hardin Joe G. , Linn Julius E.
Published: February 2007

During gold sodium thiomalate (GST) therapy, 15% of 100 unselected patients described recurring post‐injection reactions (PIRs), consisting of transient stiffness, arthralgias, myalgias, and constitutional symptoms. Six patients with more severe reactions requested discontinuation of chrysotherapy and for these, gold thioglucose (GTG) substitution abolished or amelioriated the reactions. The major significance of the PIR is that it may be a frequent cause of unwarranted premature abandonment of chrysotherapy.
HLA and Recurrent Episodic Arthropathy Associated with Rubella Vaccination
Authors: Griffiths Marie M. , Spruance Spotswood L. , Ogra Pearay L. , Thompson George R. , Dewitt Charles W.
Published: February 2007

The frequencies of 21 HLA antigens in 33 patients who developed recurrent, episodic arthropathy after receiving the HPV–77 DK–12 rubella vaccine have been determined and compared with those of a control population. Trends toward increased frequencies of HLA antigens B12 (P = 0.02) and B14 (P = 0.04) and of the haplotype A2, B12 (P = 0.01) did not reach significance when corrections for the number of antigen determinations were included in the statistical analysis. These data show that the syndrome of recurrent arthropathy following rubella vaccination is genetically distinct from the connective tissue diseases associated with HLA–B27.
Therapeutic Studies in NZB/NZW F1 Mice
Authors: Gerber N. Lynn , Powell Deborah , Steinberg Alfred D.
Published: February 2007

Cyclophosphamide (Cy) has been demonstrated to be effective in treating autoimmune disease in NZB/NZW F1 mice. This study was designed to compare the efficacy of chlorambucil (Chlor) with that of a known effective drug (Cy) in the treatment of murine lupus. NZB/W female mice were treated with Cy, Chlor, or nothing on a once‐a‐month dosage schedule. The age of onset of proteinuria, the severity of glomerular lesions, and the median survival were compared among the three treatment groups. Cy was found to be superior to Chlor and controls in all measures.
Ultrastructural Study of Avian Synovium Infected with an Arthrotropic Reovirus
Authors: Walker E. R. , Friedman M. H. , Olson N. O. , Nee P. B. De
Published: February 2007

Three‐week‐old chicks were inoculated via the foot pad with the avian reovirus (strain WVU 2937) that has been proved to be the causative agent in avian viral arthritis. The initial stages of the avian reovirus infection in the synovium of the hock joint were studied by transmission electron microscopy to shed light on the early virus‐host relationship of an arthrotropic virus and synovial tissue. At 48 hours postinoculation (PI), coated, partially coated, and uncoated virus particles were seen in a dense lysosome‐like inclusion in the cytoplasm of subsynovial fibroblasts. Virus replication was demonstrated in fibroblasts of the subsynovium 4 days PI. Infiltration of leukocytes into the area of the virus replication was noted at the time of virus replication (4 days PI). By the second week of the infection (11 days PI), the subsynovium was heavily infiltrated with lymphocytes and plasma cells, and proliferative changes had occurred in the synovial lining cells.
Limited Anti‐DNA Antibody Specificity in Systemic Lupus Erythematosus
Authors: Berzofsky Ronald N. , Dorsch Carole A. , Stevens Mary Betty
Published: February 2007

Twenty‐one sera from 11 patients with systemic lupus erythematosus were titrated with 125I‐ss‐calf thymus DNA to determine their maximum capacity to bind DNA. Only five sera were capable of binding > 90% of the input DNA. The remaining sixteen sera showed maximum DNA binding levels between 35% and 85%. The inability of these sera to bind all of the input DNA is shown to be dependent on variations in the molecular weight of the DNA antigen. The possibility that these differences in DNA binding reflect differences in antigenic specificity is discussed.
The Primary Plasmin Inhibitor in Rheumatoid Synovial Fluid
Authors: Clemmensen Inge , Donde René , Andersen R. Bach
Published: February 2007

In 20 consecutive rheumatoid arthritis patients, 14 women and 6 men, age 26–76, average 62 years, the concentration of the recently found “primary plasmin inhibitor” and phase proteins was estimated in plasma and synovial fluid. In 12 patients a complex between the inhibitor and plasmin could be demonstrated by crossed immunoelectrophoresis into immunoglobulins against the primary plasmin inhibitor and immunoglobulin against plasminogen. Only free inhibitor was found in corresponding plasma. All plasminogen present in synovial fluid could be activated to plasmin upon addition of urokinase (24 nM/1). In those patients where enzyme‐inhibitor complex in synovial fluid was present, a higher concentration of phase proteins in synovial fluid was found, indicating an increased degree of inflammation despite identical scores in the Lansbury clinical index in the two groups. From these experiments it was concluded that the fibrinolytic capacity in rheumatoid synovial fluid is not decreased. It is suggested that the fibrin‐like material in synovial tissue and upon the synovial membrane is a poor substrate for plasmin.
Radioimmunoassay of serum myoglobin in polymyositis and other conditions
Authors: Nishikai Masahiko , Reichlin Morris
Published: February 2007

Radioimmunoassay of serum myoglobin was done in 53 patients with polymyositis syndromes and other conditions. Serum myoglobin values in 33 healthy subjects ranged from 4 to 77 [mean 33.3 ± 19.8 (SD)] ng/ml. Fifty percent of polymyositis patients had elevated serum myoglobin levels (> 80 ng/ml). Serum myoglobin values in polymyositis patients fluctuated more sensitively than CPK and GOT. Combined estimation of myoglobin and CPK offers advantages for the detection of muscle injury and the prediction of disease exacerbation.
Adsorption of polymorphonuclear leukocyte lysosomal enzymes to monosodium urate crystals
Authors: Ginsberg Mark H. , Kozin Franklin , Chow Donald , May James , Skosey John L.
Published: February 2007

Monosodium urate (MSU) crystals induced prompt release of iysozyme, and slower release of β‐glucuronidase, α‐mannosidase, and lactic dehydrogenase (LDH) from polymorphonuclear leukocytes. At increasing crystal concentrations, an increasing delay in the apparent onset of β‐glucuronidase release was detected which appears to be due to selective adsorption of enzyme activities to the MSU crystals: β‐glucuronidase > LDH > α‐mannosidase > lysozyme. Lysosomal enzyme adsorption by MSU crystals may then contribute to experimental error or may modulate gouty inflammation.
Acute bilateral symmetrical pathologic fractures of the lateral tibial plateaus in a patient with Gaucher's disease
Authors: Iii Frank Seinsheimer , Mankin Henry J.
Published: February 2007

A 41‐year‐old woman with Gaucher's disease developed bone crises of both proximal tibiae and of her spine concurrent with a syndrome of severe gastroenteritis. Three to six months later the bilateral symmetrical pathologic collapse of both lateral tibial plateaus occurred. The unusual occurrence of multiple bone crises with the gastroenteritis suggests a common causative agent, possibly a severe viremia.
Pathogenesis of chronic inflammation in experimental ferritin‐induced arthritis.
Authors: Ohno Osamu , Tateishi Hiroomi , Cooke T. Derek
Published: February 2007

The earliest and most severe changes in articular collagenous tissues (ACT) occur within 24 hours of antigen challenge and are associated with and are possibly secondary to maximal immune complex deposition in ACT surfaces. The immuno‐electron microscopic (immuno‐em) staining characterizes the ferritin as aggregates with antibody and suggests its occurrence and deposition as a preformed immune complex. These data indicate a direct interaction between immune complexes and collagenous matrix which could relate to both antigen persistence and chronicity of the immune response. The changes described in this model have features in common with rheumatoid disease and suggest the potential for similar mechanisms of cartilage degradation.
Drugs affecting the release of rheumatoid factor in a plaque‐forming cell assay
Authors: Moore Terry L. , Robbins Dick L. , Rose Jean E. , Vaughan John H.
Published: February 2007

Addition of propranolol to the agarose phase of a plaque‐forming cell (PFC) assay for rheumatoid factor (RF) caused reduction in the number of plaques seen. This reduction in rheumatoid factor plaque‐forming cell (RF PFC) did not depend upon an effect at the β‐adrenergic receptor, since d‐ and l‐propranolol reduced equally well. Furthermore, in a series of polycyclic compounds with varying β‐receptor blocking capabilities there was no agreement between plaque reduction and blocking. When propranolol was tested in the agarose in an anti‐sheep erythrocyte (SRC) plaque assay (anti‐SRC PFC), it had no inhibitory effect, but it was capable of inhibiting the generation of new anti‐SRC PFC in an in vitro culture. Propranolol is thought to exert these effects through its membrane stabilizing (anesthetic) properties.
Hemarthrosis as the presenting manifestation of true myeloma joint disease
Authors: Mintz Gregorio , Robles‐Saavedra Elsa J. , Enríquez Rubén D. , Jiménez F. Javier , Juàn MA. Lourdes
Published: February 2007

This is the first report of a patient with hemarthrosis due to invasion of the synovial membrane by myeloma cells. With angiographic studies of the affected joint it was apparent that the tumor tissue extended from the destructive bone lesion of the femoral condyle into the synovial membrane. Intraarticular spontaneous bleeding was the first manifestation of a monoclonal IgG multiple myeloma; the hemarthrosis recurred after drainage but was controlled with local roentgen therapy.
Neoantigen of the membrane attack complex of human complement
Authors: Curd John G. , Sundsmo John S. , Kolb William P. , Bluestein Harry G. , Müller‐Eberhard Hans J.
Published: February 2007

Since complement activation and hematological abnormalities occur in systemic lupus erythematosus (SLE), the present study is an investigation of whether the membrane attack complex of complement might be bound to peripheral blood leukocytes (PBL) in vivo. Assembly of the membrane attack complex results in the generation of neoantigen (neoAg) which is complex‐specific and not expressed by any of the individual complement proteins. FITC antiserum specific to neoAg was employed to detect the membrane attack complex on PBL from 7 normal donors, 12 patients with SLE, and 2 patients with rheumatoid arthritis (RA): 3 ± 1% of normal, 25 ± 13% of SLE, and 23 ± 11% of RA PBL were positive. The majority of the neoAg positive PBL in SLE were polymorphonuclear neutrophils (PMN) as shown by adherence to plastic, phagocytosis of carbonyl iron, and differential cell counts. The PBL were > 98% viable as indicated by the trypan blue exclusion technique. These observations strongly suggest that the membrane attack complex may be bound to viable PBL in patients with SLE and RA, and further raise the possibility that the membrane attack complex may have a function other than lysis.
Immunopathologic studies of rheumatoid arthritis.
Authors: Paget Stephen A. , Anderson Karen , Phillips Paul E.
Published: February 2007

A sensitive complement‐dependent chromium release cytotoxicity assay was used to determine whether sera from rheumatoid arthritis (RA) patients contain antibody specific for an antigen on rheumatoid synovial cell cultures. Two hundred eight RA sera–RA synovial culture combinations were studied employing 21 sera and 16 synovial membranes; control combinations were derived from 5 normal sera and 10 degenerative joint disease synovial membranes. Anticomplementary activity of some rheumatoid sera was overcome using an increased complement concentration. The percent cytotoxicity of RA serum–RA culture combinations, both homologous and autologous, was not significantly greater than that of RA serum–control culture combinations. No correlation between duration of disease or duration of cell culture and percent cytotoxicity was found. Thus a unique antigen on cultured rheumatoid synovial cells was not recognized by rheumatoid serum antibody by use of this cytotoxicity assay.
Monozygotic Twins With Klinefelter's Syndrome Discordant For Systemic Lupus Erythematosus And Symptomatic Myasthenia Gravis
Authors: Michalski Joseph P. , Snyder Steven M. , Mcleod Rima L. , Talal Normal
Published: February 2007

Monozygotic twins with Klinefelter's syndrome were evaluated for two distinct illnesses. One subject had clinical and serologic evidence of systemic lupus erythematosus and no symptoms of muscle weakness. His identical twin had typical symptoms and laboratory evidence of myasthenia gravis. Antibodies to acetylcholine receptors were present in both subjects. These patients are discussed in relation to genetic, hormonal, and immunologic mechanisms involved in the pathogenesis of these two disorders.
Comparison Of The Presence Of Immune Complexes In Felty'S Syndrome And Rheumatoid Arthritis
Authors: Andreis Mario , Hurd Eric R. , Lospalluto Joseph , Ziff Morris
Published: February 2007

Evidence has been found to document the presence of circulating immune complexes in all patients with Felty's syndrome. The sera of all 12 patients studied showed intermediate complexes by analytical ultracentrifugation. The sera of 9 of 12 patients (75%) showed precipitin lines upon immunodiffusion against IgM rheumatoid factor. Both findings were statistically increased above those in a matched group of patients with classic rheumatoid arthritis. The presence of circulating immune complexes in the sera of the Felty patients was consistent with the observation that large inclusions containing IgG, IgM, and complement were phagocytized by normal polymorphonuclear cells when incubated with sera of Felty patients. Normal polymorphonuclear cells phagocytosed inclusions from 77% of Felty sera, compared with 27% of classic rheumatoid arthritis sera. It is suggested that the uptake of immune complexes by polymorphonuclear cells plays a role in the neutropenia of Felty's syndrome.
Studies Of The Effects Of Pregnancy Serum On Polymorphonuclear Leukocyte Functions
Authors: Persellin Robert H. , Leibfarth June K.
Published: February 2007

The phagocytosis of both viable and heat‐killed Staphylococcus aureus by normal human neutrophils was diminished in the presence of pregnancy serum. Particle ingestion was reduced significantly (P < 0.0025) after 5 minutes of incubation when leukocytes were in 15% serum obtained during the latter phases of gestation. Control sera from normal adult females or males or from cord blood all functioned normally in support of phagocytosis. Intracellular metabolic events occurring after ingestion, including bacterial killing and nitro‐blue tetrazolium reduction, were decreased in proportion to the number of particles ingested. Differential studies involving leukocytes obtained from either pregnant or control subjects, when suspended in either pregnancy or control serum pools, showed the inhibition was due to a humoral and not a cellular factor. Mixing experiments demonstrated that serum obtained during gestation contained a suppressor or neutrophil function rather than a deficiency of a factor required for phagocytosis. The pregnancy serum suppressant affected cells, not the particles ingested, and was found to be non‐dialyzable and heat‐stable. Hydrocortisone added to control sera to exceed the steroid concentrations found in pregnancy sera did not retard phagocytosis nor diminish bactericidal activity. The data suggest that the active serum component exerts its inhibitory action at the cell surface. Since polymorphonuclear leukocytes are important mediators of inflammation and are implicated in the pathogenesis of tissue destruction, the subsidence of inflammatory diseases during gestation could be related, at least in part, to the inhibitory effects of pregnancy serum on leukocyte functions.
Synthesis by an Established Lymphocyte Cell Line From a Rheumatoid Synovium
Authors: Gilliland Bruce C. , Ford Denys K. , Mannik Mart
Published: February 2007

Lymphocytes derived from the synovium of a patient with rheumatoid arthritis were shown to synthesize predominantly IgG as measured by an equilibrium binding assay. Chromatographic separation of the radiolabeled lymphocyte culture supernatant revealed rheumatoid factor activity associated with IgG and IgM. In addition, immunofluorescence studies on fixed lymphocytes demonstrated that the majority of cells stained positive for both IgG and rheumatoid factor.
The growth kinetics of synovial fibroblastic cells from inflammatory and noninflammatory arthropathies
Authors: Anastassiades Tassos P. , Ley Janice , Wood Anne , Irwin David
Published: February 2007

The growth kinetics of subcultured human synovial fibroblasts from 16 patients with inflammatory and noninflammatory arthropathies were studied in antibiotic free media. The experimental design allowed a clear distinction between the growth rates and final saturation densities achieved. The effects of refeeding and of the serum concentration were evaluated for each line. Inflammatory lines achieved significantly higher final saturation densities and growth rates than noninflammatory lines for most protocols, but the differences between rheumatoid and nonrheumatoid groups were less marked. Inflammatory fibroblasts demonstrated a greater independence to nutritional and growth stimulatory factors in their micro‐environment than noninflammatory fibroblasts.
Clinical features of the arthritis of mixed connective tissue disease
Authors: Halla James T. , Hardin Joe G.
Published: February 2007

Seventeen of 19 patients with mixed connective tissue disease (MCTD) had arthritis as a significant initial feature of their disease; 8 were given an initial diagnosis of rheumatoid arthritis (RA) and 4 received chrysotherapy. RA‐like hand deformities were present in 35% and contractures and/or persistent loss of joint motion in 47%. Joint radiographs showed abnormalities in 41% and included erosions and/or cysts in 30%. The arthritis of MCTD may be both erosive and deforming and this disease should be considered in patients presenting as RA with unusual features.
Hematologic and serologic studies in 6‐sulfanilamidoindazole arthritis
Authors: Miller Morgan L. , Samuelson Cecil O. , Ward John R.
Published: February 2007

6‐sulfanilamidoindazole (6‐SAI), an antibacterial sulfonamide, is known to cause an acute, self‐limited inflammatory reaction in the hind paws of older rats. Administration of 6‐SAI results in hyperfibrinogenemia which precedes the onset of clinical arthritis. The hyper‐fibrinogenemia is associated with the prolongation of dilute blood clot lysis times, appearance of heparin‐precipitable fibrinogen, elevations in fibrin degradation products, and complement titers and serum electrophoretic pattern changes that consist of decreased albumin concentrations and increased beta globulin concentrations. Alterations in 6‐SAI medicated young rats are less marked and require higher doses.
Mixed lymphocyte reaction in healthy women with rheumatoid factor. lack of association with hla‐dw4
Authors: Engleman Edgar G. , Sponzilli Ernest E. , Batey Marion E. , Ramcharan Savitri , Mcdevitt Hugh O.
Published: February 2007

In independent studies, 51% and 36% of patients with rheumatoid arthritis have been shown to possess HLA‐Dw4 compared to 7% and 13% of controls. In one study Dw4 positive patients more frequently had rheumatoid factor in their sera than did Dw4 negative patients. In order to determine if the Dw4 specificity is associated with the disease or with the presence of rheumatoid factor, the frequency of this HLA antigen has been determined in 24 healthy women known to have rheumatoid factor (median titer 1:160). Only 3 were found to have the Dw4 specificity, suggesting that this specificity is not associated with rheumatoid factor in the absence of rheumatoid arthritis.
Mixed connective tissue disease in siblings
Authors: Horn John R. , Kapur Janet J. , Walker Sara E.
Published: February 2007

Mixed connective tissue disease (MCTD) was diagnosed in a brother and sister, and 18 additional family members spanning three generations were studied to detect evidence of autoimmune disease. Symptoms or signs of MCTD without complete expression of the disease were found in 8 relatives of the original cases. Antibodies to ribonucleoprotein and high‐titer antinuclear antibodies were found only in the affected siblings. Tests for rheumatoid factor were positive in 9 of 17 relatives of the patients; the titers ranged from 1:160 to 1:2560. The brother and sister with MCTD had an identical HLA genotype— 11,12/2,12. The same genotype was inherited by 3 of their siblings, who had impressive rheumatic complaints. This report emphasizes the association between inflammatory connective tissue disease and a specific HLA type within a single kindred.
Correlation between articular cartilage collagenase activity and osteoarthritis
Authors: Ehrlich Michael G. , Houle Patricia A. , Vigliani Gloria , Mankin Henry J.
Published: February 2007

Articular cartilage collagenase activity was determined for 28 sections obtained from twelve femoral heads. For each one square centimeter area, a section was graded by a histologic‐histochemical grading system for the severity of the arthritis. Collagenase activity was found primarily in those areas of moderately severe disease, but not in mild or end stage arthritis.
Differential effects of propranolol on lymphocyte rosette formation and response to plant mitogens
Authors: Dunne James V. , Peters Clarence J. , Moore Terry L. , Vaughan John H.
Published: February 2007

The effects of propranolol on various lymphocyte functions were studied to gain a better understanding of the recently demonstrated suppressive effect of propranolol on rheumatoid factor production. D‐ and L‐propranolol at a concentration of 1 X 10−4 M inhibited the formation of human EA rosettes. The inhibition occurred within one minute of adding the compounds, was reversible, and did not affect cell viability. Addition of propranolol to preformed EA rosettes failed to disaggregate them. Patching and capping of SIg by an Fab′2 anti‐IgG were inhibited at 2.5 X 10−5M and above. Propranolol at 2.5 X 10−5M also inhibited lymphocyte response to phytohemagglutinin and pokeweed mitogen without evidence of cell toxicity by trypan blue staining or absolute numbers of surviving cells. Congeners of propranolol with mainly beta adrenergic blocking properties did not show inhibitory effects. The inhibitory activities of propranolol are interpreted in terms of propranolol's membrane stabilizing effects and ability to interfere with membrane receptor movement.
Effect of inherited deficiency of the fifth component of complement on arthritis induced in mice by mycoplasma pulmonis
Authors: Keystone E. , Taylor‐Robinson D. , Pope C. , Taylor G. , Furr P.
Published: February 2007

Mycoplasma pulmonis inoculated parenterally into mice deficient in the fifth component of complement (C5) caused a chronic arthritis of significantly greater magnitude than in immunologically normal mice. During the chronic phase of arthritis M pulmonis organisms were isolated from the joints and organs of C5 deficient mice more frequently and in larger numbers than from immunologically normal mice. The implications of the results are discussed in relation to the pathogenesis of M pulmonis induced arthritis and human connective tissue diseases.
Mechanisms of cellular interaction with monosodium urate crystals. igg‐dependent and igg‐independent platelet stimulation by urate crystals
Authors: Ginsberg Mark H. , Kozin Franklin
Published: February 2007

Monosodium urate crystals (MSU) stimulate suspensions of washed platelets or neutrophils. When MSU crystals are coated with IgG, as occurs in plasma, stimulation is markedly enhanced. These studies which use MSU‐induced human platelet serotonin secretion as a model examine the nature of cellular recognition mechanisms for MSU crystals and IgG‐coated MSU crystals. F(ab')2 fragments of specific anti‐Fc antibody blocked and the lipopolysaccharide of Salmonella minnesota R595 enhanced human platelet secretion induced by IgG–coated urate crystals. These agents had little effect on stimulation by uncoated crystals. This indicated that urate crystals stimulate platelets independently of fluid phase IgG. Urate crystals directly stimulated suspensions of washed rabbit platelets which lack Fc receptors. In contrast to human cells, stimulation was blocked by IgG. This again demonstrated IgG‐independent cell stimulation by urate crystals. Calcium pyrophosphate dihydrate crystals could trigger human platelet secretion only when coated with IgG. This suggests that when crystals are coated with IgG, the surface‐bound IgG alone may be the stimulus to the cell. This was supported by the finding that polyvinylpyridine‐N‐oxide, a hydrogen acceptor, blocked human platelet stimulation by uncoated, but not IgG‐coated, urate crystals. These data indicate that urate crystals (and potentially other surface or particles) can stimulate a mediator cell by at least two mechanisms: by direct stimulation without the mediation of adsorbed IgG or, when coated with IgG, by triggering the cell via immunoglobulin receptors.
Humoral immune stimulation and antiepithelial antibodies in yersinia infection
Authors: Gripenberg Marianne , Miettinen Aaro , Kurki Pekka , Linder Evert
Published: February 2007

Results consistent with a general humoral immune stimulation were found when 127 sera from 89 patients with Yersinia enterocolitica infection were studied. Significantly increased gammaglobulin concentrations and elevated isohemagglutinin titers were seen in these sera as compared to sera from normal blood donors and patients with streptococcal infection. Antinuclear and anti–smooth muscle antibodies were demonstrated in both yersinia and streptococcal infection. The prevalence of non–organ specific antiepithelial antibodies reacting with gastrointestinal and thyroid epithelial cells was significantly increased in yersinia infection.
Complement‐fixing hidden rheumatoid factor in children with benign rheumatoid nodules
Authors: Moore Terry L. , Dorner Robert W. , Zuckner Jack
Published: February 2007

Rheumatoid nodules have been described in many children without evidence of clinical disease. These have been referred to as benign rheumatoid nodules (BRN). Except for one report, no serological abnormalities have been demonstrated. Four children with BRN have been studied. By means of a hemolytic assay, high titers of hidden rheumatoid factor (RF) have been found in the blood, i.e., 19S IgM RF detected after acid separation of IgM‐containing fraction from the serum. The median hidden RF titer of the children with BRN was 1:362 and in healthy and disease controls was 1:7. The difference was significant at P < 0.001.

The results indicate that patients with BRN have active complement‐fixing 19S IgM RF in their serum. Thus, the association of hidden RF with BRN raises the possibility that the deposition of immune complexes (19S IgM‐7S IgG) leads to small vessel vasculitis and nodular formation.
Acute hematogenous osteomyelitis progressing to septic synovitis and eventual pyarthrosis. the vascular pathway
Authors: Atcheson Steven G. , Ward John R.
Published: February 2007

A case suggesting sequential infection of bone, synovial membranes, and finally synovial fluid is presented. Hematogenous osteomyelitis manifests itself differently in children than in adults. In children, the avascular epiphyseal cartilage in the growing long bone is an effective barrier to the spread of bone infection to the joint. After obliteration of the growth plate, vascular anastomoses form between metaphysis and epiphysis, and at maturity the entire bone shares a common blood supply with the capsule and synovium of the adjacent joint. In the adult with acute osteomyelitis, contiguous joint infection should be anticipated. In septic arthritis, unless caused by penetrating trauma, the synovium must be infected before the joint fluid. Even when bacterial joint infection is present, repeated arthrocenteses may be required over several days to confirm the diagnosis.
Transverse myelitis in mixed connective tissue disease
Authors: Weiss Terry D. , Nelson James S. , Woolsey Robert M. , Zuckner Jack , Baldassare Andrew R.
Published: February 2007

Neurologic disease is reported to occur in just 10% of patients with mixed connective tissue disease (MCTD). Most commonly, this is manifested by mild trigeminal neuralgia. This report details the clinical and neuropathologic findings of transverse myelitis in a patient with MCTD. Neurologic features include progressive areflexic paraplegia with loss of bowel and bladder function. Neuropathologically there was thinning of the thoracic cord, widespread loss of axons and myelin sheaths, reactive astrocytosis, macrophage formation, vascular thickening with perivascular chronic inflammatory cell infiltration, and calcium deposits. This case demonstrates that severe neurologic disease unresponsive to therapy can occur in MCTD.
Tγ cells in systemic lupus erythematosus
Authors: Hamilton Maurice E. , Winfield John B.
Published: February 2007

Circulating T cells bearing receptors for the Fcportion of IgG (Tγ) were identified by sensitive immunofluorescent techniques with rabbit IgG b4 allotype/anti‐b4 complexes. A twofold decrease in both proportion and absolute number of Tγ cells was found in patients with active systemic lupus erythematosus (SLE) relative to values obtained during disease remission. The reduction in Tγ cells was most evident in patients with severe hypocomplementemia. A deficit of Tγ cells in active patients was not demonstrated. The percentage of total T cells rosetting with sheep erythrocytes was reduced in peripheral blood of most patients regardless of disease activity status, but particularly during SLE exacerbation. Cells lacking intrinsic surface immunoglobulin, IgG Fc receptors, and receptors for sheep erythrocytes were increased. These cells, operationally termed null. exhibited an inverse linear relationship with T cells that was not apparent in regression analyses performed against other lymphocyte subpopulations. Such differences were not found for B cells and IgG receptor‐bearing non‐B/non‐T cells which were present in normal proportions in virtually all patients. The origin and functional significance of these unusual lymphocyte subpopulation abnormalities are discussed.
Pha‐Induced Cellular Cytotoxicity
Authors: Ruíz‐Arg¨︁elles Alejandro , Díz‐Jouanen Efraín , Alarcón‐Segovia Donato
Published: February 2007

Phytohemagglutinin‐induced cellular cytotoxicity by normal mononuclear cells (MNC) is inhibited by serum of patients with active untreated systemic lupus erythematosus (SLE) but not by that of patients with untreated inactive SLE or rheumatoid arthritis. Threehour preincubation of normal MNC with SLE sera suffices to inhibit throughout the assay. Preincubation with phytohemagglutinin (PHA) before addition of sera does not prevent the inhibition. DEAE‐cellulose chromatography, Sephadex G‐200 fractionation and immunoelectrophoretic analysis have shown the nonimmunoglobulin nature of this factor. It is thermostable and not affected by deoxyribonuclease or ribonuclease treatment. The mitogen‐induced cellular cytotoxicity‐inhibiting factor seems to be independent of other serum factors capable of blocking PHA‐induced blastogenic transformation.
Coexistent gout and rheumatoid arthritis
Authors: Wallace Daniel J. , Klinenberg James R. , Morhaim Daniel , Berlanstein Bruce , Biren Pamela C. , Callis Gilbert
Published: February 2007

A 73‐year‐old woman with Felty's syndrome and arthritis mutilans of long duration presented with tophaceous gout. The 7 previously reported cases of coexistent gout and rheumatoid arthritis (RA) are critically reviewed. Possible explanations for the rare coexistence of RA and gout are discussed: if uric acid is an inhibitor of the immune response, then hyperuricemia and gout could protect against development of RA. Conversely, crystalline protein binding may be a critical factor in the pathogenesis of gout, and the presence of abnormal proteins in RA could protect against gout.
Long‐term chrysotherapy in rheumatoid arthritis
Authors: Srinivasan Ramachandran , Miller Bruce L. , Paulus Harold E.
Published: February 2007

The efficacy of chrysotherapy appears to increase with prolonged administration. In patients who were followed for 3 years after gold therapy was started, remissions occurred in 73% of those who continued chrysotherapy. Only 6% of those who stopped gold injections during the first 18 months subsequently developed “spontaneous” remissions, although initially both groups had comparable moderately severe rheumatoid arthritis of 6 to 8 years' duration. Therefore, in the absence of definite toxicity, maintenance gold injections should be continued indefinitely.
Alpha‐1‐antitrypsin phenotypes in rheumatoid arthritis and systemic lupus erythematosus
Authors: Karsh Jacob , Vergalla John , Jones E. Anthony
Published: February 2007

Alpha‐1‐antitrypsin phenotypes were determined in 37 patients with rheumatoid arthritis and 40 patients with systemic lupus erythematosus. No significant increase in non‐MM phenotypes was found. It appears that alpha‐1‐antitrypsin phenotypes neither predispose to the development nor enhance the severity of the two rheumatic diseases.
Reflex sympathetic dystrophy syndrome of the knee following meniscectomy
Authors: Kim Hong Joon , Kozin Franklin , Johnson Roger P. , Hines Robert
Published: February 2007

Three cases are reported in which severe pain and tenderness, color and temperature changes, and patchy osteopenia developed after meniscectomy. These clinical and radiographic features, combined with positive scintigraphs and a typical synovial histologic appearance, suggested a reflex sympathetic dystrophy syndrome (Sudeck's atrophy). This finding has not been reported previously as a complication of meniscectomy.
The training of united states rheumatologists, 1927‐1976
Authors: Henke Curtis J. , Epstein Wallace V.
Published: February 2007

A questionnaire completed in 1977 by 940 United States rheumatologists concerning the duration, content, and quality of their subspecialty training experience has been analyzed. The effect of quantitative changes in program content on the evaluation of such programs was elucidated by means of linear regression analysis. Respondents provided a rating scale for the content of future training programs. Stratification of responses by academic and nonacademic clinicians provides further insights into past and future training programs for rheumatologists in the United States.
Long term effectiveness of low dose mithramycin for paget's disease of bone
Authors: Russell A. S. , Chalmers I. M. , Percy J. S. , Lentle B. C.
Published: February 2007

Nineteen patients with Paget's disease of bone were studied 7 months to 5 years after therapy with mithramycin in a dose averaging 11.5 μg/kg body weight daily for 10 days. Thirteen patients, including 3 with the longest followup intervals, remained free of pain. Objective measures of disease activity (serum alkaline phosphatase level and 99mtechnetium pyrophosphate bone scan) were less favorable. There was no evidence of long term toxicity.
Connective tissue activation
Authors: Castor C. William , Ritchie James C. , Williams Charles H. , Scott Mary E. , Whitney Sherry L. , Myers Stephen L. , Sloan Tod B. , Anderson Byron E.
Published: February 2007

Connective tissue activating peptide‐III (CTAP‐III) isolated from human platelets is a potent mitogen for human connective tissue cells in culture in addition to stimulating glycosaminoglycan synthesis, glucose consumption, and lactate formation. The amino acid composition of apparently homogeneous CTAP‐III was determined, confirming the presence of two disulfide links and providing a calculated molecular weight of 11,633 daltons. Comparison of the mitogenic activity of serum and plasma‐serum suggests that CTAP‐III is a major mitogenic component of human serum. Seventeen strains of human connective tissue cells (synovial, cartilage, dermal and thyroid) incorporated [3H]‐thymidine at up to 30 times control at levels under the influence of microgram quantities of CTAP‐III and caused detectable increases in thymidine incorporation at levels as low as 10–29 ng/ml. Prostaglandin E1 (0.01 μg/ml) and dibutyryl cyclic AMP (25 μg/ml) potentiated the glycosaminoglycan stimulating effect of CTAP‐III, but not its mitogenic effect. Cycloheximide and actinomycin D blocked the biologic actions of CTAP‐III. Cortisol and penicillamine had little effect on the mitogenic activity of CTAP‐III, whereas antirheumatic agents such as acetylsalicylic acid and phenylbutazone opposed the mitogenic activity when added to cultures at clinically relevant concentrations. A weak antiheparin factor secreted by platelets, low affinity platelet factor 4 (LA‐PF4), was shown to be similar to CTAP‐III in biologic actions, electrophoretic mobility, amino acid composition, and antigenic determinants.
Unusual electromyographic findings in a patient with polymyalgia rheumatica
Authors: Gross Milton D. , Borkin Mark H. , Rupp Stephen
Published: February 2007

A case of polymyalgia rheumatica (PMR) with biopsy‐proven giant cell arteritis (GCA) is described in which there were marked abnormalities noted on electromyography (EMG). Spike potentials, positive waves, and fibrillation potentials were seen in the proximal musculature of the upper and lower extremities as well as in the erector spinae muscles. Investigation failed to reveal abnormalities in either creatinine phosphokinase (CPK), aldolase, or muscle obtained at biopsy. The presence of these EMG findings in the PMR‐GCA syndrome is unusual. Response to therapy with systemic corticosteroids and normalization of the EMG are documented.
Central Nervous System Lupus Erythematosus
Authors: Kassan Stuart S. , Kagen Lawrence J.
Published: February 2007

Cyclic‐GMP (C‐GMP), a normal constituent of the central nervous system, was found to be present in increased amounts in the cerebrospinal fluid (CSF) of systemic lupus erythematosus (SLE) patients with active neurologic disease. Twenty‐four CSF samples from 17 patients with SLE were evaluated for C‐GMP concentration by radioimmunoassay. This study extends our initial observations and examines three groups of SLE patients based on their clinical status at the time of each lumbar puncture: those with active neurologic and psychologic abnormalities (group I), active neurologic abnormalities (group II), and psychologic abnormalities without active neurologic involvement (group III). Groups I and II had mean CSF C‐GMP values of 3.1 nM ± 0.64 (SE) and 4.1 nM ± 0.10 respectively, which were both significantly higher than the mean for group III (1.2 nM ± 0.43) (P < 0.05). Other CSF findings did not display this close correlation with activity of neurologic disease. In 4 SLE patients, significantly higher levels of CSF C‐GMP were found on serial sampling during times when neurologic abnormalities were active. Thus elevated CSF C‐GMP concentration may be a marker of active neurologic disease in SLE.
The Immunologic and Clinical Associations of the Split Products of C3 in Plasma in Juvenile Rheumatoid Arthritis
Authors: Miller John J. , Hsu Yao‐Pi , Moss Richard , Kelomaa‐Sulonen Kerttu , Osborne Cara L. , Olds‐Arroyo Lynne
Published: February 2007

A qualitative counterimmunoelectrophoretic assay for the complement activation products C3c and C3d was used to study plasma from children with juvenile rheumatoid arthritis (JRA) and other rheumatic diseases. Positive tests for C3c,d were found in all patients with active systemic lupus erythematosus (SLE), 7 of 10 patients with active systemic JRA, 16 of 29 with active polyarticular JRA, 7 of 20 with active pauciarticular JRA, and in only 2 of 20 with inactive joint disease. The incidence of positive assays for C3c,d in JRA was increased in the presence of positive latex fixation tests, antinuclear antibody tests, or elevated values for antiglobulins as determined by affinity chromatography, but these associations were not statistically significant. Three joint fluids from children with pauciarticular JRA were negative for C3c,d. These studies show that the subgroups of JRA defined by clinical criteria are heterogeneous by current laboratory parameters and that evidence implicating antigen‐antibody complexes in the pathogenesis of JRA is lacking in many patients.