bluuebunny/crossref_metadata_2025 huggingface dataset:
Sex‐Linked differences in susceptibility of cynomolgus monkeys to type II collagen–induced arthritis. Evidence that epitope‐specific immune suppression is involved in the regulation of type II collagen autoantibody formation
Authors: Terato Kuniaki , Arai Haruyoshi , Shimozuru Yasunori , Fukuda Taneo , Tanaka Hiroshi , Watanabe Hideto , Nagai Yutaka , Fujimoto Koji , Okubo Fumio , Cho Fumiaki , Honjo Shigeo , Cremer Michael A.
Published: February 2007

To determine whether sex‐linked factors are important in the susceptibility and resistance of cynomolgus monkeys to type II collagen–induced arthritis, we immunized 5 males and 10 females with chick type II collagen (CII) and studied their clinical and immune responses. All 10 females developed overt arthritis and produced antibodies to CII and cross‐reactive antibodies to monkey type II collagen (MkII). In contrast, only 1 male monkey developed arthritis, which was transient and mild in severity. Examination of antisera obtained from the male monkeys disclosed high titers of antibody to CII, but little antibody to MkII. The cyanogen bromide peptide recognition patterns varied markedly from animal to animal, implying that monkeys are capable of recognizing multiple arthritogenic determinants on CII.
Central nervous system toxicity associated with weekly low‐dose methotrexate treatment
Authors: Wernick Richard , Smith David L.
Published: February 2007

Central nervous system (CNS) toxicity from low‐dose methotrexate (MTX) has been reported rarely, and reported symptoms consist primarily of dizziness and headache. We reviewed the records of 25 consecutive patients treated with low‐dose MTX, and found 5 who had spontaneously reported unpleasant cranial sensations, mood alteration, or memory impairment. Rechallenge with MTX on 5 occasions in 3 patients led to recurrent CNS symptoms in all cases. CNS toxicity was the sole reason for discontinuation of MTX in 2 patients. These 5 patients differed from the 20 without CNS toxicity in age (mean 68 versus 50) and baseline serum creatinine level (1.3 mg/dl versus 0.9 mg/dl), but not in weekly dosage of MTX (12 mg versus 16 mg). These results suggest that CNS toxicity is more common than previously reported, particularly in older patients with mild renal insufficiency.
Sleep fragmentation in rheumatoid arthritis
Authors: Mahowald Mark W. , Mahowald Maren L. , Bundlie Scott R. , Ytterberg Steven R.
Published: February 2007

Fatigue is commonly reported by patients with rheumatoid arthritis (RA), and it is frequently used to evaluate disease activity and response to therapy. We theorized that the feeling of fatigue in patients with RA may be a manifestation of disturbance of sleep. Sixteen patients with chronic, active RA, who were selected for early onset of fatigue (<6 hours after morning awakening), were extensively evaluated by formal all‐night polysomnographic recording and multiple sleep latency testing (MSLT). Although no sleep deprivation was found, all patients had some type of marked disturbances of sleep, including unanticipated sleep apnea (2 patients), frequent movement of extremities (all 16 patients), and frequent arousal (all 16 patients). The alpha‐delta sleep pattern was present in 13 patients, and 7 were found by MSLT to be hypersomnolent. None of the patients accurately recognized the degree of their sleep disruption. Our findings from the MSLT indicate that fatigue in patients with RA may be a manifestation of sleep fragmentation, rather than a nonspecific constitutional symptom.
Psoriatic arthritis in children
Authors: Southwood Taunton R. , Petty Ross E. , Malleson Peter N. , Delgado Egle A. , Hunt David W. C. , Wood Betty , Schroeder Maria‐Louise
Published: February 2007

A proposed definition of juvenile psoriatic arthritis (JPsA) was used to identify definite or probable JPsA in 35 children. Definite JPsA (24 patients) was defined as arthritis associated, but not necessarily coincident, with a typical psoriatic rash, or arthritis plus at least 3 of 4 minor criteria: dactylitis, nail pitting, psoriasis‐like rash, or family history of psoriasis. Probable JPsA (11 patients) was defined as arthritis plus 2 of the minor criteria. In 33 of 35 patients, the onset of arthritis was pauciarticular, but the disease followed a polyarticular course in 23 of 35. Chronic anterior uveitis (6 of 35), antinuclear antibodies (22 of 35), anticollagen antibodies (10 of 35), HLA‐DR4 (2 of 28), and HLA‐DR8 (5 of 28) occurred with frequencies similar to those seen in patients with juvenile rheumatoid arthritis. JPsA may have more in common with juvenile rheumatoid arthritis than with the seronegative spondylarthropathies with which it is traditionally associated.
Inhibition of in vitro vascular endothelial cell proliferation and in vivo neovascularization by low‐dose methotrexate
Authors: Hirata S. , Matsubara T. , Saura R. , Hirohata K. , Tateishi H.
Published: February 2007

Neovascularization in the rheumatoid synovium plays an important role in the propagation of rheumatoid synovitis because the emigration of mononuclear cells and the growth of pannus are critically dependent on the development of small blood vessels. Inhibition of local vascular endothelial cell (EC) proliferation, which is essential for growth of these vessels, therefore, would have the potential to suppress rheumatoid inflammation. We investigated the effects of methotrexate (MTX), low doses of which are commonly administered to rheumatoid arthritis patients, on DNA synthesis by human umbilical vein EC in vitro and on rabbit corneal neovascularization in vivo. MTX inhibited both basal and EC growth factor–stimulated tritiated deoxyuridine (3H‐UdR) incorporation into EC in a dose‐dependent manner. Significant inhibition was observed at a concentration of 5 × 10−9M, which is that attained in the serum of treated patients. Neovascularization in vivo was also suppressed by low‐dose intramuscular injections. These results suggest that MTX has an antiangiogenic effect, and may suppress rheumatoid inflammation through the reduction of synovial small blood vessels responsible for mononuclear cell infiltration and proliferation of synovial tissue.
Normotensive renal failure in systemic sclerosis
Authors: Helfrich David J. , Banner Barbara , Steen Virginia D. , Medsger Thomas A.
Published: February 2007

Of 140 patients with “scleroderma renal crisis” encountered during a 33‐year period, 15 of 131 (11%) whose blood pressures were recorded were normotensive during this complication. In comparison with 116 patients with hypertension, the normotensive patients significantly more often had microangiopathic hemolytic anemia (90% versus 38%) and thrombocytopenia (83% versus 21%). Pulmonary hemorrhage occurred in 6 normotensive patients. More normotensive patients had received high doses of corticosteroids (prednisone gE;30 mg/day) during the 2 months immediately preceding renal crisis (64% versus 16%). A role for corticosteroids in precipitating renal crisis is suggested. The 12‐month survival was significantly reduced in the normotensive patients (13% versus 35%).
The presence of antibodies to lymphotoxin and tumor necrosis factor in normal serum
Authors: Jeffes Edward W. B. , Ininns Elizabeth K. , Schmitz Kristen L. , Yamamoto Robert S. , Dett Carmen A. , Granger Gale A.
Published: February 2007

Lymphotoxin (LT) and tumor necrosis factor (TNF) are cytokines that probably play a role in several autoimmune diseases. In this report, we describe the detection, in normal nonimmune serum, of naturally occurring antibodies that bind to recombinant human LT and TNF. The naturally occurring antibodies that bind to LT and TNF could explain why normal immunoglobulin is effective therapy in idiopathic thrombocytopenic purpura and Kawasaki syndrome.
Development and initial validation of a dual‐language english–spanish format for the arthritis impact measurement scales
Authors: Hendricson William D. , Jon Russell I. , Prihoda Thomas J. , Jacobson James M. , Rogan Alice , Bishop George D. , Castillo Richard
Published: February 2007

Language, cultural, and educational barriers complicate efforts to validate health status questionnaires that have been translated into Spanish. To overcome these problems, a prototype dual‐language format was developed for the Arthritis Impact Measurement Scales. Validity testing with 72 patients diagnosed as having rheumatoid arthritis indicated high levels of test‐retest reliability, item‐to‐scale internal consistency, and construct validity for both Anglo and Hispanic subjects. A technique for developing and pilot‐testing a questionnaire written in a regional Spanish dialect is described. Linguistic considerations, questionnaire design, and other applications are discussed in light of the results obtained.
Autoantibodies to the major nucleolar phosphoprotein B23 define a novel subset of patients with anticardiolipin antibodies
Authors: Li Xiaozhou , Jane Mcneilage L. , Whittingham Senga
Published: February 2007

Of 164 sera with antinucleolar antibodies, 7 (4.3%) were shown by Western blotting to react with a 37‐kd polypeptide in a nuclear extract of HeLa cells and with the recombinant protein expressed by a complementary DNA clone encoding the major nucleolar protein B23. Six of the 7 sera (86%) had antibodies to cardiolipin (aCL), and the sample that was negative for aCL had had lupus anticoagulant on previous testing. All 7 patients had either systemic lupus erythematosus (SLE) or a variant of SLE, suggesting that anti‐B23 identifies a subset of patients with SLE associated with a high frequency of aCL.
High‐grade atrioventricular heart block in an adult with systemic lupus erythematosus: The association of nuclear RNP (U1 RNP) antibodies, a case report, and review of the literature
Authors: Bilazarian Seth D. , Taylor Allen J. , Brezinski Damian , Hochberg Marc C. , Guarnieri Thomas , Provost Thomas T.
Published: February 2007

High‐grade atrioventricular heart block (HGAVB) occurring as a manifestation of systemic lupus erythematosus is an exceedingly rare event. We describe a patient with HGAVB who had myositis and antibodies to nuclear RNP (previously associated with myocarditis). A review of the literature on HGAVB associated with systemic lupus erythematosus is also presented.
Destructive arthritis, rheumatoid factor, and HLA–DR4. Susceptibility versus severity, a case–control study
Authors: Calin Andrei , Elswood Judith , Klouda Peter T.
Published: February 2007

In response to the continuing debate as to whether seronegative rheumatoid arthritis (RA) and seropositive RA are part of the same disease spectrum or are distinct disorders, we evaluated 720 patients with definite and classic RA, of whom 53 subjects had definite persistently seronegative destructive disease. For all but 1 seronegative RA patient, a seropositive RA case control was identified and matched for age, disease duration, degree of destruction on hand radiographs, and disease‐modifying drug therapy. DR typing was undertaken on these 105 patients, together with scoring of hand radiographs. The frequency of DR4 was 69% in seropositive RA patients and 60% in seronegative RA patients (P = 0.22), versus 36% in 318 healthy controls (P = 0.008 and P = 0.007 versus seropositive and seronegative RA, respectively). Patients were matched and rematched with different controls in a series of subanalyses in order to make comparisons of hand radiograph scores. We found that HLA–DR4 was associated with destructive RA in both seropositive and seronegative RA patients. In general, DR4+ patients had more severe disease by radiologic criteria than did DR4– patients. Thus, HLA–DR4 may be an additive factor to the serologic status and may be more closely related to disease severity than to disease susceptibility.
The clinical significance of iC3b neoantigen expression in plasma from patients with systemic lupus erythematosus
Authors: Negoro Nobuo , Okamura Mikio , Takeda Tadanao , Koda Shinichi , Amatsu Koji , Inoue Takatoshi , Curd John G. , Kanayama Yoshiharu
Published: February 2007

We studied the expression of an iC3b neoantigen (iC3b‐NEO) in plasma from patients with systemic lupus erythematosus (SLE), by using a monoclonal antibody specific for iC3b/C3dg/C3d, to investigate the activation of the third component of complement in SLE. The plasma iC3b‐NEO level in 40 untreated patients with active SLE was significantly higher than that in 36 normal subjects (mean ± SD 31.5 ± 13.9 μg/ml versus 12.3 ± 3.3 μg/ml; P < 0.001). The plasma iC3b‐NEO level was highly correlated with clinical disease activity (τ = 0.62, P < 0.0001), and it was the parameter most closely correlated with renal histologic activity in lupus nephritis (τ = 0.52, P < 0.0001). Also, patients with diffuse proliferative lupus nephritis had the highest levels of plasma iC3b‐NEO among all World Health Organization classes of lupus nephritis (P < 0.01). We conclude that the plasma iC3b‐NEO level is strongly associated with clinical disease activity and renal histologic activity in patients with SLE, and that plasma iC3b‐NEO may be a sensitive and useful measure of complement activation in SLE.
Antiribosomal S10 antibodies in humans and MRL/lpr mice with systemic lupus erythematosus
Authors: Bonfa E. , Parnassa A. P. , Rhoads D. D. , Roufa D. J. , Wool I. G. , Elkon K. B.
Published: February 2007

Autoantibodies directed against a ribosomal small subunit protein of 20,000 molecular weight were found in sera from 5 of 44 patients with systemic lupus erythematosus (11%) and 5 of 48 MRL/lpr mice (10%). This ribosomal protein was identified as S10 on the basis of two‐dimensional gel electrophoresis and immunoblotting, as well as immunoblots of the purified S10 protein. The S10 protein antigen was readily extracted from ribosomes at low salt (300 mM KCI) and low magnesium (0.5 mM) concentrations, consistent with the highly exposed location proposed for this protein on the 40S subunit. Anti‐S10 antibodies were observed significantly more frequently in lupus sera containing both anti‐Sm and antiribosomal P protein antibodies and in MRL/lpr sera with anti‐Sm activity, suggesting a linked pattern of autoantibody response. Together with anti‐Sm and antiribosomal P protein antibodies, anti‐S10 represents a third autoantibody highly specific for lupus in humans and MLR/lpr mice.
Activation of the complement system in systemic sclerosis. Relationship to clinical severity
Authors: Senaldi Giorgio , Lupoli Salvatore , Vergani Diego , Black Carol M.
Published: February 2007

Using newly developed techniques, we investigated the complement pathways and the extent of their activation in patients with systemic sclerosis (SSc) of both the diffuse cutaneous and limited cutaneous types. Plasma levels of the fragments C3d, C4d, and Ba were measured in patients with SSc and in matched control subjects. All fragments and ratios were higher in SSc patients than in controls (P < 0.05), demonstrating that complement activation occurs in SSc. Levels of C3d, C3d:C3, Ba, and Ba:factor B were higher in patients with diffuse cutaneous SSc than in those with limited SSc (P < 0.01). All fragments and ratios were higher in diffuse cutaneous SSc patients than in controls (P < 0.01). C3d, C3d:C3, C4d, and C4d:C4 levels were also higher in patients with limited cutaneous SSc than in controls (P < 0.05). These results show that complement activation occurs in SSc patients and that it reflects clinical severity. Complement activation may therefore have a pathogenetic role in SSc, and its measurement may prove useful in monitoring the disease.
Suppression of human synovial cell proliferation by dihomo‐γ‐linolenic acid
Authors: Baker Daniel G. , Krakauer Kathrin A. , Tate Guillermo , Laposata Michael , Zurier Robert B.
Published: February 2007

Prostaglandin E1 (PGE1) and oils enriched in its precursor fatty acids suppress inflammation and joint tissue injury in several animal models. Since synovial cell proliferation is a hallmark of rheumatoid arthritis, we studied the effect of dihomo‐γ‐linolenic acid (DGLA), an immediate precursor of PGE1, on the growth of human adherent synovial cells (ASC) in tissue culture. When stimulated by appropriate concentrations of recombinant interleukin‐1β (rIL‐1β), ASC proliferate and produce PGE. DGLA‐enriched medium suppressed both baseline and rIL‐1β–stimulated ASC growth fivefold, compared with medium supplemented with arachidonic acid. Indomethacin reduced the effect of the DGLA. Synovial cells incorporated the DGLA, and rIL‐1β–stimulated cells that were incubated with DGLA exhibited a 14‐fold increase in PGE1 (to 25.2 ± 6.0 ng/ml, mean ± SD) and a 70% decrease in PGE2 (to 25.2 ± 4.2 ng/ml) compared with cells in control medium. At equivalent concentrations (5 × 10−7M), PGE1 increased the level of cellular cAMP to a greater extent than did PGE2 (16.8 ± 2.0 pmoles versus 4.3 ± 1.9 pmoles, mean ± SEM). Exogenous PGE1 was also a more effective inhibitor of cell growth. Similarly, cAMP concentrations in cells exposed to DGLA for 6 hours were greater than concentrations in arachidonic acidenriched cultures (17.8 ± 3.3 pmoles versus 2.1 ± 2.0 pmoles). These observations suggest that DGLA can restrain ASC growth, an effect which may be due to its capacity to increase PGE1 production and subsequent cellular cAMP concentration.
Isotype analysis of the anti–CENP‐B anticentromere autoantibody: Evidence for restricted clonality
Authors: Eisenberg Robert A. , Earnshaw William C. , Bordwell Bonnie J. , Craven Sylvia Y. , Cheek Robert , Rothfield Naomi F.
Published: February 2007

Utilizing the centromere B fusion protein (CENP‐B) and specific, matched monoclonal antiisotype reagents in an enzyme‐linked immunosorbent assay, we found that anti–CENP‐B autoantibodies were skewed to the IgG1 isotype. The overall k:λ light chain ratio was 2:1, although several individual sera showed a strong predominance of one of the light chains. Isoelectric focusing of light chain–skewed sera showed polyclonal patterns. Our findings are consistent with the anti–CENP‐B autoantibody response being a chronic, antigen‐driven response.
Antihistone antibodies in rheumatoid arthritis and Felty's syndrome
Authors: Cohen Michael G. , Webb John
Published: February 2007

Although antihistone antibodies are frequently detected in patients with systemic lupus erythematosus, they appear to be uncommon or present only at low levels in rheumatoid arthritis (RA) patients. We used an enzyme‐linked immunosorbent assay to study sera from 42 patients with RA, and we confirmed that antihistone antibodies mainly occurred at low levels in these patients. In contrast, 83% of 24 patients with Felty's syndrome had antihistone antibodies, often at high levels. Thus, antihistone antibodies may be a common autoimmune abnormality in patients with Felty's syndrome but not in other patients with RA. In addition, we demonstrated that some rheumatoid factors have cross‐reactive antihistone antibody activity.
Development of a disability measurement tool for juvenile rheumatoid arthritis. The juvenile arthritis functional assessment scale
Authors: Lovell Daniel J. , Shear Edith , Hartner Sandra , McGirr Gerri , Schulte Marion , Levinson Joseph , Howe Steven
Published: February 2007

A disability assessment tool, the Juvenile Arthritis Functional Assessment Scale, was developed for, and validated in, patients with juvenile rheumatoid arthritis (JRA). Standards for this 10‐item tool were developed using the scores of 63 normal school children as controls and comparing these results with those of 71 age‐matched JRA patients (age 7–16 years). The JRA patients scored statistically significantly higher on the scale, which also demonstrated excellent internal and convergent validity and internal reliability. The test is easily administered in 10 minutes by a physical or occupational therapist in a clinical or office setting. This tool represents the first normalized disability assessment tool developed for JRA patients.
Efficacy of physical conditioning exercise in patients with rheumatoid arthritis and osteoarthritis
Authors: Minor Marian A. , Webel Richard R. , Kay Donald R. , Hewett John E. , Anderson Sharon K.
Published: February 2007

A group of 120 patients with rheumatoid arthritis or osteoarthritis volunteered to be subjects for this study of aerobic versus nonaerobic exercise. Patients were stratified by diagnosis and randomized into an exercise program of aerobic walking, aerobic aquatics, or non‐aerobic range of motion (controls). The retention rate for the 12‐week program was 83%. Exercise tolerance, disease‐related measures, and self‐reported health status were assessed. The aquatics and walking exercise groups showed significant improvement over the control group in aerobic capacity, 50‐foot walking time, depression, anxiety, and physical activity after the 12‐week exercise program. There were no significant between‐group differences in the change scores for flexibility, number of clinically active joints, duration of morning stiffness, or grip strength. Our findings document the feasibility and efficacy of conditioning exercise for people who have rheumatoid arthritis or osteoarthritis.
Differences in the fine specificity of ANTI–Ro (SS‐A) in relation to the presence of other precipitating autoantibodies
Authors: Rader Michael D. , Codding Chris , Reichlin Morris
Published: February 2007

In sera from patients with systemic lupus erythematosus or Sjögren's syndrome, we determined the fraction of antibody that remained reactive with human Ro (SS‐A) after absorption with bovine spleen extract, and the reactivity with the 60‐kd and 54‐kd red blood cell Ro (SS‐A) bands by Western blot. Of the 3 groups of sera studied, those containing anti–Ro (SS‐A) alone had the highest degree of reactivity with human Ro (SS‐A) after absorption with bovine spleen extract, followed, in descending order, by sera containing anti–Ro (SS‐A) and anti–La (SS‐B), and sera containing anti–Ro (SS‐A) and anti–nuclear RNP. The groups of sera could be distinguished on this basis. Sera with anti–Ro (SS‐A) and anti–nuclear RNP could also be distinguished from the other 2 types of sera by their uniform and preferential reactivity with the 60‐kd red blood cell Ro (SS‐A), by Western blot analysis. These findings indicate that there are both qualitative and quantitative differences, associated with the presence of other autoantibodies, in the fine specificity of anti–Ro (SS‐A) sera.
New radiographic grading scales for osteoarthritis of the hand. Reliability for determining prevalence and progression
Authors: Kallman Douglas A. , Wigley Fredrick M. , Scott William W. , Hochberg Marc C. , Tobin Jordan D.
Published: February 2007

We developed and evaluated scales for grading the prevalence and progression of the individual radiographic features of osteoarthritis (OA) of the hand. Four equally time‐spaced hand radiographs from 50 participants in the Baltimore Longitudinal Study of Aging, who were followed for at least 20 years, were read separately and „blindly”︁ by 4 experienced, trained readers. Eleven hand joints were individually assessed for the presence of osteophytes, joint space narrowing, subchondral cysts, subchondral sclerosis, lateral deformity, and cortical collapse, and were also graded using the Kellgren/Lawrence scale, a global estimate of OA. The intraclass correlation coefficient was used to determine cross‐sectional inter‐ and intrareader reliability. Interreader agreement on OA progression was evaluated using life‐table analysis. Each of the grading scales for the individual radiographic features of OA of the hand, except for cysts, were cross‐sectionally reliable between readers. Each reader was able to reproduce his original scores almost perfectly when grading the radiographs a second time. Using these scales, the different readers agreed on all the features of longitudinal progression of OA of the hand, except cysts. We believe that this method for grading hand radiographs for OA has proved to be reliable for both cross‐sectional and longitudinal studies.
Elevated mean corpuscular volume as a predictor of hematologic toxicity due to methotrexate therapy
Authors: Weinblatt Michael E. , Fraser Patricia
Published: February 2007

Retrospective analysis of 23 rheumatoid arthritis patients receiving low‐dose methotrexate (MTX) demonstrated an association between the mean corpuscular volume (MCV) and hematologic toxicity. All 6 patients who developed hematologic toxicity were folate deficient, and 4 of 6 had marked macrocytosis. Furthermore, the mean MCV of the patients who developed toxicity was significantly higher than that of the controls without toxicity (P < 0.02). This difference in MCV was associated with an increased probability of developing toxicity with time (P < 0.005). These results suggest that sustained elevation in the MCV may be a predictor of impending hematologic toxicity due to folate depletion.
Prevalence of the use of unconventional remedies for arthritis in a metropolitan community
Authors: Cronan Terry A. , Kaplan Robert M. , Posner Linda , Blumberg Elaine , Kozin Franklin
Published: February 2007

Of 1,811 individuals sampled in a metropolitan community, 382 reported having a musculoskeletal complaint. Eighty‐four percent of them had used an unconventional remedy within the previous 6 months. Most individuals used inexpensive, unharmful remedies such as exercise, prayer, and relaxation. This study indicates that people with musculoskeletal disorders often use unconventional remedies, but raises questions regarding the seriousness of this problem.
Impact of juvenile arthritis on families. An educational assessment
Authors: Konkol Lisa , Lineberry Jeff , Gottlieb Jan , Shelby Pamela E. , Iii Miller , Lorig And Kate
Published: February 2007

State of the art patient education programs have as their goals changes in behaviors, coping styles, health status, and/or costs. The accomplishment of these goals often involves not only the patient but also his or her whole family. This is especially true if the patient is a child. Based on this premise, we undertook an educational needs assessment of 50 children with juvenile arthritis (JA) and their families. Through utilization of a grounded theory methodology, open‐ended questionnaires were completed by JA children, their parents, and their siblings. The resulting analysis suggests (1) the need for family‐based education, (2) differing needs of various family members, and (3) several hypotheses for further study.
Methods used by Urban, low‐income minorities to care for their arthritis
Authors: Bill‐Harvey Dee , Rippey Robert M. , Abeles Micha , Pfeiffer Carol A.
Published: February 2007

The purpose of this study is to describe the current treatment methods minorities use and believe are effective in relieving the pain and discomfort of arthritis. One hundred sixty subjects from two urban, low‐income minority communities reported to case finders that they had some form of arthritis. Subsequently they were interviewed and examined by a rheumatologist. Sixty‐six percent were black, and 34% were Hispanic. The study found that 83% had some type of rheumatic disease. Differences existed between the black and Hispanic samples in age, rheumatic disease distribution, and methods of care. The majority of black respondents were older, with a frequent diagnoses of osteoarthritis, compared to the Hispanics, who reported fibrositis as their dominant rheumatic problem. An array of conventional and nonconventional therapies were used by both groups to care for their arthritis. Prayer (92%), equipment (70%), and heat (33%) were reported as „most helpful”︁ for the blacks. Hispanics reported prayer (50%), heat (40%), and topical ointments as „most helpful”︁.

In order to communicate and provide optimal care to patients from divergent cultural backgrounds, it is important to understand both likenesses and differences, and to be sensitive to the patient's belief system and health care practices.
Health status and disease activity in systemic lupus erythematosus
Authors: Joyce Kathleen , Berkebile Carole , Hastings Clare , Yarboro Cheryl , Yocum And David
Published: February 2007

The physical manifestations of disease activity and health status of patients with systematic lupus erythematosus (SLE) were measured in this study. Forty‐nine patients completed the Arthritis Impact Measurement Scale (AIMS) and consented to examination for physical features of SLE documented by a Clinical Activity Index (CAI). Results showed a mean score of 22 on the AIMS and 6.6 on the CAI. The total scores for each measure were significantly correlated (r = 0.55, p < 0.001), indicating a relationship between health status and clinical disease activity. The total score for CAI was significantly correlated with the physical activity, pain, and depression subscales of health status. The total score for health status was significantly correlated with mucocutaneous, musculoskeletal, and general features of CAI. Within scale correlations were also found. Mucocutaneous aspects of disease activity were significantly correlated with pain and depression. Musculoskeletal features were significantly correlated with physical activity and pain. General aspects of SLE, including fatigue, were significantly correlated with physical activity. The study concludes that there is a relationship between certain physical features of SLE and key components of health status.
Common problems experienced by adults with osteoarthritis
Authors: Weinberger Morris , Tierney William M. , Booher Patricia
Published: February 2007

Functional status and noncompliance were assessed at baseline in 327 patients with osteoarthritis (OA), 96% of whom were interviewed again later either by telephone or at their next scheduled primary care visit. One‐third of the sample reported noncompliance at baseline. During the follow‐up interviews, commonly identified problems included having an inadequate supply of medicines to last until their next physician visit (47%), experiencing gastrointestinal complaints (36%), and reporting barriers to primary care (32%). For OA patients with hypertension or heart disease (N = 241), 75% reported clinically important symptoms. Patients with poorer functional status at baseline generally reported more subsequent problems. We conclude that patients frequently have correctable problems (e.g., medication noncompliance and side effects, barriers to care). These patients may be identified prospectively by their poor functional status. Arthritis health care professionals may wish to consider patient‐oriented interventions to obviate these problems when evaluating functional status.
Understanding compliance with the medical regimen: The scope of the problem and a theoretical perspective
Authors: Agras W. Stewart
Published: February 2007

This article reviews the scope of the compliance problem and introduces a social cognitive model as a framework for understanding the many factors influencing compliance behaviors. Among the broad categories of factors influencing compliance are the nature of the regimen, immediate controlling factors such as the locale in which the regimen is to be followed, the patients' expectations concerning the regimen, characteristics of the health‐care setting, and social support. Each of these factors is considered in some detail. It is concluded that compliance is a complex behavior deserving of thorough investigation by the health‐care team, requiring long‐term monitoring in chronic health problems, and is susceptible to change by a variety of interventions.
Compliance measurement with arthritis regimen
Authors: Dunbar Jacqueline , Dunning E. Jean , Dwyer Kathleen
Published: February 2007

Rheumatoid arthritis affects nearly 6.5 million Americans, causing significant disability and suffering. Improvement of treatment efficacy is of considerable importance. Because adherence moderates treatment effects, efficacy studies need to account for the extent to which the patient complied. This paper reviews the methods of assessing adherence. These methods fall into four categories: (1) clinical measures (therapeutic outcome and clinician judgment); (2) self‐report (interviews, questionnaires, and daily records); (3) direct measures (direct observation and biologic assays); and (4) indirect measures (pill counts, pharmacy refills, and electronic monitors). The most commonly used measure is some form of self‐report. The clinical measures are problematic as compliance indicators and should not be used in this regard. Selections among the other categories should be made based upon the behavior being studied, the cost and resources available, the capabilities of the patient, the questions being asked, and the level of accuracy and detail desired. There are no perfect measures.
Minimal intervention and arthritis treatment: Implications for patient and physician compliance
Authors: Hovell Melbourne F. , Black David R.
Published: February 2007

A rationale based on a public health perspective for using minimal intervention programs in the treatment of arthritis is presented. Minimal interventions are relatively inexpensive, relatively free from side effects, and produce therapeutic effects that range from statistically significant to clinically important. Empirical evidence regarding the relative efficacy of minimal intervention programs continues to accumulate in general preventive medicine. Extension to arthritis treatment and control is recommended. This will require (1) practitioners to recognize the public health perspective, (2) consensus judgment that a treatment is likely to produce therapeutic benefits at little cost and with minima) side effects, and (3) empirical validation of efficacy based on clinical trial results. It is concluded that the concept of minimal intervention could increase physicians' use of such treatments and thereby increase the therapeutic benefits to patients suffering from arthritic disease.
Comparative spermatogenesis, spermatocytogenesis, and spermatozeugmata formation in males of viviparous species of clinid fishes (Teleostei: Clinidae, Blennioidei)
Authors: Fishelson Lev , Gon Ofer , Holdengreber Vered , Delarea Yakob
Published: February 2007

Spermatogenesis and spermatocytogenesis in 16 species of viviparous clinid fishes (Clinidae, Blennioidei) from various localities were followed for the first time by means of light and electron microscopy. The testes of the studied species are of the lobular type, with germinal stem cells situated at the apical ends of the lobules and a vas efferens along the internal margin. Maturation of the spermatides takes place in spermatocysts formed by Sertoli cells around the B‐spermatogonia. The gradual condensation and relocation of the chromosomes along the nuclei membranes are highly prominent in this process, which can be divided into several stages. Anisodiametric and slightly flattened sperm heads are eventually formed, 0.4–0.5 μm in diameter and 7.5 ± 1 μm long, bearing 80 ± 15 μm long flagella. The sperms are packed into spermatozeugmata within the spermatocysts, enveloped and penetrated by the mucotic material of the Sertoli cells. With division of the germ cells and maturation of the spermatids, the spermatocyst dimensions increase, attaining 40 ± 8 μm in diameter in the smaller species of Heteroclinus, and up to 90 ± 10 μm in the larger males of Clinus superciliosus and C. cottoides. Accordingly, the volume of the maturing spermatocysts attains ca. 1,300 ± 100 μm3 in the smaller species, and ca. 6,500 ± 300 μm3 in the larger ones. As sperm head volume is ca. 2.24 μm3, the number of sperm in the smallest mature spermatocysts reaches ca. 440 and in the largest over 2,900. Upon release from the cysts, the spermatozeugmata are transported along the sperm ducts to the posterior ampullae where they are stored in the epididymis. During copulation, the sperms are transported from there to the female via the intromittent organ. The sperm formation parameters and their structure and numbers are discussed. Anat Rec Part A, 2007. © 2007 Wiley‐Liss, Inc.
Scaling of the first ethmoturbinal in nocturnal strepsirrhines: Olfactory and respiratory surfaces
Authors: Smith Timothy D. , Bhatnagar Kunwar P. , Rossie James B. , Docherty Beth A. , Burrows Anne M. , Cooper Gregory M. , Mooney M.P. , Siegel M.I.
Published: February 2007

Turbinals (scroll bones, turbinates) are projections from the lateral wall of the nasal fossa. These bones vary from simple folds to branching scrolls. Conventionally, maxilloturbinals comprise the respiratory turbinals, whereas nasoturbinals and ethmoturbinals comprise olfactory turbinals, denoting the primary type of mucosa that lines these conchae. However, the first ethmoturbinal (ETI) appears exceptional in the variability of it mucosal covering. Recently, it was suggested that the distribution of respiratory versus olfactory mucosae varies based on body size or age in strepsirrhine primates (lemurs and lorises). The present study was undertaken to determine how the rostrocaudal distribution of olfactory epithelium (OE) versus non‐OE scales relative to palatal length in strepsirrhines. Serially sectioned heads of 20 strepsirrhines (10 neonates, 10 adults) were examined for presence of OE on ETI, rostral to its attachment to the nasal fossa wall (lateral root). Based on known distances between sections of ETI, the rostrocaudal length of OE was measured and compared to the length lined solely by non‐OE (primarily respiratory epithelium). In 13 specimens, the total surface area of OE versus non‐OE was calculated. Results show that the length of non‐OE scales nearly isometrically with cranial length, while OE is more negatively allometric. In surface area, a lesser percentage of non‐OE exists in smaller species than larger species and between neonates and adults. Such results are consistent with recent suggestions that the olfactory structures do not scale closely with body size, whereas respiratory structures (e.g., maxilloturbinals) may scale close to isometry. In primates and perhaps other mammals, variation in ETI morphology may reflect dual adaptations for olfaction and endothermy. Anat Rec, 2007. © 2007 Wiley‐Liss, Inc.
Neocortical and hippocampal neuron and glial cell numbers in the rhesus monkey
Authors: Christensen Jeppe Romme , Larsen Karen Bonde , Lisanby Sarah H. , Scalia Jason , Arango Victoria , Dwork Andrew J. , Pakkenberg Bente
Published: February 2007

The rhesus monkey is widely used as an experimental animal model in the study of brain function and disease. While previous quantitative studies have provided knowledge of regional numbers, little is known of the total neocortical neuron and glial cell numbers in this species. The aim of this study is to establish quantitative norms. We use the optical fractionator and Cavalieri principle to examine the right hemisphere of eight young rhesus monkeys taken from the control group of an ongoing study. Applying these methods to agar‐embedded and vibratome‐sectioned tissue, we generate estimates of cell numbers and regional volumes of neocortical and hippocampal regions with coefficients of variance (CV) around 10%. The mean unilateral neocortical neuron number is 1.35 × 109 (CV ± 0.10) and the mean unilateral neocortical glial cell number is 0.78 × 109 (CV ± 0.17). Mean unilateral neocortical volume is found to be 8.5 (CV ± 0.10) cm3 after processing, or 19 cm3 when correcting for shrinkage. The neuron/glia ratio is 1.77. The neurons are distributed with 18% in the frontal cortex, 57% in the temporal and parietal cortices, and 25% in the occipital cortex. In the hippocampal subregions, we found unilateral neuron number of 1.72 × 106 (CV ± 0.13) and glial number of 2.25 × 106 (CV ± 0.17) in CA1, and 0.80 × 106 (CV ± 0.27) neurons and 1.05 × 106 (CV ± 0.26) glial cells in CA2–3. Comparisons with related studies show quantitative variation, but also variations in methods and applications. The results are phylogenetically consistent, apart from the neuron/glia ratio, which is remarkably higher than what is found in other species. Anat Rec, 2007. © 2007 Wiley‐Liss, Inc.
Skin eruptions with gold therapy—influence of sesame oil
Authors: Batterman Roberit C. , Grossman Arthur J. , Leifer Paul
Published: February 2007

This report indicates that some sensitivity reactions occurring during chrysotherapy can be caused by a sesame oil vehicle. A group of 25 patients was given weekly injections of sesame oil alone, and twenty per cent developed skin sensitivity reactions of a type usually attributed to gold. It was found possible to continue chrysotherapy in some patients having such reactions by changing the menstruum of the preparation in use.

Iste reporto indica que certe reactiones de sensibilitate occurrente durante chrysotherapia pote esser debite a un vehiculo de oleo de sesamo. Un gruppo de 25 patientes recipeva injectiones septimanal de oleo de sesamo sol, e vinti pro cento disveloppava reactiones de sensibilitate cutanee del typo usualmente attribuite a auro. Esseva trovate possibile continuar le chrysotherapia in certe patientes con tal reactiones per alterar le excipiente del preparato usate.
Studies on dexamethasone, a new synthetic steroid, in rheumatoid arthritis—a preliminary report
Authors: Bunim Joseph J. , Black Roger L. , Lutwak Leo , Peterson Ralph E. , Whedon G. Donald
Published: February 2007

Observations concerning the antirheumatic and physiologic effects of a new synthetic corticosteroid, dexamethasone, are presented. This preparation, the most potent of any steroid heretofore studied, did not cause sodium retention or potassium loss in doses sufficient to suppress rheumatoid disease. Increased nitrogen and calcium excretion were observed. Further clinical studies are indicated. For the present, it is suggested that the daily dose of dexamethasone should not exceed 4 mg.
Spondylitis in chronic ulcerative colitis
Authors: Zvaifler N. J. , Martel William
Published: February 2007

A review of the roentgen films and hospital charts in 100 examples of chronic ulcerative colitis showed a 6 per cent prevalence of ankylosing spondylitis. There were no differences in the course or severity of the colitis that distinguished the patients with spondylitis from the entire group. The radiologic features of the spinal involvement were identical to those seen in ankylosing spondylitis. The concurrence of these two diseases is of interest from an etiologic viewpoint but is not explained.
Rat heart‐lung preparation: Standardization of work performance; lung weights
Authors: Solomon Neil , Sayers George
Published: February 2007

The preparation of an isolated rat heart‐lung is described in detail. This isolated system exhibits a high degree of uniformity of work performance as measured by left ventricular work index (LVWI) (proportional to the product of cardiac output and mean arterial blood pressure). The procedures described are of considerable importance to studies of the tissue‐level activity of corticosteroids.
Pathologic observations concerning the cutaneous lesion of progressive systemic sclerosis: An electron microscopic histochemical and immunohistochemical study
Authors: Fisher Edwin R. , Rodnan Gerald P.
Published: February 2007

The results of a comprehensive histochemical and electron microscopic study of skin biopsies from 15 patients with progressive systemic sclerosis exhibiting varying degrees of sclerodermatous involvement strongly suggest that the alterations in this disorder result from an increase of otherwise normal collagen fibers. The failure to demonstrate preferential localization of gamma globulin or other plasma proteins within these lesions is unlike that observed in other so‐called connective tissue diseases purported to have an immunoallergic pathogenesis.
Studies on the pathogenesis of ochronotic arthropathy
Authors: O'Brien William M. , Banfield William G. , Sokoloff Leon
Published: February 2007

Analysis of the anatomic findings in the knees of three patients with ochronosis suggests that the critical problem in the pathogenesis of the arthropathy is the affinity of cartilage for the pigment or its precursors. Electron microscopic and certain in vitro studies having a bearing on hypothetical alternatives are presented.
Acne conglobata and arthritis
Authors: Windom Robert E. , Sanford J. P. , Ziff Morris
Published: February 2007

Acne conglobata has the same features as acne vulgaris plus double comedones and dissecting interconnecting subcutaneous abscesses which heal to leave scar bridges. This report describes the association of acne conglobata with an asymmetric self‐limited, non‐deforming peripheral arthritis in a young male. It is suggested that the association of acne conglobata and arthritis is the consequence of the same pathogenetic mechanism as that involved in the association of arthritis with ulcerative colitis.
Rheumatoid factors in patients with silicosis with round nodular fibrosis of the lung in the absence of rheumatoid arthritis. With a note on the failure to induce such factors in animals
Authors: Schroeder Walter , Franklin Edward C. , McEwen Currier
Published: February 2007

Sera of 10 patients with silicosis and round nodular fibrosis of the lung in the absence of rheumatoid arthritis had positive rheumatoid factor tests. The proteins responsible for this were identical or at least closely related to those seen in patients with rheumatoid arthritis. It was not possible to induce “rheumatoid factor‐like” proteins in rats and guinea pigs by prolonged injections of silica. The possible significance of these proteins in the pathogenesis of the disease is discussed.
Studies on ochronosis. I. The distribution of homogentisic acid in guinea pigs
Authors: La Du Bert N. , O'Brien William M. , Zannoni Vincent G.
Published: February 2007

A specific enzymatic method for homogentisic acid was used to study its distribution in guinea pigs. Thirty minutes after intraperitoneal administration, relatively high concentrations were found in skin and cartilage. This unusual distribution pattern agrees with the localization of ochronotic pigment in alcaptomria. Binding experiments demonstrated that homogentisic acid was bound by albumin, but not by homogenates of cartilage and skin. A scheme to explain the events leading to ochronosis is presented.
Hyperuricemia in a male Filipino population
Authors: Decker John L. , Lane James J. , Reynolds William E.
Published: February 2007

In view of the high frequency of gouty arthritis reported in Filipinos, a population of normal Filipino males and an age‐matched group of Caucasian males were examined. The mean serum uric acid value (with standard deviation) was found to be 6.3 ± 1.4 mg. per 100 ml. for Filipinos and 5.0 ± 1.1 mg. per 100 ml. for Caucasians, using the uricaseultraviolet spectrophotometric method of Praetorius. The serum uric acid frequency distribution curve was found to be symmetrical for the Caucasians and skewed to high values for the Filipinos.
Articular manifestations in primary hyperparathyroidism
Authors: Zvaifler Nathan J. , Reefe William E. , Black Roger L.
Published: February 2007

The articular manifestations noted in three patients with proven functioning parathyroid adenomas are presented. The joint symptoms, physical findings and radiographic abnormalities described illustrate the diversity of lesions associated with hyperparathyroidism. The relationship of subperiosteal bone resorption near articular surfaces, periarticular and synovial calcification and calcification of articular cartilage to the patient's joint symptoms is discussed.
Long term uricosuric therapy in gout
Authors: Thompson George R. , Duff Ivan F. , Robinson William D. , Mikkelsen William M. , Galindez Henrique
Published: February 2007

The effectiveness of long term uricosuric therapy was evaluated in sixty‐four patients with primary gout. Serum uric acid was reduced to normal in half the patients; the majority manifested a urate diuresis. In seventeen of fifty patients with tophi, these lesions decreased in size. Acute gouty attacks were reduced to less than one per year in forty‐five, patients; the chronic symptoms present in fifty‐one patients improved in forty., Effectiveness of therapy was categorized as good, moderate, and poor, with examples of illustrative cases.