bluuebunny/crossref_metadata_2025 huggingface dataset:
Hemarthrosis associated with sodium warfarin therapy
Authors: Wild James H. , Zvaifler Nathan J.
Published: February 2007

Three patients with hemarthrosis of the knee joint complicating sodium warfarin oral anticoagulation therapy are described. In all 3 the prothrombin time was at least 2.4 times the control value at the time of hemarthrosis. After initial bleeding was controlled, 2 patients had recurrences at times when their prothrombin times were again more than 2.5 times greater than those of the normal control subject. Joint symptoms persisted in all patients until the warfarin dose was substantially decreased or discontinued. Underlying joint disease was present in 1 individual and may have predisposed him to the occurrence of hemarthrosis. No long‐term joint damage was recognized as resulting from the hemarthrosis at followup 1 to 2 years later. The authors conclude that hemarthrosis associated with oral anticoagulant therapy occurs when the prothrombin time is excessively prolonged and may remain symptomatic until anticoagulation is reduced or discontinued. Management includes careful diagnostic aspiration, despite the prolonged prothrombin time, and discontinuation of anticoagulation.
Perforation of nasal septum in rheumatic diseases
Authors: Willkens Robert F. , Roth Gilbert J. , Novak Alvin , Walike Joseph W.
Published: February 2007

Perforation of the nasal septum was noted in 12 patients with rheumatic disease, including rheumatoid arthritis (RA), psoriatic arthritis (PsA), systemic lupus erythematosus (SLE), progressive systemic sclerosis (PSS), and mixed connective tissue disease (MCTD). Biopsies were taken from the rim of the perforation in 7 of the 12 and revealed no vasculitis, immunoglobulin deposition, or consistent abnormality. Nasal septal perforation is an occassional finding in rheumatic disease and the cause is unknown.
Esophageal varices in felty's syndrome. A case report and review of the literature
Authors: Klofkorn Raymond W. , Steigerwald James C. , Mills David M. , Smyth Charley J.
Published: February 2007

A case of upper gastrointestinal tract hemorrhage secondary to esophageal varices in a patient with Felty's syndrome prompted a review of the pathogenesis and treatment of this condition. Six previously reported cases of this association were found. The clinical picture is that of long‐standing rheumatoid arthritis with severe articular and extraarticular manifestations including splenomegaly, depression of the blood elements, mild liver function abnormalities, portal hypertension without cirrhosis or portal vein obstruction, an elevated splenic blood flow, and a reduction in portal hypertension by simple splenectomy. The presence of portal hypertension with varices may be another indication for splenectomy in patients with Felty's syndrome.
Acute arthritis caused by aeromonas hydrophila. Clinical and therapeutic aspects
Authors: Chmel Herman , Armstrong Donald
Published: February 2007

Two cases of Aeromonas hydrophila arthritis are reported and a third case present in the literature is reviewed. All three cases occurred in patients with myelogenous leukemia; the knee joint was involved in 2 patients and the metacarpal—phalangeal joint in the third. In the 2 patients presented here, synovial fluid antibiotic levels were measured and were adequate; but A hydrophila was repeatedly cultured from the knee joints, a fact suggesting that other factors, such as normal functioning leukocytes and specific opsonizing antibody against the organism, are also necessary to kill A hydrophila.
Fibrinogen catabolism in systemic lupus erythematosus
Authors: Sergent John S. , Sherman Raymond L. , Al‐Mondhiry Hamid
Published: February 2007

Because there is mounting evidence that localized intravascular coagulation maycontribute to tissue injury following a variety of immunologic events, including immune complex diseases, fibrinogen catabolism was studied in patients with systemic lupus erythematosus to determine factors correlating with accelerated coagulation. 125I‐fibrinogen half‐life in controls was 80.1 ± 11 hours and the mean SLE half‐life was 60.5 ± 12. SLE patients in complete clinical remission had normal half‐lives, but patients with symptomatic clinical disease, including renal disease, had significantly reduced fibrinogen survival. Accelerated fibrinogen consumption also correlated with positive tests for anti‐DNA antibodies, but not with hypocomplementemia. These observations support the hypothesis that the coagulation system is activated in patients with immune complex diseases. Further studies are required to define the role, if any, that coagulation may play in causing tissue injury.
Metabolic changes in rabbit articular cartilage due to inflammation
Authors: Deshmukh Kalindi , Hemrick Susan
Published: February 2007

The effects of inflammation on the articular cartilage of rabbit knee joints were studied. The inflammation was induced by intraarticular injections of croton oil or rabbit peritoneal leukocyte lysates. An increase in the activities of various lysosomal enzymes was observed in the synovial fluid as well as in the cartilage of the inflamed joints. Loss of proteoglycans, increased rate of degradation of collagen and proteoglycans, and increased rate of their synthesis were evident in the treated cartilage. The rate of uptake of 3H‐thymidine was also increased. A significant change was observed in the type of collagen synthesized by these explants in vitro. In addition to synthesizing their characteristic Type II collagen, the cartilage explants from the treated joints synthesized Type I collagen.
Differentiation and characterization of autoantibodies and their antigens in sjögren's syndrome
Authors: Alspaugh Margaret A. , Talal Norman , Tan Eng M.
Published: February 2007

Autoantibodies in Sjögren's syndrome (SS) were identified by their precipitin reactions with tissue antigens in immunodiffusion. The source of antigens was a sonicated extract of human lymphoid cells (WiI2) grown in tissue culture. Three distinct precipitin systems were identified and referred to as precipitins SS‐A and SS‐B, and rheumatoid arthritis precipitin. These studies show that precipitins SS‐A and SS‐B are present in high frequency in sera of patients with SS without associated rheumatoid arthritis (RA) and are absent or present in low frequency in many other connective tissue diseases. On the other hand patients with SS who also had clinical features compatible with RA (SS‐RA) did not have precipitins SS‐A and SS‐B but had rheumatoid arthritis precipitin (RAP). The latter precipitin was also present in RA patients in a similar order of frequency as in SS‐RA. All three precipitin systems were shown to be reactions between immunoglobulins and cellular antigens. The origin of SS‐A and SS‐B antigens was demonstrated by immunofluorescence to be primarily from the nucleus but the origin of RAP in the cell has not been established.
Carpal arthritis with ankylosis in late onset still's disease
Authors: Medsger Thomas A. , Christy Wallace C.
Published: February 2007

Thirteen patients are described in whom Still's disease began after age 15. All had objective evidence of arthritis, and 10 developed chronic synovitis of larger joints, especially the wrists. A characteristic evolution of roentgenographic changes was observed in 7 patients. Carpometacarpal and intercarpal joint spaces became selectively narrowed without erosions, and bony ankylosis eventually occurred. These roentgenographic changes may be a valuable clue to the diagnosis of Still's disease, regardless of the age at onset.
Predominance of t cells in the lymphocytic infiltrates of synovial tissues in rheumatoid arthritis
Authors: Bankhurst Arthur D. , Husby Gunnar , Williams Ralph C.
Published: February 2007

Synovial tissues from 5 patients with rheumatoid arthritis (RA) were examined with immunofluorescence microscopy for the presence of lymphocytes with either bone marrow‐derived (B) or thymus‐derived (T) surface markers. Five synovial tissues with severe to mild lymphocytic infiltrations by bright field microscopy were examined in parallel with immunofluorescence. B cells were identified with a pepsin‐digested fluoresceinated anti‐F (ab')2 antiserum and T cells were detected with a specific rabbit anti‐T lymphocyte antiserum. By these techniques 75–90% of the lymphocytes in these frozen sections were identified as T cells. Cell suspensions were also prepared by collagenase digestion of two of the five synovial tissues. The lymphocytes in these cell suspensions were predominantly T lymphocytes (78–85%) as shown by their ability to form spontaneous rosettes with sheep erythrocytes (E rosettes).
Antibodies to native and denatured collagens in sera of patients with rheumatoid arthritis
Authors: Andriopoulos Nicolaos A. , Mestecky Jiri , Miller Edward J. , Bradley Edwin L.
Published: February 2007

A passive hemagglutination assay was used to detect antibodies to native human collagens and to collagen chains in the sera of 110 rheumatoid patients and those of 75 normal controls. The incidence and titer of anticollagen antibodies in rheumatoid arthritis are high, but in controls they are low or in most instances absent. No correlation was found between the stage of RA, or titers of rheumatoid factor, or ANA and the incidence and/or titers of antibody to any given type of collagen.
Lymphocytotoxic antibody activity in cryoprecipitates from serum of patients with SLE
Authors: Zvaifler Nathan J. , Bluestein Harry G.
Published: February 2007

Complement‐dependent cytotoxic activity against normal human peripheral blood lymphocytes was detected in 11 of 17 cryoprecipitates from the serum of patients with systemic lupus erythematosus (SLE). The lymphocytotoxicity was eliminated by treatment with 2‐mercaptoethanol and iodoacetamide, and it was inhibited by antibody to human IgM but not anti‐IgG. The titers of lymphocytotoxic activity in the cryoprecipitates were roughly proportional to the corresponding serum titers, but when they were normalized for IgM concentration it was apparent that selective concentration of lymphocytotoxic antibody occurred in the cryoglobulins. The relationship between cryoprecipitable lymphocytotoxicity and a number of laboratory and clinical parameters of SLE was studied. The amount of protein in the cryoprecipitates, which was greatest in patients with significant renal disease, correlated with a reduction of serum complement and the amount of antibody to DNA. However the lymphocytotoxic activity of the cryoglobulins did not correlate with the severity of SLE. The titer of lymphocytotoxic antibody was independent of a) the presence or absence of active lupus nephritis, b) the total protein or immunoglobulin content of the cryoprecipitates, c) serum complement levels, and d) the amount of circulating antibody to DNA. These findings cast doubt upon the pathogenetic significance of cryoprecipitable lymphocytotoxic antibody.
Study of thymic factors. II. Failure of thymosin to alter the natural history of nzb and nzb/nzw mice
Authors: Gershwin M. Eric , Steinberg Alfred D. , Ahmed Aftab , Derkay Craig
Published: February 2007

The effects of daily injections of thymosin, bovine fraction V, on the natural history of NZB and NZB/NZW F1 mice were investigated. With the use of several dose schedules, no significant differences were discovered in treated versus control groups when survival, autoantibodies, and mitogen responsiveness were compared. These results provide further evidence that thymosin may have little or no role in the treatment of the autoimmune disease of New Zealand mice. More encouraging research in thymic extracts and their measurement is necessary before clinical trials in SLE are considered.
Association of Sjögren's syndrome with HLA‐B8
Authors: Fye Kenneth H. , Terasaki Paul I. , Moutsopoulos Haralampos , Daniels Troy E. , Michalski Joseph P. , Talal Norman
Published: February 2007

HLA antigens were examined by microdroplet lymphocyte cytotoxicity in 31 patients with Sjögren's syndrome. Fifty percent of 22 Caucasian patients (7 of 17 females and 4 of 5 males) had HLA‐B8, as compared to 21% of 1205 controls (P = 0.002). The presence of HLA‐B8 was not correlated with parotid salivary flow, kerato‐conjunctivitis sicca, or focus score. Because of its association with a number of autoimmune diseases, including Sjögren's syndrome, it is suggested that HLA‐B8 is genetically linked to an immune response gene(s) that predisposes the individual to autoimmune phenomena. The expression of autoimmunity may be determined by infectious or environmental factors.
Rheumatoid factor in acute bacterial endocarditis
Authors: Sheagren John N. , Tuazon Carmelita U. , Griffin Calvin , Padmore Neville
Published: February 2007

Sera from 55 parenteral drug abusers with endocarditis due to Staphylococcus aureus were assayed for the presence and titer of rheumatoid factor. Thirteen (24%) of the 55 patients with endocarditis had sera positive for rheumatoid factor at one point or another in their courses; only 2 (7%) of 30 noninfected drug users were found to be positive. It appeared that more severe cases, as evidenced by duration of fever after initiation of antibiotic therapy, were more likely to develop rheumatoid factor.
Fibrous myopathy. A rheumatic complication of drug abuse
Authors: Johnson Kent R. , Hsueh Willa A. , Glusman Sheldon M. , Arnett Frank C.
Published: February 2007

A progressive fibrous myopathy may result from chronic intramuscular drug abuse. This complication may mimic other rheumatic disorders and early recognition may prevent disability. The patient described here presented with fixed flexion and extension contracture of hips and knees, respectively, after abusing meperidine and other agents for 3 years. Soft tissues of thighs and buttocks were “wood hard,” EMG showed absence of action potentials in affected muscles, and biopsy revealed extensive replacement of muscle with dense, acellular fibrous tissue. Possible mechanisms are discussed.
Effect of fenoprofen calcium on acute gouty arthritis
Authors: Wanasukapunt Sunt , Lertratanakul Yongsuk , Rubinstein Herbert M.
Published: February 2007

Twenty‐seven patients with thirty‐six joints affected with acute gouty arthritis were treated with fenoprofen calcium for a duration not exceeding 8 days and with a variable dose not exceeding 3.2 g daily. The results indicate that fenoprofen calcium was an effective drug in these patients. Side effects were modest.
The lupus anticoagulant
Authors: Boxer Michael , Ellman Leonard , Carvalho Angelina
Published: February 2007

The clinical and laboratory experience with the lupus anticoagulant was reviewed in 37 patients. The anticoagulant is thought to act by blocking the activation of prothrombin by the prothrombin activator complex of factors Xa, V, and phospholipid. Although the anticoagulant has been principally associated with diseases of immune origin, 14 of the present patients had disorders not thought to be immune in nature. Eighteen patients underwent twenty‐one operative procedures with only a single episode of excessive bleeding. In the authors' experience, the lupus anticoagulant is a rare cause of bleeding.
Clinical significance of immune deposits in the skin in SLE
Authors: Wertheimer David , Barland Peter
Published: February 2007

The lupus band test (LBT) was evaluated in 53 SLE patients. There was no significant correlation between the presence of a positive LBT and active clinical nephritis, renal histology, hypocomplementemia, or elevated anti‐nDNA antibodies. In 14 patients the classes of immunoglobulins in the skin and the glomeruli were directly compared and differences were present in 11 patients. Repeat LBTs frequently became positive in patients after successful suppression of disease activity.
Frequency of neoplasia in systemic lupus erythematosus and rheumatoid arthritis
Authors: Lewis Robert B. , Castor C. William , Knisley Robert E. , Bole Giles G.
Published: February 2007

A patient population admitted to the hospital for either SLE or RA was surveyed for the subsequent development of neoplasms. The frequency of neoplasm in SLE patients appeared to be exaggerated, whereas the frequency of subsequent neoplasm in rheumatoid patients was unexpectedly low. A paucity of nephritis in the SLE group was noted. Further reports are encouraged so that the magnitude of the risk of malignancy developing with immunosuppressive therapy can be more precisely ascertained.
Lymphocyte response to virus antigens in systemic lupus erythematosus
Authors: Wolf Robert E. , Ziff Morris
Published: February 2007

The cell‐mediated immune response of lymphocytes to rubella, measles, parainfluenza types 1, 2, and 3, varicella‐zoster, and herpes virus type 1 virus antigens was evaluated in 15 SLE patients and 15 matched controls by incorporating 3H‐thymidine in whole blood cultures as a measure of blastic transformation. SLE patients were less responsive than normal individuals to six of eight virus antigens tested. Culture of washed SLE cells in AB plasma did not reverse the hyporesponsiveness. The results indicated that a functional impairment of the circulating lymphocytes appeared to be responsible for the in vitro hyporesponsiveness of SLE patients to virus antigens.
Organic brain syndrome in rheumatoid arthritis following corticosteroid withdrawal
Authors: Gupta Ved P. , Ehrlich George E.
Published: February 2007

Six patients with seropositive nodule‐forming rheumatoid arthritis developed severe central nervous system manifestations consistent with a diagnosis of organic brain syndrome. Organic brain syndrome occurred while 5 of these patients were undergoing corticosteroid withdrawal after prolonged administration. Neuropsychiatric symptoms rapidly cleared, responding to reinstitution of oral or parenteral corticosteroids in large doses in 4 patients, to increase in dosage in 1 patient, and to no drug therapy in the remaining 1. Marked reduction in rheumatoid factor in sera and demonstration of IgM deposits in the choroid plexus in 1 of the patients raised the possibility of immune complex‐mediated central nervous system vasculitis.
Systemic lupus erythematosus associated with klinefelter's syndrome
Authors: Stern R. , Fishman J. , Brusman H. , Kunkel H. G.
Published: February 2007

Studies in estrogen metabolism were carried out in 2 males with systemic lupus erythematosus (SLE) who also had Klinefelter's syndrome. Although these studies revealed elevated levels of urinary estrogens in 1 patient, abnormalities of estradiol metabolism suggesting persistent estrogen stimulation were detected in both. This report notes an association between SLE and Klinefelter's syndrome and suggests that chronic estrogenic stimulation may be significant in the development of SLE in these 2 patients.
Avidity of antibodies in sle
Authors: Leon Shalom A. , Green Anthony , Ehrlich George E. , Poland Marcia , Shapiro Bernard
Published: February 2007

The avidity of antibodies to DNA in the sera of 8 patients with SLE was determined by saturation analysis and Scatchard plots. Five of the patients had severe lupus nephritis; the other 3 had relatively mild or no kidney disease. The Scatchard plots revealed components with high relative avidity in the patients with severe nephritis (K values 4.4–10.4 x 105 M−1 for nDNA), compared with the patients who had mild or no kidney disease (K values 0.3–1.8 x 105 M−1 for nDNA). Avidity measurements may be helpful in the evaluation and treatment of patients with SLE.
Evidence of rheumatoid arthritis in ancient india
Authors: Sturrock R. D. , Sharma J. N. , Buchanan W. W.
Published: February 2007

The scarcity of references in ancient medical literature to any disease resembling rheumatoid arthritis (RA) has led many WEstern rheumatologists to believe that rheumatoid arthritis is a disease of relatively recent origin. In a recent paper on this problem, Short traces the first adequate description of what was probably rheumatoid arthritis to Thomas Sydenham (1624–1689) and emphasizes that European and Greek medical literature before Sydenham's time may have confused gout and other forms of polyarthritis as manifestations of the same disease (1). Studies in human paleopathology have as yet produced no convincing evidence for the existence of RA in ancient human remains, but Short suggested that a study of the ancient medical literature of the Eastern civilizations may provide some new information on the true antiquity of rheumatoid arthritis (1).
Effect of altered lymphocyte function on immunologic disorders in nzb/nzw mice
Authors: Mehta Jagdish , Knotts Linda L. , Hahn Bevra H.
Published: February 2007

NZB/NZW F1 female mice were treated with the immunosuppressive enzyme L‐asparaginase (Asnase) for up to 32 weeks. Asnase diminished circulating anti‐DNA and antinuclear antibodies, diminished deposition of γ‐globulins in kidneys, significantly delayed the onset of proteinuria, and reduced deaths from nephritis. These effects were associated with reduction of cellular IgM antibody synthesis to both T‐dependent and T‐independent antigens, but the graft‐versus‐host reaction was not affected. After several weeks of therapy, antibodies against Asnase appeared in the circulation, the effect on antibody synthesis was lost, ANA and anti‐DNA appeared, followed by proteinuria and deaths from nephritis. Therefore Asnase proved to be an effective therapy in NZB/NZW mice, but its usefulness was limited by the appearance of inactivating antibodies.
Glucocorticosteroid inhibition of nonphagocytic discharge of lysosomal enzymes from human neutrophils
Authors: Ignarro Louis J.
Published: February 2007

Glucocorticosteroids and mineralocorticosteroids were tested for their capacity to inhibit the nonphagocytic discharge of two lysosomal enzymes—a cartilage matrix‐degrading neutral protease and β‐glucuronidase—from highly purified human neutrophils. Lysosomal enzyme discharge from neutrophils adherent to nonphagocytizable, immobilized, heat‐aggregated IgG was inhibited by the four glucocorticosteroids—methylprednisolone sodium succinate, triamcinolone acetonide hemisuccinate, para‐methasone acetate, and hydrocortisone sodium succinate. These glucocorticoids also inhibited zymosan‐induced release of β‐glucuronidase from neutrophils that had been pretreated with cytochalasin B in order to completely prevent the onset of phagocytosis. Inhibition by the glucocorticoids of lysosomal enzyme discharge provoked by a soluble divalent cation ionophore was also observed. Neither desoxycorticosterone acetate nor aldosterone hemisuccinate, two mineralocorticosteroids, inhibited lysosomal enzyme release. Similarly, the salt moieties of some of the steroids tested, such as sodium succinate and sodium acetate, failed to elicit an effect on enzyme release. Therefore interference with lysosomal enzyme discharge was restricted to the glucocorticosteroid ring structure. Because interference either with the adherence of neutrophils to immune reactants or with the activities of the discharged lysosomal enzymes by the glucocorticoids could be interpreted as inhibition of lysosomal enzyme release, steroidal effects on these parameters were examined. None of the glucocorticoids tested elicited any significant effects on neutrophil adherence or lysosomal enzyme activity. Thus it appears that glucocorticosteroids are capable of inhibiting directly the nonphagocytic discharge of lysosomal enzymes from human neutrophils.
Differences in the collagen types synthesized by lapine articular chondrocytes in spinner and monolayer culture
Authors: Norby David P. , Malemud Charles J. , Sokoloff Leon
Published: February 2007

In five different secondary monolayer cultures of rabbit articular chondrocytes, 72−89% of the collagen synthesized was Type I, as determined by α chain separation and CNBr‐cleavage peptide analysis. When sister cells were transferred to spinner bottles after primary monolayer culture growth, 88% of the collagen formed in four separate experiments was Type II. A reversion to Type I collagen synthesis occurred when the spinner‐cultured cells were returned to monolayer flasks. The change in the species of collagen depended on the suspension condition and not on the low Ca2+ content (0.33 mM) of the spinner medium. These findings parallel the switch to phenotypic glycosaminoglycan synthesis that also occurs when monolayer‐cultured cells are transferred to spinner bottles. Whether this phenomenon arises through a genetic control mechanism rather than environmental selection for particular cohorts of cells has not yet been determined.
Synovial chondromatosis affecting the temporomandibular joint
Authors: Rosen Phillip S. , Pritzker Kenneth P. H. , Greenbaum Joseph , Holgate Richard C. , Noyek Arnold M.
Published: February 2007

A case of synovial chondromatosis affecting the temporomandibular joint is reported and the literature is reviewed. Chondromatosis occurs most frequently in this joint in middle‐aged women, and it presents with pain and tenderness over the joint. Radiologically, the condition is detected by widening of the joint space with the variable presence of radiodense loose bodies. Pathologically, the loose bodies in the case presented were demonstrated to arise from cartilaginous metaplasia of the synovial lining. The stimulus for synovial chondrometaplasia at this site is unknown.
Immunohistochemical localization of prostaglandin e in rheumatoid synovial tissues
Authors: Husby Gunnar , Bankhurst Arthur D. , Williams Ralph C.
Published: February 2007

Synovial tissues removed at synovectomy from patients with active rheumatoid arthritis (RA) or osteoarthritis (OA) were examined for prostaglandin E (PGE) by immunohistochemical techniques using rabbit antisera specific for PGE. Marked increments of PGE were noted in RA synovia in comparison to OA, with staining concentrated in synovial lining cells, interstitial inflammatory cells, and endothelial cells of blood vessels. A correlation was noted between the degree of synovial lymphocytic infiltrate and the intensity of PGE staining. These studies provide initial cellular localization of PGE in such tissues.
An immunofluorescent method using crithidia luciliae to detect antibodies to double‐stranded DNA
Authors: Crowe William , Kushner Irving
Published: February 2007

The immunochemical specificity of the immunofluorescent Crithidia luciliae method for detection of antibodies to double‐stranded DNA (dsDNA) was confirmed by demonstrating abolition of staining by DNase digestion and by absorption with dsDNA. This method was less sensitive than a Millipore filter method for detecting antibodies to DNA. It was positive only in subjects with systemic lupus erythematosus or drug‐induced antinuclear factors. This technique appears suitable for study of the immunochemical characteristics of antibodies to dsDNA.
Aseptic necrosis presenting as wrist pain in sle
Authors: Urman Jeffrey D. , Abeles Micha , Houghton Alan N. , Rothfield Naomi F.
Published: February 2007

Aseptic necrosis of the wrist in systemic lupus erythematosus (SLE) is not rare. In 156 patients with SLE, aseptic necrosis occurred in 11 patients, of whom 3 (27%) had wrist involvement. Onset of pain was insidious and the symptoms were thought to be related to synovitis due to SLE. An average of 11 months elapsed before aseptic necrosis was correctly diagnosed. An awareness of this possibility is important in the management of any patient with SLE who complains of wrist pain.
Antigen‐induced arthritis in mice
Authors: Brackertz Dieter , Mitchell Graham F. , Mackay Ian R.
Published: February 2007

Antigen‐induced arthritis was established in the mouse by immunization with methylated bovine serum albumin (mBSA) in complete Freund's adjuvant with B pertussis vaccine. The knee joint was injected after 21 days with mBSA in saline. The arthritis was chronic, antigen‐specific, and T‐cell dependent in hypothymic nu/nu mice. C57BL and BALB/c mice were susceptible, whereas CBA mice were relatively resistant. Susceptibility was dominant; one gene was loosely linked to the “b” allele of the H‐2 complex of C57BL mice.
Decreased lymphocyte reactivity to a suboptimal concentration of phytohemagglutinin in sjögren's syndrome
Authors: Michalski Joseph P. , Mccombs Candace
Published: February 2007

Significantly decreased lymphocyte reactivity to a suboptimal concentration of phytohemagglutinin (PHA) was found in patients with Sjögren's syndrome (SS), whereas the response to an optimal concentration was generally normal. Kinetic studies were performed on control lymphocytes. Only suboptimal PHA concentrations stimulated tritiated thymidine (3H‐TdR) incorporation in proportion to the number of potentially reactive lymphocytes. Kinetic studies of SS patients suggested that their low reactivity was attributable to fewer functionally reactive lymphocytes rather than to a decreased rate of proliferation.
Connective tissue activation
Authors: Castor C. W. , Ritchie J. C. , Scott M. E. , Whitney S. L.
Published: February 2007

This report describes a small basic protein found in human platelets which stimulates hyaluronic acid formation, glucose uptake, and lactate formation in several types of human connective tissue cells. In addition, it stimulates the incorporation of [3H] methyl thymidine into DNA in human synovial cell cultures. This platelet factor (connective tissue activating peptide‐III, CTAP‐III) clearly differs from CTAP‐I, found in human lymphocytes, and may play a role as a mediator of the inflammatory process.
Chronic polyarthritis associated with hypogammaglobulinemia
Authors: Grayzel Arthur I. , Marcus Robert , Stern Richard , Winchester Robert J.
Published: February 2007

Two adult patients with hypogammaglobulinemia and chronic synovitis were studied. Synovial tissue and fluid were examined by histologic, virologic, and immunologic methods. The synovium lacked characteristic histologic features of rheumatoid arthritis, and B lymphocytes were absent from the synovial tissue, fluid, and peripheral blood. These 2 patients may represent a form of chronic synovitis produced in the absence of any B lymphocyte response.
Comparison of clinical features in HLA‐B27 positive and negative patients with ankylosing spondylitis
Authors: Khan Muhammad A. , Kushner Irving , Braun William E.
Published: February 2007

The clinical features of ankylosing spondylitis (AS) were compared in 63 HLA‐B 27 positive (+) and 15 B27 negative (−) individuals with this disease. There were no differences in age at onset, functional class, degree of deformity, pain, severity of X‐ray changes, or frequency of peripheral joint involvement or of reconstructive orthopedic surgery. These data demonstrated that skeletal manifestations of AS were essentially the same in B27(+) and (−) patients, and provide no evidence for the speculation that AS in B27(−) patients is milder or is a different disease from that occurring in B27(+) patients. On the other hand, acute anterior uveitis was found to be significantly more common in B27(+) patients, a fact suggesting that the “uveitis of AS” may in fact be an independent condition occurring in B27(+) individuals, rather than a manifestation of AS per se.
Disseminated immune deposits in lupus erythematosus
Authors: Brentjens Jan , Ossi Elena , Albini Boris , Sepulveda Marion , Kano Kyoichi , Sheffer John , Vasilion Peter , Marine Edward , Baliah Tadla , Jockin Hubert , Andres Giuseppe
Published: February 2007

Immunohistologic studies were performed on autopsy tissues of 2 patients with systemic lupus erythematosus. All tissues examined—the kidney, lung, spleen, liver, intestine, peritoneum, and choroid plexus—contained immune deposits. Antinuclear antibody concentration in immunoglobulin G eluted from lung and spleen tissue was higher than in serum immunoglobulin G. These findings support the assumption that in systemic lupus erythematosus the renal as well as the extrarenal lesions can be attributed to vascular deposition of immune complexes.
Digital mucinous pseudocysts
Authors: Goldman John A. , Goldman Leon , Jaffe Murray S. , Richfield Daniel F.
Published: February 2007

Thirty‐one patients with 46 digital mucinous pseudocysts are reviewed. The pseudocysts are usually soft, fluctuant, dome‐shaped, dimpled, smooth lesions located near and often associated with a linear defect of the fingernail. Transillumination confirms the diagnosis. Treatment is conservative, usually consisting of intralesional injections. If surgery is necessary, distal interphalangeal joint injection of methylene blue aids in complete removal by identifying the mesothelial‐lined pedicle leading from the distal joint to the pseudocyst.
Industrial rheumatology
Authors: Hadler Nortin M.
Published: February 2007

Regional musculoskeletal diseases are exceedingly common in all segments of society, and dramatically so in industry. For generations, medicine has assumed that many such entities are use‐associated. A critical review of several examples of back and upper extremity disease demonstrates that the literature supporting these assumptions is almost entirely anecdotal. It is argued that if defined patterns of usage were associated with defined clinical syndromes, such knowledge would have considerable therapeutic and prophylactic potential. Industrial rheumatology is proposed as an investigative discipline for the study of such relationships. The prerequisites in terms of assumptions and methods as well as potential fallacies and pitfalls are discussed.
Bone Marrow Transplantation in Patients with Gold‐Induced Marrow Aplasia
Authors: Baldwin John L. , Storb Rainer , Thomas E. Donnall , Mannik Mart
Published: February 2007

Aplastic anemia is a rare but usually fatal complication of gold salt therapy for rheumatoid arthritis. This report describes 3 patients who developed aplastic anemia while receiving gold salts, and a fourth patient who developed aplastic anemia after receiving gold and then cytotoxic agents. These patients failed to respond to conventional therapy for aplastic anemia and subsequently received bone marrow transplants from HLA‐matched siblings. Engraftment occurred in all 4 patients. One patient is alive 2 years after transplantation, and 3 patients died of complications following transplantation.
Cathepsin D Agglutinators in Rheumatoid Arthritis
Authors: Artmann G. , Fehr K. , Böni A.
Published: February 2007

The incidence and titer of cathepsin D agglutinators (CDA) were significantly higher in seropositive rheumatoid arthritis (RA) sera than in the sera of healthy blood donors or of patients with other rheumatic diseases, including seronegative RA. A significant elevation was also found in synovial fluid (SF) samples from seropositive RA patients. CDA in the SF tended to be increased when compared with the corresponding serum. The levels of CDA correlated positively with those of rheumatoid factors (RF) when the latter were determined with IgG anti‐CD Ripley‐coated erythrocytes, but not when they were determined by the Waaler‐Rose or latex tests. The increased CDA titers do not seem to be the result of significant amounts of IgM agglutinators or of the presence of IgM‐RF. These findings suggest the existence of a link between the formation of RF and CDA, but the nature of this link cannot be fully explained.
Thoracic Duct Drainage in Sle with Cutaneous Vasculitis
Authors: Nyman Kenneth E. , Bangert Ruth , Machleder Herbert , Paulus Harold E.
Published: February 2007

A 25‐year‐old woman had systemic lupus erythematosus manifested primarily by severe cutaneous vasculitis that was unresponsive to oral prednisone and azathioprine. She was treated with thoracic duct drainage (TDD). Her course was followed by serial photographs, skin biopsies, and serum immunoglobulin, antinuclear antibody, and complement levels. After I week of drainage there was obvious clinical improvement. During the remainder of her drainage, the vasculitis continued to improve. It was possible to taper oral corticosteroids and to discontinue azathioprine during TDD without any clinical or laboratory evidence of exacerbation. The patient had no recurrence of vasculitis 22 weeks after the termination of TDD.
T‐Lymphocyte Subpopulation in Untreated SLE
Authors: Rivero Santiago J. , Llorente Luis , Díaz‐Jouanen Efraín , Alarcón‐Segovia Donato
Published: February 2007

An active subpopulation of T lymphocytes characterized by their ability to form early rosettes with sheep erythrocytes (active E‐RBL) was studied in the blood of 50 patients with untreated systemic lupus erythematosus (SLE) and in 50 normal controls. The findings were related to the absolute number of circulating lymphocytes and total E‐receptor‐bearing lymphocytes (total E‐RBL). Lupus patients with active disease had markedly decreased absolute lymphocyte counts, but the decrease of both the total and the active E‐RBL surpassed what would be expected from the lymphopenia. Patients with inactive disease had moderately decreased absolute lymphocyte counts with a marked and disproportionate decrease in total E‐RBL and a moderate decrease in active E‐RBL, which seemed to reflect only the absolute lymphopenia. Patients with active disease had significantly lower active E‐RBL than those with inactive disease. The changes of these and other lymphocyte subpopulations in relation to disease activity in SLE may reflect the influence of factors leading to T‐cell depletion and immaturity. Circulating thymic products may be one of those factors.
Local and Systemic Reactions to Puncture Injuries by the Sea Urchin Spine and the Date Palm Thorn
Authors: Cracchiolo Andrea , Goldberg Leonard
Published: February 2007

Puncture wounds were caused in 9 patients by sea urchin spines and 1 patient by a date palm thorn. All 10 patients developed local inflammatory reactions, which were moderate to severe in 7. Two patients exhibited severe systemic illnesses, and a marked synovitis was present in 2 others. Several of the patients presented as difficult diagnostic problems with signs and symptoms suggestive of an arthritic disease. Six required surgical removal of the foreign body.
The in Vivo Metabolism of the Third Component of Complement in Systemic Lupus Erythematosus
Authors: Petz Lawrence D. , Powers Runas , Fries James R. , Cooper Neil R. , Holman Halsted R.
Published: February 2007

The in vivo metabolism of purified C3, the third component of complement, labeled with 125‐iodine (125I‐C3) was studied in 17 normal volunteers and in 24 patients with systemic lupus erythematosus (SLE). The latter had varying degrees of disease severity and differing clinical and serologic manifestations. The study sought correlations of patterns of complement metabolism with clinical and laboratory parameters of disease activity. The data indicate that an increased fractional catabolic rate (FCR) of C3 is characteristic of active SLE because the FCR was increased in 14 of 16 patients with active disease but in only 1 of 8 patients with clinically inactive disease. This relationship is further emphasized by the fact that the FCR was increased in all patients with anti‐DNA antibodies and in all patients judged to have severe disease activity. All patients with normal values for FCR and C3 synthesis rate had clinically inactive disease and no patient judged to have active disease had normal values for both determinations. The synthesis rate of C3 was reduced in a total of 10 patients, but this did not correlate with disease activity, duration of disease, therapy, or certain other laboratory data. Causes of hyposynthesis have not been defined although two clinical settings in which it was found were late stage renal disease with inactive SLE, and severe disease activity with hypercatabolism of C3 and a profound reduction in serum C3 concentration. Hypersynthesis of C3, possibly as a compensatory mechanism, was found in 5 of the 7 patients with the highest FCR, one of whom had a normal level of C3 in spite of hypercatabolism. Such data indicate that various mechanisms determine serum C3 levels. This recognition may allow for more knowledgeable clinical interpretation of serum complement concentrations in SLE.
Discordant Distribution of IgM and IgG Antibodies to DNA and RNA in Monozygotic Twins with Systemic Lupus Erythematosus
Authors: Pillarisetty Rao J. , Block Sidney R. , Talal Norman
Published: February 2007

Sera from six sets of twins (five monozygotic and one dyzygotic) in whom one or both has systemic lupus erythematosus (SLE) were evaluated for antibodies to DNA and RNA. Sera from three monozygotic twin sets were further studied to determine the distribution of 19S and 7S antibodies to DNA and RNA.

The presence of significant binding of polyriboadenylic acid and of native DNA correlated with the presence of clinical SLE in this study. Sucrose density gradient fractionation studies of the sera revealed that the clinically normal twins had some binding of Poly A and DNA limited to the 19S region, whereas the twins with SLE generally had significant levels of 19S and 7S antibodies to DNA and/or Poly A. On the other hand, concordance for presence or absence of antibodies to double‐stranded RNA was demonstrated within each twin set irrespective of concordance or discordance for clinical SLE. These results suggest that genetic factors may be important in determining which nucleic acids antigens become immunogenic, but genetic factors alone do not determine the immunoglobulin class distribution of antibodies to nucleic acids.
Depressed in Vitro B—Lymphocyte Differentiation in Systemic Lupus Erythematosus
Authors: Bobrove Arthur M. , Miller Patricia
Published: February 2007

Peripheral blood lymphocytes from 20 patients with systemic lupus erythematosus (SLE) and 21 normal donors were incubated with pokeweed mitogen in order to assess in vitro terminal—differentiation of B lymphocytes into cells synthesizing intracytoplasmic immunoglobulin (Ig). Although the percentage (mean ± SEM) of B lymphocytes bearing surface Ig in the initial cell suspensions was not statistically different in SLE than in normal subjects (15 ± 2.2% versus 16 ± 1.9%, respectively), the frequency of cells containing intracytoplasmic Ig per 103 mononuclear cells was significantly lower in mitogen—stimulated cultures derived from the patients than from the normal controls (10 ± 2.3 versus 56 ± 13.0 for IgM, P < 0.01; 21 ± 3.6 versus 63 ± 10.4 for IgG, P < 0.01; 13 ± 3.1 versus 24 ± 3.8 for IgA, P < 0.05 respectively). Coculturing active SLE lymphocytes with cells from normal subjects resulted in a significant (P < 0.05) increase in the frequency of cells containing intracytoplasmic IgG when stimulated with pokeweed mitogen. Moreover, culturing SLE lymphocytes in cell—free media derived from activated normal lymphocytes also resulted in a significant increase in the frequency of IgG—containing cells. These results suggest that B—lymphocyte differentiation in vitro is depressed in SLE and may, at least partially, be reversed by products derived from normal lymphocytes.
On the Nature of Rheumatoid Rice Bodies
Authors: Berg Ed , Wainwright Randy , Barton Betty , Puchtler Holde , Mcdonald Thomas
Published: February 2007

The nature of rice bodies was studied, utilizing histochemistry, immunofluorescence, and scanning and transmission electron microscopy. Rice bodies were found to consist primarily of fibrous material, most of which was fibrin with small amounts of collagen. Channels containing a variety of viable cells permeated the rice bodies. Blood vessels occurred in a few rice bodies indicating a former connection with the synovial membrane. Nonvascularized rice bodies might represent a further degeneration of the vascular type. Rice bodies seem to be a nonspecific response to inflammation.
The Effect of Synovial Tissue on the Breakdown of Articular Cartilage in Organ Culture
Authors: Fell Honor B. , Jubb R. W.
Published: February 2007

Living (pig) cartilage in contact with synovium lost both proteoglycan and collagen and sometimes became reduced to a mass of fibroblast‐like chondrocytes without matrix; dead cartilage lost proteoglycan but less collagen. Similar changes appeared in living cartilage grown at a distance from the synovium but in the same dish; dead cartilage was unaffected. Conclusion: the synovium has a) a direct, presumably enzymatic action on cartilage matrix and b) an indirect effect mediated through the chondrocytes.
Zymosan—Induced Arthritis
Authors: Keystone E. C. , Schorlemmer H. U. , Pope C. , Allison A. C.
Published: February 2007

Zymosan particles, which are able to activate complement by the alternative pathway and to induce enzyme secretion from macrophages, were injected into knee joints of mice. After various time intervals, synovia were assessed histologically for various markers of inflammation. Within 7 days after intraarticular injection of zymosan, a chronic inflammatory arthritis with mononuclear cell infiltration, synovial hypertrophy and pannus formation was observed. Latex particles, which do not activate complement or macrophages, produced only mild, transient inflammatory reactions.
Use of a Hapten‐Carrier System in Experimental Immune Arthritis in the Rabbit
Authors: Ménard Henri A. , Demers Jean‐Claude
Published: February 2007

Animals immunized systemically with dinitro‐phenylated‐bovine serum albumin (DNP‐BSA) in complete Freund's adjuvant, show delayed hypersensitivity skin responses to DNP‐BSA and to BSA, but not to other DNP‐conjugates. These animals show high levels of antibodies to BSA and to DNP by radioimmunoassay. When injected with the carrier (BSA), the right knee joint develops a chronic arthritis. The left knee, when injected with the DNP hapten conjugated to another carrier (human serum albumin), shows an acute arthus response of the same magnitude as the right knee, but fails to develop a chronic synovitis. It appears that in this model, chronicity is not mediated primarily by a humoral mechanism to the initiator.
Interaction of D‐Penicillamine with Gold Salts
Authors: Davis P. , Barraclough D.
Published: February 2007

Serum and urinary gold levels were monitored in 18 patients previously treated with gold salts for rheumatoid arthritis and the effects of D‐penicillamine studied. There was no statistically significant change in urinary gold levels on D‐penicillamine therapy although there were some individual variations. Serum gold levels fell during D‐penicillamine therapy but the rates of fall did not differ from those seen in patients not treated. In vitro studies on protein binding of gold salts suggest that a high affinity exists between gold salts and albumin with low levels of unbound gold even at concentrations far exceeding those seen in vivo. These preliminary results suggest that at therapeutic levels only small amounts of gold are available for chelation by penicillamine. It is concluded that penicillamine at low dosage is an unreliable chelator of gold salts in vivo and its use in the management of gold toxicity remains speculative.
Localization of C‐reactive protein in synovium of patients with rheumatoid arthritis
Authors: Gitlin Jonathan D. , Gitlin Joan I. , Gitlin David
Published: February 2007

Synovial biopsies from 8 patients with rheumatoid arthritis, 2 patients with degenerative osteoarthritis, and 4 patients with nonarthritic disease were studied for localization of C‐reactive protein (CRP) using immuno‐fluorescence microscopy. The nuclei of many synoviocytes and histiocytes in rheumatoid synovial membrane were found to bind CRP. Cultures of rheumatoid synovium in 14C‐labeled amino acids produced radioactive IgG, IgM, IgA, and C3, but not CRP, indicating the synovial‐bound CRP was not of local origin. A few CRP‐binding nuclei were present in one osteoarthritic synovium, but none was found in the other and none in synovium from the 4 non‐arthritic patients. The nature of the nuclear CRP ligand in rheumatoid synovium was not determined.