bluuebunny/crossref_metadata_2025 huggingface dataset:
Rheumatoid Synovial Cyst of the Hip. A Case Report
Authors: Samuelson Cecil , Ward John R. , Albo Dominic
Published: February 2007

Synovial cysts are not uncommon in rheumatoid arthritis. These periarticular herniations of the synovialis are not difficult to diagnose in peripheral joints but have rarely been identified in the hips. A patient who presented with femoroinguinal swelling is presented. This swelling proved to be a synovial cyst originating from the hip joint. The diagnosis of synovial cyst should be considered whenever femoroinguinal swelling occurs in a patient with rheumatoid arthritis.
Sequential changes in human polymorphonuclear leukocytes after urate crystal phagocytosis. An electron microscopic study
Authors: Schumacher H. Ralph , Phelps Paulding
Published: February 2007

Monosodium urate crystals added to human polymorphonuclear leukocytes are rapidly phagocytized. Crystals initially lie within phagosomes with a distinct, closely approximated phagosomal membrane. By 8 minutes phagolysosome distension is seen in some cells, degranulation begins, and phagolysosome membrane dissolution is seen. By 30 minutes there are many cell deaths with release of ingested crystals and cellular contents. Urate crystals have a profound and rapidly toxic effect on isolated leukocytes. The loss of phagolysosome membranes may be important in producing cell death.
The radiographic pattern of polyarthritis in Reiter's syndrome
Authors: Sholkoff Stephen D. , Glickman Morton G. , Steinbach Howard L.
Published: February 2007

Roentgenographic and scintiphotographic studies of the arthritis of Reiter's syndrome demonstrate concurrent involvement of various small joints of the lower extremities often associated with sacroiliitis. The most frequently affected sites are the heels, toes, sacroiliac joints, and ankles and tarsals. Simultaneous involvement of these sites is characteristic of this syndrome.
A defect in the renal excretion of uric acid in Filipinos
Authors: Healey L. A. , Bayani‐Sioson Pelagia S.
Published: February 2007

Hyperuricemia is present in Filipinos living in the United States but is not found in Filipinos living in the Philippine Islands. This study investigates the role of the kidney in the development of Filipino hyperuricemia. An oral purine load was given to 13 Filipinos and 10 Caucasian subjects. All 10 of the Caucasians showed a marked increase, whereas 4 Filipinos had little or no increase in urinary uric acid. It had been postulated previously that some patients with gout are hyperuricemic because the kidneys retain uric acid. The Filipino subjects studied suggest that such a renal defect existed prior to the development of hyperuricemia or gout.
Direct lysis of lymphocytes by complement in patients with systemic lupus erythematosus
Authors: Stastny Peter , Ziff Morris
Published: February 2007

Lymphocytes from patients with active systemic lupus erythematosus (SLE) were found to undergo lysis when exposed to rabbit complement. A simple test procedure for quantitating this phenomenon was devised. In patients with active SLE and severe leukopenia, lymphocytes dropped to 29% after incubation with complement. The mean percent survival of lymphocytes from 15 patients with active SLE was 52 (21–78%). In 50 control subjects there was little or no decrease in the number of lymphocytes after exposure to complement. The results suggest that circulating lymphocytes of patients with active SLE may be coated with autoantibody rendering them susceptible to lysis upon addition of complement.
Reiter's disease, ankylosing spondylitis and rheumatoid arthritis occurring within a single family
Authors: Good Armin E.
Published: February 2007

A family is reported in which three brothers had respectively, ankylosing spondylitis, Reiter's disease, and Reiter's disease followed by rheumatoid arthritis; the father had atypical spondylitis following stigmata of Reiter's disease. The literature of Reiter's disease affecting more than a single family member is reviewed.
Arthroplasty of the knee with tibial and/or femoral metallic implants in rheumatoid arthritis. Rheumatologic evaluation
Authors: Turner Robert A. , Brown Ernest M. , Sbarbaro John L. , Hollander Joseph L.
Published: February 2007

Fifty‐five patients with rheumatoid arthritis underwent 68 femoral mold and/or tibial plateau knee arthroplasties. The records of all patients were reviewed and 42 patients were examined and evaluated 1–6.5 years after surgery using a simple 100 point scoring system equally emphasizing pain, mobility, and functional capacity. Although 84.5% showed some improvement, mean overall change was modest at + 15.3 points. Forty‐seven complications occurred in 38 of the 68 operations. Implications for rheumatologists and referring physicians are discussed.
Ultrastructural comparison of rheumatoid and nonrheumatoid synovial fibroblasts grown in tissue culture
Authors: Wynne‐Roberts C. Rosales , Castor C. William
Published: February 2007

Ten rheumatoid and seven nonrheumatoid tissue culture strains of synovial fibroblasts were studied biochemically and by electron microscopy. No obvious differences in the ultrastructure of the rheumatoid and nonrheumatoid cell strains were detected. Acid phosphatase and β‐glucuronidase measurements were similar in the two groups. No morphologic evidence of an infectious agent was found in any of the cell strains. The diverse morphology found in both groups of cells is described.
Serum anti‐immunoglobulins in psoriatic arthritis as compared with rheumatoid arthritis
Authors: Tapanes Francisco J. , Rawson Arnold J. , Hollander Joseph L.
Published: February 2007

Serum anti‐immunoglobulins of IgG, IgA and IgM types were measured in patients with rheumatoid arthritis, patients with psoriatic arthritis, and normal subjects by absorption on cross‐linked IgG, with subsequent elution. Relatively elevated values of all three types of serum anti‐immunoglobulins were found in seropositive rheumatoids, and elevated values of anti‐immunoglobulins of the IgG type were found in seronegative rheumatoids. Values in patients with psoriatic arthritis fell within the normal range.
Development of malignant cerebral lymphoma in a patient with systemic lupus erythematosus treated with immunosuppression
Authors: Lipsmeyer Eleanor A.
Published: February 2007

A young woman with a clinical diagnosis of systemic lupus erythematosus was treated with corticosteroids and azathioprine. Within nine months, she died of a cerebral reticulum cell sarcoma. Previous reports of lymphoma in patients with systemic rheumatic or “autoimmune disease” and in homograft patients undergoing immunosuppression are discussed. A mechanism of recording cases of malignancy in systemic rheumatic disease occurring both with and without immunosuppression is advocated.
Therapeutic studies in NZB/W mice. II. Relative efficacy of azathioprine, cyclophosphamide and methylprednisolone
Authors: Gelfand Michael C. , Steinberg Alfred D.
Published: February 2007

Five‐month‐old female NZB/W mice were treated with daily injections of azathioprine, cyclophosphamide or methylprednisolone. Treatment was continued for 2 or 3 months at different dosages. Renal histology, proteinuria, antibodies to DNA and survival were studied. All drugs were found to modify the disease favorably. At low doses (1.5 mg/kg/day) azathioprine was most effective. Cyclophosphamide was superior at higher doses (4.5 mg/kg/day). Different two‐drug combinations were also compared. The combination of cyclophosphamide plus methylprednisolone was most effective. Combined therapy increased survival without increasing toxicity.
Epidemiologic studies of serum uric acid levels among micronesians
Authors: Reed Dwayne , Labarthe Darwin , Stallones Reuel
Published: February 2007

Data from epidemiologic studies of Chamorro and Palauan populations of Micronesia were analyzed for associations of serum uric acid levels with other characteristics of the populations. The mean serum uric acid levels for those groups were significantly higher than those reported for Western populations, but the frequency distribution patterns were similar, being unimodal and slightly skewed toward higher values. Analysis by geographic subgroups showed differences in mean serum uric acid levels, but those differences did not follow any pattern of association with sociocultural indices. There was a general association of serum uric acid levels with total daily caloric intakes. Correlation analysis of individual characteristics indicated that serum uric acid levels were positively associated with measures of blood pressure, obesity and serum triglyceride levels. There was no consistent association with serum cholesterol or glucose levels, electrocardiogram abnormalities, smoking habits or measures of occupation, education or sociocultural attitudes. The overall impression was that, except for a possible dietary influence, the risk of hyperuricemia was more strongly associated with being a Micronesian than with geographic residence or life style.
Azathioprine in Rheumatoid Arthritis A Double‐Blind, Cross‐Over Study
Authors: Urowitz Murray B. , Gordon Duncan A. , Smythe Hugh A. , Pruzanski Waldemar , Ogryzlo Metro A.
Published: February 2007

Seventeen patients with classic rheumatoid arthritis resistant to conventional therapy were treated in a double‐blind, cross‐over study with azathioprine (2.0 to 2.5 mg/kg/day) and placebo for two 16‐week periods. Patients receiving azathioprine showed significant improvement in articular index, joint count, grip strength and effusions, manifest by 6 weeks but greater at 16 weeks. Erythrocyte sedimentation rate and latex titer did not change. White blood cell counts decreased on azathioprine, but normal counts did not preclude a response. Rash, nausea and hair thinning occurred in only 4 patients.
Inhibition of mixed leukocyte culture responses by serum and γ‐globulin fractions from certain patients with connective tissue disorders
Authors: Williams Ralph C. , Lies Richard B. , Messner Ronald P.
Published: February 2007

Sera and IgG fractions from normal subjects as well as patients with rheumatoid arthritis and systemic lupus erythematosus were added to mixed leukocyte reactions (MLC) in an attempt to study the effects on cell‐to‐cell interactions in such systems. Seven and seven‐tenths percent of 52 RA sera and 26% of 27 SLE sera showed suppression of MLC reactivity. MLC suppression appeared to be localized to IgG serum fractions separated by DEAE chromatography. This suppressive effect showed a strong correlation with presence of lymphocytotoxic antibody in individual sera.
IV. Joint erosion in rheumatoid arthritis
Authors: Krane Stephen M.
Published: February 2007

In rheumatoid arthritis, destruction of the collagenous structures that comprise the joint is associated with proliferation of synovial lining cells. Erosion of cartilage, bone, and soft connective tissue occurs predominantly in areas adjacent to these cells and the collagen of these tissues is susceptible to degradation at neutral pH by collagenase from the proliferating cells. The collagen fragments thus solubilized are further broken down by other proteases. Cartilage collagen is attacked more slowly by synovial collagenase than are soft tissue collagens, presumably due to its particular primary structure and post‐translational modifications of this primary structure. Proteoglycans are degraded probably by proteolytic attack on the protein backbone. The inorganic mineral phase of bone prevents collagenolytic attack on bone matrix; mechanisms of mineral dissolution may include a local decrease in pH and release of substances such as prostaglandins from the inflammatory cells. The degradation of each structural component results in specific alterations in form and function of the joint.
Gonococcal arthritis. Clinical features correlated with blood, synovial fluid and genitourinary cultures
Authors: Brandt Kenneth D. , Cathcart Edgar S. , Cohen Alan S.
Published: February 2007

The clinical picture was analyzed in 31 patients with acute arthritis and proven gonococcal infection. Patients with positive blood cultures and those with positive synovial fluid cultures were mutually exclusive. However, these two groups were indistinguishable on the basis of mean duration of illness prior to initial examination, the number of joints involved or the magnitude of synovial fluid leukocytosis. Notably, features that have been particularly associated with gonococcemia—eg, chills, a migratory polyarticular prodrome and typical skin lesions, were present in most cases. Thus, on clinical grounds none of the patients in the present series could be clearly categorized into either the bacteremic or septic joint syndromes of gonococcal arthritis.
Hemarthrosis as the presenting manifestation of myeloproliferative disease
Authors: Harris Benjamin K. , Ross H. Arlene
Published: February 2007

In evaluating a patient with hemarthrosis, it is customary to consider trauma, neoplasm (1,2), infection, and coagulation abnormalities in the differential diagnosis. Hemorrhagic effusions are also seen with neuropathic joints (3), and recent reports have linked hemarthrosis to the pseudogout syndrome (4), sickle trait (5), and metallic joint prostheses (6). We have just had the opportunity to study 2 patients in whom painful hemarthrosis was the presenting manifestation of a myeloproliferative syndrome.
Vasculitis of the breast. An unusual manifestation of polyarteritis
Authors: Dega Francis J. , Hunder Gene G.
Published: February 2007

A 72‐year‐old woman had a tender breast mass due to arteritis. A diagnosis of polyarteritis rather than cranial or focal arteritis (as suspected in previously reported similar cases) was indicated by a muscle biopsy, which showed arteritis, and a temporal artery biopsy, which was normal.
Chondrocalcinosis in elderly persons
Authors: Ellman Michael H. , Levin Bertram
Published: February 2007

Fifty‐eight elderly people were surveyed for chondrocalcinosis with knee, hip and pelvic roent‐genograms using Type M industrial x‐ray film. Chondrocalcinosis was found in 16 subjects (27.6%), an incidence greater than reported in previous studies. Roentgenograms of the knees alone showed the presence of chondrocalcinosis in 15 subjects. Varus deformity of the knees, increased wrist complaints and wrist involvement with clinical arthritis were significantly more common in subjects with chondrocalcinosis. Symptoms associated with acute inflammatory arthritis were not more common in people with chondrocalcinosis.
The effect of cyclophosphamide on b and t lymphocytes in patients with connective tissue diseases
Authors: Hurd Eric R. , Giuliano V. J.
Published: February 2007

Absolute numbers of B (IgG‐, IgM‐, and IgA‐staining) and T lymphocytes (sheep erythrocyte rosette‐forming cells) were determined in patients with systemic lupus erythematosus and other connective tissue diseases in cyclophosphamide‐treated and noncyclo‐phosphamide‐treated patients and in control subjects. In patients receiving cyclophosphamide, all three types of immunoglobulin‐staining varieties of circulating B lymphocytes were significantly decreased. At the same time the circulating T lymphocytes were also significantly reduced. In patients with scleroderma trcated with therapeutic doses of cyclophosphamide and studied sequentially, the reduction in B lymphocytes oc‐curred first, with eventual depletion of both cell types. In 2 patients, an early rebound increase in T cells occurred followed by a marked reduction. These data indicate that the immunosuppressive effects of cyclophosphamide may be associated with a reduction in both cell types.
Hydralazine therapy in hypertensive patients with idiopathic systemic lupus erythematosus
Authors: Reza Michael J. , Dornfeld Leslie , Goldberg Leonard S.
Published: February 2007

Seven hypertensive patients with idiopathic systemic lupus erythematosus were treated with hydralazine. They received a mean daily dose of 203 mg for a mean duration of 21 months. All were taking prednisone alone or in combination with azathioprine. During therapy with hydralazine, there were no new symptoms nor exacerbation of pre‐existing symptoms attributable to systemic lupus. Laboratory parameters, including antinuclear antibody titers and complement levels, either improved or remained stable. The results indicate that hydralazine can be safely used in hypertensive patients with systemic lupus who are receiving concomitant immunosuppressive therapy.
Connective tissue activation
Authors: Castor C. William , Scott Mary E. , Ritchie James C. , Harnsberger Sandra C.
Published: February 2007

Alpha‐ and beta‐adrenergic blocking agents and imipramine inhibit the increased hyaluronate synthesis that may be induced in human synovial cultures by connective tissue activating peptide (CTAP). Considerations of drug concentration requirements, actions of analogues, and time studies all indicate that the adrenergic blockers do not act in this circumstance as conventional blockers of alpha or beta receptor sites. It is suggested that the membrane‐stabilizing properties of these agents may be the important determinant for their limited “antiactivation” effect. Ethacrynic acid, a potent and more complete inhibitor of connective tissue activation, appears to act via a different mechanism.
Electron microscopic studies of the cartilage‐pannus junction in rheumatoid arthritis
Authors: Kobayashi Ikuo , Ziff Morris
Published: February 2007

The junction between pannus and cartilage was examined in the rheumatoid joint. Three types of cartilage‐pannus junction were observed. In one, proliferating small blood vessels, surrounded by highly cellular infiltrates, penetrated deeply into the cartilage. Degeneration of the cartilage was observed around the cellular accumulations. In the second, phagocytic and fibroblastic cells invaded the cartilage. In the third, fibrous pannus overlay the cartilage. Lysis of cartilage by infiltrating cells appeared to be a major cause of cartilage erosion in rheumatoid arthritis.
Effect of topical administration of antiinflammatory drugs to rats with adjuvant arthritis
Authors: Heilman Richard D. , Reo Richard R.
Published: February 2007

Oral or intramuscular administration of antiinflammatory agents produces numerous undesirable side effects. This work explores the hypothesis that topical administration of such agents directly to the site of inflammation would have beneficial antiinflammatory effects. Topical administration of steroidal and nonsteroidal antiinflammatory drugs to rats with adjuvant arthritis was as effective as oral or intramuscular administration. Peak blood levels of radioactivity following administration of equal doses of hydrocortisone‐3H were considerably lower after topical administration than after oral administration.
Effect of complement and polymorphonuclear leukocyte depletion on experimental skin lesions resembling systemic lupus erythematosus
Authors: Natali P. G. , Mottolese M. , Nicotra M. R.
Published: February 2007

Immunopathologic cutaneous lesions resembling human systemic lupus erythematosus (SLE) can be induced in mice sensitized to ultraviolet (UV)‐irradiated DNA following whole body irradiation with UV light. The lesions are characterized by the formation of immune complexes at different skin sites. The role played by cellular and humoral mediators in the pathogenesis of this experimental model was investigated. The results obtained suggest that inflammation that follows UV radiation is the major factor responsible for this pathology. Accordingly mice that were rendered neutrophil (PMN) deficient did not manifest skin lesions, and depletion of C3 complement component left them unchanged. In addition time course studies showed that PMN depletion did not prevent a delayed skin involvement. Thus multiple factors seem to mediate the onset of the immunopathologic changes previously described.
Detection by counterimmunoelectrophoresis of pneumococcal antigen in synovial fluid from septic arthritis
Authors: Dorff Gerald J. , Ziolkowski James S. , Rytel Michael W.
Published: February 2007

Pneumococcal antigen type 20 has been identified by counterimmunoelectrophoresis in synovial fluid of a case of septic arthritis in a patient with underlying rheumatoid arthritis. The titer of antigen was high: 1:400. Implications of this finding in the diagnosis and pathogenesis of septic arthritis are discussed.
Specific detection and semiquantitation of microorganisms in tissue by nucleic acid hybridization. II. Investigation of synovia from pigs with chronic erysipelothrix arthritis
Authors: Steinman Charles R. , Hsu Konrad
Published: February 2007

Synovial tissues from animals with chronic Erysipelothrix arthritis were examined by a technique based on RNA‐DNA hybridization in an attempt to detect the inducing organism, Erysipelothrix insidiosa (EI). Twelve synovial specimens from 5 animals whose joints lacked culturable EI also lacked EI detectable by this technique. Because the technique is capable of detecting approximately one organism per 50 mammalian cells, it is concluded that no more than this number were present in the involved tissue. Implications of these results for proposed pathogenetic mechanisms in this disorder and in human rheumatoid arthritis are discussed.
Induction of peripheral blood lymphocyte transformation by autologous synovial fluid lymphocytes and synovial fluid
Authors: Crout James E. , McDuffie Frederic C. , Ritts Roy E.
Published: February 2007

Synovial fluid lymphocytes and synovial fluid from most patients with rheumatoid arthritis induced blastogenesis of autologous peripheral blood lymphocytes. In vitro transfer of the mitogenic activity of the synovial fluid to peripheral blood lymphocytes was not accomplished, but diminished response of the peripheral blood lymphocytes to phytohemagglutinin stimulation after incubation in synovial fluid was demonstrated. These findings suggest that a similar blastogenic response in vivo may induce the lymphoid hyperplasia regularly observed in rheumatoid arthritis.
Mixed leukocyte reaction in rheumatoid arthritis
Authors: Keystone Edward C. , Gladman Dafna D. , Urowitz Murray B. , Clarke David A. , Falk Judy A. , Osoba David , Gordon Duncan A.
Published: February 2007

The mixed leukocyte reaction (MLR) responses of 29 patients with classic rheumatoid arthritis (RA) were compared with those of 24 age‐ and sex‐matched healthy controls. Pools of stimulating cells were selected to include the major cross‐reacting HL‐A specificities. In pooled human serum the MLR response of the RA lymphocytes was significantly enhanced relative to the response controls (P < 0.05). In autologous serum there was suppression of the MLR response in patients with RA which correlated with disease activity. The data suggest the presence of an intrinsically enhanced cellular reactivity of RA lymphocytes suppressed by serologic factor(s). The mechanisms of this enhancement of suppression are discussed.
Immunologic observations on 9 sets of twins either concordant or discordant for SLE
Authors: Block Sidney R. , Lockshin Michael D. , Winfield John B. , Weksler Marc E. , Imamura Masakatsu , Winchester Robert J. , Mellors Robert C. , Christian Charles L.
Published: February 2007

The influence of genetic and nongenetic factors on abnormalities of the immune response in systemic lupus erythematosus (SLE) was studied in 9 sets of twins in which one or both twins had SLE. Particular emphasis was placed on contrasting the results between the sibs of 3 monozygotic pairs discordant for clinical SLE. Depression of cell‐mediated immunity, determined by lymphocyte blastogenic response to mitogens, was associated with the clinical expression of illness. In contrast, auto‐reactive antilymphocyte antibodies and lymphocyte tubuloreticular structures were found in both clinically affected and unaffected subjects and were more prominently associated with the presence of other serologic abnormalities. No evidence of antigens or cell surface determinants unique to affected sibs was encountered.
Articular manifestations of hypertrophic pulmonary osteoarthropathy in bronchogenic carcinoma. A clinical and pathologic study
Authors: Schumacher H. Ralph
Published: February 2007

Eight patients with bronchogenic carcinoma presented with painful joint effusions as part of the syndrome of hypertrophic osteoarthropathy. Elevated sedimentation rates and symptomatic relief with aspirin were common, but synovial fluids all had leukocyte counts less than 500/mm3. Synovial microvascular injury was found in all patients, and electron‐dense deposits in synovial vessel walls were identified in 5 cases. These vascular deposits suggest a role for circulating materials in pathogenesis.
Significance Of Persisting Serologic Abnormalities In SLE
Authors: Lightfoot Robert W. , Hughes Graham R. V.
Published: February 2007

The significance of abnormal serum anti‐DNA and complement levels persisting in SLE patients on treatment has been explored. Instances when serologic abnormalities returned to normal were followed by a significantly longer mean duration of remission. When anti‐DNA persisted at abnormal levels, a more severe exacerbation was likely to follow, although this result was not the case for persisting hypocomplementemia. These data did not result from two variants of SLE, one mild and one severe, because duration of remission correlated directly with dosage of steroid. Randomly discovered abnormalities in anti‐DNA and complement levels were of limited predictive value, because they frequently persisted for over 1 year before exacerbations occurred. Hypocomplementemia resolved spontaneously without recognizable exacerbation in nearly half the observed instances.
Association between hla and cutaneous necrotizing venulitis
Authors: Glass David , Soter Nicholas A. , Gibson David , Carpenter C. B. , Schur Peter H.
Published: February 2007

A group of patients has been identified with cutaneous necrotizing venulitis (vasculitis). These patients, some with concomitant connective tissue disorders, have skin lesions that separate them from the arteritis commonly described as rheumatoid vasculitis. HLA typing has been performed on 31 of these unrelated patients with cutaneous necrotizing venulitis, including 19 with associated chronic disorders. The antigen pair A11,BW35 was found in 5 of these 19 patients and in 11 of 346 controls. This difference in frequency is statistically significant. Because HLA genes appear to be linked to immune response genes, these data suggest that such genes may exist in patients with this form of cutaneous necrotizing venulitis with associated connective tissue disease.
Histochemical investigation of adjuvant‐induced arthritis
Authors: Nusbickel Fred R. , Troyer Henry
Published: February 2007

Rats with adjuvant‐induced arthritis were observed to have increased alkaline phosphatase, acid phosphatase (two isozymes), and ATPase activity in the radial zone of articular cartilage, at the osteochondral junction, and in the bone marrow elements. A qualitative and quantitative reduction of azure A, PAS, colloidal iron, alcian blue critical electrolyte concentration staining (0.4 and 0.9 M (mg Cl2) was also observed in corresponding areas. These findings suggest the degradation of the articular cartilage matrix with possible simultaneous or resultant calcification.
Effect of sodium salicylate on human and mouse granulopoiesis in vitro
Authors: Gabourel J. D. , Moore M. A. S. , Bagby G. C. , Davies G. H.
Published: February 2007

Sodium salicylate inhibited generation of granulocyte and macrophage colonies when added to soft agar cultures of mouse or human bone marrow cells (CFUc) containing colony‐stimulating factor (CSF). This effect was dose‐dependent with over 90% inhibition at 48 mg%. The salicylate effect was not decreased with increasing concentrations of CSF, but inhibition was reversed when salicylate‐treated CFUc were washed with drug‐free medium before plating. CSF production was not inhibited by salicylate.
Lymphocytes eluted from synovial tissue of juvenile rheumatoid arthritis patients
Authors: Abrahamsen Tore G. , Fr øland Stig S. , Natvig Jacob B. , Pahle Jan
Published: February 2007

Synovial tissues from 11 patients with juvenile rheumatoid arthritis were investigated. The elution of lymphocytes was performed according to a procedure previously described for synovial tissue of adult rheumatoid arthritis patients (1). The T lymphocytes were predominant (mean: 71%) in all cell suspensions studied, whereas the average proportion of B lymphocytes was 4%. In addition, Fc‐receptor‐bearing lymphocytes were demonstrable (mean: 8%). Transformation of the lymphocytes was induced by the unspecific mitogens phytohemagglutinin, pokeweed mitogen, and concanavallin A, whereas antigens such as PPD and candida albicans antigen were usually ineffective.
Increased spontaneous activity of antibody‐forming cells in the peripheral blood of patients with active sle
Authors: Budman Daniel R. , Merchant E. Bruce , Steinberg Alfred D. , Doft Bernard , Gershwin M. Eric , Lizzio Elaine , Reeves J. Patton
Published: February 2007

Thirty‐seven patients with criteria for systemic lupus erythematosus (SLE) and 18 normal controls were studied for their spontaneous background IgM antibody plaque‐forming cell number to specific chemical haptens. Active SLE patients had significantly more plaque‐forming cells in their peripheral blood to a total of five chemical determinants than did patients with inactive disease or controls. This increased number of plaque forming‐cells correlated with depressed serum C3 levels by Spearman rank‐order analysis. The finding of elevated numbers of spontaneous IgM plaque‐forming cells to defined chemical haptens supports the concept that active SLE demonstrates a generalized increase in B‐cell activity toward a variety of antigens.
Effects of antiinflammatory agents on the acute response of immune synovitis in rabbits
Authors: Goldlust Marvin B. , Rich Lois C. , Harrity Thomas W.
Published: February 2007

Immune synovitis in rabbits was investigated as a potential in vivo model for evaluating new antiinflammatory agents. Antigen‐induced increases in knee width as well as β‐glucuronidase and acid phosphatase activities in exudates were observed. Histologically, polymorphonuclear leukocytes appeared within hours in synovial tissues and reached maximum infiltration at about 24 hours. Subsequently, mononuclear cells, including plasma cells, appeared. The 6‐hour Arthus‐like phase of synovitis can be depressed by some antiinflammatory agents, colchicine and steroids being particularly effective. It is suggested that this model can be utilized to define potentially more effective antiinflammatory drugs.
Increased Frequency of HLA‐Cw3 and HLA‐Dw4 in Rheumatoid Arthritis
Authors: McMichael Andrew J. , Sasazuki Takehiko , McDevitt Hugh O. , Payne Rose O.
Published: February 2007

Thirty‐nine patients with rheumatoid arthritis were HLA typed for the full range of A and B locus specificities and for Cw3 and Dw4. HLA‐Dw4 was significantly more frequent in patients (36%) than in controls (13%). The frequency of Cw3 was also increased, probably because this allele is in linkage disequilibrium with Dw4.
Monocyte—Reactive Antibodies in Patients with Systemic Lupus Erythematosus
Authors: Arend William P. , Emmerich Toby E. , Sturge Jerrilyn C. , Starkebaum Gordon A.
Published: February 2007

Cold‐reactive antibodies cytotoxic for peripheral monocytes from more than half of normal donors were found in the sera of 2 of 25 patients with systemic lupus erythematosus (SLE) and 1 of 26 with rheumatoid arthritis (RA), and they were absent in 25 normal sera. In contrast, lymphocytotoxic activity for T or B lymphocytes was found in over half of the lupus sera. The antibodies to monocytes were primarily IgM and exhibited varying specificities. Some of the antibodies were directed against antigenic determinants common to monocytes, T and B cells, or against determinants shared between monocytes and one lymphocyte type. One serum possessed a high titer of antibodies that were specific for monocytes. The clinical significance of antimonocyte antibodies remains to be established.
Lymphocyte Involvement in Rheumatoid Arthritis
Authors: Paulus H. E. , Machleder H. I. , Levine S. , Yu D. T. Y. , Macdonald N. S.
Published: February 2007

Grip strength, ring size, duration of morning stiffness, and the number of tender joints improved significantly in 9 patients with severe rheumatoid arthritis during prolonged continuous removal of thoracic duct lymphocytes through a surgical fistula. There was no improvement in 4 subjects in whom surgery failed to establish satisfactory lymph drainage. Reinfusion of unlabeled or 51Cr‐labeled autologous lymphocytes resulted in transient exacerbation of disease activity in 3 subjects. Following reinfusion, some 51Cr‐labeled lymphocytes could be found in the inflamed synovium and synovial fluid by autoradiography, and radioactivity was detected over the joints by surface counting of gamma radiation. Active rheumatoid arthritis recurred in all subjects at variable intervals after cessation of lymph drainage. These findings are compatible with the hypothesis that some of the lymphocytes in the thoracic duct lymph are essential for the continued activity of the inflammation associated with rheumatoid arthritis.
Computer analysis of factors influencing frequency of infection in systemic lupus erythematosus
Authors: Ginzler Ellen , Diamond Herbert , Kaplan David , Weiner Max , Schlesinger Michael , Seleznick Mitchel
Published: February 2007

Data from a prospective study of the clinical course in 223 patients with systemic lupus erythematosus followed for 655 patient‐years were analyzed by computer to determine the influence on frequency of infection of 1) corticosteroid dose; 2) azathioprine; 3) active disease, measured by new disease exacerbations, elevated ESR, hypocomplementemia, active urinary sediment, and proteinuria; 4) uremia; and 5) leukopenia. The frequency of all infections, and of bacterial and opportunistic infections specifically, increased progressively with increasing steroid dose. Azathioprine use, independent of steroid dose, did not account for an increased risk of bacterial, opportunistic, or nonspecific viral infections. Leukopenia did not predispose to infection, except possibly when associated with azathioprine‐induced bone marrow suppression. Active renal disease, especially when manifested by abnormal urine sediment, was associated with an increase in infection frequency.
Carpal tunnel syndrome with polymyalgia rheumatica
Authors: Ahmed Tahir , Braun Alan I.
Published: February 2007

Association of carpal tunnel syndrome with systemic diseases is well established. Carpal tunnel syndrome preceded or existed simultaneously in 5 patients with polymyalgia rheumatica. It is probably related to tenosynovitis resulting in increase in the volume of the contents of the tunnel.
Psychosocial factors in juvenile rheumatoid arthritis
Authors: Henoch Monica Jean , Batson Jean W. , Baum John
Published: February 2007

A detailed survey of 88 children with juvenile rheumatoid arthritis (JRA) was made in an attempt to elucidate characteristics that may participate in the etiologic mechanism. Data from a random pediatric population from the same geographic area were also included for comparisons. The most striking findings were psychosocial factors. Children whose parents were unmarried as a result of divorce, separation, or death comprised 28.4% of the JRA population, compared to 10.6% of the comparison group. In addition, adoption occurred three times more often in the JRA population. Fifty‐one percent of these events (divorce, separation, death, or adoption) occurred near the date of onset of the disease.
Ankylosing Spondylitis With Subsequent Development of Rheumatoid Arthritis, Sjögren'S Syndrome, and Rheumatoid Vasculitis
Authors: Clayman Michael D. , Reinertsen James L.
Published: February 2007

Twelve years after the onset of ankylosing spondylitis, a patient developed severe seropositive rheumatoid arthritis with subcutaneous nodules. This was subsequently complicated by Sjögren's syndrome and rheumatoid vasculitis. The literature is reviewed, and the nature of the association between ankylosing spondylitis and rheumatoid arthritis is discussed.
Analysis of dna structure by hydroxyapatite columns and ethidium bromide fluorescence techniques. a comparative study and effect on dna binding
Authors: Davis Paul , Burrington Michael , Russell Anthony S. , Richard Morgan A.
Published: February 2007

Seven duplex DNA preparations have been structurally analyzed by hydroxyapatite column chromatography and an ethidium bromide fluorescence technique. Significant contamination of one preparation with single‐stranded DNA was detected by hydroxyapatite column chromatography. Five of the other six preparations were found to contain significant single‐stranded regions by the ethidium bromide fluorescence technique. Synthetic poly dAT was found to be duplex in structure. The presence of single‐stranded regions considerably influenced DNA binding results in a radioimmunoassay.
Horizontal splitting in patellar articular cartilage
Authors: Meachim G. , Bentley G.
Published: February 2007

Horizontal splits at the interface between the uncalcified and the calcified layers of the articular cartilage have been found in 31 of 50 transverse slabs of left patellae from a random series of 50 necropsy subjects aged 18 to 96 years. Evidence is presented that the splits are not due to autolysis nor to technical artefact, and it is here suggested that they result from shearing damage at the uncalcified‐calcified cartilage interface during life.
Interrelationship between stimulation of prostaglandin e and hyaluronate production by poly (i).Poly (c) and interferon in synovial fibroblast culture
Authors: Yaron Michael , Yaron Ilana , Wiletzki Chana , Zor Uriel
Published: February 2007

The interferon‐inducer, polyinosinate. Polycyctidylate [Poly (I). Poly (C)] stimulated both prostaglandin E (PGE) and hyaluronic acid (HA) production by human cultured synovial fibroblasts. Increased accumulation of PGE in the medium was noted within 3 hours of culture, while accumulation of HA was observed only after a 24 hour lag period. The stimulation of PGE and HA production by Poly (I) Poly (C) was prevented by aspirin and indomethacin. Human interferon was also effective in stimulating both PGE and HA production. Concomitant addition of cortisol to culture medium abrogated the stimulatory effect of Poly (I). Poly (C) and interferon on both PGE and HA production. Exogenous PGE2, however, overcame the inhibitory effect of cortisol on HA production. The present results suggest that the stimulatory effect of both interferon and Poly (I). Poly (C) on HA production may be mediated by PGE. Prostaglandins may thus play a role in the inflammatory process associated with viral infections.
Central retinal vein occlusion complicating systemic lupus erythematosus
Authors: Silverman Michael , Lubeck Marvin J. , Briney Walter G.
Published: February 2007

Retinal lesions occur in 25 to 30% of patients with systemic lupus erythematosus (SLE). Visual loss, however, is rare. A patient who developed central retinal vein occlusion and blindness during the course of active SLE is described. The pertinent literature is reviewed with attention to possible pathophysiologic mechanisms.
Rheumatoid arthritis, amyloidosis, and chylous effusions
Authors: Baim Sanford , Samuelson Cecil O. , Ward John R. , Cathcart Edgar S.
Published: February 2007

A patient with rheumatoid arthritis and secondary amyloidosis is described. The initial clinical expression of the amyloidosis was bilateral chylous pleural effusions due to intrinsic amyloid obstruction of the lymphatics. This is an unusual initial manifestation of secondary amyloidosis.
Association of IgG Anti‐Brain Antibodies with Central Nervous System Dysfunction in Systemic Lupus Erythematosus
Authors: Wilson H. Alexander , Winfield John B. , Lahita Robert G. , Koffler David
Published: February 2007

Sera from 20 patients with systemic lupus erythematosus (SLE) and active central nervous system (CNS) dysfunction were examined by indirect immunofluorescence for antibodies to neuronal membrane determinants. Warm‐reactive IgG antibodies were demonstrable in 82% (9/11) of patients with clinical evidence for seizures or diffuse CNS disease, but these antibodies generally were absent in non‐CNS SLE sera or when focal neurologic deficit or psychosis was the primary CNS manifestation. Cold‐reactive antibodies of the IgM class were equally prevalent in patients with or without CNS disease and appeared to be more directly correlated with extra‐CNS systemic illness. Absorption experiments with lymphocytes, brain homogenate, and various other tissues suggested a predominant brainspecificity for IgG antibodies and partial lymphocyte cross‐reactivity for IgM antibodies. Interpretations of this special association between IgG anti‐brain antibodies and diffuse CNS dysfunction in SLE are discussed.
Studies on the Specificity and Clinical Correlation of Antiribosomal Antibodies in Systemic Lupus Erythematosus Sera
Authors: Koffler David , Miller Thomas E. , Lahita Robert G.
Published: February 2007

The specificity of antibodies reactive with cytoplasmic ribosomes detected in systemic lupus erythematosus (SLE) sera was studied by a radioimmunoassay procedure with 3H labeled HeLa cell polysomes. The antibodies were directed primarily against RNA or a ribosomal RNA‐protein complex (rRNP). Anti‐RNA antibodies exhibited comparable reactivity with ribosomal RNA, nuclear RNA, structural RNA, and a slightly lower degree of reactivity with low molecular weight RNA. Anti‐rRNP antibodies may be detected by precipitation in agar gel and appear to require both the RNA and protein moieties of ribosomes for reactivity. SLE sera containing only anti‐rRNP antibodies are limited to patients with active disease. Sera from patients with both active and inactive SLE contain either anti‐RNA or a mixture of anti‐RNA and anti‐rRNP antibodies. The possible participation of anti‐ribosomal antibodies in immune complex formation is discussed.
The phlogistic potential of urate in solution
Authors: Malawista Stephen E. , Blaricom Gretchen Van , Cretella Stella B. , Schwartz Morris L.
Published: February 2007

Physiologic concentrations of urate in solution had a clear and dosage‐dependent suppressive effect on the concomitant uptake of radioiodinated human serum albumin (131I‐HSA) during the ingestion of particles (bacteria) by human polymorphonuclear leukocytes (PMN). The effect was rapid, reversible on washing the cells, and demonstrable over a wide range of incubation times and ratios of particles to PMN. In this method, the incubated cells are washed, and most surface radio‐activity is thereby removed; the amount of label trapped during particle ingestion then usually provides a sensitive measure of phagocytosis. However, no evidence for an effect of urate on phagocytosis was found by use of several other methods for the assessment of particle uptake, including 1) direct microscopic counts of cell‐associated bacteria, 2) studies in which the bacteria were radiolabeled (instead of the media), and 3) the quantitative recovery of surviving bacteria from the media and from disrupted cells. An alternative explanation for the results with 131I‐HSA is that urate interferes reversibly with the binding of albumin to the cell membrane, including those portions that become internalized during phagocytosis, thereby creating the false impression of less phagocytosis, when there is really only less trapped label (i.e., albumin). In fact, non‐phagocytizing leukocytes—which do not transport albumin across the cell membrane—incubated in serum‐buffer with added urate and with 131I‐HSA and then drained (not washed) had much less cell‐associated radioactivity than controls without added urate. Washing removed the difference (and most of the label from both groups). Crystals of urate and of silica are known to kill the cells that ingest them by disrupting the membranes of phagolysosomes, but only after protective protein has been digested. In the presence of dissolved urate, this inflammatory mechanism might be augmented by the relative lack of protective, membrane‐associated protein. Indeed, as measured by the release of lactic dehydrogenase, injury to cells given silica crystals was augmented considerably in the presence of dissolved urate.
Urate binding to serum albumin
Authors: Holmes Edward W. , Blondet P.
Published: February 2007

Fractional excretion of uric acid (Curate/Ccreat X 100) was determined in a 4‐year‐old analbuminemic child and an age‐matched control. Fractional excretion of urate was 19% in the analbuminemic child and 24% in the control subject. These values are within the range reported for normal children of this age. We conclude from this study that urate binding to serum albumin is not an important determinant of the renal clearance of uric acid, and by inference there is no significant binding of urate to serum albumin in vivo.
An evaluation of salivary scintigraphy in sögren's syndrome
Authors: Daniels Troy E. , Powell Malcolm R. , Sylvester Robert A. , Talal Norman
Published: February 2007

Sequential salivary scintigraphy, labial salivary gland biopsy, and measurement of stimulated parotid flow rate were performed in 50 patients suspected of having Sjören's syndrome. The value of these tests in the diagnosis of this disease was compared. Salivary scintigraphy and labial salivary gland biopsy can be used together to disgnose the oral component of Sjören's syndrome. Abnormal salivary scintigraphy correlated with both of the other tests and may be considered optional in the diagnostic evaluation.
Polyarteritis nodosa in childhood
Authors: Ettlinger Robert E. , Nelson Audrey M. , Burke Edmund C. , Lie J. T.
Published: February 2007

The clinical and pathologic findings of 2 infants and 7 older children with polyarteritis nodosa who were autopsied are reported. The most frequent clinical features included prolonged high fever, skin rash, abdominal symptoms, leukocytosis, proteinuria, and signs of either cardiac or renal failure. The 2 infants died of cardiac arrest, whereas renal or neurologic involyement was the most common cause of death in the older children. A consistent finding at autopsy was arteritis of the epicardial coronary arteries.
IgG rheumatoid factor
Authors: Pope Richard M. , Mcduffy Sandra J.
Published: February 2007

IgG rheumatoid factor was detected in the sera of the majority of patients with seropositive rheumatoid arthritis. Values suggestive of IgG rheumatoid factor were noted in one‐quarter of patients with seronegative inflammatory arthropathies. These determinations were always low and correlated with elevated IgG concentrations, suggesting nonspecific adherence of IgG rather than a true antigen‐antibody reaction. In support of this conclusion, nonrheumatoid factor IgG was capable of concentration‐dependent nonspecific adsorption to the solid phase. IgG, but not IgM, rheumatoid factor corresponded with disease activity in patients with seropositive rheumatoid arthritis, suggesting that IgG rheumatoid factor may be important in the pathogenesis.
Early complement component depletion and mixed cryoglobulinemia in a “healthy” family
Authors: Waterman John R. , Winkelstein Jerry A. , Berzofsky Ronald N. , Hsu Susan H. , Bias Wilma B. , Arnett Frank C.
Published: February 2007

A family containing two apparently healthy brothers with profound early complement component depletion (C1, C4, C2) and mixed IgG‐IgM polyclonal cryoglobulins was studied. The cryoglobulins possessed rheumatoid factor activity and depleted early complement components in normal human serum. Circulating immune complexes could not be detected by utilizing standard methods. The phenomenon was not HLA‐linked. This study demonstrates the familial occurrence of a chronic hypocomplementemic state associated with cryoglobulinemia in clinically normal subjects.