bluuebunny/crossref_metadata_2025 huggingface dataset:
Synovial fluid lymphocytes in rheumatoid arthritis
Authors: Utsinger Peter D.
Published: February 2007

There is significant evidence implicating immunologic mechanisms in the pathogenesis of rheumatoid arthritis (RA). To investigate the possibility that a cellular imbalance of T and B lymphocytes plays a role in perpetuating synovitis, an examination of the peripheral blood and synovial fluid lymphocytes of patients with seropositive rheumatoid arthritis was undertaken. A significant lymphopenia was encountered in RA patients, with values approximately midway between those in normal controls and the severe lymphopenia seen in a group of patients with systemic lupus erythematosus. A significantly greater diminution of T than B cells was noted in RA, and normal percentage distributions of lymphocytes in peripheral blood were documented. Normal percentages of T and B cells, similar to those in peripheral blood, were found in synovial fluids of patients with seropositive RA, seronegative RA, osteoarthritis, and gout. Two seropositive patients exhibited synovial fluid, but not peripheral blood, lymphocytes that stained both for IgG and IgM. These cells regenerated predominantly IgM after trypsinization and short‐term culture with significant diminution of cells staining for IgG. It is postulated that double staining was secondary to surface immunoglobulins with rheumatoid factor activity binding intraarticular IgG. Such cells were not detected in peripheral blood in any of the groups of patients studied.
Acute gouty arthritis without urate crystals identified on initial examination of synovial fluid
Authors: Schumacher H. Ralph , Jimenez Sergio A. , Gibson Terry , Pascual Eliseo , Traycof Roger , Dorwart Bonnie B. , Reginato Antonio J.
Published: February 2007

Nine patients who ultimately proved to have acute gouty arthritis did not have urate crystals demonstrable by compensated polarized light in the first joint fluid aspirated despite leukocyte counts as high as 100,000/mm3. In 6 cases crystals were found in fluid from the same joint 5 hours to 1 day later. Factors that might explain the difficulty in identifying crystals include aspiration of the wrong site because diffuse swelling obscured predominant involvement of a bursa or adjacent small joint, loculation within a joint, crystal dissolution leaving only tiny birefringent chunks, and inexpert or insufficient search. Some cases remain without any tentative explanation. The possibility of acute gouty arthritis should not be excluded if crystals are not demonstrable in the first search of joint fluid. Repeated searches for typical monosodium urate crystals may be required for diagnosis.
Cryoimmunoglobulinemia in felty's syndrome
Authors: Weisman Michael , Zvaifler Nathan J.
Published: February 2007

Seven of 9 patients with Felty's syndrome exhibited cryoglobulins in greater amounts than found in uncomplicated RA but similar to amounts found in RA with vasculitis. Antinuclear antibodies were found in high titer in the sera and cryoglobulins of Felty's patients; when compared to SLE patients, whose sera and cryoglobulins also contained antinuclear factors, an antinuclear antibody reacting with nuclei of polymorphonuclear granulocytes appeared to be selectively concentrated in the cryoglobulins of some Felty's patients.
Effect of aspirin on liver tests in patients with ra or sle and in normal volunteers
Authors: Seaman William E. , Plotz Paul H.
Published: February 2007

Aspirin was given to 20 patients with RA, 16 patients with SLE, and 3 normal volunteers. Four of the RA patients, 7 of the SLE patients, and 1 normal volunteer developed abnormal liver tests during the study. The abnormalities (elevated transaminases) were most frequent and of rapid onset in patients with clinically active SLE. Increases in BUN and creatinine related to aspirin were observed in several subjects. In a retrospective survey of 80 patients with SLE, aspirin appeared responsible for two‐thirds of episodes of liver test abnormalities in 19 patients.
Comprehensive study of humoral and cellular immune abnormalities in 26 patients with systemic amyloidosis
Authors: Scheinberg Morton A. , Cathcart Edgar S.
Published: February 2007

Serum immunoglobulin abnormalities in non‐familial and systemic primary amyloidosis are distinct from those seen in multiple myeloma and more closely resemble those seen in benign monoclonal gammopathy. Surface lymphocyte characteristics also differentiate amyloid patients with or without monoclonal immunoglobulins from those with malignant B‐cell dyscrasias. In vitro lymphocyte transformation with phytohemagglutinin and pokeweed mitogen is normal in amyloidosis, but T‐cell function is significantly depressed in both primary and secondary amyloid disease as measured by concanavalin A responses.
Organization of ground substance proteoglycans in normal and osteoarthritic knee cartilage
Authors: Brandt Kenneth D. , Palmoski Marshall
Published: February 2007

A study of the organization of proteoglycans in articular cartilage indicates that nonaggregated proteoglycans existed in larger numbers in osteoarthritic than in normal cartilage and that proteoglycan aggregates in arthritic cartilage were smaller than normal. After dissociation from hyaluronic acid and tissue glycoproteins, no difference in hydrodynamic size of disaggregated proteoglycans was noted, but chondroitin sulfate chains of those from diseased cartilage were shorter than normal. The data suggest that there is a defect in proteoglycan aggregation in osteoarthritic cartilage which could be of pathogenetic significance.
Hereditary C2 deficiency. Association with skin lesions resembling the discoid lesion of systemic lupus erythematosus
Authors: Stern Richard , Fu Shu Man , Fotino Merilena , Agnello Vincent , Kunkel Henry G.
Published: February 2007

Two patients with hereditary homozygous C2 deficiency are described. They showed many similar clinical features. Both had discoid‐like skin rashes and serologic abnormalities consistent with SLE, but neither had evidence of involvement of any organ other than skin. Although biopsy of these lesions revealed expected changes by light microscopy, typical immunofluorescent findings were not present. The presence of the HL‐A haplotype 10,W18 was seen in both families and was associated with the C2 deficiency gene. The 2 patients were mutually nonreactive in MLC tests and both were found to be homozygous for the LD7a type.
Identification of antibodies to nuclear acidic antigens by counterimmunoelectrophoresis
Authors: Kurata N. , Tan E. M.
Published: February 2007

Saline extracts of rabbit thymus were found to contain many nuclear antigens that reacted with antibodies in the sera of patients with systemic rheumatic diseases. Counterimmunoelectrophoresis (CIE) was used to detect antibodies to nuclear acidic protein (Sm), nuclear ribonucleoprotein (RNP), and antibody to nuclear antigen B, which was reported previously in Sjögren's syndrome. All these nuclear antigens behaved as anions with different mobilities in CIE and could be distinguished from one another by the locations of the precipitin lines. They could also be distinguished by the facts that the nuclear RNP precipitin lines were abolished by digestion with ribonuclease whereas others were unaffected, and that Sm precipitin lines developed later than other precipitin lines. With this technique antibody to nuclear RNP was detected in 46% of patients with systemic lupus erythematosus (SLE) compared to 26% detected by the hemagglutination technique. Similarly the increased sensitivity of the CIE technique was able to show that antibody to B antigen was present in 12% of SLE patients, whereas this antibody was not detectable in the same group of patients by immunodiffusion. This study shows that CIE is a rapid and sensitive technique for detecting precipitating antibodies to a number of nuclear acidic antigens. Methods are described to identify the immunochemical specificities of the precipitin lines by the use of standard reference sera.
Obstructive pulmonary disease in rheumatoid arthritis
Authors: Collins Ronald L. , Turner Robert A. , Myron Johnson A. , Whitley Nancy O. , McLean Ross L.
Published: February 2007

Twenty‐six of 43 patients (60.5%) with classic rheumatoid arthritis (RA) participating in a controlled, prospective study were found to have maximal midexpiratory flow rates (MMEFs) suggestive of obstructive pulmonary disease. Cigarette smokers with RA had significantly lower MMEFs than either nonsmokers with RA or smokers with degenerative joint disease. There was an increased prevalence of the Pi phenotype MS among the RA patients. Interstitial fibrosis, tobacco smoking, and protease inhibitor deficiencies were all significant factors in producing airway obstruction in patients with RA.
Intracellular distribution of radiogold. Localization to large granule membranes
Authors: Penneys Neal S. , McCreary Sally , Gottlieb Norman L.
Published: February 2007

The distribution of gold in Kupffer cells and in subcellular fractions of rat liver was studied at intervals following intraperitoneal injection of 195Au sodium thiomalate (Myochrysine). Kupffer cells, isolated by digestion of whole liver with Pronase, had radioactive gold counts per milligram of protein that were twice the counts in the digested liver supernatant. After fractionaction of liver cells by differential centrifugation, radiogold was found predominantly in the nuclear, mitochondrial, and lysosomal fractions. When the distribution of isotope was related to the protein content, the highest gold concentration was found in the lysosomal fraction, where it was 28 times that in the soluble fraction. Most radiogold was nondialyzable, probably a result of binding to larger intracellular compounds. Approximately 95% of the nondialyzable gold was in the organelle membrane or attached to membrane‐adsorbed material, as determined by treatment of dialyzed mitochondrial and lysosomal fractions with Triton X‐100. These data suggest that the intracellular locus of gold action may reside in organelle membranes.
Carpo:Metacarpal ratio. A new quantitative measure of radiologic progression of wrist involvement in rheumatoid arthritis
Authors: Trentham David E. , Masi Alfonse T.
Published: February 2007

Analysis of 878 hand films shows the carpo: metacarpal ratio to be a sensitive quantitative index of progression of carpal involvement in rheumatoid arthritis. This index, easily calculated by dividing the lengths of the carpus by the third metacarpal, showed marked consistency in the ratio regardless of age, race, or sex in normal adults. A decreased ratio correlated highly with recognized radiographic stages of rheumatoid arthritis and thus suggested utility in longitudinal studies of patients with this disease.
Carrageenin‐induced arthritis. III. Proteolytic enzymes present in rabbit knee joints after a single intraarticular injection of carrageenin
Authors: Lowther Dennis A. , Gillard Gerald C. , Baxter Elsmaree , Handley Christopher J. , Rich Kathryn A.
Published: February 2007

A single intraarticular injection of carrageenin into the rabbit knee joint initiates an inflammatory reaction in the synovial tissues. The exudate from the joint was able to degrade proteoglycan at pH 5.2 and pH 7.2. Further characterization of proteolytic enzymes in the inflamed synovial tissues showed the presence of cathepsin D, a neutral protease, and cathepsin B1. Maximum activities of two lysosomal enzymes, acid phosphatase and cathepsin D, were observed within 7 days of injection. Most of this activity was found to be associated with cells in the synovial fluid.
Measuring synovial fluid viscosity with a white blood cell diluting pipette. A simple, rapid, and reproducible method
Authors: Hasselbacher Peter
Published: February 2007

A convenient and accurate way to measure the relative viscosity of synovial fluid is to use a white blood cell diluting pipette as a simple viscometer. The technique is reproducible with 2% accuracy and adds little to the time required for routine synovial fluid analysis. The magnitude of the variation of synovial fluid viscosity with temperature is demonstrated, and it is suggested that routine clinical measurements be made at room temperature. Clinical data confirm that a single viscosity measurement has little or no diagnostic value.
Pathways of complement activation in chronic discoid lupus
Authors: Schrager Mark A. , Rothfield Naomi F.
Published: February 2007

To assess the relative roles of the classic and alternative pathways of complement activation in chronic discoid lupus erythematosus (CDLE), serum levels of properdin, C3, and C4, and deposition of these proteins in the dermal‐epidermal junction (DEJ) of 20 CDLE patients were compared to the findings in patients with clinically active and inactive SLE. Properdin was demonstrated in the DEJ of 10 of 14 (71%) histologically typical skin lesions from patients with CDLE, usually in association with deposits of immunoglobulin, C3, and C4. Properdin levels in CDLE patients were significantly increased (137 ± 34%) (P < 0.05) when compared to normal controls (101 ± 18%) or to patients with clinically active SLE (89 ± 32%). C3, C4, DNA‐binding, and antinuclear antibody tests in CDLE were indistinguishable from those in normals, but significantly different from patients with active SLE (P < 0.05). The complement profiles of patients with clinically inactive SLE resembled those of CDLE patients more closely than those of active SLE patients.
Correlation between levels of breakdown products of C3, C4, and properdin factor b in synovial fluids from patients with rheumatoid arthritis
Authors: Perrin L. H. , Zubler R. H. , Nydegger U. E. , Lambert P. H. , Miescher P. A.
Published: February 2007

Synovial fluids from 31 patients with seropositive rheumatoid arthritis (RA) and 23 patients with seronegative RA had significantly increased levels of breakdown products of C3, C4, and properdin factor B when compared to patients with osteoarthritis (OA) (P < 0.01). The same patients exhibited a considerable overlap of native C3, C4, and properdin factor B levels when their results were compared with those of OA patients. The parallel increase of C3d, C4d, and Ba levels in patients with RA suggests an activation of the complement system rather than a nonspecific enzymatic breakdown in synovial fluids.
Intracellular collagen fibers at the pannus‐cartilage junction in rheumatoid arthritis
Authors: Harris Edward D. , Glauert Audrey M. , Murley Alan H. G.
Published: February 2007

Sections of the pannus‐articular cartilage junction from a patient with rheumatoid arthritis (RA) were prepared for electron microscopy. Cells at this interface contained membrane‐bound collagen fibrils, apparently in various stages of digestion. Previous studies have demonstrated intracellular collagen fibrils at sites of very active and rapid collagen resorption. It is suggested that at certain times in certain patients with RA, phagocytosis of cartilage collagen fragments and subsequent intracellular digestion may serve as a supplemental pathway to extracellular collagen degradation.
Azathioprine in early rheumatoid arthritis
Authors: Dwosh I. L. , Stein H. B. , Urowitz M. B. , Smythe H. A. , Ogryzlo M. A. , Hunter T.
Published: February 2007

This study compares the effect of azathioprine with those of gold and chloroquine in early (Class II) rheumatoid arthritis (RA). Thirty‐three similar patients with classic or definite RA of less than 5 years duration were randomly entered, 11 into each drug group. Assessment of standard clinical and laboratory measures at 12 and 24 weeks showed significant improvement in all three groups. In general, all three drugs were effective antirheumatic agents with low toxicity. However, because of serious potential toxicity, azathioprine could not be recommended over gold and chloroquine in early RA therapy.
Prostaglandin E1 treatment of NZB/NZW mice
Authors: Zurier Robert B. , Sayadoff Donna M. , Torrey Susan B. , Rothfield Naomi F.
Published: February 2007

NZB/NZW F1 hybrid mice were treated with pharmacologic doses of prostaglandin E1 (PGE1) (200 μg subcutaneously either once or twice daily) from 6 through 52 weeks of age. PGE1‐treated mice were protected against development of anemia, clinical nephritis, and death. At 52 weeks, 18 of 19 treated mice were alive, whereas only 2 of 19 untreated control mice were alive. None of the 10 mice treated with PGE1 twice daily exhibited significant (>2+) proteinuria at 1 year of age. PGE1 treatment did not prevent development of antibodies to nuclear antigens. The data also suggest that survival of NZB/NZW mice is prolonged when treatment with PGE1 is begun at 24 weeks, an age at which mice already show evidence of nephritis. Thus all 6 mice treated with PGE1 (200 μg sc twice daily) from 24 weeks were alive at 52 weeks, whereas only 2 of 6 untreated control mice were alive. The mechanisms whereby PGE1 treatment influences the course of disease in NZB/NZW mice are not known.
Multicenter evaluation of synovectomy in the treatment of rheumatoid arthritis
Authors:   ARTHRITIS FOUNDATION COMMITTEE ON EVALUATION OF SYNOVECTOMY
Published: February 2007

A controlled multicenter evaluation of synovectomy in the treatment of rheumatoid arthritis followed 59 patients for 3 years. Finger joints and knees were studied. After 1 year synovectomized joints were better than controls in several features. After 3 years these differences had disappeared in the fingers, but swelling remained less in synovectomized knees. Recurrences were as frequent in synovectomized as in control finger joints, but were slightly less frequent in synovectomized than in control knees. Radiologic bony erosions in fingers and knees of both groups progressed equally during the 3 years.
Carrageenin‐induced arthritis
Authors: Carmichael D. J. , Gillard G. C. , Lowther D. A. , Handley C. J. , Santer V. B.
Published: February 2007

A localized inflammatory response was initiated by both single and repeated injections of carrageenin into femorotibial joints. Histologic changes were observed 24 hours after a single intraarticular injection, and an inhibition in the in vitro rate of proteoglycan synthesis was detected 72 hours after the injection. This inhibition was relieved in vitro by the addition of β‐D‐xyloside, an exogenous initiator of glycosaminoglycan biosynthesis. Following repeated carrageenin injections, most cells appeared to be dead on histologic examination and no in vitro proteoglycan synthesis could be detected; nor could any stimulation be achieved by adding xyloside.
Renal localization of antiglobulins in glomerulonephritis and after renal transplantation
Authors: Rossen Roger D. , Rickaway Ruth H. , Reisberg Margaret A. , Singer Donald B. , Schloeder Francis X. , Suki Wadi N. , Hill L. Leighton , Eknoyan Garabed
Published: February 2007

Localization of fluorescein‐conjugated heat‐aggregated IgG (FA IgG) was demonstrated by immunofluorescence in renal glomeruli of 16 of 69 patients with glomerulonephritis. FA IgG bound more frequently in kidney biopsies from patients with diffuse glomerulonephritis and depressed renal function, and localized selectively in glomeruli that contained heavy deposits of IgM, C3, and C4. The factors that caused FA IgG to bind were specifically reactive with the Fc piece of the IgG molecule and were resistant to 56°C heat for 30 minutes. Localization of FA IgG in the kidney did not correlate with the presence of soluble immune complexes or detectable antiglobulin antibodies in the sera. Binding of FA IgG was also seen in glomeruli and arteries of 18 of 21 kidney allografts studied at the time of impending rejection. But the factors responsible for binding FA IgG in the allografts were heat labile and thus could have been Clq. Although the role of these “antiglobulins” in the immunobiology of glomerulonephritis remains unknown, the fact that they occurred mainly in patients with relatively severe glomerular injury suggests that they could play some part in promoting renal glomerular injury.
Macrophage migration inhibitory factor in rheumatoid pericarditis
Authors: Andreis Mario , Hurd Eric R.
Published: February 2007

The pericardial effusion in a case of rheumatoid pericarditis was studied to determine whether immune complexes and mediators of cellular immunity, represented by migration inhibitory factor (MIF), were present. MIF‐like activity was detected in the pericardial fluid, but only traces of immune complexes were revealed by ultracentrifugation. The MIF‐like activity was partially characterized by column fractionation and sugar inhibition tests. The role of lymphokines in the pathogenesis of this case of rheumatoid pericarditis is strongly suggested.
Cellular infiltrates in scleroderma skin
Authors: Fleischmajer R. , Perlish J. S. , Reeves J. R. T.
Published: February 2007

The purpose of this study was to determine the frequency, distribution, and nature of cellular infiltrates in 108 skin biopsies from patients with systemic scleroderma (SS) and localized scleroderma (LS). Cellular infiltrates, perivascular or diffuse, were noted in 49% of SS and 84% of LS patients and consisted of lymphocytes, plasma cells, and macrophages. No correlation was noted between the presence or severity of skin cellular infiltrates and serum serologic abnormalities.
Pathology of skeletal muscle in mixed connective tissue disease
Authors: Oxenhandler R. , Hart M. , Corman L. , Sharp G. , Adelstein E.
Published: February 2007

To characterize the pathology of muscle involvement in mixed connective tissue disease (MCTD), skeletal muscle biopsies from 13 patients with MCTD were examined by routine light microscopy, histochemistry, and direct immunofluorescence. The histologic and histochemical changes observed corresponded closely to changes seen in idiopathic polymyositis and the myopathy associated with systemic lupus erythematosus. Eight of 13 cases examined by direct immunofluorescence demonstrated immunoglobulin deposition either within normal appearing vessels, within normal fibers, around or on the sarcoplasmic membrane, or within the perimysial connective tissue. The histologic findings support Sharp's observation of the high incidence of focal inflammatory lesions in skeletal muscle biopsies of patients with MCTD. Immunoglobulin deposition in these muscle biopsies suggests an immunologic basis for the muscular symptomatology in MCTD.
Acute myocardial infarction following gold sodium thiomalate induced vasomotor (nitritoid) reaction
Authors: Gottlieb Norman L. , Brown Harvey E. ,
Published: February 2007

A vasomotor (nitritoid) reaction occurred following an initial injection of gold sodium thiomalate (GST; MyochrysineR) in a 69‐year‐old man with rheumatoid arthritis (RA). An acute anterior wall myocardial infarction, documented by serial electrocardiographic and serum enzyme changes, developed immediately thereafter. A second patient, a 49‐year‐old man with RA and a history of GST‐associated vasomotor reactions, was monitored clinically and electrocardiographically after GST administration. Sinus tachycardia developed and peripheral blood pressure fell within 2 minutes of injection, simultaneous with the onset of vasomotor symptoms. Vasomotor reactions from GST may compromise myocardial perfusion by their action on arteriolar smooth muscle, and thus result in peripheral vasodilatation, or they may act by adrenergic discharge initiated by such a reaction, and thus increase myocardial work and oxygen demand. Aurothioglucose (SolganalR), rarely produces vasomotor reactions, and may be preferred to GST in elderly RA patients with concomitant cardiovascular disease or atherosclerosis.
Brown's Syndrome
Authors: Killian Paul J. , Mcclain Bruce , Lawless Oliver J.
Published: February 2007

Two patients presented with an ocular complication of rheumatoid arthritis that was extraocular in location. Clinical manifestations include vertical diplopia, an intermittent nature, a clicking sensation, and apparent inferior oblique palsy. A stenosing tenovaginitis of the superior oblique tendon and its sheath is the probable underlying pathologic mechanism.
Relation Between HLA‐B27 and Clinical Features in Patients with Yersinia Arthritis
Authors: Laitinen Ossi , Leirisalo Marjatta , Skylv Grethe
Published: February 2007

A study of 74 yersinia arthritis patients implied that the clinical picture of the disease may be modified by genetic background associated with the histocompatibility antigen B27 (HLA‐B27). Sixty‐six percent of patients were B27 positive. Joint symptoms were somewhat more severe in B27+ patients. Iritis, conjunctivitis, carditis, signs of urologic inflammation, and complete Reiter's triad occurred only in the B27+ group, whereas erythema nodosum was more common in B27— group. Several B27+ patients also had “B27+ rheumatic diseases,” such as ankylosing spondylitis or Reiter's disease, in their history.
A Description of Rheumatology Practice
Authors: Healey Louis A.
Published: February 2007

Four rheumatologists kept a log of the diagnoses of all patients seen in their offices for 2 months. The great majority of patients had rheumatic complaints. Musculoskeletal pain syndromes and back syndromes were encountered most frequently; rheumatoid arthritis and osteoarthritis were also common. Patients with SLE and connective tissue diseases were relatively infrequent.
Family Study of Systemic Lupus Erythematosus
Authors: Lowenstein Mitchell B. , Rothfield Naomi F.
Published: February 2007

The clinical history, deposition of IgG, IgM, IgA, C3, C4, and properdin at the dermal‐epidermal junction (DEJ) of clinically normal skin, serum ANA, DNA‐binding, C3, C4, Factor B, and properdin were compared in 27 systemic lupus erythematosus (SLE) probands, 21 first‐degree household contact relatives (FDHCR), 19 first‐degree nonhousehold contact relatives (FDNHCR), 15 spouses, 26 controls, and 16 chronic discoid lupus erythematosus patients. Female consanguineous relatives of SLE patients had a higher incidence of rheumatic symptoms than male relatives (P < 0.01). Female FDHCR and male spouses had a higher incidence of protein deposition at the DEJ than sex‐matched controls (P = 0.026 and 0.0028). The incidence of protein deposition at the DEJ in FDNHCR did not differ from sex‐matched controls. ANA titers of the consanguineous relatives were significantly higher than those of the spouses or sex‐matched controls irrespective of household contact with their proband. The observation of protein deposition at the DEJ in normal appearing skin of FDHCR and spouses suggests the importance of environmental factors, whereas the elevations of ANA titers in consanguineous relatives suggests the importance of genetic factors in the pathogenesis of SLE.
The Activating Effect of Synovial Fluid and Washings of Synovial Membrane on Autologous Lymphocytes in Rheumatoid Arthritis
Authors: Sebŉk J. , Talerman A. , Wouters H. W. , Lems P. H.
Published: February 2007

The effect of synovial fluid and washings of synovial membrane on autologous lymphocytes from patients with rheumatoid arthritis and other diseases has been studied using a rapid method based upon the increase in intranuclear birefringence occurring in the early stages of lymphocyte activation. Retardation of polarized light indicating increased lymphocyte activation was seen in lymphocytes from patients with rheumatoid arthritis but not in lymphocytes from patients with other diseases.
Polyclonal Hyperviscosity Syndrome
Authors: Hadler Nortin M. , Gabriel Don , Chung K. Su , Teague Patricia , Napier Mary A.
Published: February 2007

The clinical course of two patients who presented with polyclonal hyperviscosity syndrome is described. Polymerizing IgG rheumatoid factors were isolated from the serum of both patients. The presence of these polymers with their extraordinary rheologic properties was the principal determinant of the abnormal rheological properties of the plasma. Neither patient had a discrete rheumatic disease. In both, a lymphoproliferative syndrome was present with features suggestive of the “pseudolymphoma” of Sjögren's syndrome.
Circulating immune complexes and antinuclear antibodies in juvenile rheumatoid arthritis
Authors: Rossen R. D. , Brewer E. J. , Person D. A. , Templeton J. W. , Lidsky M. D.
Published: February 2007

Materials with the Clq binding properties of soluble immune complexes (IC) were found in sera from 11 of 51 consecutive (22%) children with juvenile rheumatoid arthritis (JRA) and in 17 of 20 adults with active sero‐positive rheumatoid arthritis (RA). IC appeared more frequently in children with systemic onset disease whereas antinuclear antibody (ANA) was found more frequently in sera from those with pauciarticular disease. Only 3 JRA sera contained anti‐immunoglobulin (rheumatoid factor); those 3 also had high Clq binding activities. Seven of 50 patients (14%) carried HLA‐B27 but B27 was not associated with high Clq binding activity or presence of ANA. The presence of free ANA more frequently in children with mild disease and IC more frequently in children with relatively severe disease suggests that children with systemic JRA may have a relative defect in antibody‐forming capacity or reticuloendothelial function which results in decreased clearance of circulating IC. Alternatively, systemic, polyarticular, and pauciarticular JRA may represent a spectrum of clinically similar diseases resulting from different etiologic agents.
Adjuvant polyarthritis
Authors: Chang Yi‐Han , Hoffman William
Published: February 2007

Intraperitoneal administration of a relatively small volume (0.2 ml) of plasma obtained from Sindbis virus‐infected animals containing approximately 480 units of interferon/ml effectively suppressed the development of adjuvant arthritis. Similarly, administration of interferon (624 units/rat/day, ip) prepared in vitro by exposing rat embryo fibroblast culture to poly I:C in the presence of cycloheximide also suppressed the development of adjuvant arthritis without affecting the humoral or the cell‐mediated immune response. The findings provide circumstantial evidence to the speculation that a virus or a virus‐like organism plays a role in the pathogenesis of this disease.
Synovectomy and total joint arthroplasty for recurrent hemarthroses in the arthropathic joint in hemophilia
Authors: London James T. , Kattlove Herman , Louie James S. , Forster Gary L.
Published: February 2007

Severe hemophiliacs with intractable bleeding into one or more joints despite adequate clotting factor replacement therapy are difficult management problems. Synovectomy has controlled bleeding only in joints without significant arthritic destruction. Total joint replacements have been performed in arthropathic joints, but not when uncontrolled bleeding was a concurrent problem. This report describes a hemophiliac with uncontrolled bleeding into an arthritic knee who was successfully managed by combining synovectomy with total knee replacement.
Fat droplets and synovial fluid leukocytosis in traumatic arthritis
Authors: Graham Jimmy , Goldman John A.
Published: February 2007

The presence of fat droplets in synovial fluid signifies major or minor joint trauma with damage to the bones or adjacent supporting structures. Synovial fluids aspirated after traumatic hemorrhage usually have a low white blood cell count. In this report 2 patients with hemorrhagic effusions had synovial fluid leukocytosis, presumably secondary to lipid droplet phagocytosis. Lipid globules intra‐ and extracellulary in the synovial fluid and a top fatty layer in the hematrocit spin of the hemorrhagic synovial fluid are indications of the traumatic etiology of this inflammatory arthritis.
Susceptibility of rheumatoid and nonrheumatoid synovial cells to antibody‐dependent cell‐mediated cytotoxicity
Authors: Griffiths Marie M. , Smith Charles B. , Pepper Barbara J.
Published: February 2007

Fibroblastic cells derived from rheumatoid (RA) and nonrheumatoid (N‐RA) synovial tissue (synovial cells) were used as targets in assays of antibody‐dependent cell‐mediated cytotoxicity (ADCC). Synovial cells that had been pretreated with human alloantisera were rapidly lysed by normal human blood mononuclear cells. RA and N‐RA synovial cells were equally susceptible to ADCC under these assay conditions. Antibody to autologous synovial cells was not detected in sera from 10 patients with RA by this method of assay.
Serum antiimmunoglobulins reactive with human and rabbit igg in rheumatoid arthritis and other conditions
Authors: Stankaitiene Diana J. , Matulis Alfonsas A. , Guobys Henrikas , Jusenaite Janina P.
Published: February 2007

IgG, IgA, and IgM antiimmunoglobulins reactive with human and rabbit IgG were measured in patients with rheumatoid arthritis (RA), patients with rheumatic fever or osteoarthritis, and normal individuals. Values of all antiimmunoglobulins were significantly evaluated in RA patients as compared with other groups and depended upon activity and stage of the disease. IgM antibodies with specificity for human IgG predominated quantitatively over others in sera of RA patients with high titers of RF, whereas most of those reactive with rabbit IgG in latex negative or positive RA patients belonged to IgG class. The reaction with human IgG included thermostable and thermolabile IgM antiimmunoglobulins but in that with rabbit IgG only thermostable antibodies were active.
Proliferative synovitis in hemophilia. biochemical and morphologic observations
Authors: Mainardi Carlo L. , Levine Peter H. , Werb Zena , Harris Edward D.
Published: February 2007

The synovium removed from the knee of a 10‐year‐old with hemophilia A was characterized morphologically and biochemically. The specimen showed villous hypertrophy with hyperplasia of synovial lining cells which contained abundant intracytoplasmic granules of hemosiderin.

Monolayer cultures prepared from enzymatically dispersed tissue were characterized by pigment‐laden fibroblast‐like cells and round cells. Both explants of synovium and adherent cells secreted a large amount of latent collagenase and neutral proteinase into the culture medium. The secretion of these enzymes dropped sharply and intracellular pigment decreased with passage of these cultures. Lysozyme was secreted by the explants but was not detected in the monolayer culture medium. These data establish the degradative potential of the synovitis found in hemophilia and support the concept that recurrent hemarthrosis without inflammation is sufficient in and of itself to produce proliferative synovitis.
Shoulder swelling in rheumatoid arthritis secondary to subacromial bursitis
Authors: Huston Kent A. , Nelson Audrey M. , Hunder Gene G.
Published: February 2007

A patient with rheumatoid arthritis was seen whose main complaint was marked swelling of the shoulders. Surgical exploration revealed the swelling to be secondary to subacromial bursitis; the glenohumeral joint appeared normal.
Normal distribution of acetylation phenotypes in systemic lupus erythematosus
Authors: Vansant Johnathan , Woosley Raymond L. , John J. Thomas , Sergent John S.
Published: February 2007

Previous reports have indicated that idiopathic systemic lupus erythematosus (SLE), like drug‐induced lupus, is more frequent in “slow” hepatic acetylators. Using dapsone acetylation rate to determine phenotypes, we found that of the 18 SLE patients studied, 9 were fast acetylators, 8 were slow, and 1 was indeterminate. This result (53% fast) is similar to acetylator phenotypes in our normal controls (50% fast) and in the population at large (52%).
Automated rheumatoid factor assay in a population of patients with rheumatic disease
Authors: Gall Eric P. , Templin David W. , Dito William R.
Published: February 2007

Rheumatoid factor has been measured in 128 patients having rheumatic disease to compare the Singer‐Plotz assay with an automated particle size assay. Correlation coefficient between the two methods using regression analysis revealed r = 0.89, P < 0.00001 when two different commercial sources of sensitized latex particles were used. Thus rheumatoid factor may be quantitated electronically and represented in arbitrary units (MPRF) without altering clinical interpretation. This methodology may be applicable to many other immunologic assays.
Hyporesponsiveness of lymphocytes to virus antigens in rheumatoid arthritis
Authors: Wolf Robert E.
Published: February 2007

The immune response of peripheral blood lymphocytes to measles, rubella, parainfluenza types 1, 2, and 3 RNA virus antigens, and to varicella‐zoster and herpes virus type 1 DNA virus antigens was evaluated in 14 patients with rheumatoid arthritis (RA) and 14 matched controls by assessing 3H‐thymidine incorporation. The results demonstrated hyporesponsivenss of lymphocytes from RA patients to virus antigens and phytohemag‐glutinin (PHA), which did not appear to be nonspecific because of a lack of correlation between response to virus antigens and response to mitogens. The pattern of decreased responsiveness was suggestive of a relative restriction of hyporesponsiveness to RNA virus antigens.
Decreased Lymphocyte Response To Pha, Con‐A, And Calcium Ionophore (A23187) In Patients With Ra And Sle, And Reversal With Levamisole In Rheumatoid Arthritis
Authors: Scheinberg Morton A. , Santos Leonilda , Mendes Nelson F. , Musatti Chloé
Published: February 2007

The mechanism of poor lymphocyte transformation to mitogens was studied in selected patients with rheumatoid arthritis and systemic lupus erythematosus. Low lymphocyte response to PHA and Con‐A in media containing autologous and homologous sera was usually associated with poor response to the calcium ionophore A23187, which induces blastogenesis by a different mechanism. The low lymphocyte response to mitogens in patients with rheumatoid arthritis could be restored by in vivo treatment with the anthelmintic drug, levamisole. The present findings suggest that intrinsic defects are responsible for the decreased cellular response in patients with rheumatoid arthritis and systemic lupus erythematosus.
Relationship of Hla‐Dw3 and Hla‐B8 to Sjögren'S Syndrome
Authors: Fye Kenneth H. , Terasaki Paul I. , Michalski Joseph P. , Daniels Troy E. , Opelz Gerhard , Talal Norman
Published: February 2007

Nineteen patients with Sjögren's syndrome were evaluated for the presence of HLA‐B8 and HLA‐Dw3. HLA‐B8 was found in 57.8% of patients and 20.1% of 96 controls (P > 0.0001). HLA‐Dw3 was detected in 73.7% of the patients and 24.0% of controls (P > 0.00001). Statistical evaluation of the association of both antigens with Sjögren's syndrome revealed that the primary association was with HLA‐Dw3 (P > 0.005). Patients with HLA‐Dw3 had a lower mean parotid salivary flow rate (0.8 ± 0.3 ml/10 minutes/gland versus 5.6 ± 1.2 ml/10 minutes/gland, P < 0.00004) and a more intense lymphocytic infiltration into labial salivary glands (focus score 7.2 ± 0.9 versus 3.4 ± 0.9, P < 0.04) than did patients without HLA‐Dw3. The difference in the intensity of the lymphocytic infiltration was even more significant when patients with both HLA‐Dw3 and HLA‐B8 were compared with patients with neither antigen (focus score 7.5 ± 1.0 versus 2.8 ± 0.8, P < 0.02). In addition, all patients with severe keratoconjunctivitis sicca had both antigens. Our observations suggest that a number of genes may interact to determine susceptibility and severity in Sjögren's syndrome.
Rapid Assessment of 99MTc‐Pertechnetate Uptake in the Knee Joint as a Parameter of Inflammatory Activity
Authors: Boerbooms Agnes M. Th. , Buys Wil C. A. M.
Published: February 2007

Shortly after intravenous injection of 99mTechnetium‐pertechnetate (99mTcO4−)(200m̈Ci), the activity of the knee joints was studied in patients with clinical arthritis of one or both knees and compared with that in normal subjects. A rest period directly before the study improved reproducibility. The values found shortly after injection were comparable with measurements at the maximum. The significance of the 99mTcO4− uptake in comparison with the histologic findings in cases of doubtful arthritis was examined.
Idiopathic Multicentric Osteolysis
Authors: Whyte Michael P. , Murphy William A. , Kleerekoper Michael , Teitelbaum Steven L. , Avioli Louis V.
Published: February 2007

Genetic, rheumatologic, immunologic, metabolic, and renal studies of a father and son with idiopathic multicentric osteolysis are reported. The disorder appeared through mutation. The father developed symptoms as an infant, his son at age 4 years and 9 months. Both have micrognathia and hypotelorism and were exceptionally tall during the symptomatic phase of their disease. Biopsies of the son's wrist showed normal synovium, encroachment on cartilage by fibrocellular tissue, and both osteoclastic resorption and repair of affected bone. Hydroxyproline in his urine was increased. No immunologic, renal, or other metabolic abnormalities were identified.
Collagen in the cellular and fibrotic stages of scleroderma
Authors: Fleischmajer Raul , Gay Steffan , Meigel Wilhelm N. , Perlish Jerome S.
Published: February 2007

The collagen in localized and systemic scleroderma skin was studied by light microscopy with silver impregnation (50 patients), electron microscopy (14 patients), and immunofluorescence microscopy using specific antibodies against Type I and Type III collagens (12 patients). In the cellular stage, the dermis and adipose tissue revealed perivascular or diffuse cellular infiltrates (mostly lymphocytes, plasma cells, and macrophages), accompanied by deposition of Type III collagen. The lower dermis also showed an increase in Type III collagen. In the fibrotic stage, the papillary layer showed a reduction and/or clumping of Type III collagen as compared to normal skin. The lower dermis and the adipose tissue revealed compact collagen consisting exclusively of Type I collagen or a mixture of Type I and Type III collagen. The pattern of Type III collagen distribution was similar to that of reticulin, thus suggesting that at least some reticulin fibrils may represent Type III collagen.
Enhancement of urate solubility by connective tissue
Authors: Perricone Elaine , Brandt Kenneth D.
Published: February 2007

Proteoglycan aggregates (PGC) facilitated dissolution of 2½ times more sodium urate crystals than nonaggregated proteoglycans. This effect of aggregates on urate solubility was abolished by digestion of the aggregates with hyaluronic acid β1 ← 3 hydrolase. PGC, however, did not sustain urate concentrations in supersaturated solutions. Potassium urate was severalfold more soluble than sodium urate. In vivo, where they exist predominantly as their sodium salts in the extracellular connective tissue, proteoglycans may not markedly influence the solubility of sodium urate.
Chrysotherapy in psoriatic arthritis
Authors: Dorwart Bonnie B. , P. Gall Eric , Schumacher H. Ralph , Krauser Ronald E.
Published: February 2007

Chrysotherapy was given to 14 patients with refractory psoriatic polyarthritis and to a comparable group of 42 patients with rheumatoid arthritis. The psoriatic patients had a higher rate of remission on gold and less severe toxicity than the rheumatoid arthritis patients. Psoriatic skin lesions were not affected by chrysotherapy.
Electron microscopic morphology of immunoglobulin aggregates and their interactions in rheumatoid articular collagenous tissues
Authors: Ohno Osamu , Cooke T. Derek
Published: February 2007

Immunoelectron microscopy for IgG and IgA was combined with plain electron microscopy and light microscopy to study a variety of articular collagenous tissues from 14 cases of classic rheumatoid arthritis. Numerous extensive aggregates of IgG and IgA positive material were found widely spread in locations that coincided with immunofluorescent staining for these immunoglobulins and B1c. This Ig positive material is thought to represent deposits of immune complexes. As great and greater amounts were seen in fibrocartilage menisci as in hyaline cartilage. A single specimen of disease tendon was also positive. Severe pathologic changes of the matrix characterized by loss of normal morphology, alterations in collagen, and overall reduced density were observed in regions of aggregate deposition with a consistent replacement and disappearance of collagen in the locale of the aggregates themselves. Polymorphonuclear cells in regions of degraded hyaline and tendon matrix were seen to have phagocytosed aggregates. These data give some credence to a direct role of immune aggregates in rheumatoid arthritis articular collagenous tissues in disease pathogenesis.
A controlled study of ana+ rf‐ arthritis
Authors: Linn Julius E. , Hardin Joe G. , Halla James T.
Published: February 2007

Thirty (7.5%) of 401 adult rheumatoid arthritis (RA) patients were antinuclear antibody positive (ANA+) and rheumatoid factor negative (RF‐), and 15 of 16 patients who were followed for a year or longer remained so. Clinical, other laboratory, and radiographic parameters were compared among this group and 90 matched RA controls divided into ANA+RF+, ANA‐RF+, and ANA‐RF‐ groups. All groups were identical, except the ANA‐RF‐ group, which had significantly fewer nodules and less destructive disease than the other three.
The satellite arthritis clinic
Authors: Pinals Robert S.
Published: February 2007

For nine years an Arthritis Consultation Clinic has served a large community that did not have a rheumatologist. A university‐based rheumatology section from another city, a local hospital, the United Way, a chapter of the Arthritis Foundation, and the County Medical Society have all contributed to the operation of the clinic. Such a clinic may be viewed as a stage in the regional development of rheumatologic care. Although primarily intended as a community service program, the clinic may also be useful in professional education on several levels.
Boundary lubricating ability of synovial fluid in degenerative joint disease
Authors: Davis Warren H. , Lee S. L. , Sokoloff Leon
Published: February 2007

The boundary lubricating ability of eleven synovial fluids was measured in a miniaturized latex–glass test system. The specimens were obtained at necropsy from knees in which the degree of degenerative joint disease varied from none to very severe. The lubricating ability of the fluid was independent of the viscosity over a wide range of shear rates. It was not diminished even in advanced lesions. In two additional fluids, the mucin clot was poor; the lubricating ability of one of these was compromised. Thus, although degenerative joint disease, during its quiescent stages, is not associated with defective synovial lubrication, the possibility that transient defects might lead to cartilage wear during life has not been excluded. The measurements are believed to be valid indicators of boundary lubricating ability under physiological conditions despite the fact that the test surfaces were not cartilaginous and the loading was relatively low (up to 47 pounds per square inch).
Identification and characterization of two new soluble nuclear antigens reactive with sera of patients with connective tissue diseases
Authors: Miyawaki Shoji , Kohmoto Kiichi , Kurata Noriyuki , Ofuji Tadashi
Published: February 2007

Two antigens, temporarily referred to as MU and TM antigens after the original serum, that are closely related to the nucleolus have been identified in the nuclear soluble extract. Both antigens reacted with the sera of a small number of patients with various connective tissue diseases, and both were different from antigens described previously in these disorders. MU antigen was sensitive to the digestion with RNase and trypsin, and was shown to be equivalent to the nuclear ribosomal components in the nuclear extract. TM antigen was resistant to the digestion with RNase and trypsin, and was localized in the nucleolus and extranucleolar portion of nuclei, but the precise nature of TM has not been established.