bluuebunny/crossref_metadata_2025 huggingface dataset:
Cathepsin D Agglutinators and Neutral Protease Agglutinators in Rheumatoid Arthritis
Authors: Fehr K. , Artmann G. , Velvart M. , Bŉni A.
Published: February 2007

Tissue culture methods demonstrated the production of agglutinators against the cathepsin D site in IgG (CDA) and a neutral protease site in IgG (NPA) by rheumatoid synovial tissue. Seven of 11 specimens from seropositive and 2 of 7 specimens from seronegative RA patients were positive for CDA, whereas 2 of 11 specimens from seropositive and 1 of 7 specimens from seronegative patients were positive for NPA. None of the 6 control specimens was positive for both types of agglutinators. Chromatography of two synovial tissue incubates showed that the CDA were of the IgG type. By the immunofluorescence technique, plasma cells containing CDA were demonstrated in rheumatoid synovial tissue and draining lymph nodes of rheumatoid joints. The staining for CDA in the synovium was different from the staining for pepsin agglutinators in adjacent sections. Phagolysosomes containing CDA were found in synovial exudate cells from rheumatoid patients as well as in phagocytosing lining cells and macrophages of the sublining layer of rheumatoid synovial tissue. These findings suggest that antibodies directed at hidden antigenic sites in IgG revealed by endogenous proteolysis take part in the immune reaction and in the inflammation of rheumatoid joints.
Failure of Proteoglycans to Form Aggregates in Morphologically Normal Aged Human Hip Cartilage
Authors: Perricone Elaine , Palmoski Marshall J. , Brandt Kenneth D.
Published: February 2007

The macromolecular organization of proteoglycans in morphologically and histochemically normal hip cartilage from aged humans has been studied. In contrast to findings in articular and nonarticular cartilage from other sources, most of the proteoglycans in these tissues did not exist in large aggregates. Treatment with hyaluronic acid β1 → 3 hydrolase failed to diminish the size of proteoglycans prepared under conditions favoring aggregation, a finding suggesting that they were not complexed with hyaluronic acid. Polyacrylamide gel electrophoresis failed to demonstrate the presence of link glycoproteins associated with the proteoglycans. After incubation in vitro with hyaluronic acid, minimal augmentation of hydrodynamic size of the preparation occurred, an indication that hyaluronate‐proteoglycan interaction had not taken place. These results suggest that proteoglycan aggregation was diminished because of a defect in the core protein of the proteoglycans resulting in an impaired ability of these molecules to interact with hyaluronic acid.
Estimates of Doses of Antiinflammatory Drugs in Man by Testing for Analgesic Potency
Authors: Kantor T. G. , Streem A. , Laska E.
Published: February 2007

Dosage estimates of antiinflammatory drugs in human arthritis Phase II trials are difficult to obtain and prolong such trials unnecessarily. Antiinflammatory drugs almost always have analgesic properties in man and good dose estimates for analgesic activity can be obtained.

In 140 patients with surgical pain, 300, 600, and 1200 mg of aspirin were compared to 75, 150, and 300 mg of 43–715 (1–isopropyl–4 phenyl–7–methyl–2 (1H) quinazolone), an antiinflammatory quinazolone derivative, for analgesia in a double—blind trial using subjective response methodology. The test drug was shown to be analgesic at a level four times more potent, milligram for milligram, than aspirin, an estimate that should be useful for later definitive Phase II trials in arthritis.
Treatment of rheumatoid arthritis with levamisole
Authors: Runge Lorne A. , Pinals Robert S. , Lourie Seth H. , Tomar Russell H.
Published: February 2007

Levamisole, an anthelminthic agent with immuno‐stimulatory properties, was used in a double‐blind, controlled therapeutic trial in rheumatoid arthritis. Patients received either levamisole 100 mg 4 days a week, or placebo, for a period of 4 months. Significant improvement in the treated group, as compared with the control group, was found in the number of tender and swollen joints, grip strength, range of joint motion, sedimentation rate, and C‐reactive protein. On double‐blind global evaluation by the examining physicians, 9 of 14 patients on levamisole and none of 13 on placebo were considered to have improved. Adverse effects did not differ in frequency between the two groups except for mild alteration in taste, which was more common with levamisole.
Lymphocyte activation in rheumatoid synovial effusion
Authors: Sebök J. , Talerman A. , Wouters H. W.
Published: February 2007

A rapid method based upon increase in intranuclear birefringence occurring in early stages of lymphocyte activation was used to examine whether there is any difference in lymphocyte activation between lymphocytes from synovial fluid and those from peripheral blood in patients with rheumatoid arthritis and other joint diseases. Increased activation of synovial fluid lymphocytes compared with peripheral blood lymphocytes was seen only in synovial effusions obtained from patients with rheumatoid arthritis.
Septic arthritis of the glenohumeral joint
Authors: Master Robert , Weisman Michael H. , Armbuster Thomas G. , Slivka Jack , Resnick Donald , Goergen Thomas G.
Published: February 2007

Seven patients (eight shoulders) with sepsis of the glenohumeral joint were studied clinically and radio‐graphically. Despite the advanced age of the patients, the presence of gram‐negative organisms, and multiple risk factors in each patient (including serious chronic underlying diseases), needle drainage and parenteral antibiotics were all that were required for successful management, provided early diagnosis with prompt institution of antibiotics and drainage occurred. Contrast arthrography safely guided therapy and revealed rotator cuff tears in four of six shoulders as well as frequent extra‐articular extensions of the disease. A nonleukemic patient with Aero‐monas hydrophilia sepsis and arthritis is reported who survived with eradication of infection and preservation of joint function. A poor prognosis for shoulder sepsis is not substantiated.
Destruction of joint homografts
Authors: Yablon Isadore G. , Brandt Kenneth D. , Delellis Ronald , Covall David
Published: February 2007

The host synovium undergoes a striking transformation at about 26 weeks after joint homografting. Histologically the synovium invaded and destroyed the graft with which it came in contact, becoming markedly hypercellular; the infiltrate consisted mainly of plasma cells and lymphocytes. The synovium at this stage closely resembled a rheumatoid pannus. The cartilage in contact with this invasive synovium lost its staining qualities, failed to take up S‐35, and was gradually destroyed. The mechanism causing this transformation remains unclear. It is postulated that these changes could be due to an inflammatory or immune response.
Migrainous phenomena in systemic lupus erythematosus
Authors: Brandt Kenneth D. , Lessell Simmons
Published: February 2007

Eleven patients with systemic lupus erythematosus (SLE) also had headaches and/or visual hallucinations typical of those found in migraine. These migrainous symptoms were commonly associated with exacerbations of SLE and abated as disease activity subsided. In some cases corticosteroids were more effective than conventional antimigraine therapy in controlling headaches and scotomas. The data suggest that migraine‐like phenomena may arise as a result of vascular dysfunction in SLE.
Direct evidence for circulating dna/anti‐dna complexes in systemic lupus erythematosus
Authors: Davis John S. , Godfrey Stephania M. , Winfield John B.
Published: February 2007

Fifteen serum cryoprecipitates from 28 patients with systemic lupus erythematosus (SLE) contained DNA demonstrable by counterimmunoelectrophoresis after exhaustive digestion of cryoimmunoglobulin with pronase. The majority of these cryoprecipitates also exhibited increased DNA binding activity in a modified Farr assay. Both DNA and anti‐DNA antibody were enriched in the cryoprecipitates relative to the supernatant serum level. These data provide direct evidence for the presence of DNA/anti‐DNA complexes in the circulation of patients with SLE.
Association between HLA‐BW38 and peripheral psoriatic arthritis
Authors: Espinoza L.R. , Vasey F.B. , Oh J.H. , Wilkinson R. , Osterland C.K.
Published: February 2007

The frequency distribution of HLA antigens was studied in a group of psoriatic patients with and without arthritis. HLA‐BW38 was found significantly increased in the group with peripheral psoriatic arthritis. There were no differences in the clinical features of the arthritis in the BW38 positive (+) and BW38 negative (‐) individuals. It is suggested that BW38 is a genetic marker and/or an indicator of peripheral joint involvement in psoriatic patients.
Intratendon sheath corticosteroid treatment of rheumatoid arthritis‐associated and idiopathic hand flexor tenosynovitis
Authors: Gray Robert G. , Kiem Iris M. , Gottlieb Norman L.
Published: February 2007

Flexor tenosynovitis (FT) is a common manifestation of rheumatoid arthritis (RA), contributing to hand deformity and manual dysfunction. The efficacy of intratendon sheath corticosteroids was assessed by reviewing the results of such treatment in 173 episodes of FT documented in 46 patients with definite or classic RA. Ninety‐three percent of initial episodes resolved completely for 3 or more months (median: 25 months); tenosynovitis did not recur in 59%. The likelihood of a favorable response did not diminish with treatment of recurrent FT in a given digit. Comparable results were found in 52 FT episodes observed in 38 non‐RA patients. No tendon sheath or soft tissue infection or tendon rupture ensued in either treatment group. The response was influenced by the specific corticosteroid preparation selected. Based on this experience, a trial of intratendon sheath corticosteroid injections prior to surgical intervention is recommended for RA patients with FT.
Micromeasurement of plasma salicylate in arthritic children
Authors: Jacobs Jerry C. , Pesce Michael
Published: February 2007

A micromethod has been developed for determination of plasma salicylate. Frequent determinations of plasma salicylate levels in children with juvenile rheumatoid arthritis may be expected to provide greater therapeutic efficacy with reduced incidence of aspirin toxicity and consequently less need for use of secondary, more toxic, agents.
Methyl ester of n‐formylmethionyl‐leucyl‐phenylalanine. Chemotactic responses of human blood monocytes and inhibition of gold compounds
Authors: Ho Peter P. K. , Young Anna L. , Southard George L.
Published: February 2007

N‐formylmethionyl‐leucyl‐phenylalanine, a potent chemotactic peptide for human polymorphonuclear leukocytes, is less chemotactic for human blood monocytes. Esterification of the N‐formylated tripeptide enhances its chemotactic activity for monocytes by more than 4 logs, whereas a decrease by 3 logs is observed for polymorphonuclear leukocytes. These results indicate the participation of the C‐terminal carboxyl group in chemotaxis of different cell types. We have also observed the selective inhibition of chemotactic responsiveness of human blood monocytes by a clinically useful antirheumatic drug, sodium aurothiomalate. Since this is the first in vitro cell migration model of inflammation in which gold compounds have demonstrated activity in micromolar concentrations, it suggests a site of action for this antirheumatic drug.
Effect of altered lymphocyte function on immunologic disorders in nzb/nzw mice.
Authors: Mehta Jagdish , Knotts Linda , Craig Carolyn , Burkholder Sharon , Miller Christine , Hahn Bevra
Published: February 2007

Administration of thymosin fraction V to NZB/NZW F1 mice, an animal model for human SLE, accelerated the appearance of proteinuria and anti‐nDNA antibodies, increased deposition of immunoglobulins in kidneys, and significantly shortened survivals. Although the addition of thymosin to in vitro cultures of spleen and lymph node cells from thymosin‐treated mice increased DNA synthesis in response to stimulation with Con A, in vivo treatment with thymosin did not affect the Con A response. There was no effect on in vitro responses to PHA or LPS, or on IgM antibody formation to SRBC (T cell dependent) or SSS III (T cell independent) immunizations. Antibodies to thymosin or contamination of our thymosin preparations with nucleic acids could not be demonstrated. The acceleration of autoimmune disease produced by thymosin treatment could not be explained by alteration of the T and B cell functions studied.
Therapeutic studies in NZB/NZW mice.
Authors: Steinberg Alfred D. , Krakauer Randall , Reinertsen James L. , Klassen Lynell W. , Ilfeld David , Reeves J. Patton , Williams Gary W. , Antonovych Tatiana
Published: February 2007

Spleen cells from normal mice were cultured with Concanavalin A to produce an immunosuppressive supernate. This supernate was used to treat the lupus‐like autoimmune disease of NZB/NZW mice. Such treated mice lived significantly longer than did controls, but only if treatment was initiated early in the course of the illness.
Quantitative sacroiliac scintigraphy in patients with crohn' disease
Authors: Davis Paul , Thomson Alan B. R. , Lentle Brian C.
Published: February 2007

Sixty patients with Crohn' disease have been assessed radiologically and by quantitative sacroiliac scintigraphy for evidence of sacroilitis and/or ankylosing spondylitis. The incidence of radiologic sacroiliitis (11%) and ankylosing spondylitis (5%) was no greater in our series than previously reported. However, the incidence of increased uptake of radiotracer at the sacroiliac joints was 52%. There was no correlation in the group as a whole between radiologic and/or scintigraphic evidence of sacroiliitis and the tissue antigen HLA‐B27.
Demonstration of anticollagen antibodies in rheumatoid arthritis synovial fluids by 14c‐radioimmunoassay
Authors: Menzel Johannes , Steffen Carl , Kolarz Gernot , Kojer Marina , Smolen Josef
Published: February 2007

Twenty‐seven synovial fluids from rheumatoid arthritis (RA) patients and 17 synovial fluids from controls were investigated in a new radioimmunoassay for anticollagen antibodies. In vitro labeled human 14C‐collagen of type I in native or denatured state was used as antigen. Passive hemagglutination was used in comparison. Parameters for defining positive results in radioimmunoassay were evaluated on the basis of control synovial fluids. Synovial fluids from 20 RA patients (74%) showed antibodies to denatured collagen; synovial fluids from 8 RA patients (30%) also demonstrated antibodies to native collagen. Control fluids of posttraumatic effusions were negative; among the other controls synovial fluid from 1 psoriatic arthritis patient reacted positively. Inhibition experiments showed that antibodies to denatured collagen cross‐reacted with native collagen. Inhibition with human denatured type III collagen displayed strong cross‐reactivity of anti–type I collagen antibodies with type III collagen.
Vertebral sarcoidosis with paravertebral ossification
Authors: Perlman Susan G. , Damergis John , Witorsch Phillip , Cooney F. Donald , Gunther Stephen F. , Barth Werner F.
Published: February 2007

A young black male with sarcoidosis developed quadriplegia after a fall. Roentgenograms of the spine revealed extensive lytic and sclerotic changes with paravertebral bony bridges simulating ankylosing spondylitis. He recovered on corticosteroid therapy after laminectomy and cervical fusion. Review of the literature suggests that this case of vertebral sarcoidosis is the most severe yet reported and the first with paravertebral ossification.
Fibrinogen Turnover in Progressive Systemic Sclerosis
Authors: Gratwick Geoffrey M. , Klein Ronald , Sergent John S. , Christian Charles L.
Published: February 2007

Large amounts of fibrin are seen in the intima of the renal arterioles in progressive systemic sclerosis (scleroderma). The half‐life or half disappearance time of plasma fibrinogen in 15 patients with scleroderma was studied using 125I fibrinogen to find whether there is an increased turnover of plasma fibrinogen paralleling this morphologic abnormality. Patients had a more rapid fibrinogen turnover than normal controls (60.7 versus 90.6 hours); the subgroup of patients with “progressive” scleroderma had a more rapid fibrinogen half‐life than those with “stable” scleroderma (56.5 versus 73.2 hours). The mean fibrinogen half‐life of 8 patients given intravenous heparin increased to within one standard deviation of normal, a finding that suggested that the fibrinogen molecule in these patients was capable of normal survival. There was a considerable variation of fibrinogen half‐lives in individual scleroderma patients over time (not seen in the normal controls) which may be the result of intermittently increased fibrinogen consumption.
Total hip replacement in children with arthritis
Authors: Singsen B. H. , Isaacson A. S. , Bernstein B. H. , Patzakis M. J. , Kornreich H. K. , King K. K. , Hanson V.
Published: February 2007

Fourteen children with juvenile rheumatoid arthritis and two with ankylosing spondylitis received 29 total hip replacements (THR). The ages at THR were 12 to 18 years, the median duration of prior hip disease was 7.1 years, and the minimum followup was one year (range 1–4 years, median 2.2 years). The primary indication for THR was pain in 5 hips and severe malposition or flexion contractures in 24 hips. (Sixteen of these also had some degree of pain.) All 29 hips demonstrated improved postoperative range of motion, and all were free of pain. In children, active rheumatic disease in other joints, prosthesis longevity, and possible lack of adequate motivation all merit special consideration prior to THR, but the results are encouraging.
Inorganic pyrophosphatase activity of the synovial fluid.
Authors: Jacobelli Sergio , Kettlun Ana María , Sapag‐Hagar Mario
Published: February 2007

Inorganic pyrophosphatase activity has been partially characterized in joint fluid and determined in patients with sporadic and familial chondrocalcinosis and their controls. Optimal pH was established at 3.5 and Km values were estimated. Ca‐2 and Mg‐2 did not affect this activity whereas orthophosphate (Pi) strongly inhibited it. In the clinical study no significant differences were found among groups. This suggests that if a pyrophosphatase defect is present it might be localized in joint tissue and not be reflected in synovial fluid.
Vertebral ankylosing hyperostosis (forestier's disease) and hla antigens in pima indians
Authors: Spagnola Alan M. , Bennett Peter H. , Terasaki Paul I.
Published: February 2007

Vertebral ankylosing hyperostosis is a common skeletal disorder among Pima Indians. Prevalence rates of approximately 50% have been reported in Pima Indian males aged 55 or older. The HLA‐B27 antigen is also found more commonly in Pima Indians than in Caucasians (18% versus 6%). Because of the increased prevalence of both vertebral ankylosing hyperostosis and HLA‐B27 in Pima Indians, a possible association between the two was thought to exist. Therefore, histocompatibility testing was done on 44 adult male Pima Indians age 55 or older with classic vertebral ankylosing hyperostosis and 33 age‐matched controls. No significant association between any histocompatibility antigen phenotype or haplotype and vertebral ankylosing hyperostosis was found. This disease, therefore, cannot be classified with the HLA‐B27 associated spondylarthropathies.
Studies on heterophile antibodies in rheumatoid arthritis
Authors: Nishimaki Tomoe , Kano Kyoichi , Milgrom Felix
Published: February 2007

Sera and synovial fluids of patients with rheumatoid arthritis were studied for the presence of heterophile antibodies to sheep and bovine erythrocytes by means of hemolysis in agar gel. It was demonstrated that 18 of 146 sera had hemolytic antibody titers of 160 or more; all 18 (12%) against sheep and 8 (6%) against bovine erythrocytes. Of 31 synovial fluids examined, 5 showed hemolysin titers of 40 or more; all 5 (16%) against sheep and 3 (10%) against bovine erythrocytes. These heterophile antibodies were shown to belong to IgM and/or IgG class. Absorption and inhibition studies revealed that antibodies of 10 positive sera and 2 synovial fluids were of Forssman specificity and antibodies of 6 sera and 3 synovial fluids were of Hanganutziu‐Deicher specificity. Two remaining sera were shown to contain a mixture of Forssman antibodies and immune anti‐B antibodies.
Studies of immune functions of patients with systemic lupus erythematosus. i. dysfunction of suppressor t‐cell activity related to impaired generation of, rather than response to, suppressor cells
Authors: Sakane Tsuyoshi , Steinberg Alfred D. , Green Ira
Published: February 2007

T cell suppressor function in patients with systemic lupus erythematosus (SLE) was evaluated by studying the ability of concanavalin A‐ (Con A) activated T cells to suppress proliferative responses by responder cells autologous with the Con A‐activated T cells. Impaired suppressor T‐cell activity in patients with SLE was observed with regard to three effector functions: 1) the allogeneic response of T cells, 2) the Con A response of T cells, and 3) the B cell response to pokeweed mitogen (PWM). No defect was found with regard to suppression of the T‐cell response to phytohemagglutinin (PHA).

Mixing experiments between SLE and normal cells were carried out to further define the nature of the SLE suppressor defect. When responder cells from SLE patients were cultured with Con A‐activated T cells from normal controls, the normal suppressor T cells caused suppression of SLE responder cells. In contrast, Con A‐activated T cells from SLE patients were incapable of exerting suppressor effects on normal responder cells. These observations indicate that the impaired suppressor activity in SLE patients resides in the generation of suppressor T cells, rather than in the response to suppressor T cell signals.
Synovial fluid lactic acid. a diagnostic aid in septic arthritis
Authors: Brook Itzhak , Reza Michael J. , Bricknell Kenneth S. , Bluestone Rodney , Finegold Sydney M.
Published: February 2007

Lactic acid concentrations in the synovial fluid of 84 patients with acute monoarticular arthritis were determined by gas liquid chromatography. Lactic acid values in 27 cases of nongonococcal septic arthritis were strikingly higher (mean 1170 mg/100 ml) than in 45 cases of inflammatory or degenerative arthritis (mean 34 mg/100 ml), as well as in 12 cases of gonococcal arthritis (mean 27 mg/100 ml). With the proper equipment, determination of lactic acid can be a relatively rapid, reliable procedure. Synovial fluid lactic acid concentrations therefore can be used as a rapid, supplemental diagnostic aid in differentiating nongonococcal septic arthritis from both gonococcal and nonseptic acute arthritis.
Regional migratory osteoporosis. a denervation disease
Authors: Clay Mccord W. , Nies Kenneth M. , Campion David S. , Louie James S.
Published: February 2007

Regional migratory osteoporosis is an uncommon entity characterized by sudden attacks of migrating lower extremity paraarticular pain, local edema, and muscle atrophy; the disease is verified by radiologic demineralization and bone scan uptake. The etiology and pathogenesis are unknown. We describe a case of regional migratory osteoporosis followed over nine years by serial electromyographic studies documenting denervation patterns coincident in time and location of each acute attack. The substantiation of denervation in regional migratory osteoporosis is of both diagnostic and pathogenetic significance.
Search for type‐c oncornavirus–related genetic information in tissues from patients with systemic lupus erythematosus
Authors: Aulakh Gurmit S. , Hicks John T. , John Martin W. , Phillips Paul E.
Published: February 2007

Single‐stranded 3H‐DNA probes complementary to the RNA of Rauscher murine leukemia virus and of simian sarcoma virus were prepared using techniques that permitted complete transcription of the viral genome of each virus. These probes were used in DNA‐DNA hybridization studies with the cellular DNA from uncultured specimens of spleens and placentas of patients with systemic lupus erythematosus (SLE). No proviral DNA sequences related to these viruses were detected in these tissues. The results presented here do not support previously reported antigenic data implicating type‐C oncornavirus infection of these organs in SLE.
High prevalence of hla‐cw1 and cw2 antigens in spondylarthritis
Authors: Kozin Franklin , Duquesnoy Rene , Rodey Glenn E. , Lightfoot Robert W. , Ryan Lawrence M.
Published: February 2007

HLA‐B27 is frequently, but not invariably, found in patients with spondylarthritic diseases. Recently it has been shown that HLA‐C‐locus antigens w1 and w2 (w1/2) are in linkage disequilibrium with B27. A group of 139 patients with seronegative arthritis or spondylitis has been studied to determine the clinical and radiographic features associated with these antigens. An increased frequency of spondylarthritis was present in HLA‐B27‐negative, Cw1/2‐positive patients when compared with B27‐ and Cw1/2‐negative patients (P < 0.01). In addition, a large group of patients who did not fulfill accepted criteria for a specific spondylarthritic syndrome were identified; the frequency of both HLA‐B27 and Cw1/2 was greater in these individuals than in healthy blood donors. Thus HLA‐Cw1/2 are spondylitis‐associated antigens. These findings suggest that the critical genetic locus is neither B27 nor Cw1/2 but is a closely linked gene.
Effects of diphosphonates on glycosaminoglycan synthesis and proteoglycan aggregation in normal adult articular cartilage
Authors: Palmoski Marshall , Brandt Kenneth
Published: February 2007

The effects of disodium ethane‐1‐hydroxy‐1,1‐diphosphonate (EHDP) and disodium dichloromethylene diphosphonate (Cl2MDP) on glycosaminoglycan synthesis and macromolecular organization of proteoglycans have been examined in normal adult canine cartilage. One to 500 μM of either compound produced reversible inhibition of glycosaminoglycan synthesis to about 70% of control levels, whereas lower concentrations had no effect. Based on Sephadex G‐200 chromatography, the average hydro‐dynamic size of glycosaminoglycans in diphosphonate‐treated cartilage was similar to that of those in control cartilage. In most cases proteoglycan aggregates from diphosphonate‐treated cartilage were smaller in hydro‐dynamic size than those from control cartilage, as judged by Sepharose 2B elution profiles. The size of purified proteoglycan subunits, obtained after dissociation of the aggregates with 4 M guanidinium chloride or after incubation of the aggregates with hyaluronic acid β1 ← 3 hydrolase, was not affected by the diphosphonates. Furthermore, proteoglycans from diphosphonate‐treated cartilage did not interact in vitro with hyaluronic acid, suggesting that diminished proteoglycan aggregation may have resulted from an abnormality in the hyaluronate‐binding region of the proteoglycan core protein.
Reevaluation of the ammonium sulfate assay for dna antibody
Authors: Rubin Robert L. , Lafferty Joyce , Carr Ronald I.
Published: February 2007

The ammonium sulfate assay has recently come under criticism for alleged inability to detect low avidity antibody to DNA. The results of this study verify that a small percentage of antibody binding is not detected when this assay is performed under the conditions generally used. However, when the values obtained by the ammonium sulfate assay were compared to those obtained by other assays on sera of known avidity for DNA, it was concluded that ammonium sulfate does not selectively dissociate low avidity antibody from DNA. Conditions of incubation buffer and duration, pH, concentration of re‐actants, and molecular weight of the antigen are described for optimal detection of DNA antibody by the ammonium sulfate assay.
Demonstration of β1h globulin together with c3 in the dermal‐epidermal junction of patients with systemic lupus erythematosus
Authors: Carlo Jaime R. , Rothfield Naomi F. , Ruddy Shaun
Published: February 2007

Skin lesions and clinically normal skin from 10 patients with systemic lupus erythematosus (SLE) were examined by immunofluorescence for the presence of C3 and its control protein, β1H globulin. β1H was always found in association with deposited C3; in the instance where C3 deposits were not found β1H was also not found. Granular deposits of C3 and β1H were found in the dermal‐epidermal junction (DEJ) in all of the 5 nonlesional skins studied. In the lesional skin, C3 was found in 4 of 5; in 2 of these 4, β1H was also found. As previously demonstrated for in vitro systems, β1H also binds in vivo to fragments of C3, presumably C3b, generated during activation of the complement system.
Survey for immune complexes in disseminated gonococcal arthritis‐dermatitis syndrome
Authors: Ludivico Charles L. , Myers Allen R.
Published: February 2007

Seventeen patients with characteristic disseminated gonococcal arthritis‐dermatitis syndrome were studied for the presence of immune complexes, and circulating gonococcal antigen and antibody. The two immune complex techniques, monoclonal rheumatoid factor assay and cryoglobulin survey, did not reveal any consistent abnormalities. Complement levels (CH50, C″3, C″4) were not consistent with peripheral consumption except in 2 patients with coinciding systemic lupus erythematosus. Gonococcal antibody was detected in 47% of patients when they presented with the syndrome. However, gonococcal antigen was not found in either serum or synovial fluid. These results do not support the hypothesis that circulating immune complexes are involved in the pathogenesis of disseminated gonococcal arthritis‐dermatitis syndrome.
Lymphocytes from synovial tissue of a boy with x‐linked hypogammaglobulinemia and chronic polyarthritis
Authors: Abrahamsen Tore G. , Frøland Stig S. , Kåss Erik , Natvig Jacob B. , Pahle Jan
Published: February 2007

Lymphocytes were eluted from synovial tissue of a boy with X‐linked hypogammaglobulinemia and chronic polyarthritis. The cell suspension contained 53% lymphocytes and 28% peroxidase‐positive, macrophage‐like cells. No B lymphocytes, 83% T lymphocytes, and 10% Fc‐receptor‐bearing lymphocytes were detected. Lymphocyte transformation was induced by polyclonal mitogens (phytohemagglutinin and pokeweed mitogen) whereas no response to antigens (purified protein derivative and Candida albicans antigen) was obtained. The eluted cells displayed antibodydependent cytotoxicity.
Antibodies reacting with ribosomal ribonucleoprotein in connective tissue diseases
Authors: Miyachi Kiyomitsu , Tan Eng M.
Published: February 2007

Precipitating antibody to an antigen present in cytoplasm was detected in the sera of 7 patients with systemic lupus erythematosus, 1 patient with an overlap syndrome of systemic lupus erythematosus and rheumatoid arthritis, and 1 patient with mixed connective tissue disease. By physicochemical and enzymatic studies, the antigen was shown to have the properties of ribosomal ribonucleoprotein (r‐RNP). Cytoplasmic staining in immunofluorescence was observed with all the 9 sera containing antibodies to r‐RNP. In certain cases, cytoplasmic staining was associated with nucleolar staining. Antibody to r‐RNP is different in immunologic specificity and clinical significance from antibody to nuclear RNP and is present primarily in patients with systemic lupus erythematosus.
Differential sensitivity of functional subsets of t cells to the cytotoxicity of natural t‐lymphocytotoxic autoantibody of systemic lupus erythematosus
Authors: Koike Takao , Kobayashi Seiichi , Yoshiki Takashi , Itoh Tetsuo , Shirai Toshikazu
Published: February 2007

A naturally occurring T‐lymphocytotoxic autoantibody (Hu‐NTA) in serum from a patient with systemic lupus erythematosus (SLE) showed a differential cytotoxic effect on functionally different T cell subsets as did natural thymocytotoxic autoantibody (NTA) of NZB mice. When the normal peripheral blood lymphocytes were treated, in the presence of complement, with Hu‐NTA at a dilution that eliminated 25 to 30% of Hu‐NTA‐sensitive T cells, there was a marked reduction or a total depletion in the ability of resultant cells to show Con A‐activated suppression on the proliferative response of responder cells in mixed lymphocyte reaction. The treatment of PBL in the same manner also resulted in a marked reduction in its responsiveness to Con A and PHA. However, the responder cells to allogeneic stimulator cells in MLR were found to be much more resistant to the cytotoxicity of Hu‐NTA than other functional T cell subsets tested. These results suggest that Hu‐NTA is responsible for the selective loss of certain functional T cell subsets including suppressor T cells in patients with SLE.
Detection of intermediate complexes by evaluation of the difference between γ‐globulin and igg concentrations
Authors: Nardella Francis A. , Gilliland Bruce C. , Mannik Mart
Published: February 2007

A simple analysis based on techniques readily available in the routine clinical laboratory has been presented for identification of patients with moderate and high levels of intermediate complexes. If the γ‐globulin concentration determined by serum protein electrophoresis minus the IgG concentration determined by radial immunodiffusion exceeds 1.0 gm/dl, intermediate complexes of IgG should be present in concentrations greater than 0.5 gm/dl. In principle, any disease association with sufficient polymerization of IgG might cause an abnormal result with this analysis. Furthermore, sera from patients with liver disease and marked β‐γ bridging on electrophoresis may also give abnormal values.
Atlantoaxial subluxation as a complication of early ankylosing spondylitis
Authors: Sorin Steven , Askari Ali , Moskowitz Roland W.
Published: February 2007

Atlantoaxial subluxation is uncommon in ankylosing spondylitis, especially early in the course of the disease. Two patients are described in whom atlantoaxial subluxation occurred early in the course of otherwise typical ankylosing spondylitis. The presumed mechanism is localized synovitis producing laxity or rupture of the transverse ligament. Cervical roentgenograms in maximal flexion and extension are necessary to evaluate both the degree of subluxation and the risk of cord compression.
Comparison of Three Immunoassays for Immune Complexes in Rheumatoid Arthritis
Authors: Gupta Ramesh C. , Mcduffie Frederic C. , Huston Kent A. , Tappeiner Gerhard , Meurer Michael , Jordon Robert E. , Luthra Harvinder S. , Hunder Gene G. , Ilstrup Duane
Published: February 2007

Three widely used radioassays that depend on different principles for the measurement of circulating immune complexes (CIC) in biologic fluids are the monoclonal rheumatoid factor (mRF), Raji cell, and C1q binding tests. A comparison of the ability of these methods to measure immune complex‐like material in 71 sera and 30 synovial fluids of 91 patients with rheumatoid arthritis (RA) was carried out by a group working in adjacent laboratories in a single institution. The highest number of abnormal levels in the seropositive group was detected by the C1q binding assay (91%). Levels of CIC by the mRF and Raji cell tests were elevated in 81% and 76% of the patients, respectively. The closest correlation was between the Raji and mRF cell tests (r = 0.44 and P = 0.002) although one depends on complement fixation and one does not. Though significant correlations between the levels of CIC determined by the Clq test and either the mRF (P = 0.2) or Raji cell (P = 0.3) assay were not found in this group, 59% of the samples had elevated levels by all three tests. The frequency of CIC in the sera of patients with seronegative RA was much lower, with the Clq test again giving the highest number of abnormal results (29% versus 16% and 12% for the Raji and mRF tests). In view of the technical problems associated with these tests, particularly lack of a uniform reliable standard, it is likely that all three tests measure the same material in most RA sera and that some of the differences observed are related to inherent variability in the tests themselves rather than intrinsic differences among the CIC detected in these samples.
Congenital Contractual Arachnodactyly
Authors: Mirise Raymond T. , Shear Stuart
Published: February 2007

A previously unreported case of congenital contractural arachnodactyly (CCA) is described. This hereditary connective tissue abnormality resembles Marfan's syndrome in certain respects, but is characterized by camptodactyly rather than joint laxity, as well as by congenital contractural deformities of the knees and elbows. In addition, there is a peculiar, fairly characteristic deformity of the external ear. Like Marfan's syndrome, it is transmitted in autosomal dominant fashion. Despite the superficial skeletal resemblance, however, the cardiovascular and ocular complications of Marfan's do not seem to occur and therefore differentiation of the two syndromes is important.
Acute Metabolic Effects of Nitrogen Mustard and Thiotepa on Rabbit Articular Cartilage and Synovium
Authors: Mankin Henry J. , Lippiello Louis
Published: February 2007

Metabolic alterations in immature rabbit joint tissues were examined following in vitro and in vivo exposure to the alkylating agents Thiotepa and nitrogen mustard. Brief exposure in vitro to either agent resulted in marked suppression of incorporation of radiolabeled precursors of protein, RNA, and glycosaminoglycan synthesis in articular cartilage, which was partially reversible after Thiotepa exposure. In vivo, nitrogen mustard had little effect on synovium and transient inhibitory effects on cartilage vital processes, whereas Thiotepa caused a prolonged inhibition of synovial metabolism with little effect on cartilage. Autoradiographic localization of labeled agents indicated that synovial tissue and cartilage were readily penetrated by nitrogen mustard, but only a few synovial lining cells and superficial chondrocytes were labeled with 35S‐Thiotepa. Furthermore, trypsin significantly reduced labeling of cartilage with 14C‐nitrogen mustard. These data suggest that alkylating agents differentially affect metabolic processes in joint tissues in vivo and that with Thiotepa, this interference occurs primarily in the synovium. The degree of interference is apparently dependent upon time of exposure to the agents and the relative DNA‐RNA synthetic activity of the joint tissue.
Synovial permeability in rheumatoid arthritis
Authors: Simkin Peter A. , Pizzorno Joseph E.
Published: February 2007

In patients with rheumatoid arthritis, as well as in persons with other kinds of synovitis, proteins enter the knee joint more rapidly than in normal individuals (P < 0.001). The rheumatoid synovium, however, is less permeable to small molecules (tritiated water, P < 0.02; urate, P < 0.05; and glucose, P < 0.002) than is the normal joint lining. This difference is explained if rheumatoid microvascular changes enhance synovial permeability to proteins while coexisting interstitial changes diminish synovial permeability to smaller molecules.
Increased C1q binding immune complexes in felty's syndrome
Authors: Hurd Eric R. , Chubick Andrew , Jasin Hugo E. , Ziff Morris
Published: February 2007

Sera from patients with Felty's syndrome (FS) and rheumatoid arthritis (RA) were examined for the presence of circulating immune complexes (IC) by using the 125I‐C1q binding and monoclonal rheumatoid factor (mRF) techniques. Of 15 patients with FS, 9 (60%) had high 125I‐C1q binding as compared to 3 of 26 RA patients (12%). The average C1q binding was significantly higher in the FS patients than in the RA patients without FS. C1q binding in both FS and RA patients was significantly higher than a group of 90 normal controls. In addition, serum C4 levels were significantly lower in the FS patients than in the RA patients. In contrast to these findings, IC levels in FS and RA patients were very similar when measured by the mRF technique. These studies indicate that FS patients have higher levels of complement‐fixing IC in their sera than RA patients without FS. These findings raise the possibility that the complement‐fixing IC found in these patients may play a role in the pathogenesis of the neutropenia of FS.
Arthritis associated with jejunoileal bypass
Authors: Zapanta Merle , Aldo‐Benson Marlene , Biegel Angenieta , Madura James
Published: February 2007

Arthritis is a common complication of small bowel bypass, occurring in 5–20% of the postsurgical patients. Thirteen patients with arthritis related to jejunoileal bypass were studied. These patients had a symmetrical polyarthritis, and 8 also had extraarticular connective tissue disease manifestations. Immunologic evaluations were done on these patients and on a control group of 12 age‐ and sex‐matched postintestinal bypass patients without arthritis. The incidence of positive ANA, rheumatoid factors, immune complexes, and antibodies to intestinal flora was the same in both groups. Patients in both groups showed similar changes in numbers of circulating T and B lymphocytes. More patients in the group with arthritis than in the control group had elevated IgA levels (38% versus 8%), but the difference was not significant (P > 0.05). This study demonstrates that immunologic abnormalities occur after jejeunoileal bypass irrespective of the onset of arthritis or related symptoms. No specific immunologic abnormalities could be associated with the arthritis occurring after small bowel bypass.
Clearance of calcium pyrophosphate dihydrate crystals in vivo
Authors: Mccarty Daniel J. , Palmer David W. , Halverson Paul B.
Published: February 2007

Synthetic triclinic calcium pyrophosphate dihydrate crystals were uniformly trace‐labeled with Ytterbium‐169 (169Yb), a pure gamma‐emitting isotope with a halflife of 31 days. The solubility of the labeled crystals was similar to that of cold synthetic crystals. The clearance rate of labeled sterile crystals, sieved to obtain the desired size, was determined after injection of microgram quantities into 4 arthritic human and 3 normal adult rabbit joints and corrected by the observed rate of clearance of free 169Yb. The derived rate constants were then used to calculate the time required for half of the injected dose of CPPD to be cleared from the joint. Crystal clearance was found in all instances. Crystal removal from normal rabbit joints was much more rapid than from the much larger human arthritic joints and was inversely proportional to the size of the crystals injected.
EFFECT OF SALICYLATE ON PROTEOGLYCAN METABOLISM IN NORMAL CANINE ARTICULAR CARTILAGE IN VITRO
Authors: Palmoski Marshall J. , Brandt Kenneth D.
Published: February 2007

In osteoarthritis, diminished aggregation of articular cartilage proteoglycans affects tissue biomechanics. Since salicylates are commonly employed in treatment of osteoarthritis, we examined the effect of sodium salicylate on proteoglycan metabolism and aggregation in normal canine articular cartilage. At salicylate concentrations of 10−3 M, 5 x 10−3 M and 10−2 M, net proteoglycan synthesis in normal canine articular cartilage was 73%, 42%, and 16%, respectively, of control levels. Catabolism of glycosaminoglycans in the presence of 10−3 M salicylate (which corresponds to a serum salicylate level of 20–25 mg %) was the same as that in control cartilage, while higher concentrations of the drug increased the rate of degradation. The hydrodynamic size of newly synthesized proteoglycan aggregates and of disaggregated proteoglycans was unaffected by sodium salicylate.
Continuing education in rheumatoid arthritis for the primary care physician
Authors: Stross Jeoffrey K. , Bole Giles G.
Published: February 2007

An educational program in rheumatoid arthritis was developed for primary care practitioners. This program is community based and utilizes physicians, identified by their peers as being influential, for the dissemination of information. A marked change in knowledge has been noted in those completing the program, but further followup is needed to determine if a change in the care of patients with rheumatoid arthritis will also result.
Disappearing lumbar hyperostosis in a patient with forestier's disease: An ominous sign
Authors: Chaiton Abe , Fam Adel , Charles Bruce
Published: February 2007

Forestier's disease, ankylosing hyperostosis of the spine, or diffuse idiopathic skeletal hyperostosis (DISH), is a relatively common disorder affecting middle aged and elderly individuals (1–11). It is characterized by a distinctive type of spinal ossification. Extraspinal heterotropic ossifications at sites of ligamentous and tendinous attachments are not uncommon (2,4,7,9–11). Although frequently asymptomatic, many patients complain of spinal stiffness and backache (2,4,9,11). Pathologic and radiologic studies have shown that the abnormal ossification process is a slowly progressive one, which may take several years for its completion (2,5,8,11).

We report here a 77‐year‐old man who developed progressive backache which was initially thought to result from advanced diffuse idiopathic skeletal hyperostosis. Serial radiographs, however, showed progressive disappearance of the distinctive lumbar hyperostosis. He was later discovered to have a leaking abdominal aortic aneurysm.
Pharmacokinetic monitoring of salicylate therapy in children with juvenile rheumatoid arthritis
Authors: Pachman Lauren M. , Olufs Richard , Procknal Josephine A. , Levy Gerhard
Published: February 2007

Free and total (sum of free and protein bound) salicylate concentrations in serum were determined in 17 children (age: 4–17 years) with definite juvenile rheumatoid arthritis. These measurements were carried out immediately before and 2,4, and 8 hours after the morning dose during a strict 8 hourly aspirin treatment regimen (regular tablets) started 5 days earlier. The ratio of the 0 to 8 hour total salicylate concentrations was 0.95 ± 0.10 (mean ± SD), indicating that steady state had been attained. The ratio of the maximum to minimum concentrations during the dosing interval ranged from 1.05 to 2.26 and decreased with increasing average concentration. The concentration ratio was less than 1.3 at average salicylate concentrations above 20 mg/100 ml. It is concluded that the timing of a blood sample is not critical for monitoring steady state serum salicylate concentrations in the usual therapeutic range if the dosing interval is 8 hours or less. Free salicylate concentrations increased more than proportionately with increasing total concentrations due to the concentration dependent protein binding of the drug in serum.
Search for epstein‐barr and type c oncornaviruses in systemic lupus erythematosus
Authors: Hicks John T. , Aulakh Gurmit S. , Mcgrath Philip P. , Washington Glennelle C. , Kim Elizabeth , Alepa F. Paul
Published: February 2007

Lymphoblastoid cell lines were derived from patients with active systemic lupus erythematosus by allowing spontaneous transformation of peripheral B lymphocytes (B cells) harboring endogenous Epstein‐Barr virus or by superinfecting peripheral lymphocytes with exogeneous Epstein‐Barr virus. Results of extensive studies aimed at identifying type C oncornaviruses in these lymphoblastoid cells were entirely negative by electron microscopy, DNA‐DNA hybridization, reverse transcriptase assays, and cocultivation experiments. These results do not support the postulated association of oncornavirus infection in human systemic erythematosus.