bluuebunny/crossref_metadata_2025 huggingface dataset:
Infected synovial cysts arising as a complication of septic arthritis in a patient with rheumatoid arthritis
Authors: Hall Anthony P. , Healey L. A.
Published: February 2007

An elderly man with rheumatoid arthritis developed a streptococcal septicemia and arthritis following excision of an elbow nodule. His left calf became swollen; thrombophlebitis was initially diagnosed, but pus was aspirated from the calf and elbow and arthrograms showed large synovial cysts in both locations. The importance of aspirating any unusual calf swelling is emphasized.
Bertram M. Gesner, 1931–1968
Authors: Weissmann Gerald , Franklin Edward C. , Uhr Jonathan W.
Published: February 2007

‘Medicine does not end in hospitals, as is often believed, but merely begins there. In leaving the hospital, a physician, jealous of his title in its scientific sense, must go into the laboratory; and there by experiments on animals he will seek to account for what he has observed in his patient. There, in a word, he will achieve true medical science.”—Claude Bernard, 1865
Osteoarthritis of the Fingers with Ankylosis
Authors: Mcewen Currier
Published: February 2007

Case reports are presented of 4 patients with what appeared to be quite usual Heberden's nodes with comparable involvement of proximal interphalangeal joints, but which progressed to erosive osteoarthritis resulting eventually in bony ankylosis of some distal and proximal joints.
The Glycosaminoglycans of the Human Joint Capsule: Isolation and Characterization
Authors: Heinegård D. , Hernborg J. , Lundberg B. J.
Published: February 2007

In human osteoarthritic knee joint capsules the total concentration of hexosamine and the concentration as hexosamine of the glycosaminoglycans was found to be 1.1 per cent and 0.2 per cent of tissue dry weight respectively. The cetylpyridinium chloride fractionation pattern indicated no major differences in comparison with normal capsules. When identified on a small level the results correlated rather well with the macro‐level analysis. Hyaluronic acid, chondroitin‐6 sulfate and dermatan sulfate could be identified whereas keratan sulfate was a minor component in the capsular digest. Another minor component which could not be conclusively identified might be heparan sulfate. Data suggestive of DS‐CS hybrids were present.
Vasculitis of the Breasts
Authors: Mccarty Daniel J. , Imbrigia Joseph , Hung Jean K.
Published: February 2007

A unique case of a 66‐year‐old white woman with multiple tender lumps in both breasts due to vasculitis has been presented. The features differentiating this case from giant cell arteritis and superficial thrombophlebitis of the chest wall (Mondor's Disease) are reviewed.
Resorption of the terminal phalanges in scleroderma
Authors: Scharer Lawrence , Smith Donald W. , Rodan Gerald P. , Holling H. Edward , Scharer Lawrece , Smith Donald W.
Published: February 2007

A case of Raynaud's phenomenon and scleroderma in a 54‐year‐old woman is reported. One of the patient's fingers had been reattached surgically after being partially amputated in a childhood accident. When sensitivity to cold and scleroderma began in later life, this finger was not affected. The circulation in all fingers was impaired, and all but the “amputated” finger showed roentgenographic evidence of severe resorption of terminal phalangeal bone.
Mycoplasmas and arthritis
Authors: Sharp John T.
Published: February 2007

The role of mycoplasmal infection in human beings with rheumatoid arthritis and Reiter's syndrome was studied by three methods. First, specimens of synovial fluid were inoculated directly onto mycoplasmal media, and after appropriate incubation, examined for growth of mycoplasmal colonies. Second, synovial fluids were inoculated into embryonated hens' eggs and, after incubation, reacted with patients' sera using radioiodine‐tagged antihuman globulin to detect binding of antibody. Third, a sensitive growth‐inhibition technic was employed for measuring antibody to mycoplasmas in the patients' sera. None of these methods provided evidence that mycoplasmal infection is a cause of rheumatoid arthritis or Reiter's syndrome.
Subchondral bone changes in patients with early degenerative joint disease
Authors: Radin Eric L. , Paul Igor L. , Tolkoff Marc J.
Published: February 2007

The relationship between early degeneration of articular cartilage and the energyabsorbing abilities of its subchondral bony bed was studied in specimens obtained at autopsy from the knees of 43 male patients. Subchondral bone plugs from patients whose cartilage had only mild mucopolysaccharide loss absorbed relatively less energy on impact than the normals. There was no apparent difference in energy absorption among the bone plugs of the normal, the moderate, and the markedly altered cartilage groups. These changes were not age related.
Sickle cell‐thalassemia presenting as arthritis of the hip
Authors: Hurwitz David , Roth Henry
Published: February 2007

Avascular necrosis of the humeral and femoral heads is reported in an otherwise asymptomatic 69‐year‐old woman with sickle cell‐thalassemia. Ten previously reported instances of avascular necrosis in patients with sickle cell‐thalassemia are briefly reviewed.
Synovial fluid findings in systemic lupus erythematosus (SLE)
Authors: Pekin Thomas J. , Zvaifler Nathan J.
Published: February 2007

Synovial fluids from 26 patients with SLE were usually clear and viscous, with few WBCs and low complement. Twelve fluids, studied in detail, were further characterized according to protein and IgG concentrations. Four were transudates. Fluids from 3 subjects with atypical features of SLE were exudates that contained increased concentrations of proteins and complement. Five other fluids were exudates with very low complement, thus similar to rheumatoid effusions, but lacking the polymorphonuclear leukocytosis and rheumatoid factor found in RA.
Epidemiologic studies on systemic lupus erythematosus comparative data for new york city and jefferson county, alabama, 1956–1965
Authors: Siegel Morris , Holley Howard L. , Lee Stanley L.
Published: February 2007

A comparative population study on SLE from 1956–1965 revealed higher attack rates in New York City than in Jefferson County, Ala. The difference was attributed to more complete case‐finding in New York rather than to regional differences in predisposing factors. In both localities, incidence, prevalence and mortality rates were approximately three times higher for Negro females than for whites. In males, however, few cases were observed, and ethnic differences were considered equivocal.
Response of Joints to Impact Loading. I. In Vitro Wear
Authors: Radin Eric L. , Paul Igor L.
Published: February 2007

Bovine joints were oscillated under the maximum possible static load in a device which measured their coefficients of fraction while the joints were running. Joint wear was evaluated by gross and histologic inspection. Joints oscillating under loads, just below the structural capability of the joints, did not show significant wear even after long periods of time. When periodic impact loading was added to this regimen, cartilage wear became rapid and was easily discernible. The implications of these findings to the wearing away of articular cartilage are discussed.
Ultrastructural studies of renal peritubular amyloid experimentally induced in guinea pigs. II. Tubular epithelial cells
Authors: Cohen Alan S. , Shirahama Tsuranobu
Published: February 2007

The ultrastructure of cells of the renal tubule and its relationship to subepithelial amyloid deposits were studied in experimentally induced amyloidosis in guinea pigs. Amyloid fibrils were demarcated primarily between the epithelial cell and its basement membrane. Basal plasmalemmal infoldings were diminished whenever the cell abutted amyloid. Pocket‐like plasmalemmal invaginations, associated with tufts of well‐oriented amyloid fibrils, were found occasionally. Intracellular membrane‐bound amyloid fibrils, fibrils in the extracellular space between two epithelial plasma membranes, and fibrils surrounded by basement membrane were also seen on rare occasions. These findings are discussed in relation to clinical features of renal amyloidosis.
Demonstration of dissecting popliteal cysts by joint scans after intra‐articular isotope injections
Authors: Levin Melvin H. , Nordyke Robert A. , Ball James J.
Published: February 2007

A new technic to demonstrate dissecting popliteal cysts of the knee is described utilizing 10 to 50 μCi (average 40) of 131I HSA intra‐articularly. In thirty‐seven scans of 26 patients, nine instances of dissecting cysts were noted. These occurred most often in rheumatoid arthritis. The importance of clinical differentiation from thrombophlebitis is emphasized. The demonstration of dissecting popliteal cysts utilizing tracer doses of 131I HSA has been found to be simple, safe and useful.
Observations on the eosinophilia of certain patients with rheumatoid arthritis
Authors: Winchester R. J. , Litwin S. D. , Koffler D. , Kunkel H. G.
Published: February 2007

In a retrospective study of 45 cases of rheumatoid arthritis selected for their severity or for elevated titers of rheumatoid factor, unexplained eosinophile counts of 5% or greater were encountered in 40%. Certain extra‐articular manifestations of rheumatoid arthritis were found in higher incidence in the group of patients with eosinophilia. The most notable of these were vasculitis, pleuropericarditis, pulmonary fibrosis and subcutaneous nodules. The eosinophilia was present for variable periods of time, sometimes persisting at elevated levels for several years or alternatively appearing in brief episodes. In a number of patients, the appearance in time of some extra‐articular manifestations was coincident with eosinophilia. Two patients had extreme elevations in the number of eosinophiles. The eosinophiles of one patient, studied in detail, showed inclusions, which by immunofluorescent microscopy, contained γG‐globulin, γM‐globulin and rheumatoid factor. The serum of this patient when incubated with another eosinophile preparation induced the formation of inclusions. Various mechanisms were discussed in which the eosinophilia is related to possible immune events occurring in the course of rheumatoid arthritis.
Studies of antilymphocyte antisera produced against normal and rheumatoid arthritis lymphocytes
Authors: Williams Ralph C. , Emmons Jean D. , Astorga Gonzalo P.
Published: February 2007

Rabbit antisera were made against pooled normal human lymphocytes and against those from patients with active rheumatoid arthritis. Sera were subsequently absorbed to remove antibody to human erythrocytes and plasma proteins. Most antilymphocyte antisera showed considerable cytotoxic or complement fixing antibody after immunization, however a striking deficit (6 of 12 animals) in the activity of the antisera against RA lymphocytes was noted when blast transformation of lymphocytes was used as a test of antilymphocyte serum (ALS) antibody.
Methods of scoring the progression of radiologic changes in rheumatoid arthritis. Correlation of radiologic, clinical and laboratory abnormalities
Authors: Sharp John T. , Lidsky Martin D. , Collins Lois C. , Moreland June
Published: February 2007

Methods of scoring osseous defects and joint space narrowing in the hands and wrists of patients with definite or classical rheumatoid arthritis were devised. The usefulness of the scores was tested in a group of 90 patients who had one or more sets of X‐ray films of the hands and wrists 36 months or more after onset of illness. Correlations were found between the extent of radiographic abnormalities or the rate of progression of radiographic changes and the age at onset, hand and wrist deformities, preceding physical signs of inflammation in the joints of the hands and wrists, hand function as measured by fist formation, the early appearance of subcutaneous nodules, and the titer of anti‐IgG. Among black patients the extent of elevation of γ‐globulins was associated with roentgenographic changes. The correlations between the scores of radiologic abnormalities and the clinical and laboratory manifestations of rheumatoid arthritis establish the value of the described methods of assessing the roentgenographic changes and indicate the usefulness of these methods in evaluating the effect of therapy in this disease.
Tetracycline in the treatment of rheumatoid arthritis. A double blind controlled study
Authors: Skinner Martha , Cathcart Edgar S. , Mills John A. , Pinals Robert S.
Published: February 2007

Mycoplasmas have been implicated as etiologic agents in rheumatoid arthritis and it has been suggested that tetracycline, which inhibits the growth of these organisms, is beneficial in the treatment of this disease. To test this hypothesis, 27 patients with classical or definite rheumatoid arthritis were selected from three university hospital arthritis clinics and assigned at random to treatment for one year with either tetracycline 250 mg/day or a placebo. The results demonstrated no significant benefit from tetracycline therapy.
Reiter's syndrome in children. A case report and review
Authors: Lockie George N. , Hunder Gene G.
Published: February 2007

A case of Reiter's syndrome in a 3‐year‐old boy is reported. No recurrence developed during the following 10 years. A review of previous cases of Reiter's syndrome in children suggests that although this disease is uncommon in children, the findings were similar to those seen in adults.
Rheumatic disease sera reactive with capillaries in the mouse kidney
Authors: Tan Eng M. , Pearson Carl M.
Published: February 2007

With an immunofluorescent technic using tissue sections of mouse kidney as substrate, sera from patients with rheumatic diseases reacted with glomerular and peritubular capillaries. The reactive factor in sera was shown to be IgG and was able to fix complement in the reaction. Capillary reactivity was frequently detected in rheumatic diseases associated with vascular lesions of undetermined etiology such as dermatopolymyositis, scleroderma, polymyalgia and temporal arteritis. It was present in lower incidence in other rheumatic diseases and in normal populations.
Studies on experimental arthritis induced by Corynebacterium rubrum. 1. Localization of the arthritogenic factor in the cell walls
Authors: Paronetto Fiorenzo
Published: February 2007

Purified cell walls of Corynebacterium rubrum injected intradermally into rats together with mineral oil induce a severe progressive form of arthritis. The arthritogenic factor contains glucosamine, muramic acid, and several amino acids. It is resistant to digestion with proteolytic enzymes and to extraction with alcoholether, chloroform, and phenol, but is lost after digestion with lysozyme. These findings suggest a link between the cell wall of Corynebacterium rubrum—most likely a mucopeptide—and the development of arthritis.
Lysosome stabilization by adjuvant arthritis serum
Authors: Persellin Robert H.
Published: February 2007

Evidence is presented that serum from rats with adjuvant arthritis stabilizes the membranes of isolated normal rat liver lysosomes. The stabilizer retarded the release of the lysosomal enzymes, acid phosphatase and β‐glucuronidase, but not the release of the mitochondrial enzyme, isocitric dehydrogenase. Stabilizing activity in serum paralleled adjuvant disease, being greatest when the inflammation was most intense and subsiding as the arthritis diminished. Activity could be removed from the serum by absorption with isolated membranes; adjuvant arthritis serum did not inhibit enzyme activities. The membrane reactant was neither a corticosteroid nor an antibody but was a large molecular weight substance with charge properties similar to an α‐globulin.
Treatment of rheumatoid joint inflammation with triamcinolone hexacetonide
Authors: McCarty Daniel J.
Published: February 2007

Prolonged (more than 1 year) reversal of inflammation, as judged by decreased swelling, tenderness and synovial thickening, occurred in 12 patients in whom the joints of one hand and the wrist were treated locally with triamcinolone hexacetonide. Better preservation of grip strength, structural joint integrity and range of motion on the treated side were evidence of a beneficial effect on function. Fewer new lesions developed on the treated side as observed radiographically over the period of follow‐up, which averaged 21 months. Recurrence and progression of arthritis, both clinical and radiologic, definitely occurred in some injected joints. Unwanted effects such as soft tissue atrophy and periarticular calcification were common; their true incidence and the significance of the latter remain to be determined. The doses used here are regarded as experimental and, while promising, warrant further study before adoption as a possible method of “medical synovectomy”.
Ankylosing hyperostosis of the cervical spine
Authors: Spilberg Isaias , Lieberman David M.
Published: February 2007

A patient with severe ankylosing hyperostosis of the cervical spine is reported and the differential diagnosis discussed.
Antibody to mycobacterial antigens in adjuvant arthritis (AA). I. Relationship to disease and delayed hypersensitivity
Authors: Perper Robert J. , Oronsky Arnold L. , Blancuzzi Vincent
Published: February 2007

The 1° and 2° antibody response of adjuvant arthritic rats to a soluble mycobacterial lipoprotein preceded the development of arthritis. In contrast, delayed hypersensitivity reactions to PPD paralleled disease activity. Treatment with immunosuppressive agents indicated that complete suppression of disease in the noninjected paw could occur without effect on the humoral response, but the delayed skin reaction was suppressed at all doses. It is suggested that the humoral antibody response to mycobacterial antigens may have relevance to the regulation of the disease.
Arthritis as the presenting feature of childhood leukemia
Authors: Fink Chester W. , Windmiller Joan , Sartain Peggy
Published: February 2007

Five cases of childhood leukemia are described in which major presentation was arthritis. Three patients had normal hematologic studies when initially examined. Both monoarticular and polyarticular arthritis were seen. Joint swelling was caused by an increase in synovial fluid, but in 1 patient there seemed to be synovial thickening. Presentations and clinical courses were extremely variable and point out the necessity to consider leukemia in the differential diagnosis of children with arthritis.
Rheumatology and international health. International relations of the american rheumatism association
Authors: Rudd Emmanuel
Published: February 2007

The International League Against Rheumatism, with its regional components, is a nongovernmental organization of professional and voluntary national societies engaged in the study and control of rheumatic diseases. It maintains official relationship with the World Health Organization (WHO), a specialized agency of the United Nations, for technical guidance of public health authorities in problems of rheumatology. The American Rheumatism Association (ARA), which started as a United States Committee for the International League, has engaged to a limited degree in international health activities.
Connective tissue activation. IV. Regulatory effects of antirheumatic drugs
Authors: Castor C. William
Published: February 2007

Cortisol, phenylbutazone, indomethacin, acetylsalicylic acid, meclofenamic acid, flufenamic acid and mefanamic acid were potent inhibitors of connective tissue activation, especially if introduced into synovial cultures within 2 hours of initiation of the activation process. Colchicine, chloroquine and gold thiomalate were ineffective, while hydroxychloroquine and sodium salicylate exhibited modest inhibitory capacity. Most of the active agents exhibited suppressive capacity at concentrations similar to those used clinically. The suppressive capacity of the various drugs was reduced 20 to 60% by the presence of serum. Antirheumatic drugs do not appear to alter the activity of the stimulatory connective tissue activating peptide molecule itself, but may act by interfering with the transcriptional and translational components of the connective tissue activation sequence.
Tubular structures in endothelium in palindromic rheumatism
Authors: Molnar Zelma , Metzger Allan L. , McCarty Daniel J.
Published: February 2007

Electron microscopy of synovial tissue in a patient with palindromic rheumatism showed tubular structures in the endothelial cells similar to those reported by others in the tissues of patients with other rheumatic diseases, neoplasms, infections and a variety of other idiopathic conditions.
Superficial temporal arteriography in patients suspected of having temporal arteritis
Authors: Hunder Gene G. , Baker Hillier L. , Rhoton Albert L. , Sheps Sheldon G. , Ward L. Emmerson
Published: February 2007

Superficial temporal arteriograms and temporal artery biopsies on 31 patients suspected of having temporal arteritis supported the same diagnosis in 29. Temporal arteriograms showed abnormalities in all 5 patients with arteritis on biopsy. In 2 additional patients arteriographic areas of irregular narrowing and dilation of the lumen of the temporal artery were present, even though random biopsy, at different sites, showed no arteritis. Temporal arteriography may complement biopsy in the diagnosis of temporal arteritis, with biopsy of the arteriographically abnormal area to confirm the diagnosis.
Synovectomy and debridement of the knee in rheumatoid arthritis (a study of 60 knees)
Authors: Ranawat Chitranjan S. , Ecker Malcolm L. , Straub Lee Ramsay
Published: February 2007

Sixty knees in 46 patients with rheumatoid arthritis (RA), Stages II and III, and severe to moderate synovitis were synovectomized and debrided, and observed for an average of 2.8 years. Improvement was noted in 73% of the knees. This figure diminished with longer followup due to recurrence of disease, development of valgus and varus deformities and involvement of hips. The results of knee surgery did not correlate with severity of disease. Some reduction in walking ability occurred as a result of progression of RA in joints other than the operated one(s).
Effect of exercise on urate crystal‐induced inflammation in canine joints
Authors: Agudelo Carlos A. , Schumacher H. Ralph , Phelps Paulding
Published: February 2007

The effect of joint motion on one model of experimental articular inflammation, the acute arthritis produced by injection of urate crystals into canine knees, has been examined. Each increased amount of joint motion produced larger effusions, higher leukocyte counts, more severe histologic evidence of polymorphonuclear leukocyte infiltration and increased leakage of intravenously injected carbon from synovial vessels. Clearance of xenon from the joint was markedly accentuated by joint motion.
Lumicolchicine: Lack of antiinflammatory effect
Authors: Malawista Stephen E. , Chang Yi‐Han , Wilson Leslie
Published: February 2007

The antimitotic effects of colchicine appear to depend upon binding of the drug to the cytoplasmic protein that forms microtubules. Lumicolchicines (photoisomers of colchicine) do not bind to microtubule protein, and do not interfere with the organization of the mitotic spindle. The antiinflammatory effects of colchicine may also depend upon binding to microtubule protein, in appropriate nondividing cells. If so, lumicolchicine would not be expected to have an antiinflammatory effect. Such was the case in this report, in which the reversed passive Arthus reaction in the rat served as test stystem.
Fender‐kicker syndrome
Authors: Douglas Angevine C , Atwater Edward C , Jacox Ralph E
Published: February 2007

Two patients with metatarsal and phalangeal fractures are reported. The unusual etiology of the fractures was the same in both cases. The condition for which we suggest the title “Fender‐Kicker” syndrome, is probably a common though frequently unrecognized entity.
Articular chondrocalcinosis microanalysis of pyrophosphate (ppi) in synovial fluid and plasma
Authors: Altman Roy D , Muniz Ofelia E , Pita Julio C , Howell David S
Published: February 2007

A new microassay method with precision of ±5% was developed to quantitate pyrophosphate in synovial fluid and plasma with starting volumes of 0.5 ml. A highly significant elevation of synovial fluid pyrophosphate concentration was found in some patients with osteoarthritis and gouty arthritis in addition to the well‐established elevation in synovial fluid of subjects with pseudogout. No gradient of pyrophosphate between plasma and synovial fluid of patients with rheumatoid arthritis or in normal subjects was detectable. Studies of various parameters reflecting inflammation failed to show a correlation with the concentration of pyrophosphate in patients with pseudogout.
Experimental viral arthritis induced with herpes simplex
Authors: Webb Francis W , Bluestone Rodney , Goldberg Leonard S , Douglas Steven D , Pearson Carl M
Published: February 2007

A chronic erosive arthritis was produced in rabbits by a single intraarticular injection of herpes simplex virus. Three months after injection, a moderate or severe arthritis was present in the injected knees of all 10 animals; mild or moderate changes were present in 9 of the contralateral (noninjected) knee joints. The histologic changes resemble those of human rheumatoid arthritis. Thus, under certain circumstances, a single exposure to herpes simplex virus appears to provoke chronic arthritis.
Prostaglandin e1 (pge1) suppression of adjuvant arthritis histopathology
Authors: Zurier Robert B , Ballas Maurice
Published: February 2007

Histopathologic studies of tibiotarsal joints from rats with adjuvant disease show complete suppression of arthritis in animals treated with prostaglandin E1 (PGE1) from time of adjuvant injection. Established synovitis is improved by PGE1 treatment and progression of arthritis and cartilage destruction is halted.
Hemodialysis and kidney transplantation for renal failure from scleroderma
Authors: Richardson James A
Published: February 2007

A merchant mariner had scleroderma with polyarthralgias and Raynaud's phenomenon for 15 years before the onset of rapidly progressive renal failure and severe hypertension. Intimal proliferation obliterated or greatly narrowed the lumina of renal arterioles. Initially, he tolerated periodic hemodialysis and efforts to reduce hypertension poorly but did better after bilateral nephrectomy. In the 18 months since successful kidney transplantation, arthralgias and Raynaud's phenomenon have disappeared and skin has become less tightly bound to underlying structures. Blood pressure remains normal. The grafted kidney shows no evidence of disease. For patients whose primary organ involvement by scleroderma is renal and whose other lesions are relatively stable, hemodialysis and kidney transplantation may provide additional years of reasonably comfortable life.
Abnormal Structures in Circulating Lymphocytes from Patients with Systemic Lupus Erythematosus and Related Diseases
Authors: Grimley Philip M. , Decker John L. , Michelitch Herman J. , Frantz Molly M.
Published: February 2007

A prospective electron microscopic study, incorporating blind controls, demonstrated tubuloreticular structures (TRS) in the buffy coat lymphocytes of 32 patients with connective tissue disease. From 1 to 8% of the lymphocyte sections were involved. The abnormal structures consisted of interwoven, electron‐dense tubules (220 to 280 Å diameter) which were located within the endoplasmic reticulum. Tubuloreticular structures were found in lymphocytes from 20 of 30 patients with systemic lupus erythematosus (SLE), 2 of 4 with discoid lupus erythematosus, 8 of 20 with other connective tissue disease and none of 22 control cases. Clinical evaluation of the patients with SLE disclosed no specific differences between those with TRS‐positive or TRS‐negative lymphocytes; there were some indications of greater disease activity in the TRS‐positive group. The biologic nature of TRS is unknown, but they have been linked to virus infection under both clinical and experimental conditions.
Relative T‐Cell Specificity of Lymphocytotoxins from Patients with Systemic Lupus Erythematosus
Authors: Lies Richard B. , Messner Ronald P. , Williams Ralph C.
Published: February 2007

Lymphocytotoxic antibody activity of dera from 23 patients with systemiclupus erythematosus (SLE) was compared using three different sets of lymphocytes‐peripheral blood lymphocytes from 20 normal controls, perpheral blood lymphocytes from 10 patients with chronic lymphocytic leudemia (CLL) and thymic [thymus‐derived (T)] cells of 5 human fetuses. A marked decreased reactivity of the SLE sera with CLL lymphocytes and marked increased reactivity with fetal thymic cells as compared to controls was found. These data suggest T‐cell specificity of lymphoctotoxic antibodies in SLE.
Correlation of Histochemical, Histologic and Biochemical Evaluations of Human Synovium with Clinical Activity
Authors: Waxman Bruce A. , Sledge Clement B.
Published: February 2007

Operative synovial specimens from rheumatoid, osteoarthritic and control joints were assayed for acid phosphatase content histochemically and biochemically; portions of these same specimens were incubated in tissue culture with chick cartilage, the collagen of which was labeled with 3H, and the protein polysaccharide of which was labeled with 35S. Activity of the disease process was also evaluated from clinical data and routine histologic examination. A linear relationship was found between the histochemical and biochemical determinations of acid phosphatase. We demonstrated significant associations between acid phosphatase content and histologic activity, between acid phosphatase content and clinical activity and between histologic and clinical activity. Rheumatoid synovia had a significantly higher mean acid phosphatase content than osteoarthritic and normal, but no consistent difference was found between osteoarthritic and normal. Rheumatoid synovia also caused greater cartilage destruction in vitro than osteoarthritic and normal synovia. These findings are interpreted as further evidence for the role of synovial lysosomal enzymes in the pathophysiology of rheumatoid arthritis and provide a rational justification of synovectomy in this disease.
Calcific Periarthritis Involving Multiple Sites in Identical Twins
Authors: Cannon Richard B. , Schmid Frank R.
Published: February 2007

Identical twins with calcific periarthritis demonstrable at multiple sites first developed painful episodes of inflammation at age 22.The occurrence of this disorder in twins has not been reported previously. This observation, particularly if supported by additional cases with familial involvement, supports the possibility that the disease might be due to genetic inheritance of a metabolic defect.
Differing Effects of Azathioprine and Cyclophosphamide on Immune Responses to Flagellin in Man
Authors: Mackay Ian R. , Dwyer John M. , Rowley Merrill J.
Published: February 2007

Azathioprine and cyclophosphamide in doses of 3 mg/kg were assessed in humans with immunopathic diseases in respect to effects on humoral antibody production and counts of antigen‐binding lymphocytes in blood, using flagellin as test antigen. The results for azathioprine‐treated patients did not differ significantly from those for nontreated control patients, whereas for cyclophosphamide‐treated patients there was significant suppression of humoral antibody to flagellin, especially IgG, and no increase in antigen‐binding lymphocytes in blood after immunization. These and other observations, relating to inhibitory effects of azathioprine on T cells and antiproliferative effects of cyclophosphamide on B cells, could have implications for therapy of immunopathic diseases.
Bladder Toxicity With Chronic Oral Cyclophosphamide Therapy in Nonmalignant Disease
Authors: Aptekar Robert G. , Atkinson John P. , Decker John L. , Wolff Sheldon M. , Chu Elizabeth W.
Published: February 2007

Urinary bladder toxicity is a prominent toxic effect of cyclophosphamide. Over 600 months of oral cyclophosphamide has been given to 46 patients with SLE, Wegener's granulomatosis, RA, idiopathic nephrotic syndrome, and hypereosinophilic syndrome. Thirteen (28%) had urinary bladder complications. Three distinct problems were apparent: chronic cystitis in 6, abnormal urine cytology in 3, acute hemorrhagic cystitis in 4.These patterns could not have been segregated without urine cytology. Persistence of abnormal findings may lead to irreversible bladder toxicity.
The effect of cyclophosphamide on leukocyte kinetics and susceptibility to infection in patients with wegener's granulomatosis
Authors: Dale David C. , Fauci Anthony S. , Wolff Sheldon M.
Published: February 2007

In eight patients with Wegener's granulomatosis effective cyclophosphamide therapy significantly reduced blood neutrophil, monocyte, and lymphocyte counts; lymphocyte counts were most severely reduced. The turnover rate for DF32P‐labeled neutrophils were decreased from elevated to normal levels with treatment. Cutaneous inflammatory responses were normal before and during therapy. In five patients, cyclophosphamide eventually had to be discontinued because of progressive severe leukopenia. Infectious complications of therapy have not been observed.
Nucleolar antigen specific for antinucleolar antibody in the sera of patients with systemic rheumatic disease
Authors: Miyawaki Shoji , Ritchie Robert F.
Published: February 2007

Phenol extractable nucleolar 7S RNA produced precipitin reactions in gel with sera containing high titers of antinucleolar antibodies (ANoA) and strongly adsorbed serum ANoA activity. Similar extracts from nuclei or cytoplasm lacked this ability. Extracted and single‐stranded DNA also precipitated with ANoA but was only slightly able to absorb serum ANoA activity. Precipitating ANoA was usually found in patients with systemic sclerosis or Raynaud's phenomenon but was also found in one‐third of patients with other rheumatic diseases.
Preliminary criteria for the classification of systemic lupus erythematosus (SLE) evaluation in early diagnosed SLE and rheumatoid arthritis
Authors: Trimble R. Bruce , Townes Alexander S. , Robinson Harry , Kaplan Stanley B. , Chandler Robert W. , Hanissian Aram S. , Masi Alfonse T.
Published: February 2007

Preliminary criteria for the classification of systemic lupus erythematosus (SLE) were applied to patients with early diagnosed SLE and rheumatoid arthritis (RA) who are participants in a prospective community study of arthritis of recent onset. Sensitivity of the criteria was 88%, and specificity against RA was 97.5%. Sensitivity increased to 92% without loss of specificity when high titer antinuclear antibody (ANA) was used as an alternative criteria manifestation to LE cells. These results show the efficacy of the proposed criteria for early diagnosed patients, and support the inclusion of high titer ANA in the SLE criteria.
Immunodiffusion and gel‐electrophoretic studies of human articular cartilage proteoglycan
Authors: Keiser Harold , Sandson John I.
Published: February 2007

Human articular cartilage proteoglycan has been prepared by non‐disruptive extraction with 4M guanidine and fractionated by CsCI density gradients. Immunodiffusion studies revealed at least three antigenic components. The proteoglycan subunit (PGS) contains an antigenic component common to proteoglycan of many species. The glycoprotein link fraction (GPL) also contains a species‐specific antigen identical to a component of human synovial fluid and one or more antigens in common with bovine GPL. SDS‐gel electrophoresis of proteoglycan fractions from normal cartilage yielded protein bands within the gels with GPL and a protein band at the gel origin with PGS. The proteoglycan subunit from the single sample of osteoarthritic cartilage studied gave an additional metachromatically staining band within the gel.
Hemophilus influenzae septic arthritis. A mimicker of gonococcal arthritis
Authors: Krauss Dennis S. , Aronson Mark D. , Gump Dieter W. , Newcombe David S.
Published: February 2007

The rare occurrence of septic arthritis due to Hemophilus influenzae in an adult with systemic lupus erythematosus is reported. The clinical presentation mimicked disseminated gonococcemia with associated gonococcal arthritis. The features of this case as well as other bacterial infections known to cause confusion with gonococcal arthritis are reviewed, and the clinical and laboratory characteristics of septic arthritis caused by H influenzae are described.
IgM rheumatoid factor and low molecular weight IgM. An association with vasculitis
Authors: Theofilopoulos Argyrios N. , Burtonboy Guy , Lospalluto Joseph J. , Ziff Morris
Published: February 2007

The occurrence of IgG rheumatoid factor (IgG RF) and low molecular weight IgM (7S IgM) has been studied in the sera of rheumatoid patients with and without vasculitis. IgG RF was found in 67% of patients with vasculitis and in only 9% of patients without vasculitis. 7S IgM was found in 80% of patients with rheumatoid vasculitis and only 18% of patients without vasculitis. Both IgG RF and 7S IgM occurred simultaneously in 60% of patients with vasculitis and 6% of patients without vasculitis. Techniques for demonstrating IgG RF and 7S IgM in serum are described. The findings reported suggest that immune complexes containing IgG RF and possibly low‐molecular weight IgM may be involved in the pathogenesis of rheumatoid vasculitis.
Cyclophosphamide and lymphocyte subpopulations in Wegener's granulomatosis
Authors: Fauci Anthony S. , Dale David C. , Wolff Sheldon M.
Published: February 2007

In 10 patients with Wegener's granulomatosis, low doses of cyclophosphamide produced: severe lymphocytopenia of long duration even after therapy ceased; a greater percentage decrease in nonrosette forming lymphocytes than in rosette forming T‐lymphocytes; normal in vitro lymphocyte responses to mitogens (PHA, ConA, and PWM) with suppressed responses to one of two antigens tested (SK‐SD). This regimen did not cause severe granulocytopenia and was successful in inducing and maintaining long‐term clinical remissions.
Lack of effect of gold therapy on abnormal IgG and IgM metabolism in rheumatoid arthritis
Authors: Mouridsen H. T. , Baerentsen O. , Rossing N. , Jensen K. B.
Published: February 2007

Turnover studies with radioactive iodine‐labeled immunoglobulins (125IgG and 131IgM) and standard clinical tests were performed in 8 patients with rheumatoid arthritis before and after 2–5 months treatment with sodium‐aurothiosulphate (Sanocrysine®). Seven untreated patients served as controls. Fractional rates of catabolism and rates of synthesis of IgG and IgM were increased in all patients. After gold treatment there was a nonsignificant decrease in IgG metabolic variables, whereas IgM variables remained unchanged. The reduction in immunoglobulin metabolism correlated with clinical and serologic activity in only 1 of the 8 cases.
Aryl sulfatase activities in normal and pathologic human articular cartilage
Authors: Schwartz Edith R. , Ogle Roy C. , Thompson Roby C.
Published: February 2007

Aryl sulfatase A and B activities were measured in articular cartilage of patients with osteoarthritis, chondromalacia, avascular necrosis, and femoral neck fractures. Although the activities of both enzymes were higher in the tissue from individuals with degenerative joint disease, the most significant finding was the substantial increase in the B:A ratio in these tissues. It is suggested that whereas cerebroside sulfate is the substrate for aryl sulfatase A, either chondroitin sulfate or keratan sulfate is the physiologic substrate for aryl sulfatase B.
Interactions of extractable nuclear antigen (ENA) and double stranded DNA
Authors: Hamburger Max , Friedlander Lester , Barland Peter
Published: February 2007

Extractable nuclear antigen (ENA) has been shown to inhibit the combination of anti‐DNA with double stranded DNA. ENA has also been found to complex with DNA by two different techniques. In one, red cells coated with DNA were shown to retain significantly more radiolabeled ENA than uncoated controls. In a second, DNA‐125I was found to be retained on a membrane filter after incubation with ENA, indicating DNA‐protein complex formation. It is suggested that the ENA may complex with DNA in vivo and that these complexes may retard the formation of anti‐DNA‐DNA complexes.
Immunologic reactivity in rheumatoid arthritis response to mitogens
Authors: Lance E. M. , Knight Stella C.
Published: February 2007

The in vitro responsiveness of peripheral blood lymphocytes to a variety of mitogens was compared in cells from normal volunteers, from patients with rheumatoid arthritis and from patients with degenerative joint disease (osteoarthritis). A consistent and marked depression in the proliferative response to Conconavalin A was noted, while statistically comparable results were obtained with PHA and allogeneic lymphocytes. The significance of these observations is discussed with particular reference to a possible discrete defect in a subpopulation of T cells in these patients.
Experimental immune synovitis in the rabbit. Relative roles of cell mediated and humoral immunity
Authors: Goldberg Victor M. , Lance Eugene M. , Davis Phillip
Published: February 2007

An experimental immune synovitis was induced in the knee joints of rabbits by repeated intraarticular injections of autologous and homologous lgG or lgG derivatives. Only in those animals which demonstrated cellular immunity by skin hypersensitivity and macrophage migration inhibition did we produce a significant synovitis. Synovial lysosomal enzyme actvity was significantly elevated in these rabbits. Cyclophosphamide had no effect on inhibiting the synovial response while ALS either markedly reduced or eliminated the synovitis.
Sulfhydryl‐dependent thermal aggregation of human gamma globulin
Authors: Gerber Donald A.
Published: February 2007

Hyaluronic acid (4 mg/ml) augmented elevenfold the copper‐catalyzed (7 βxM) thermal (63°C, 2 hours) aggregation of human gamma globulin (2 mg/ ml) in 0.075 M phosphate buffer, pH 7.4. Almost no augmentation of aggregation occurred with hyaluron‐idase‐treated hyaluronate. Hyaluronate‐augmented copper‐catalyzed thermal aggregation was inhibited by L‐histidine, gold thiomalate, N‐ethylmaleimide, p‐chlo‐romercuribenzoic acid, and ethylenediaminetetraacetic acid. Together with previous reports of a decreased blood histidine concentration in rheumatoid arthritis, these studies provide a possible explanation for the affinity of this disease for joints.
Extensive phalangeal cystic lesions
Authors: Schriber R. A. , Firooznia H.
Published: February 2007

A young black man is presented with a 33‐month course of insidious but eventually striking hand deformity and limitation of motion in the absence of any other symptoms. Radiologic and histologic findings of the digits support the diagnosis of sarcoidosis, though physical, laboratory, and chest x‐ray examination show no evidence of this multisystem disease.
Mechanisms of lysosomal enzyme release from leukocytes
Authors: Hoffstein Sylvia , Weissmann Gerald
Published: February 2007

In order to determine the possible mechanisms whereby interactions between phagocytic cells and crystals of monosodium urate (MSU) lead to cell death with simultaneous release of both cytoplasmic and lysosomal enzymes, phagocytic leukocytes of the smooth dogfish shark Mustelus canis were studied by means of light and electron microscopy, and biochemistry. Lysosomes of these cells can be stained supravitally with toluidine blue and are large enough (0.7–0.8 m̈) to be clearly resolved with the light microscope. Light microscopic observations showed that of cells exposed to MSU 87% of those containing visible ingested crystals died within 1 hour, whereas 92% of adjacent cells in the same wet mount without such crystals survived. Cell death occured after a latent period of 10–15 minutes following fusion of lysosomes with crystal‐containing phagosomes. Electron microscopic examination of both dogfish and human leukocytes exposed to MSU for more than 1 hour and then fixed in situ revealed occasional discontinuities or ruptures in secondary lysosome membranes. Endogenous peroxidase activity could be cytochemically localized in primary and secondary lysosomes and in the cytoplasm adjacent to such ruptured secondary lysosomes. It was not seen adjacent to primary lysosomes, a result indicating that the cytoplasmic reaction product was not a diffusion artifact. To exclude the possibility that crystals were exercising their affect primarily upon the plasma membrane, suspensions of dogfish buffy coat cells were incubated with cytochalasin B (5 m̈g/ml, 10 minutes), which inhibits phagocytosis but not exocytosis of lysosomal enzymes by stimulated phagocytes. Whereas cells exposed to MSU crystals released 30% of their content of lysosomal β‐glucuronidase activity and 28% of their cytoplasmic lactate dehydrogenase (LDH) activity within 3 hours, preincubation with cytochalasin B reduced the release of LDH activity within that period to 6% but reduced the release of β‐glucuronidase activity only to 20%. Preincubation with 10–3 M cyclic adenosine monophosphate (cAMP) and theophylline (10–3 M), which inhibit lysosomal fusion, reduced the release of both LDH and β‐glucuronidase activities to 7% and 6% respectively. Cells that were preincubated with both cytochalasin B and cAMP + theophylline released only 1% LDH activity and 4% β‐glucuronidase activity. These results are compatible with the “suicide sac” hypothesis of lysosomal enzyme release mediated by MSU for the following reasons: a) cell death was seen to follow uptake, not mere exposure to crystals, b) ultrastructural studies indicated that the primary injury was to the secondary lysosome membrane, and c) cell death was reduced when either phagocytosis or lysosomal fusion was inhibited.
Efficacy of lithium in rheumatoid arthritis with granulocytopenia (felty's syndrome)
Authors: Gupta Ramesh C. , Robinson William A. , Smyth Charley J.
Published: February 2007

Lithium carbonate was given orally for 6 weeks in varying doses to 10 patients with Felty's syndrome. All patients receiving 900 mg of lithium daily showed statistically significant elevations in granulocyte count during therapy. The effect was usually noted within a week and did not persist when the drug was withdrawn. The percentage increase in mean absolute granulocyte count varied between 138% and 617% of control value in different patients; the lower values were observed in those patients with basal serum lithium concentrations less than 0.5 mEq/liter. It is concluded that a consistent rise in peripheral blood granulocytes was achieved by lithium carbonate in a dosage of 900 mg daily in patients with Felty's syndrome.
Identification of neutral proteases in human neutrophil granules that degrade articular cartilage proteoglycan
Authors: Malemud Charles J. , Janoff Aaron
Published: February 2007

Human polymorphonuclear neutrophil (PMN) granule extract (25 m̈g of protein) released 60% of the available 35SO4 from labeled rabbit articular cartilage in 0.5 hour at neutral pH. N‐acetyl‐L‐alanyl‐L‐alanyl‐L‐prolyl‐L‐alanine chloromethyl ketone (NAc‐AAPACK), a specific elastase inhibitor, was only minimally effective against whole granule extract, and N‐α‐tosyl‐L‐lysine chloromethyl ketone, which inhibits trypsin but not elastase, was completely ineffective. Preparative disc‐gel electrophoresis of PMN granule extract revealed two separate regions with independent activity against 35SO4‐labeled cartilage. One region contained elastases and, when tested alone, was completely inhibited by NAcAAPACK. The other contained lysozyme and two esterases active against N‐acetyl‐L‐phenylalanine‐α‐naphthol. Purified lysozyme proved inactive, suggesting that the chymotrypsin‐like esterases were responsible for proteoglycan degradation by this region of the gel.
Spontaneous remission of felty's syndrome
Authors: Luthra Harvinder S. , Hunder Gene G.
Published: February 2007

The clinical course of a patient with Felty' syndrome is described. This patient was unusual because during a 3‐year period of splenomegaly and leukopenia she did not develop repeated infections, leg ulcers, or other complications of Felty' syndrome. Then a spontaneous remission began. During the subsequent 6 years, neither symptoms nor signs of Felty' syndrome have recurred.