bluuebunny/crossref_metadata_2025_split huggingface dataset:
Serum keratan sulfate levels in osteoarthritis patients
Authors: Sweet M. Barry E. , Coelho Angelina , Schnitzler Christine M. , Schnitzer Thomas J. , Lenz Mary Ellen , Jakim Itzhak , Kuettner Klaus E. , Thonar EUGENE J.‐M. A. 
Published: February 2007

AbstractSerum levels of keratan sulfate (KS), measured by an enzyme‐linked immunosorbent–inhibition assay, were found to be significantly higher in 31 patients with hypertrophic osteoarthritis (OA) than those in 41 adults without joint disease. Seventy‐seven percent of patients with OA, but only 12% of control subjects, had serum levels which were more than 1 SD above the mean of the control group. Following replacement of a single osteoarthritic hip joint, serum KS levels decreased, at first, in all patients. Subsequently, the concentration of serum KS progressively increased; 6 months following surgery, KS levels were similar or close to the preoperative levels in virtually all patients. The results suggest that patients with hypertrophic OA may have a generalized imbalance of cartilage proteoglycan metabolism. Measurements of serum KS are likely to prove most useful in studying this particular subset of patients with generalized OA.
Successful management of catastrophic gastrointestinal involvement in polyarteritis nodosa
Authors: Karp David R. , Kantor Owen S. , Halverson John D. , Atkinson John P. 
Published: February 2007

AbstractA patient with polyarteritis nodosa developed necrotizing enterocolitis, as indicated by pneumatosis intestinalis seen on computed tomographic scans of the abdomen. Despite immunosuppressive therapy and concomitant resolution of the intramural and portal venous gas and general clinical improvement, on 2 occasions (between 20 and 30 days later) the patient developed bowel infarctions and perforations that necessitated bowel resection. Leaks developed at anastomotic sites, but were not closed surgically. However, these sites and the lower quadrants of the abdomen were drained, and the patient was given total parenteral nutrition. Over a 2‐month period the patient completely recovered from this nearly always fatal gastrointestinal complication of polyarteritis nodosa. The medical, surgical, and radiographic approach we used may be applicable to the management of similar cases in the future.
Clinical assessment of atlantoaxial instability using the sharp‐purser test
Authors: Uitvlugt Gregory , Indenbaum Samuel 
Published: February 2007

AbstractAnterior atlantoaxial subluxation is common in rheumatoid arthritis patients with involvement of the cervical spine. Sharp and Purser have described a test for the clinical assessment of this instability. We assessed the validity of the Sharp‐Purser test in 123 outpatients with rheumatoid arthritis. Our findings indicate a predictive value of 85% and a specificity of 96%. The sensitivity was 88% when subluxation was > 4 mm. Our results show that the Sharp‐Purser test is a useful clinical examination to diagnose atlantoaxial instability.
The diagnosis of polyarteritis nodosa
Authors: Albert Daniel A. , Rimon David , Silverstein Marc D. 
Published: February 2007

AbstractWe investigated diagnostic testing in polyarteritis nodosa (PAN) by calculating, from published data, the sensitivity and specificity of visceral angiography and muscle, nerve, testicle, kidney, and liver biopsy. Test sequence strategies were constructed by Bayesian inference using a computer program written for this purpose. Test sequences were compared with an aggressive strategy consisting of repeated tests until there was a positive finding or until the available tests were exhausted, and a conservative strategy consisting of 1 biopsy procedure plus angiography. The Bayesian analysis agreed most closely with the conservative approach for most prior probabilities (degree of suspicion) that a patient had PAN. The aggressive strategy had an overall sensitivity of 90% and specificity of 91%, whereas the conservative strategy was 85% sensitive and 96% specific. Furthermore, the aggressive strategy was more costly ($2,986 versus $1,961) and had a higher rate of morbidity (3.8 versus 2.7 days of hospitalization per patient evaluated) than did the conservative strategy. The mortality rates of both strategies were equivalent (∼0.05 deaths per hundred patients evaluated). The per‐case cost of diagnosis increased as prevalence decreased, and at 10% prevalence, the aggressive strategy cost more than $17,000 per case diagnosed. Sensitivity analysis revealed that the strategies were moderately affected by the test characteristics, within reasonable assumptions, but that the differences in conservative and aggressive approaches remained. Thus, our analysis based on available data and the assumption of test independence suggests that the preferred diagnostic evaluation of patients with symptoms suggestive of PAN consists, in most cases, of a single biopsy procedure, with angiographic evaluation if necessary.
Systemic joint laxity (the hypermobile joint syndrome) is associated with temporomandibular joint dysfunction
Authors: Harinstein David , Buckingham Robert B. , Braun Thomas , Oral K. , Bauman Dorothy H. , Killian Paul J. , Bidula Leo P. 
Published: February 2007

AbstractA consecutive series of 37 individuals admitted to the hospital for elective temporomandibular joint (TMJ) reconstructive surgery and 3 seen as outpatients with TMJ disease were evaluated for rheumatic disease or for another etiologic factor that might account for this problem. These 40 patients were screened by history, physical examination, and laboratory study. We soon noticed that many patients had generalized joint laxity. Eighteen of the first 40 individuals satisfied established criteria for the hypermobile joint syndrome. An additional 3 were found to have Ehlers‐Danlos syndrome or a forme fruste of this disorder. Many were markedly hypermobile and could perform a number of flexible maneuvers. Although excessive joint laxity is known to be associated with a variety of rheumatic conditions, TMJ disease has not been recognized as one of them. No patient in this series had a systemic inflammatory disorder or any other apparent etiologic factor for TMJ disease. We suggest that there is a cause‐and‐effect relationship between generalized joint laxity and TMJ disease.
Treatment with gamma‐interferon triggers the onset of collagen arthritis in mice
Authors: Mauritz Nils Johan , Holmdahl Rikard , Jonsson Roland , Van Meide Peter H. Der , Scheynius Annika , Klareskog Lars 
Published: February 2007

AbstractWe investigated the effect of gM‐interferon (gM‐IFN) on the development of type II collagen (CII)‐induced arthritis. DBA/1 mice were immunized with rat CII and 16 days later, were treated with subcutaneous injections of recombinant rat gM‐IFN into the right paws twice a week. Compared with controls, the gM‐IFN‐treated mice developed arthritis with a higher frequency and severity. Immunohistochemical analysis of gM‐IFN‐treated paws from CII‐immunized mice revealed an increase in the numbers of class II antigen‐expressing cells and an infiltration of CD4+ lymphocyte‐like cells. The auto‐antibody response toward CII was suppressed by gM‐IFN treatment. The findings implicate gM‐IFN in a role that triggers arthritis by enhancing local inflammatory processes in the joints, or possibly, by permitting homing of T cells to the joints.
Sequential development of antibodies to specific sm polypeptides in a patient with systemic lupus erythematosus: evidence for independent regulation of anti—double‐stranded dna and anti‐sm antibody production
Authors: Ter Borg E. J. , Horst G. , Hummel E. , Jaarsma D. , Limburg P. C. , Kallenberg C. G. M. 
Published: February 2007

AbstractWe describe a patient with systemic lupus erythematosus who, after a disease flare, sequentially produced antibodies to specific Sm polypeptides (demonstrated by counterimmunoelectrophoresis, immunoblotting, and RNA immunoprecipitation) concomitantly with the disappearance of anti—double‐stranded DNA antibodies. Immunoblotting studies revealed that antibodies to the D polypeptide appeared first, followed by antibodies to BB′ and E polypeptides, respectively. Our findings suggest that antibodies to the Sm‐specific polypeptides do not occur simultaneously and that the regulation of their production is independent of that of antibodies to double‐stranded DNA.
Induction of an acute erosive monarticular arthritis in mice by interleukin‐1 and methylated bovine serum albumin
Authors: Staite Nigel D. , Richard Karen A. , Aspar Danielle G. , Franz Katherine A. , Galinet Louise A. , Dunn Colin J. 
Published: February 2007

AbstractWe examined the effect of interleukin‐1 (IL‐1) administration on a mild and transient inflammatory response in the knees of mice injected intraarticularly with methylated bovine serum albumin (mBSA). Injection of mBSA on day 0 into nonsensitized mice caused a weak inflammatory response confined to the infrapatellar fat pads and involved infiltration by mononuclear cells, neutrophils, and eosinophils. The response developed between days 4 and 7 and resolved by day 28. No erosion of cartilage or subchondral bone was seen. In contrast, mBSA‐treated mice injected with recombinant human IL‐1β subcutaneously in the ipsilateral footpad on days 0–3 developed a severe monarticular arthritis in the antigen‐injected knee. Pannus developed, extending over the articular surfaces, and extensive erosion of cartilage and subchondral bone occurred. Multinucleated giant cells, together with fibrin‐like material, were observed at sites of active bone erosion and debris, and large numbers of neutrophils were seen in the joint space. These pathologic features represent a new arthritis model in which IL‐1 profoundly augments a weak inflammatory response and induces acute erosive joint destruction, supporting the hypothesis that IL‐1 is an important cytokine in the pathogenesis of arthritis.
Prolonged improvement of raynaud's phenomenon and scleroderma after recombinant tissue plasminogen activator therapy
Authors: Fritzler Marvin J. , Hart David A. 
Published: February 2007

AbstractWe describe a patient with systemic sclerosis (SSc; scleroderma) characterized by severe Raynaud's phenomenon, cutaneous sclerosis, and digital ulceration and subsequent amputation who was treated with recombinant tissue plasminogen activator (rt‐PA) after acute myocardial infarction. She showed prompt improvement of the Raynaud's phenomenon and healing of the digital ulceration. After 18 months of followup, the Raynaud's phenomenon has remained mild, and there has been improvement in the cutaneous sclerosis. Since the pathophysiology of SSc has been associated with disorders of fibrinolysis and coagulation, this patient represents an interesting index case that might prompt further evaluation of rt‐PA therapy in carefully selected patients.
Atypical presentations of polymyalgia rheumatica
Authors: Fitzcharles Mary‐Ann , Esdaile John M. 
Published: February 2007

AbstractSeventy patients with polymyalgia rheumatica (PMR) were seen at a suburban rheumatology practice from July 1983 to December 1987. Six of these patients presented without the typical limb girdle features associated with PMR. Presenting symptoms included peripheral synovitis or unilateral shoulder pain (3 patients), lower leg pain (3 patients), carpal tunnel syndrome (1 patient), and abdominal pain (1 patient). The disease evolved into the recognizable syndrome of PMR over a period of 2–12 months. We suggest that PMR may present in a variety of guises, or have a “stuttering evolution” to the full syndrome. The presenting manifestations of these atypical cases result from peripheral synovitis and thus represent a variant of the more common subclinical proximal synovitis seen in PMR. Increased clinical awareness of atypical presentations may assist earlier diagnosis and effective treatment.
Inflammation and cartilage metabolism in rheumatoid arthritis. Studies of the Blood Markers Hyaluronic Acid, Orosomucoid, and Keratan Sulfate
Authors: Poole A. Robin , Witter James , Roberts Nancy , Piccolo Frank , Brandt Ragnhild , Paquin Julie , Baron Murray 
Published: February 2007

AbstractSingle analyses of peripheral blood of rheumatoid arthritis (RA) patients showed a significant reduction in the mean value for keratan sulfate (KS) compared with that in control subjects, but the mean value for orosomucoid (OM) was elevated compared with that in control subjects. Some RA patients displayed highly elevated levels of hyaluronic acid (HA), while others exhibited normal levels. There was a significant inverse correlation between OM and KS content in RA patients, as well as a direct correlation between HA and OM. In longitudinal studies of RA patients, parallel changes in OM and HA and inverse changes between KS and OM or HA were commonly observed. Clinical analyses revealed that there was an inverse correlation between KS and morning stiffness, and direct correlations between the number of tender joints and HA, and between HA or the erythrocyte sedimentation rate and the number of joints with effusions. The reason(s) for the inverse correlation between KS and OM as an index of systemic inflammation remains to be established. Circulating HA represents an index of joint inflammation, for which a marker has not been previously available.
Enhanced Production Of Interleukin‐1 And Tumor Necrosis Factor α By Cultured Peripheral Blood Monocytes From Patients With Scleroderma
Authors: Umehara Hisanori , Kumagai Shunichi , Murakami Masao , Suginoshita Toshihiko , Tanaka Koichiro , Hashida Seiichi , Ishikawa Eiji , Imura Hiroo 
Published: February 2007

AbstractCultured peripheral blood mononuclear cells from 20 patients with scleroderma were shown to produce high levels of interleukin‐1α, interleukin‐1β, and tumor necrosis factor α. There were positive correlations between the production of these 3 molecules. Purified monocytes from these patients produced much more tumor necrosis factor α than did those from normal subjects, even without lipopolysaccharide stimulation. These results show the hyperactivity of monocytes from scleroderma patients.
Idiotypic characteristics of immunoglobulins associated with human systemic lupus erythematosus: association of high serum levels of IdGN2 with nephritis but not with HLA class ii genes predisposing to nephritis
Authors: Hahn Bevra H. , Kalunian Kenneth C. , Fronek Zdenka , Panosian‐Sahakian Niver , Louie James S. , Mcdevitt Hugh O. , Ebling Fanny M. 
Published: February 2007

AbstractSerum levels of IdGN2 (an idiotype enriched in nephritogenic antibodies), IdX (an idiotype not enriched in nephritogenic antibodies), IgG, and anti‐DNA were measured in 23 Caucasian patients with lupus nephritis, in age‐ and sex‐matched lupus patients without nephritis, and in similarly matched healthy individuals. Serum levels of IdGN2 were significantly higher in the patients with lupus nephritis than in those without, and they were higher in all lupus patients compared with the healthy control subjects. However, the same observations were true for serum levels of IdX. There were significant positive correlations between the serum levels of IgG, IdGN2, IdX, and anti‐DNA. HLA typing at the DR and DQ loci was performed in 105 lupus patients of different races (Caucasian, black, and Asian/Polynesian/Filipino). Serum levels of IdGN2 in 83 of these individuals did not correlate with any of the HLA class II haplotypes currently known to predispose to lupus nephritis. We conclude that the high serum levels of IdGN2, which are characteristic of some patients with lupus nephritis, may often result from polyclonal B cell activation rather than from idiotype‐specific up‐regulation associated with one or more of the class II genes that predispose to nephritis in this disease.
Low molecular weight serine proteinase inhibitors of human articular cartilage. Isolation, Characterization, and Biosynthesis
Authors: Andrews John L. , Ghosh Peter 
Published: February 2007

AbstractThe major low molecular weight serine proteinase inhibitor of human articular cartilage was purified to homogeneity as determined by single‐peak elution with 4 high resolution techniques. The purified protein was found to be a potent inhibitor of human leukocyte elastase and cathepsin G, as well as the native serine proteinases derived from human articular cartilage and intervertebral disc. The inhibitor and lysozymes were synthesized by human articular cartilage in vitro. These properties and the ability of this cationic inhibitor to bind to cartilage matrix components suggest a possible role in the modulation of matrix catabolism in normal and pathologic states.
Magnetic resonance imaging of articular destruction in juvenile rheumatoid arthritis
Authors: Verbruggen Leon A. , Shahabpour Maryam , Roy Peter Van , Osteaux Michel 
Published: February 2007

AbstractWe describe herein magnetic resonance imaging of the right knee of a patient affected by a severe form of juvenile rheumatoid arthritis. Magnetic resonance imaging findings of articular damage of the knee during the disease course and after arthroscopic synovectomy are described.
Activation of t cell subsets in the peripheral blood of patients with Sjögren's syndrome multicolor flow cytometric analysis
Authors: Ichikawa Yukinobu , Shimizu Hiroaki , Yoshida Miyoko , Arimori Shigeru 
Published: February 2007

AbstractUsing 3‐color flow cytometry, we determined the proportions of activated T cells (DR+), including CD4+ cells, CD8+ cells, and their subsets, in the peripheral blood of 17 patients with Sjögren's syndrome (SS). Activated T cells were significantly increased in CD4+ cells, CD8+ cells, and T suppressor inducer (CD4+, Leu‐8+), T helper (CD4+, Leu‐8‐), and T cytotoxic (CD8+, CD11‐) subsets, but not the T suppressor/natural killer subset (CD8+, CD11+), in patients with SS as compared with the controls. Furthermore, the proportions of activated T cells in the CD4+, Leu‐8‐subset, the CD8+ subset, or the CD8+, CD11‐ subset showed a positive correlation with serum gamma globulin levels in the SS patients. Our findings suggest that a certain immunoregulatory balance between T helper and T suppressor activities is maintained in SS patients, although this balance seems to occur at highly activated levels, and that quantitative changes of some lymphocyte subsets are important factors in maintaining this balance. We discuss the possibility that CD4+, Leu‐8+ cells recirculate into peripheral lymph nodes, while CD4+, Leu‐8‐ cells migrate into inflammatory tissues such as salivary glands, since the Leu‐8 antigen is reported to be a homing receptor in peripheral lymph nodes. This process might be accelerated in SS, and each T cell subset may further participate in immunologic activation in the lymph nodes or target tissues.
Nontropical pyomyositis as a cause of subacute, multifocal myalgia in the Acquired Immunodeficiency Syndrome
Authors: Wolf Rienhart F. , Sprenger Herman G. , Mooyaart Eduard L. , Tamsma Jouke T. , Kengen Roland A. , Weits Jan 
Published: February 2007

AbstractWe report a case of nontropical pyomyositis in a patient with acquired immunodeficiency syndrome and disseminated Mycobacterium avium infection, in which severe myalgia was the presenting symptom over several weeks. Multifocal muscle lesions were identified by gallium scanning and magnetic resonance imaging techniques. The epidemiology, possible pathogenesis, clinical features, diagnostic imaging, and therapy are reviewed. Early suspicion of nontropical pyomyositis in severely immunocompromised patients with “cryptic” myalgia is recommended.
Prognostic significance of anticentromere antibodies and anti–topoisomerase i antibodies in Raynaud's disease. A prospective study
Authors: Weiner Ethan S. , Hildebrandt Sabine , Senécal Jean‐Luc , Daniels Lesley , Noell Steven , Joyall France , Roussin André , Earnshaw William , Rothfield Naomi F. 
Published: February 2007

AbstractSeventy‐seven patients with Raynaud's disease were studied for a mean of 4 years (range 1–11 years) to determine the relationship between autoantibodies and long‐term clinical outcome. Anticentromere antibodies (ACA) were assayed by indirect immunofluorescence and by immunoblotting of HeLa cell chromosome extracts. Antibodies to topoisomerase I (anti–topo I) were assayed by immunodiffusion and immunoblotting. Antibodies to the major centromeric protein, CENP‐B, and anti–topo I were studied by enzyme‐linked immunosorbent assay (ELISA). Eight patients developed telangiectasias, 4 developed skin tightening, and 4 developed a connective tissue disease other than scleroderma. The presence of ACA at the start of the study was associated with the development of telangiectasias (P < 0.003). An initial 100‐kd band on immunoblot in conjunction with a positive anti–topo I ELISA result was associated with the development of tight skin (P < 0.0025), while a 100‐kd band with a negative anti–topo I ELISA result was associated with the subsequent development of a connective tissue disease other than scleroderma (P < 0.0073). Patients who were initially ACA positive, had the 100‐kd band on immunoblot, or had positive ELISA results for anti–topo I or for anti‐CENP‐B were 63‐fold more likely to develop signs of connective tissue disease by the end of the study (P < 0.000009). The presence of any of these autoantibodies was more sensitive (100%), although less specific (75%), than were findings from nailfold capillaroscopy (sensitivity 67% and specificity 95%) in predicting subsequent clinical progression. We conclude that findings of assays for anti–topo I and ACA complement the findings from nailfold capillaroscopy in providing useful prognostic information in Raynaud's disease.
Treatment of rheumatoid arthritis with an anti‐CD4 monoclonal antibody
Authors: Horneff Gerd , Burmester Gerd R. , Emmrich Frank , Kalden Joachim R. 
Published: February 2007

AbstractThe effect of treatment with a monoclonal antibody against the CD4 antigen present on T helper cells was studied in 10 patients with severe intractable rheumatoid arthritis. In an open trial, monoclonal antibody 16H5 was infused at a dosage of 0.3 mg/kg of body weight on 7 consecutive days. Studies of the kinetics demonstrated a drastic depletion of CD4+ cells, to as low as 25 cells/μl, 1 hour after the first infusion. The subsequent recovery of the CD4+ cell numbers 24 hours after infusion did not reach initial levels, and after the full 7‐day treatment cycle there was a significant reduction of the number of CD4+ cells (mean ± SD 51 ± 28%; P < 0.02). There was a reduced or even inverse CD4:CD8 ratio, which generally persisted 3–4 weeks. Lymphocyte transformation assays demonstrated significantly reduced reactivity in 5 of the 9 patients who completed the 7‐day course, whereas 4 individuals exhibited an unexpected elevation in the T cell response to mitogens and common antigens. Parallel laboratory studies showed a significant decrease in the erythrocyte sedimentation rate (P < 0.05), rheumatoid factor titer (P < 0.04), and total immunoglobulin values (P < 0.01), as well as a reduction in C‐reactive protein levels, in 7 of the 9 patients. Clinically, there was a significant reduction in the Ritchie articular index (P < 0.05) and in the number of swollen joints (P < 0.04). Adverse effects were urticaria in 2 patients, which led to withdrawal of therapy in 1 of them, and chills with fever, suggestive of a lymphokine release syndrome, in another 2 patients. Only low levels of human anti‐mouse immunoglobulin antibodies developed (not exceeding 1.7 mg/liter). It was therefore possible to repeat the treatment cycle, achieving still better efficacy, in 4 of the patients (reductions in the Ritchie index and the number of swollen joints P < 0.02). Our findings indicate that treatment with monoclonal antibodies against the CD4 antigen leads to immunomodulation which results in clinical benefits, at least during initial observation periods (up to 6 months postinfusion). However, it remains to be determined whether long‐term remission can be induced with this therapeutic approach. The use of immunosuppressive therapies or repeated antibody treatments will have to be considered.