bluuebunny/crossref_metadata_2025_split huggingface dataset:
Use of dynamic magnetic resonance imaging with fast imaging in the detection of early and advanced sacroiliitis in spondylarthropathy patients
Authors: Braun Jürgen , Bollow Matthias , Eggens Ulrich , König Hermann , Distler Armin , Sieper Joachim 
Published: February 2007

AbstractObjective. To evaluate the new magnetic resonance imaging (MRI) method of dynamic MRI with fast imaging in the diagnosis of sacroiliitis among patients with spondylarthropathy.Methods. Fifteen patients with a history of inflammatory back pain without radiographic evidence of grade II or greater sacroiliitis (group 1), 25 patients with definite ankylosing spondylitis (group 2), and 12 patients with noninflammatory spinal pain (controls) (group 3) were examined. Dynamic MRI with fast imaging was performed after intravenous bolus injection of the contrast agent gadolinium—diethylenetriamine pentaacetic acid. The degree of enhancement was graded as representing acute sacroiliitis, latent sacroiliitis, or no sacroiliitis.Results. Acute sacroiliitis was detected in 22 of 30 sacroiliac (SI) joints in group 1 patients and in 27 of 50 SI joints in group 2 patients; latent sacroiliitis was seen in 25 of 80 SI joints in patients from groups 1 and 2. No group 3 patient was found to have sacroiliitis.Conclusion. Early sacroiliitis can be demonstrated by dynamic MRI in spondylarthropathy patients in whom abnormalities are not revealed by conventional radiography.
Immunohistochemical characterization of inflammatory cells and immunologic activation markers in muscle and nerve biopsy specimens from patients with systemic polyarteritis nodosa
Authors: Cid Maria‐Cinta , Grau Josep Maria , Casademont Jordi , Campo Elías , Coll‐Vinent Blanca , López‐Soto Alfons , Ingelmo Miguel , Urbano‐Márquez Alvaro 
Published: February 2007

AbstractObjective. To investigate the phenotype of infiltrating cells in classic lesions of polyarteritis nodosa (PAN).Methods. Twenty‐one muscle and 10 sural nerve biopsy samples from 24 patients with systemic PAN were studied using avidin—biotin—peroxidase and alkaline phosphatase—anti—alkaline phosphatase immunohistochemical techniques.Results. The inflammatory infiltrates consisted mainly of macrophages (41%) and T lymphocytes (41%), particularly of the CD4+ subset. Granulocytes were present in varying quantities (0–45%) and were more abundant in heavily infiltrated vessels and in those with fibrinoid necrosis. Dendritic cells could be identified in 4 samples. Proliferating and interleukin‐2 receptor—expressing cells, present in 71% and 79% of the patients, respectively, were more frequent in untreated patients.Conclusion. T cell—mediated immune mechanisms may play a role in the development and perpetuation of PAN lesions.
Evidence of a local intestinal immunomodulatory effect of sulfasalazine in rheumatoid arthritis
Authors: Kanerud Lars , Scheynius Annika , Hafström Ingiäld 
Published: February 2007

AbstractObjective. To analyze whether the intestinal mucosa in rheumatoid arthritis (RA) is immnunologically abnormal and whether sulfasalazine (SSZ) possesses any local intestinal immunoregulatory effect.Methods. Lymphocyte subpopulations and HLA—DR expression were evaluated in biopsy specimens from the duodenal—jejunal mucosa and in peripheral blood samples obtained from 17 patients with RA, both before and after 16 weeks of SSZ treatment. The same mucosal assays were also performed in 7 controls.Results. The mucosa of the small intestine in RA patients showed no differences in morphology, HLA—DR expression, or the amounts and distribution of CD3+, CD4+, CD8+, and γ/δ+ lymphocytes compared with the control group. However, there was a reduction in mucosal CD3+ and γ/δ+ lymphocyte numbers after SSZ therapy, which did not correspond to a change in peripheral blood CD3+ lymphocyte number. SSZ treatment also tended to diminish the peripheral blood CD4+:CD8+ cell ratio (P = 0.05).Conclusion. No signs of inflammation or immunologic abnormalities were seen in RA duodenal‐jejunal mucosa. In this part of the intestine, however, SSZ exerted immunoregulatory effects that were not encountered in the peripheral blood.
Western blot band intensity analysis. Application to the diagnosis of lyme arthritis
Authors: Kowal Krzysztof , Weinstein Arthur 
Published: February 2007

AbstractObjective. To determine the usefulness of quantitative band‐intensity analysis of Western blots for the diagnosis of Lyme arthritis.Methods. IgG Western blots for antibodies to Borrelia burgdorferi were performed on sera from 39 patients with Lyme arthritis, 30 patients with syphilis, 50 patients with connective tissue diseases, and 10 healthy individuals. Band positions and band intensities were calculated using a computerized image analysis system.Results. Lyme arthritis patients had more bands and higher‐intensity bands than did non‐Lyme patients. The presence of at least 2 bands of moderate to high intensity (>40 optical units) or at least 5 bands of lower intensity (>20 optical units) was over 90% sensitive and 100% specific for the diagnosis of Lyme arthritis. A 60‐kd band was present in all Lyme arthritis patients. The presence of an 83‐, 39‐, 21‐, or 18‐kd band was highly specific for Lyme arthritis.Conclusion. Band intensity analysis increases the objectivity and accuracy of Western blot interpretation for the diagnosis of Lyme arthritis.
Investigating the genetic basis for ankylosing spondylitis. Linkage studies with the major histocompatibility complex region
Authors: Rubin Laurence A. , Amos Chris I. , Wade Judith A. , Martin John R. , Bale Sherri J. , Little A. Hugh , Gladman Dafna D. , Bonney George E. , Rubenstein Joel D. , Siminovitch Katherine A. 
Published: February 2007

AbstractObjective. To assess the hypothesis that B27 or a gene(s) in close proximity (e.g., within or near the major histocompatibility complex [MHC]) represents a disease‐causing ankylosing spondylitis (AS) gene, and therefore contributes directly to the pathogenesis of this disorder.Methods. MHC haplotypes were determined by both serologic and molecular analyses in 15 multiple‐case AS families from Toronto and Newfoundland. Segregation of MHC haplotypes with AS within these families was examined by linkage and identity‐by‐descent analyses. Attributable risk estimates for various genetic markers and for sex were calculated.Results. Linkage analyses established significant linkage between AS and the MHC, the maximal logarithm of odds (LOD) score being 3.48 at a recombination frequency (θ) of 0.05. In a second analysis in which the population association of the MHC gene HLA—B27 with AS was taken into account, the maximal LOD score was 7.5 at θ = 0.05. Identity‐by‐descent analyses showed a significant departure from random segregation among affected avuncular (P< 0.05) and cousin (P< 0.01) pairs. The presence of HLA—B40 in HLA—B27 positive individuals increased the risk for disease more than 3‐fold, confirming previous reports. Disease susceptibility modeling suggested an autosomal dominant pattern of inheritance, with penetrance of approximately 20%.Conclusion. These data provide the first conclusive demonstration of linkage between the MHC region and AS, and confirm that genes within this region contribute directly to the genetic susceptibility for AS.
Lack of a renal–protective effect of misoprostol in rheumatoid arthritis patients receiving cyclosporin a. results of a randomized, placebo–controlled trial
Authors: Weinblatt Michael E. , Germain Bernard F. , Kremer Joel M. , Wall Bruce A. , Weisman Michael H. , Maier Agnes L. , Coblyn Jonathan S. 
Published: February 2007

AbstractObjective. To assess whether the synthetic prostaglandin misoprostol is renal protective in rheumatoid arthritis (RA) patients who are beginning cyclosporin A (CSA) therapy.Methods. In this randomized, placebo–controlled, multicenter trial, 50 patients with active RA were randomized to receive either misoprostol (800 μg/day) or placebo for 16 weeks. After 2 weeks of pretreatment with misoprostol or placebo, all patients concomitantly received CSA at an initial and maximum dosage of 5 mg/kg/day for 12 weeks.Results. A significant increase in the serum creatinine level was observed in both treatment groups, with no difference noted between groups. There was a high withdrawal rate in both groups, primarily due to adverse events.Conclusion. A renal–protective effect was not demonstrated for misoprostol compared with placebo in RA patients who are beginning CSA therapy.
Therapeutic effect of recombinant vaccinia virus expressing the 60‐kd heat‐shock protein on adjuvant arthritis
Authors: Antonio López‐Guerrero José , Ortiz Maria Antonia , Páez Eduardo , Bernabéu Carmelo , Pedro López‐Bote Juan 
Published: February 2007

AbstractObjective. To analyze the effects of recombinant viruses for 2 heat‐shock proteins in the treatment of adjuvant arthritis.Methods. Virus vaccinia recombinant for mycobacterial heat‐shock protein 65 (hsp65‐VV) and human hsp60 (hsp60‐VV) were administered to rats during different stages of adjuvant arthritis. Arthritis score and immunity to the recombinant virus were analyzed.Results. When delivered at the pre‐arthritis stage, both constructs ameliorated arthritis; greater protection was observed with hsp60‐VV. A specific T cell response to the recombinant proteins was detected. Furthermore, hsp60‐VV displayed a clear therapeutic effect on established arthritis.Conclusion. Our results suggest novel avenues of therapeutic intervention in autoimmune arthritis associated with immunity to hsp60.
Methotrexate in rheumatoid arthritis. a five‐year prospective multicenter study
Authors: Weinblatt Michael E. , Kaplan Herbert , Germain Bernard F. , Block Sidney , Solomon Sheldon D. , Merriman Richard C. , Wolfe Frederick , Wall Bruce , Anderson Larry , Gall Eric , Torretti Dennis , Weissman Barbara 
Published: February 2007

AbstractObjective. To evaluate the efficacy and tolerability of oral methotrexate (MTX) in rheumatoid arthritis (RA) in a long‐term prospective trial.Methods. One hundred twenty‐three patients with RA who completed a 9‐month multicenter randomized trial comparing MTX and auranofin enrolled in this 5‐year prospective study of MTX.Results. Significant (P = 0.0001) improvement compared with baseline was noted in all clinical disease variables, functional status, and the Westergren erythrocyte sedimentation rate (ESR). “Marked improvement” occurred in 87 (71%) and 85 (69%) of the patients, respectively, in the joint pain/tenderness index and the joint swelling index at the last evaluable visit. Forty‐four patients (36%) withdrew during the study. Eight (7%) withdrew due to lack of efficacy, and 8 (7%) due to adverse experiences, including 1 patient with cirrhosis. At 5 years, 64% of patients were still taking MTX and completed the study.Conclusion. This large prospective study of long‐term MTX treatment demonstrates sustained clinical response and improvement in the Westergren ESR and functional assessment scores, with an acceptable toxicity profile.
In vivo production of interleukin‐10 by non–t cells in rheumatoid arthritis, sjöugren's syndrome, and systemic lupus erythematosus.
Authors: Llorente Luis , Richaud‐Patin Yvonne , Fior Renato , Alcocer‐Varela Jorge , Wijdenes John , Fourrier Brigitte Morel , Galanaud Pierre , Emilie Dominique 
Published: February 2007

AbstractObjective. Interleukin‐10 (IL‐10) is a potent stimulator of B lymphocytes in vitro. In vivo dysregulation of IL‐10 gene expression was therefore analyzed in patients with rheumatoid arthritis (RA), primary Sjögren's syndrome (SS), and systemic lupus erythematosus (SLE).Methods. Spontaneous production of IL‐10 by peripheral blood mononuclear cells was measured using reverse transcription polymerase chain reaction and enzyme‐linked immunosorbent assay in untreated patients with either RA (n = 10), SS (n = 10), or SLE (n = 10), and in 15 normal control subjects.Results. IL‐10 production was dramatically higher in RA, SS, and SLE patients than in controls. In each group, both B lymphocytes and monocytes, but not T lymphocytes, produced IL‐10.Conclusion. IL‐10 production is increased in RA, SS, and SLE. It may play a role in B lymphocyte hyperactivity and in the development of autoimmunity.
Interferon‐γ–inducible protein p16. a new target of antinuclear antibodies in patients with systemic lupus erythematosus
Authors: Seelig Hans Peter , Ehrfeld Hans , Renz Manfred 
Published: February 2007

AbstractObjective. To determine the cellular expression and localization of interferon‐γ (IFNγ)–inducible protein p16, a new antigen specificity of antinuclear antibodies (ANA), and to evaluate the prevalence of anti‐p16, particularly in SLE patients.Methods. Serum levels of anti‐p16 were determined by immunoblotting with recombinant p16 and cellular p16 messenger RNA (mRNA) by Northern blotting. We also utilized immunoprecipitation of 35Smethionine–labeled proteins, immunostaining of blotted proteins of subcellular fractions, and immunofluorescence studies with affinity‐purified rabbit and human anti–recombinant p16.Results. Protein p16 was localized within the nucleolus and nucleoplasm and constitutively expressed in Raji, HeLa, HEp‐2, K562, and HL‐60 cells. Synthesis of mRNA and protein was increased in the presence of IFNγ. The prevalence of anti‐p16 was 29% in 374 SLE patients (35% in those positive for anti–double‐stranded DNA) and 0% in 188 healthy individuals. Anti‐p16 was always accompanied by positive findings on indirect immunofluorescence for ANA.Conclusion. Anti‐p16 represents a main ANA specificity. Anti‐p16 may help to elucidate IFNγ‐dependent nuclear processes and to link autoantibody production to states of IFNγ activation.
Expression and shedding of intercellular adhesion molecule 1 and lymphocyte function–associated antigen 3 by normal and scleroderma fibroblasts.
Authors: Shi‐Wen Xu , Panesar Manvinder , Vancheeswaran Rama , Mason Justin , Haskard Dorian , Black Carol , Olsen Irwin , Abraham David 
Published: February 2007

AbstractObjective. To examine intercellular adhesion molecule 1 (ICAM‐1) and lymphocyte function‐associated antigen 3 (LFA‐3) in cultures of normal and systemic sclerosis (SSc) dermal fibroblasts.Methods. The surface and soluble forms of ICAM‐1 and LFA‐3 were measured by flow cytometry and capture enzyme‐linked immunosorbent assay, respectively.Results. Surface ICAM‐1 was significantly higher on SSc fibroblasts compared with normal controls. β‐estradiol did not directly enhance ICAM‐1 or LFA‐3 expression in either normal or SSc cells, but significantly augmented the cytokine‐induced increase in ICAM‐1. Soluble ICAM‐1 (sICAM‐1) and sLFA‐3 were detected in fibroblast cultures. While no difference was found in the level of sLFA‐3, the shedding of sICAM‐1 was significantly increased (P < 0.001) in cells from SSc patients.Conclusion. SSc fibroblasts express intrinsically elevated levels of surface ICAM‐1 and release higher levels of sICAM‐1 in vitro. Increased expression of ICAM‐1 by interferon‐γ and tumor necrosis factor α alone, and the further induction in combination with β‐estradiol may underlie an aspect of fibroblast dysfunction in SSc and the female predisposition to the disease.
Measurement of health status in children with juvenile rheumatoid arthritis
Authors: Singh Gurkirpal , Athreya Balu H. , Fries James F. , Goldsmith Donald P. 
Published: February 2007

AbstractObjective. To develop and validate a self‐ or parent‐administered instrument for measuring functional status in children with juvenile rheumatoid arthritis (JRA).Methods. We adapted the Stanford Health Assessment Questionnaire (HAQ) for use in children ages 1–19 years, by adding several new questions, such that for each functional area, there was at least 1 question relevant to children of all ages. The face validity of the instrument was evaluated by a group of 20 health professionals and parents of 22 healthy children. The questionnaire was then administered to parents of 72 JRA patients (mean age 9.1 years, onset type systemic in 16, polyarticular in 21, pauciarticular in 35).Results. The instrument showed excellent internal reliability (Cronbach's α = 0.94), with a mean inter‐item correlation of 0.6. The convergent validity was demonstrated by strong correlations of the Disability Index (average of scores on all functional areas) with Steinbrocker functional class (Kendall's tau b = 0.77, P < 0.0001), number of involved joints (Kendall's tau b = 0.67, P < 0.0001), and morning stiffness (Kendall's tau b = 0.54, P < 0.0001). Spearman's correlation coefficient between Disability Index scores from questionnaires administered to parents and those from questionnaires administered to older children (>8 years) was 0.84 (n = 29; P < 0.001), showing that parents can accurately report for their children. The test–retest reliability, studied at a 2‐week interval, revealed virtually identical Disability Index scores measured on the 2 occasions (0.96 versus 0.96; P > 0.9 by paired t‐test; Spearman's correlation coefficient = 0.8, P < 0.002).Conclusion. The Childhood HAQ, which takes less than 10 minutes to complete, is a valid, reliable, and sensitive instrument for measuring functional status in children with JRA.
Hla type as a predictor of mixed connective tissue disease differentiation ten‐year clinical and immunogenetic followup of 46 patients
Authors: Gendi Nagui S. T. , Welsh Ken I. , Van Venrooij Walther J. , Vancheeswaran Rama , Gilroy Jill , Black Carol M. 
Published: February 2007

AbstractObjective. To determine any clinical or genetic markers of differentiation and outcome in a previously described cohort of 46 patients with mixed connective tissue disease (MCTD).Methods. Patients were clinically evaluated, chart notes reviewed, and HLA subtyping and immunology profiles performed where possible. Eleven had died and 7 were lost to followup.Results. MCTD had differentiated into systemic lupus erythematosus in 12 patients and into systemic sclerosis in 13. The latter was associated with HLA‐DR5 (P = 0.038), and nondifferentiation was associated with HLA‐DR2 or DR4 (P = 0.007). Three HLA‐DR4 positive patients had MCTD that evolved into rheumatoid arthritis. Erosive and/or deforming arthritis was associated with HLA‐DR1 or DR4 (P = 0.015). HLA‐DR3 was associated with interstitial lung fibrosis (P = 0.044) and keratoconjunctivitis sicca (0.001 < P < 0.01). Severe Raynaud's phenomenon predicted higher mortality (0.01 < P < 0.05).Conclusion. We suggest that MCTD is, for most patients, an intermediate stage in a genetically determined progression to a recognized connective tissue disease. Those whose disease remains undifferentiated might be considered a distinct subset.
Long‐term survival in systemic lupus erythematosus patient characteristics associated with poorer outcomes
Authors: Ward Michael M. , Pyun Elise , Studenski Stephanie 
Published: February 2007

AbstractObjective. To investigate the associations of age, sex, race, and socioeconomic status with long‐term survival in patients with systemic lupus erythematosus (SLE).Methods. We examined survival in an inception cohort of 408 patients with SLE. The cohort included 177 black females, 162 white females, 49 white males, and 20 black males. The median duration of followup was 11 years (range 0.1‐22 years).Results. One hundred forty‐four patients died during the study. The 5‐, 10‐, and 15‐year survival estimates for the entire cohort were 82%, 71%, and 63%, respectively. In univariate analyses, mortality rates increased with age and were higher among males, blacks, those without private medical insurance, and those living in census tracts with lower household incomes. In multivariate analyses, age, sex, and both socioeconomic indicators were associated with total mortality (mortality from any cause), while race was not. Lower socioeconomic status and increased age were also associated with higher rates of death from SLE.Conclusion. Socioeconomic status, but not race, is associated with mortality in SLE. SLE‐related mortality also tends to increase with age, which suggests that SLE may not be less severe when it occurs later in life.
Prednisone treatment of elderly‐onset rheumatoid arthritis
Authors: Schaardenburg Dirkjan Van , Valkema Roelf , Dijkmans Ben A. C. , Papapoulos Socrates , Zwinderman Aeilko H. , Hubert Han K. , Pauwels Ernest K. J. , Breedveld Ferdinand C. 
Published: February 2007

AbstractObjective.Prednisone is frequently used in the treatment of elderly‐onset rheumatoid arthritis (RA), but the balance between efficacy and toxicity, including the effect on bone mass, has not been investigated in long‐term studies. This prospective, randomized study was undertaken to compare disease activity and bone mass during long‐term treatment with prednisone versus chloroquine in this patient population.Methods.Patients with active RA diagnosed at age ≥ 60 were randomized to receive prednisone (15 mg/day for 1 month, with the dosage tapered as low as possible thereafter) (n = 28) or chloroquine (n = 28). Patients who did not show a response received other second‐line drugs as an adjunct to prednisone or as a replacement for chloroquine. Bone mass was measured by dual‐energy x‐ray absorptiometry. The study duration was 2 years.Results.During the 2 years, treatment with other second‐line drugs was needed for 12 patients in the prednisone group (43%) and 8 in the chloroquine group (29%). Functional capacity and disease activity improved significantly in both groups and did not differ significantly between the groups, except for a greater improvement in the prednisone group at 1 month. Radiographic scores for joint destruction progressed similarly in both groups. There was a nonsignificant excess bone loss of 1.8% in the spine and 1.5% in the hip in the prednisone group, compared with the chloroquine group.Conclusion.Neither treatment was entirely satisfactory since a significant number of patients needed an additional second‐line drug over the 2‐year period.
Severe anemia as the presenting manifestation of giant cell arteritis
Authors: Michael Weiss L. , Gonzalez Emilio , Miller Stephen B. , Agudelo Carlos A. 
Published: February 2007

AbstractGiant cell (temporal, cranial) arteritis (GCA) is usually confirmed in patients presenting with classic features. Those who present with atypical features often undergo prolonged evaluations until a diagnosis is established. Severe anemia as an initial manifestation of GCA has rarely been described. We describe herein 2 patients with biopsy‐proven GCA who presented with severe anemia and significant weight loss, which corrected after corticosteroid therapy.
Racial differences in the incidence of gout
Authors: Hochberg Marc C. , Thomas John , Johniene Thomas D. , Mead Lucy , Levine David M. , Klag Michael J. 
Published: February 2007

AbstractObjective. To estimate the incidence of and examine risk factors for the development of gout in black and white male physicians.Methods. Data from 2 cohorts of former medical students, 352 black men in the Meharry Cohort Study and 571 white men in the Johns Hopkins Precursors Study, were analyzed. Cases of gout were identified by self‐report. Baseline variables and incident hypertension were examined as risk factors for the development of gout in both cohorts.Results. The incidence of gout was 3.11 and 1.82 per 1,000 person‐years in the black men and the white men, respectively (P< 0.05); the cumulative incidence was 10.9% and 5.8%, respectively (P= 0.04). The relative risk (RR) for gout among the black men was 1.69 (95% confidence interval [95% CI] 1.02–2.80). This excess risk persisted after adjustment for baseline systolic blood pressure (adjusted RR = 1.96 [95% CI 1.14–3.38]). Incident hypertension was independently associated with the development of gout in univariate analysis (RR = 3.78 [95% CI 2.18–6.58]); when this variable was included as a time‐dependent covariate in a Cox model, the excess risk for gout in black men was reduced and no longer significant (adjusted RR = 1.30 [95% CI 0.77–2.19]).Conclusion. The approximately 2‐fold excess risk for gout among black men is explained, in part, by a greater risk of incident hypertension.