bluuebunny/crossref_metadata_2025_split huggingface dataset:
Serum thrombomodulin
Authors: Boehme Michael W. J. , Nawroth Peter P. , Kling Elisabeth , Lin Jie , Amiral Jean , Riedesel Jutta , Raeth Ulrich , Scherbaum Werner A. 
Published: February 2007

AbstractObjective. Soluble thrombomodulin (sTM), a proposed serum marker of endothelial cell injury, was investigated as a parameter of disease activity in patients with systemic lupus erythematosus (SLE).Methods. Levels of sTM were determined by enzyme‐linked immunosorbent assay. Disease activity was assessed using 3 established scoring systems: the American College of Rheumatology (ACR), the New York Hospital for Special Surgery (NYHSS), and the Systemic Lupus Activity Measure (SLAM) systems.Results. A close correlation was found between sTM levels and disease activity as assessed with all 3 scoring systems: r = 0.52 by the ACR, 0.75 by the NYHSS, and 0.82 by the SLAM.Conclusion. We found that sTM is a sensitive serologic marker of organ involvement in patients with SLE. Furthermore, sTM may prove to be an important marker for vasculitis in general.
Treatment of glucocorticoid‐resistant or relapsing takayasu arteritis with methotrexate
Authors: Hoffman Gary S. , Leavitt Randi Y. , Kerr Gail S. , Rottem Menachem , Sneller Michael C. , Fauci Anthony S. 
Published: February 2007

AbstractObjective. To identify the role of methotrexate (MTX) in the treatment of persistent or recurrent Takayasu arteritis that is refractory to treatment with glucocorticoids (GC) alone.Methods. An open‐label pilot study of weekly low‐dose MTX + GC treatment was performed. Outcome was evaluated according to clinical characteristics, laboratory abnormalities, findings on routinely performed angiographic studies, and ability to withdraw GC and MTX therapy. Eighteen patients entered the study; 2 dropped out, and 16 were followed up for a mean period of 2.8 years (range 1.3–4.8 years).Results. Weekly administration of MTX (mean stable dose of 17.1 mg) and GC resulted in remissions in 13 of 16 patients (81%). However, 7 patients (44%) had relapses as GC was tapered to or near discontinuation. Retreatment again led to remission, and 3 of 7 patients in this group have successfully stopped GC therapy. Of those patients who achieved remission, 8 (50%) have sustained remissions of 4–34 months (mean 18 months), and 4 of this group have not required GC or MTX therapy for 7–18 months (mean 11.3 months). Three patients experienced disease progression in spite of treatment.Conclusion. About half of all Takayasu arteritis patients have chronic active disease for which GC therapy alone does not provide sustained remissions that allow withdrawal of treatment. Weekly low‐dose MTX is an effective means of inducing remission and minimizing GC therapy and toxicity in most of these patients. Further long‐term studies will be required to assess the durability of remission and the need for maintenance MTX therapy in this subset of Takayasu arteritis patients.
Reduction of mortality and lymphadenopathy in mrl‐lpr/lpr mice treated with nonmitogenic anti‐cd3 monoclonal antibody
Authors: Henrickson Michael , Giannini Edward H. , Hirsch Raphael 
Published: February 2007

AbstractObjective. To evaluate the therapeutic efficacy of nonmitogenic anti‐CD3 monoclonal antibody (MAb) in a preexisting autoaggressive response, using the MRL‐lpr/lpr (MRL/I) murine model of autoimmune disease.Methods. Female MRL/I mice, 8–10 weeks of age, were treated with nonmitogenic anti‐CD3 MAb or phosphate buffered saline and effects on mortality, lymphadenopathy, T cell phenotypes, anti‐DNA titers, and total IgG titers were measured.Results. Nonmitogenic anti‐CD3 MAb treatment resulted in a dramatic reduction in lymphadenopathy and mortality, as well as an early reduction in α/β+, CD4–, CD8–, Thy+, B220+ (double‐negative) lymph node cells. No significant effects on anti‐DNA or IgG titers were observed. No morbidity was observed following administration of nonmitogenic anti‐CD3 MAb.Conclusion. A short course of treatment with nonmitogenic anti‐CD3 MAb can suppress preexisting autoimmune responses without inducing the cytokinemediated toxicity characteristic of mitogenic forms of anti‐CD3 MAb. The use of nonmitogenic anti‐CD3 MAb may be efficacious in the clinical setting for the treatment of T cell–mediated autoimmune disorders.
A randomized, double‐blind, 24‐week controlled study of low‐dose cyclosporine versus chloroquine for early rheumatoid arthritis
Authors: Landewé ROBERT B. M. , Goeithè Henk S. , Van Rijthoven ANDRE W. A. M. , Breedveld Ferdinand C. , Dijkmans BEN A. C. 
Published: February 2007

AbstractObjective. To investigate whether low‐dose cyclosporin A (CSA) is safe and effective in comparison with chloroquine (CQ) in patients with early rheumatoid arthritis (RA).Methods. We performed a randomized, double‐blind study comparing CSA with CQ in patients with early RA (duration <2 years) who had had active disease for at least 3 months. Forty‐four RA patients with a mean disease duration of 6 months were randomly allocated to receive CSA (initial dosage 2.5 mg/kg/day, maintenance dosage 3.6 mg/kg/day) or CQ (initial dosage 300 mg/day, maintenance dosage 100 mg/day) for 24 weeks.Results. Five patients (2 taking CSA and 3 taking CQ) discontinued the study prematurely. Intention‐to‐treat analysis disclosed a decrease in the swollen joint count by 7 in both groups. The erythrocyte sedimentation rate and C‐reactive protein level did not change significantly. CSA and CQ were tolerated equally well, although mild paraesthesia occurred more frequently in the CSA‐treated group. The serum creatinine level increased by 13 μmoles/liter (95% confidence interval [95% CI] 4, 22) in the CSA group and by 6 μmoles/liter (95% CI 1, 11) in the CQ group (difference not statistically significant).Conclusion. Both CSA and CQ are effective in alleviating the symptoms of active early RA. There is only slightly impaired renal function after 24 weeks of drug administration of either drug in patients with early RA.
Synovial interleukin‐1 receptor antagonist and interleukin‐1 balance in rheumatoid arthritis
Authors: Firestein Gary S. , Boyle David L. , Yu Carolyn , Paine Mary M. , Whisenand Teri D. , Zvaifler Nathan J. , Arend William P. 
Published: February 2007

AbstractObjective. To quantify interleukin‐1 receptor antagonist (IL‐1ra) and IL‐1 production and gene expression by rheumatoid arthritis (RA) synovial tissue (ST) cells.Methods. IL‐1α, IL‐1β, and IL‐1ra protein levels were measured by enzyme‐linked immunosorbent assay in fresh and cultured ST cells, purified synovial macrophages, and fibroblast‐like synoviocytes (FLS). The relative expression of the secreted form of IL‐1ra (sIL‐1ra) and the alternatively spliced intracellular form (icIL‐1ra) was determined by reverse transcription polymerase chain reaction (RT‐PCR) techniques.Results. IL‐1α, IL‐1β, and IL‐1ra were present in fresh and cultured ST cell samples of synovium from RA and osteoarthritis patients. IL‐1ra:IL‐1 ratios ranged from 1.2 to 3.6, which is below the 10–100‐fold excess of IL‐1ra needed to inhibit IL‐1 bioactivity. Isolated CD14+ synovial macrophages secreted IL‐1ra, but the amount was much less than that of alveolar or in vitro–derived macrophages. Cultured FLS contained intracellular IL‐1ra but secreted little IL‐1ra into the culture supernatants. RT‐PCR showed that icIL‐1ra mRNA was more abundant than sIL‐1ra mRNA in FLS and unfractionated ST cells.Conclusion. IL‐1ra production by RA ST cells is deficient relative to total production of IL‐1.
Aberrant production of gliostatin/platelet‐derived endothelial cell growth factor in rheumatoid synovium
Authors: Takeuchi Masanori , Otsuka Takanobu , Matsui Nobuo , Asai Kiyofumi , Hirano Takayoshi , Moriyama Akihiko , Isobe Ichiro , Eksioglu Yaman Z. , Matsukawa Kohei , Kato Taiji , Tada Toyohiro 
Published: February 2007

AbstractObjective. To purify a protein inhibitor from rheumatoid arthritis (RA) synovial fluids which suppresses the apparent incorporation of 3H‐thymidine into fibroblasts and synovial cells, and to define its biochemical features that have clinical relevance to the pathogenesis of RA.Methods. Several standard chromatographic techniques were employed for the purification of the protein. Immunochemical methods with monoclonal antibody were used to quantify and visualize the protein in sera, synovial fluids, and tissues from RA patients.Results. The chemical properties of purified inhibitor from RA synovial fluids confirmed its identity as gliostatin/platelet‐derived endothelial cell growth factor (PD‐ECGF), a potent angiogenic factor. The gliostatin/ PD‐ECGF level in synovial fluid and serum was higher in RA patients than in osteoarthritis controls.Conclusion. These findings strongly suggest that gliostatin/PD‐ECGF might play an important role in the aberrant neovascularization of rheumatoid synovium.
“Homozygosity” for the HLA–DR shared epitope contributes the highest risk for rheumatoid arthritis concordance in identical twins
Authors: Jawaheer D. , Thomson W. , Macgregor A. J. , Carthy D. , Davidson J. , Dyer P. A. , Silman A. J. , Ollier W. E. R. 
Published: February 2007

AbstractObjective. To assess the contribution of HLA–DRB1 alleles in determining rheumatoid arthritis (RA) concordance in monozygotic twins.Methods. Ninety‐one monozygotic twins pairs in which at least 1 twin was affected were typed for HLA–DRB1 using both serologic methods and polymerase chain reaction amplification with sequence‐specific oligonucleotide hybridization. The role of DR4 and of the shared epitope in disease concordance was investigated. Relative risks (RR) with 95% confidence intervals were determined.Results. Increased concordance for RA was observed in both DR4 positive and shared epitope positive pairs (RR 3.4 and 3.7, respectively). A 5‐fold risk for RA concordance was seen in twins who were “homozygous” for the shared epitope, compared with those negative for the shared epitope.Conclusion. In the absence of the shared epitope, RA concordance in monozygotic twins is rare. In contrast, “homozygosity” for the shared epitope is the most important factor in determining RA concordance.
HLA and T cell receptor β‐chain DNA polymorphisms identify a distinct subset of patients with pauciarticular‐onset juvenile rheumatoid arthritis
Authors: Charmley Patrick , Nepom Barbara S. , Concannon Patrick 
Published: February 2007

AbstractObjective. To evaluate and extend upon a reported association of a T cell receptor (TCR) V β coding region polymorphism with pauciarticular‐onset juvenile rheumatoid arthritis (JRA).Methods. TCR V β6.1 genotypes and haplotypes in JRA and control groups were determined by DNA amplification.Results. Haplotypes of the V β6.1 gene which encode a nonfunctional form of V β6.1 were significantly associated with pauciarticular JRA in patients possessing the HLA–DQA1*0101 allele (P = 0.0073).Conclusion. A TCR V β gene segment in the vicinity of V β6.1, possibly V β6.1, is apparently involved in the pathogenesis of pauciarticular‐onset JRA in DQA1*0101‐positive individuals.
Identification of neisseria gonorrhoeae in synovial fluid using the polymerase chain reaction
Authors: Liebling Michael R. , Arkfeld Daniel G. , Michelini Giulia A. , Nishio Midori J. , Eng Bett J. , Jin Tian , Louie James S. 
Published: February 2007

AbstractObjective. To analyze synovial fluid (SF) for the presence of Neisseria gonorrhoeae DNA using the polymerase chain reaction (PCR).Methods. We used a modified, nested PCR to detect the presence of N gonorrhoeae DNA in 41 samples of SF obtained from 10 patients with clinical gonococcal arthritis whose SF samples were sterile by culture and from 27 controls, including 11 patients with Reiter's syndrome. Results obtained using this method were compared with those obtained using the GEN‐PROBE system, an RNA–DNA hybridization technique.Results. With nested PCR, N gonorrhoeae DNA was detected in 11 of 14 SF samples obtained from patients with culture‐negative clinical gonococcal arthritis but in none of the 11 SF samples from Reiter's syndrome patients. The specificity of this technique was 96.4%, with a sensitivity of 78.6%. The rate of false‐positive results was 3.6%. The GEN‐PROBE technique was unable to detect N gonorrhoeae ribosomal RNA in any of the samples.Conclusion. These findings demonstrate the potential utility of the PCR in confirming the clinical diagnosis of gonococcal arthritis as well as providing insight into the pathogenesis of this disorder in patients whose SF are sterile by standard culture techniques. PCR may also prove helpful in differentiating N gonorrhoeae arthritis from acute Reiter's syndrome.
Use of the polymerase chain reaction to study arthritis due to neisseria gonorrhoeae
Authors: Muralidhar Bethi , Rumore Peter M. , Steinman Charles R. 
Published: February 2007

AbstractObjective. To explore the utility of the polymerase chain reaction (PCR) in the diagnosis, management, and investigation of arthritis due to Neisseria gonorrhoeae.Methods. The PCR was used to detect DNA from N gonorrhoeae in model systems and in extracts of synovial fluid (SF) from patients with systemic gonococcal infections and objective evidence of arthritis.Results. One N gonorrhoeae organism or its equivalent was detectable in human SF from inflamed joints. Five of 8 patients with systemic N gonorrhoeae infection and arthritis had N gonorrhoeae DNA demonstrated by PCR in at least 1 pretreatment SF specimen that was N gonorrhoeae culture positive. Thirty‐seven of 38 control specimens were negative, the exception probably being due to cross‐contamination from a positive specimen. All specimens that were positive for N gonorrhoeae by other methods were also positive by PCR. Two others were positive by PCR but negative by other methods. Four pretreatment specimens were negative by all methods, including PCR. This suggests that, for these patients, negative cultures reflected true absence of N gonorrhoeae, and not the presence of unculturable organisms. This group also had a significantly shorter duration of disease than did the patients with N gonorrhoeae DNA found in their SF. All patients had a prompt response to antibiotic treatment. Two of 3 patients whose specimens were previously positive showed marked decreases in SF N gonorrhoeae DNA after treatment.Conclusion. The PCR using these or similar oligonucleotide primers can be a useful adjunct in the diagnosis of gonococcal arthritis and can be of value in assessing its response to therapy. In some N gonorrhoeae–associated arthritides, there appears to be a lack of both viable and nonviable N gonorrhoeae organisms in the SF. These observations may have implications regarding the pathogenesis of this form of arthritis.
Paradiaphyseal calcific tendinitis with cortical bone erosion
Authors: Fritz Pierre , Bardin Thomas , Laredo Jean‐Denis , Ziza Jean‐Marc , D'Anglejan Georges , Lansaman Juliette , Bucki Barbara , Forest Maurice , Kuntz Daniel 
Published: February 2007

AbstractObjective. To determine the clinical, radiologic, and histologic features of calcific tendinitis with cortical bone erosion.Methods. The records of 6 patients with paradiaphyseal calcific tendinitis and adjacent bone cortex erosion were reviewed.Results. Calcific tendinitis involved the linea aspera in 4 patients, the bicipital groove in 1 patient, and the deltoid insertion in another. Calcium deposits were associated with cortical bone erosions, revealed on plain radiographs in 4 patients and computed tomography scans in 2. Bone scans were performed in 2 patients and showed local hyperfixation of the isotope. In 4 patients, suspicion of a neoplasm led to a biopsy. Calcium deposits appeared to be surrounded by a foreign body reaction with numerous giant cells. Apatite crystals were identified by transmission electron microscopy and elemental analysis in 1 surgical sample.Conclusion. Paradiaphyseal calcific tendinitis with cortical bone erosion is an uncommon presentation of apatite deposition disease.
Improved pulmonary function in systemic sclerosis after treatment with cyclophosphamide
Authors: Åkesson Anita , Scheja Agneta , Lundin Anders , Wollheim Frank A. 
Published: February 2007

AbstractObjective. Pulmonary fibrosis is a common feature of systemic sclerosis (SSc) and a major cause of morbidity and mortality. Since alveolitis may be an essential step in the development of pulmonary fibrosis, we investigated the use of immunosuppressive drug therapy to improve pulmonary function in patients with SSc.Methods. Eighteen patients with progressive pulmonary dysfunction, diminished vital capacity (VC), and/or decreased static lung compliance (Cst) were treated with cyclophosphamide and corticosteroids for 1 year. Eight patients had diffuse cutaneous SSc and 10 had limited cutaneous SSc. The median disease duration was 2.5 years (range 0.5–17 years).Results. VC increased in 14 of 18 patients and the median VC rose from 74% to 80% of predicted. Cst improved in 8 of 12 patients and the median Cst increased from 59% to 66% of predicted. Pulmonary nonfibrotic opacities disappeared in 9 of 12 patients. The erythrocyte sedimentation rate (ESR) and serum concentrations of orosomucoid, C‐reactive protein, and aminopropeptide type III collagen all improved. The patients were divided into 2 groups based on the presence or absence of elevations in acute‐phase protein levels and ESR before therapy. Among the 12 patients with biochemical signs of inflammation, VC increased in 11, and Cst improved or was unchanged in 7 of the 8 who were tested. The median VC in this subgroup increased from 73% to 80% of predicted and the median Cst increased from 57% to 60% of predicted. In the group of 18 patients overall, the skin score decreased, while esophageal and renal function remained stable.Conclusion. Cyclophosphamide may have a beneficial effect on pulmonary fibrosis in patients with SSc and elevated levels of acute‐phase proteins. Controlled trials of cyclophosphamide in pulmonary SSc should be performed and should focus on such patients.
Magnetic resonance imaging and p‐31 magnetic resonance spectroscopy provide unique quantitative data useful in the longitudinal management of patients with dermatomyositis
Authors: Park Jane H. , Vital Terri L. , Ryder Nova M. , Hernanz‐Schulman Marta , Leon Partain C. , Price Ronald R. , Olsen Nancy J. 
Published: February 2007

AbstractObjective. To evaluate the utility of magnetic resonance imaging (MRI) and P‐31 magnetic resonance spectroscopy (MRS) in the longitudinal management of patients with dermatomyositis (DM).Methods. The study group consisted of 11 patients, including 3 children, all of whom had a clinical diagnosis of DM. A control group of 8 subjects was studied simultaneously. MRI included images as well as calculations of T1 and T2 relaxation times. The P‐31 MRS protocol evaluated metabolic status (i.e., inorganic phosphate/phosphocreatine ratios and phosphocreatine and ATP levels) during rest, exercise, and recovery.Results. T2‐weighted images of the thigh muscles showed inflammation even when serum creatine phosphokinase levels were in the normal range. Metabolic abnormalities, which were accentuated with exercise, were found in 10 patients. In some individuals, bioenergetic defects preceded other changes and persisted after resolution of inflammation. In general, clinical impressions correlated with MRI/MRS data.Conclusion. MRI and MRS provide unique data which are quantitative and which cannot be obtained from routine laboratory tests. These MR evaluations appear to be of value in assessing the status of DM patients during treatment with steroids and immuno‐suppressive drugs.
Is there an association between injectable collagen and polymyositis/dermatomyositis?
Authors: Rosenberg Michael J. , Reichlin Morris 
Published: February 2007

AbstractObjective. Recent case reports have raised the possibility that use of injectable bovine collagen may be associated with polymyositis/dermatomyositis (PM/DM). Because the number of collagen users is high, PM/DM would be expected to occur in some for reasons unrelated to the collagen use. A central issue is whether the number of observed cases exceeds the number expected on the basis of background rates alone. The present study was undertaken to investigate this.Methods. The number of observed cases was determined by review of the medical records of collagen users who had reported illnesses consistent with PM/DM. Because of the uncertainty about diagnosis of PM/DM, population incidence rates, number of patients treated with collagen, and duration of followup after treatment, we examined a range of estimates of each of these factors that would affect the expected number of cases.Results. From reports among collagen users, 7 probable or definite cases of PM/DM were confirmed. In contrast, 13 cases would be expected based on the best estimates of relevant factors. Under the most conservative estimates for factors that influence the number of expected cases, 12 cases would be expected, while worst‐case assumptions would yield an expected 130 cases.Conclusion. The consistent finding of fewer‐than‐expected PM/DM cases among collagen users suggests that collagen use is not associated with the development of PM/DM.
Serum antibodies to klebsiella capsular polysaccharides in ankylosing spondylitis
Authors: Sahly Hany , Podschun Rainer , Sass Rainer , Bröker Barbara , Kekow Jörn , Gross Wolfgang Ludwig , Ullmann Uwe 
Published: February 2007

AbstractObjective. To measure antibodies to Klebsiella capsular polysaccharides in the sera of HLA–B27 positive patients with ankylosing spondylitis (AS), compared with HLA–B27 positive and HLA–B27 negative healthy control subjects.Methods. Antibodies were detected by means of an enzyme‐linked immunosorbent assay specific for each of the 77 known Klebsiella serotypes.Results. Significantly elevated frequencies and titers of antibodies to capsular polysaccharides K26, K36, and K50 were detected in sera from AS patients, compared with controls.Conclusion. These results suggest the predominance of Klebsiella serotypes K26, K36, and K50 in patients with AS.
Application of neural networks to the classification of giant cell arteritis
Authors: Astion Michael L. , Wener Mark H. , Thomas Ronald G. , Hunder Gene G. , Bloch Daniel A. 
Published: February 2007

AbstractObjective. Neural networks are a group of computer‐based pattern recognition methods that have recently been applied to clinical diagnosis and classification. In this study, we applied one type of neural network, the backpropagation network, to the diagnostic classification of giant cell arteritis (GCA).Methods. The analysis was performed on the 807 cases in the vasculitis database of the American College of Rheumatology. Classification was based on the 8 clinical criteria previously used for classification of this data set: 1) age ≥50 years, 2) new localized headache, 3) temporal artery tenderness or decrease in temporal artery pulse, 4) polymyalgia rheumatica, 5) abnormal result on artery biopsy, 6) erythrocyte sedimentation rate ≥50 mm/hour, 7) scalp tenderness or nodules, and 8) claudication of the jaw, of the tongue, or on swallowing. To avoid overtraining, network training was terminated when the generalization error reached a minimum. True cross‐validation classification rates were obtained.Results. Neural networks correctly classified 94.4% of the GCA cases (n = 214) and 91.9% of the other vasculitis cases (n = 593). In comparison, classification trees correctly classified 91.6% of the GCA cases and 93.4% of the other vasculitis cases. Neural nets and classification trees were compared by receiver operating characteristic (ROC) analysis. The ROC curves for the two methods crossed, indicating that the better classification method depended on the choice of decision threshold. At a decision threshold that gave equal costs to percentage increases in false‐positive and false‐negative results, the methods were not significantly different in their performance (P = 0.45).Conclusion. Neural networks are a potentially useful method for developing diagnostic classification rules from clinical data.