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  • 1
    ISSN: 1365-2516
    Quelle: Blackwell Publishing Journal Backfiles 1879-2005
    Thema: Medizin
    Notizen: Summary. Synovium is an essential component of the joint and plays a critical role in maintaining a balance between physiological processes and pathological changes in the joint. Recurrent intra-articular bleeding as occur in haemophilia induce pathological synovial changes in the joint. From a certain point on, synovitis inevitably plays a major role in joint destruction, although in the early phase of haemophilic arthropathy its role may be secondary to cartilage damage as a result of the direct effects of blood on cartilage. The changed haemosiderotic, synovial tissue produces catabolic cytokines and enzymes harmful for cartilage.
    Materialart: Digitale Medien
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  • 2
    Digitale Medien
    Digitale Medien
    Oxford, UK : Blackwell Publishing Ltd
    Scandinavian journal of immunology 36 (1992), S. 0 
    ISSN: 1365-3083
    Quelle: Blackwell Publishing Journal Backfiles 1879-2005
    Thema: Medizin
    Notizen: Previously we have shown that blood mononuclear cells (MNC) obtained from patients with rheumatoid arthritis (RA) have the capacity to induce depletion of proteoglycans (PG) in human cartilage explants. This was observed especially after stimulating MNC with mycobacterial antigens, rather than with the miiogen Concanavalin A (Con A). We have now co-cultured cartilage explants in the presence of T-cell clone A2b obtained from the rat model of adjuvant arthritis (A A). We show that inhibition of the cartilage PG synthesis is a consequence of antigenspecific T-cell activation and that it is mediated by a humoral factor. This seems to be a cytokine rather than an enzyme. Moreover, at the level of polyclonally responding T cells. inhibition of PG synthesis due to T-cell activation by mycobacterial antigens was shown to depend on prior mycobacterial immunization. Arthritogenic T-cell clone A2b also showed PG synthesis inhibitory effects when co-cultured with cartilage alone. The inhibitory activity was shown to be unrelated to the degree of T-cell proliferation. We conclude that antigen-specific T-cell activation may be one of the initiating events leading to cartilage damage in arthritic processes. The measurement of T-cell-mediated PG synthesis inhibition may be a more sensitive and relevant assay for the detection of pathogenic T cells than T-cell proliferation.
    Materialart: Digitale Medien
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  • 3
    ISSN: 1437-160X
    Schlagwort(e): Proteoglycan depletion ; Human articular cartilage ; Tissue culture ; Synovium ; Rheumatoid synovial fluid ; Mononuclear-cell factor
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Summary To investigate mechanisms of cartilage destruction that may apply to rheumatoid arthritis, young and old human, and young porcine, articular cartilage was cultured for 8 days and the effects on proteoglycan (PG) metabolism of normal synovium supernatant (NSS), rheumatoid synovial fluid (RFL), and blood mononuclear cell supernatant (MCF) were studied. The effects were chondrocyte-mediated. An inverse correlation was found between baseline net PG synthesis and the effect of NSS on PG synthesis. Responses of young (porcine and human) cartilage were similar. In young cartilage the three agents induced PG depletion by suppression of net PG synthesis. In old cartilage NSS and RFL induced PG depletion, whereas MCF did not. In cartilage of low baseline net PG sysnthesis, NSS and MCF stimulated both PG release and PG synthesis; NSS stimulated predominantly PG release, and MCF predominantly PG synthesis. In conclusion, young and old human cartilage differ in the quality of their in vitro response to potentially catabolic factors. This may be due to the difference in baseline net PG synthesis. Synovial extracts differ from mononuclear-cell supernatants in their effects on old cartilage. It is suggested that this is caused by the presence, in different relative amounts, of factors that influence either PG synthesis or PG release.
    Materialart: Digitale Medien
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  • 4
    Digitale Medien
    Digitale Medien
    Springer
    Rheumatology international 10 (1990), S. 107-112 
    ISSN: 1437-160X
    Schlagwort(e): Natural antibodies ; CD5+B cells ; Rheumatic diseases-Actin ; Myosin ; ssDNA
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Summary The prevalence and Ig class of natural antibodies in the sera of healthy individuals and of patients with rheumatic diseases were studied. The presence, even in high concentrations, of natural antibodies in normals was confirmed. In the rheumatic diseases tested, however, a discordance in the levels and Ig class of anti-actin, anti-myosin and anti-ssDNA antibodies was noted. IgM anti-actin antibodies occur infrequently, whereas IgM anti-myosin and anti-ssDNA are increased in these diseases. IgG anti-actin antibodies are increased in the sera of patients with RA, but not in patients with SLE, polymyositis or mixed connective tissue disease (MCTD). IgG anti-myosin as well as anti-ssDNA antibodies were increased in patients with RA and SLE, but not in patients with polymyositis or MCTD. These findings suggest that these natural antibodies are unlike the multispecific autoantibodies produced by lymphocytes from the CD5+B cell lineage and that they may have undergone affinity maturation. Perhaps natural antibodies are a feature of health rather than of disease.
    Materialart: Digitale Medien
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  • 5
    ISSN: 1573-3521
    Schlagwort(e): rheumatoid arthritis ; psychological distress ; pain ; functional status ; disease impact ; social support ; coping with stress
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin , Psychologie
    Notizen: Abstract In order to examine determinants of psychological distress and its course in the first year after diagnosis in rheumatoid arthritis patients, self-report data and clinical and laboratory measures were collected in 91 patients (70% female, mean age 57 years) shortly after diagnosis and 1 year later. Multiple regression analysis indicated that sex, pain and functional status, disease impact on daily life, life events, and perceived social support were related to psychological distress (anxiety and depressed mood) shortly after diagnosis. Coping strategies were related to distress levels only 1 year later. Multiple regression analysis of change in anxiety and depressed mood revealed that a decrease of psychological distress after 1 year could be predicted by male sex, an initially less severe inflammatory activity and an initially more extended social network. In addition, a decrease in distress was related to parallel improvements in clinical status. Results indicate the importance of a multimodal assessment of demographic variables, clinical and life stressors and social resources for the understanding of distress and the identification of risk factors in the first stage of the disease. Personal coping resources appear to become more important predictors of distress in a later phase of the disease.
    Materialart: Digitale Medien
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  • 6
    Digitale Medien
    Digitale Medien
    Springer
    Journal of behavioral medicine 15 (1992), S. 189-214 
    ISSN: 1573-3521
    Schlagwort(e): osteoarthritis ; pain ; disability ; review
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin , Psychologie
    Notizen: Abstract Pain and disability are cardinal symptoms in osteoarthritis. The literature is reviewed in order to identify causes of these symptoms at the articular, kinesiological, and psychological level. It is concluded that pain and disability are associated with degeneration of cartilage and bone (articular level), with muscle weakness and limitations in joint motion (kinesiological level), and with anxiety, coping style, attentional focus on symptoms, and possibly depression (psychological level). Biobehavioral mechanisms of pain and disability which explain the observed associations are described and the empirical evidence for these mechanisms is evaluated. Methodological and conceptual deficiencies in the research reviewed are pointed out and suggestions for further research are given.
    Materialart: Digitale Medien
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  • 7
    Digitale Medien
    Digitale Medien
    Springer
    Clinical rheumatology 12 (1993), S. 500-505 
    ISSN: 1434-9949
    Schlagwort(e): Corticosteroid Treatment ; Intravenous Methylprednisolone Pulses ; Oral Prednisolone Pulses ; Methotrexate ; Rheumatoid Arthritis ; Disease Activity
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Summary We randomly assigned 30 active rheumatoid arthritis (RA) patients who started oral methotrexate (MTX, 7.5 mg/week) treatment, into 3 groups. Group I received no additional corticosteroids; Group II was treated with 3 oral pulses of 100 mg prednisolone and Group III with 3 intravenous pulses of 1000 mg methylprednisolone (MP) on alternate days during the first week. Parameters of disease activity were measured at the start, after 10 days and at regular intervals up to 1 year. In Group I maximal improvement occurred after 18 weeks and in Group III after 6 weeks. This effect was sustained during the study. The initial effects in Group II were not as strong as in Group III and of shorter duration. No serious side effects were noticed. Our results suggest, that MP-pulse therapy seems to be useful in bridging the gap between the introduction of MTX and the response to this drug. Furthermore, we found that patients who were HLA-DR4-positive showed a better clinical response after 1 year than HLA-DR4-negative patients.
    Materialart: Digitale Medien
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  • 8
    ISSN: 1434-9949
    Schlagwort(e): Corticosteroids ; Low Dose Prednisone ; Osteocalcin
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Summary The effect of low dose prednisone on calcium and bone metabolism was evaluated in 8 healthy, young, male volunteers. Sodium and calcium intake were kept stable during the whole study period of 7 weeks. Week 0 was the baseline period; during week 1, 3 and 5 prednisone (10 mg/day) was given, during week 3 together with 500 mg elementary calcium and during week 5 with 4000 IU vitamin D on alternate days. During week 2, 4 and 6 no medication was given. No changes occurred in fasting urinary excretion of calcium or hydroxyproline, nor in serum levels of alkaline phosphatase, 25-Vitamin D, PTH, creatinine and inorganic phosphorus. A rapid decrease of serum osteocalcin during prednisone intake was found (p〈0.01). This dip also occurred during prednisone and vitamin D treatment, but did not occur when calcium was added to prednisone, although the baseline value was lower at the start of combined treatment with prednisone and calcium. Serum calcium decreased during prednisone (p〈0.05), but when prednisone was given together with calcium, an increase of serum calcium was found. (p〈0.05). It is concluded that 10 mg prednisone/day decreases bone formation, as shown by its effect on osteocalcin, while no influence is seen on bone resorption. Thus, prednisone, even when used in low doses, influences bone metabolism by uncoupling bone formation (decreased) and bone resorption (unchanged). These data suggest that the Cs-associated decrease in serum osteocalcin and in serum calcium does not occur during calcium suppletion.
    Materialart: Digitale Medien
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  • 9
    ISSN: 1434-9949
    Schlagwort(e): Ischemic Necrosis of Bone ; Osteonecrosis ; Amyloidosis ; Corticosteroids ; Magnetic Resonance Imaging
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Summary A 36-year-old white male suffering from auto-immune granulocytopenia with recurrent infections and subsequent systemic AA-amyloidosis developed ischemic necrosis of bone (INB) in several joints following long-term corticosteroid treatment. Early signs of INB in one joint were detected by Magnetic Resonance Imaging and joint damage could be prevented by core decompression. The importance of early detection of INB Magnetic Resonance Imaging is stressed. According to the present theory regarding the pathogenesis of INB, amyloidosis might contribute to intraas well as extra-osseous factors. However, no relation was found between amyloidosis and INB.
    Materialart: Digitale Medien
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  • 10
    Digitale Medien
    Digitale Medien
    Springer
    Quality of life research 6 (1997), S. 0-0 
    ISSN: 1573-2649
    Schlagwort(e): Aged ; coping ; disabled ; osteoarthritis ; pain ; quality of life
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract This study examines the quality of life (QOL) of community living elderly people aged 55-74 with chronic, episodic or sporadic pain in the hip or knee and of a reference group without pain (total n=306). Firstly, it was hypothesized that the experienced QOL is lower in people with more chronic pain. Secondly, the potential mediating and moderating roles of disability and of coping with problems in general on the relationship between pain chronicity and QOL were assessed. A Visual Analogue Scale was used to assess global QOL. Physical as well as psychosocial disability was assessed with the Sickness Impact Profile (SIP). Coping with problems in general was assessed with the Utrecht Coping List. As expected, a significantly lower QOL was found in people with more chronic pain (p=0.045). The difference in QOL between the group with chronic pain and a reference group without pain was 10%. A multivariate regression model showed that physical and especially psychosocial disability are mediators in the relationship between pain chronicity and QOL and that ‘seeking social support’ as a coping style is a more important predictor of the experienced QOL than either pain chronicity or physical disability. No moderating role of the style of coping with problems was found.
    Materialart: Digitale Medien
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