Selective suppression of autoantibody responses in NZB/NZW MICE treated with long-term cyclophosphamide

Autoimmune responses were assayed in 80 cyclophosphamide-treated and control NZB/NZW mice over a period of 1 year. Fluctuation between positive and negative immunofluorescent heterogeneous ANA tests and daily alterations of ANA titers were detected in young mice of both sexes. Although highdose cyclophosphamide therapy (8 mg/kg/day) failed to prevent the spontaneous appearance of ANA, titered ANA values were partially suppressed in highdose treated mice. This study permitted sequential comparisons between ANA titers and anti-DNA as useful indices of cyclophosphamide-induced suppression of autoimmune disease. ANA titers were relalively resistant to cyclophosphamide therapy. Antibodies directed specifically against DNA were suppressed in mice receiving high-dose cyclophosphamide. In treated animals, decreased anti-DNA levels were associated with protection from severe glomerulonephritis and renal vasculitis. Treatment with lowdose cyclophosphamide (1 mg/kg/day) appeared paradoxically to stimulate autoantibody production and renal disease/vasculitis.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/37726/1/1780180312_ftp.pd

Evaluation of a continuing education program in rheumatoid arthritis

A continuing medical education (CME) program in rheumatoid arthritis was implemented and evaluated in six community hospitals. It was targeted at primary care physicians and utilized physicians identified by their peers as being educationally influential for the dissemination of content knowledge. Although inpatient and outpatient audits of physician records demonstrated little change in three control communities, substantial improvement in the utilization of diagnostic procedures and patient management was documented in the three intervention communities utilizing the influential physicians. CME delivered through community-based educationally influential physicians is an effective way to change physician behavior in small communities with no prior ongoing educational programs. This approach should improve the primary care given to patients with rheumatoid arthritis and reduce the need for participation of academic faculty in traditional CME programs.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/37747/1/1780230711_ftp.pd

Metabolism of 5'-nucleotide monosaccharides in inflammatory connective tissue

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/33223/1/0000613.pd

Microautoradiographic study of the intracellular and extracellular distribution of glycerol-1,3-C 14 labeled lipids in experimental connective tissue

No Abstract.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/37704/1/1780090205_ftp.pd

Acute nongonococcal infectious arthritis

A retrospective analysis of 71 nongonococcal joint infections in 63 patients in reported. Staphylococcus aureus was isolated from 59% of the patients. Five patients died as a result of infections. The outcome in Gram-n egative joint infections was similar to the overall outcome in the entire series of patients. All 11 joints with infected prostheses ultimately required removal of the prostheses. All patients were treated with appropriate parenteral antibiotics, and surgical intervention was used in 40 joints. Six patients underwent surgical treatment because of inability to sterilize the joint with antibiotics and because of repeated joint aspirations. The outcome with surgical intervention was good only in patients younger than 16 years of age. Medical therapy (parenteral antibiotics and frequent joint aspirations) led to good results in 74% of the patients. Outcome of joint infection was also influenced by factors which contribute to imparied host resistance.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/37749/1/1780230803_ftp.pd

Frequency of neoplasia in systemic lupus erythematosus and rheumatoid arthritis

A patient population admitted to the hospital for either SLE or RA was surveyed for the subsequent development of neoplasms. The frequency of neoplasm in SLE patients appeared to be exaggerated, whereas the frequency of subsequent neoplasm in rheumatoid patients was unexpectedly low. A paucity of nephritis in the SLE group was noted. Further reports are encouraged so that the magnitude of the risk of malignancy developing with immunosuppressive therapy can be more precisely ascertained.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/37730/1/1780190605_ftp.pd

Distinctive serum globulin responses to parenteral treatment with 17-Β-estradiol in female NZB/NZW mice

After 6 weeks of treatment with 17-Β-estradiol, two distinct groups of female NZB/NZW mice were identified. Group I females developed significant increases in serum Α 2 , Β- and Γ-globulins and had few serologic abnormalities. Serum globulins did not increase in Group II females. This blunted response correlated with a pretreatment increase in the frequency of positive tests for ANA, LE phenomena and cryoproteins in 4-week-old Group II mice.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/37721/1/1780150107_ftp.pd

Synovial fluid lipids in normal individuals and patients with rheumatoid arthritis

Normal human synovial fluid contains trace amounts of phospholipids and cholesterol. Phospholipid composition is similar to that in serum. Rheumatoid synovial fluid contains increased amounts of phospholipid, cholesterol, and neutral lipids. In most cases the concentration is 40 to 60 per cent of that found in simultaneously collected serum specimens. A direct relationship appears to exist between total synovial fluid protein and lipid concentration. No relationship could be established between lipid content in rheumatoid synovial fluid, and total cell content, hyaluronic acid, severity or duration of synovitis in the involved joint.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/37694/1/1780050606_ftp.pd

Antinuclear Antibodies, Rheumatoid Factor and c-Reactive Protein in Serum of Normal Women Using Oral Contraceptives

Some women who report to a hospital or arthritis clinic note exacerbation of rheumatic complaints and develop serologic abnormalities while taking oral contraceptives. The current study concerns the detection of antinuclear antibodies, rheumatoid factor and C-reactive protein in normal women using these drugs. Prospective study of 82 women before and during oral contraceptive use permitted the detection of 4 who developed antinuclear antibodies, 9 who developed rheumatoid factor and 30 who developed C-reactive protein after less than 1 year of drug use. The prevalence of positive tests was greater in a group of 210 women who were using OC than that found in a group of 174 who had never used these drugs. None of these women developed rheumatic symptoms while using oral contraceptives.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/37718/1/1780140208_ftp.pd

Experimental osteoarthritis induced by selective myectomy and tendotomy

A new model of osteoarthritis has been developed that utilizes an extraarticular surgical technique to alter gait and weight-bearing capabilities in the hind limbs of experimental animals. Guinea pigs, averaging 650 gm in weight, were subjected to unilateral resection of a segment of the gluteal muscles at the sacral origin, to section of the infrapatellar ligament, or to both procedures. Progressive changes consistent with osteoarthritis developed over 10–24 weeks as judged by gross, radiologic, and microscopic findings. In addition, an increase in mean cartilage water content and 35 SO 4 −2 incorporation into proteoglycans by 10 and 14 weeks, respectively, were consistent with the chemical changes observed in early osteoarthritis. Abnormalities developed not only in the operated hind limb, but in the contralateral, unoperated hind limb at a slightly later time. Thus, this animal model provided the opportunity to evaluate a mild gait abnormality and other biomechanical influences on the evolution of osteoarthritis which is uninfluenced by any intraarticular joint trauma.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/37774/1/1780290214_ftp.pd