Peripheral nerve entrapments.
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Biomedical subjects
Publications and source records attributed to A Cracchiolo.
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The levels of six lysosomal enzymes (acid phosphatase, beta-acetylglucosaminidase, cathepsin D, beta-galactosidase, arylsulfatase A, and beta-glucuronidase) and four neutral and alkaline hydrolases (esterase, inorganic phyrophosphatase, alkaline phosphatase, and 5'-nucleotidase) were measured in osteoarthritic, rheumatoid and control synovia. All enzyme levels in diseased synovium except esterase values in osteoarthritis were significantly elevated compared with controls. The mean values of the group of acid hydrolases and the group of neutral and alkaline hydrolases in osteoarthritic synovia were 1.9- and 2.0-fold greater than those of control specimens. In rheumatoid synovia, the values were 4.2- and 4.5 fold greater than control for the same enzymes. Levels in rheumatoid synovia were significantly higher than those in osteoarthritic synovia with the exception of 5'-nucleotidase. Only a limited correlation between the extents of inflammation present in the synovia and the levels of a lysosomal marker enzyme (cathepsin D) was observed. These results demonstrate that whatever the mechanism, increased levels of acid hydrolases as well as certain neutral and alkaline hydrolases are present in osteoarthritic and rheumatoid synovia, and these enzymes are probably contained in the synovial lining cells.
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Single or multiple destruction of joints arises from many causes, ranging from the acute destructive process (usually monarticular) in septic joint disease to the chronic, slowly evolving destruction of cartilage and adjacent bone that occurs in osteoarthritis. Medical treatment of a few of these conditions (including rheumatoid arthritis) is reasonably satisfactory if it is initiated early. On the other hand, surgical procedures are indicated if physical and X-ray examination of the involved joints discloses the presence of a significant destructive process involving both articular cartilage and bone. Several very satisfactory such operative techniques, including synovectomy (in the relatively early phases) and prosthetic joint replacement, have been recently developed. These are especially favorable in destructive disease of the hip, knee, or small joints of the hand. The various differential diagnostic, radiographic medical, and surgical procedures are discussed in some detail in this conference.
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