Biomedical subjects
Publications and source records attributed to B Fishel.
A case of juvenile dermatomyositis developing intermuscular fascial plane calcification in the thighs early in the course of the disease is described. The use of CT was helpful in localizing the calcium deposits between the muscular layers before surgical removal of the calcification. These procedures may have prevented fistulization and development of contracture of the joints.
The Schizosaccharomyces pombe centromere-linked genes, LYS1 and CYH1 on chromosome I and TPS13 and RAN1 on chromosome II, have been isolated. The genetic order of these markers with respect to their centromeres was determined to establish relative directionality on the genetic and physical maps. Chromosome walking toward the centromeres reveals a group of repetitive sequences that occur only in the centromere regions of chromosomes I and II and at one other specific location in the S. pombe genome, presumably the centromere of chromosome III. The major class of large repeated sequence elements is 6.4 kilobases (kb) long (repeat K), portions of which occur at least twice on chromosome II and in several tandemly arranged intact copies at another centromeric location. Repeat K in turn contains groups of smaller repeats. Genetic recombination is strongly suppressed in the centromere II region, which contains at least 30 kb of repeated sequences. Centromeric DNA organization is much more complex in fission yeast than has been described in budding yeast (Saccharomyces cerevisiae), possibly because of the larger more condensed nature of the S. pombe chromosomes.
Two girls, one with progressive systemic sclerosis and a second with dermatomyositis, developed calcinosis in the skin of the prepatellar area. Calcinosis was accompanied by local inflammation and skin ulceration. Oral colchicine therapy in a dosage of 1 mg per day was followed within two months by significant regression of local inflammation and healing of the skin ulcers.
An unusual case of neuropathic arthropathy in a patient with tabes dorsalis is presented. The special feature consisted of multiple joint involvement in the upper limbs and spine. This uncommon location of Charcot joints can probably be attributed to the patient's occupation which involved heavy strains on his upper limbs.
Serum lipid and lipoprotein concentrations were measured in 51 women with rheumatoid arthritis treated with both nonsteroidal and steroidal drugs and compared to a group of women with rheumatoid arthritis not receiving anti-inflammatory drugs and to a healthy control group. Significantly lower concentrations of total cholesterol and low density lipoprotein cholesterol were found in the rheumatoid patients on nonsteroidal or steroidal anti-inflammatory drugs, while no difference was found in high density lipoprotein cholesterol and triglycerides. In the group of rheumatoid patients who received no nonsteroidal or steroidal anti-inflammatory drugs, the triglyceride level was higher than in the control group, and that of HDL-C was lower. Total cholesterol and LDL-C levels were higher in the patients not on anti-inflammatory drugs than in patients receiving anti-inflammatory drugs. The results of this study suggest that hyperlipidemia is not one of the predisposing factors for coronary disease in patients with rheumatoid arthritis receiving anti-inflammatory therapy. Anti-inflammatory drugs may play a role in the regulation of serum lipids in patients with rheumatoid arthritis.
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In an eight-week double-blind study comparing the new long-acting aspirin derivative, diflunisal, in doses up to 1 g/day with aspirin in doses up to 4 g/day in 16 patients with classical or definite rheumatoid arthritis, diflunisal was more effective in reducing the total articular index (Ritchie) and erythrocyte sedimentation rate and in increasing grip strength. Diflunisal had an earlier effect on erythrocyte sedimentation rate than antiinflammatory doses of aspirin. Patients on diflunisal experienced fewer side effects than patients on aspirin. Ten patients with rheumatoid arthritis who previously participated in the eight-week study comparing diflunisal to aspirin (five patients from each group) were continued on 1 g diflunisal per day for six months. The efficacy of diflunisal therapy persisted during a six-month period, and there were no side effects. The switchover from 4g aspirin to 1g diflunisal a day was accompanied by further improvement in the Ritchie total score, erythrocyte sedimentation rate, and grip strength and by disappearance of side effects. Diflunisal 1 g/day proved to be an efficient and well-tolerated drug in patients with rheumatoid arthritis.
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Increased activity of hepatic microsomal enzymes can be evaluated by measuring D-glucaric acid excretion in urine and gamma-glutamyltransferase (EC 2.3.2.2) activity in serum. Aside from diverse foreign compounds, endogenous steroid hormones have been shown to be normal substrates of the microsomal enzyme system. Because there is an increase in steroid production in pregnancy, we sought to determine whether these indices of induction increase during pregnancy. In 90 women in various stages of pregnancy, all with normal kidney function, we measured glucaric acid excretion in urine and activity of the transferase in serum and in urine. Glucaric acid increased markedly during pregnancy, from 14.4 +/- 2.1 in the first trimester to 23.5 +/- 2.8 mumol of D-glucaro-1,4-lactone per gram of creatinine in the third trimester. We saw no correlation between glucaric acid excretion and the transferase activity in serum or urine. Activity of gamma-glutamyl-transferase remains within normal limits throughout pregnancy, which leaves doubt as to the value of this measurement in evaluating enzyme induction owing to endogenous steroids.
We tried to determine whether short-term treatment with alpha-methyldopa, quinidine, digoxin, diazepam or furosemide--drugs in common use in hospitals--is capable of stimulating the activity of hepatic microsomal drug-metabolizing enzymes. Glucaric acid (GA) excretion and serum activity of gamma-glutamyl transpeptidase (GGT) were used as indicators of hepatic microsomal enzyme activity. Increased GA excretion was found in 45% and increased serum GGT activity in 40% of the patients on drug treatment. Only 14.3% showed an increase in both indicators. The excretion of GA rose significantly in patients who received drugs for less than 10 days, as compared with those who received drugs for less than 10 days, whereas the percentage of high GGT values did not rise significantly with increased duration of treatment. The lack of correlation between serum GGT activity and GA excretion casts doubt on the value of GGT as a consistent indicator of microsomal enzyme induction. GA excretion, on the other hand, seems to be a dependable index of microsomal enzyme induction in response to short-term treatment with standard doses of several widely used drugs.
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A case of chylous cyst of the shoulder joint containing cholesterol crystals is presented. The patient suffered from rheumatoid arthritis of short duration. The cyst completely disappeared following therapy with gold.
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