Early diagnosis of ankylosing spondylitis.
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Biomedical subjects
Publications and source records attributed to B Pal.
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Limited joint mobility and shoulder capsulitis were evaluated in 109 consecutive diabetic patients attending an out-patient diabetic clinic. Forty-nine had insulin-dependent diabetes mellitus (IDDM) and 60 had non-insulin-dependent diabetes mellitus (NIDDM). Seventy-five normal subjects were also examined. Limitation of joint mobility was detected in 24 (49%) patients with IDDM and in 31 (52%) patients with NIDDM but in only 17 (20%) normal subjects (p less than 0.001). There were no significant differences between diabetic patients with and without joint limitation with regard to age, sex, type of DM, mean daily insulin dosage and overall diabetic control as assessed by estimation of glycosylated haemoglobin concentration. However, patients with impaired joint mobility had a longer duration of diabetes (p = 0.01) and a significantly increased frequency of retinopathy compared to patients without joint limitation (p less than 0.05). Normal subjects with restricted joint mobility were older than those without restriction (p = 0.05). Shoulder capsulitis was present in 19% of patients with diabetes mellitus and 5% of normal subjects. However, there was no significant association between limited joint mobility and shoulder capsulitis in the diabetics.
A controlled trial of continuous lumbar traction in the treatment of back pain and sciatica showed similar improvements in both the treated group (weighted traction) and the control group (simulated traction). The findings of this study question the justification of admitting patients with back pain into hospitals for purposes of traction alone.
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Clinically and immunologically rheumatoid arthritis (RA) is possibly a heterogeneous disorder. Despite numerous efforts clearer definition of this heterogeneity has been of limited success. Measurements of rheumatoid factor (RF) and antinuclear antibodies (ANA) by conventional methods define subpopulations of patients with RA and in a few recent studies an association of human leucocyte antigens (HLA) undoubtedly indicates the immunogenetic differences in the susceptibility of RA patients with different status of autoantibodies. The studies on a few isolated non-HLA genetic markers in RA are controversial. To understand the role of genetic factors in susceptibility 24 single gene characters other than HLA were investigated in 225 patients with RA classified by humoral status (presence or absence of RF and ANA) into three groups and in 104 healthy control individuals from the north east of England. Locus by locus comparison suggested associations of MN, Lewis, and Bf system with RF positive patients. Although the associations with MN and Lewis blood groups require further investigations, the involvement of the Bf locus is in agreement with the immunological component of the disease suggested by HLA associations and it could be due to the phenomenon of linkage disequilibrium. Measures of genetic distance applied to the subpopulations of patients with RA, divided according to the presence or absence of humoral factors, suggest that RF+ ANA+, RF- ANA-, and RF+ ANA- subgroups are distinct genetic diseases, each affecting a different subsection of the population which is genetically distinct. Such genetic heterogeneity may suggest a different pathogenetic mechanism for each of these subpopulations of rheumatoid arthritis.
Supplementation of the diet of adult male rats with 4,000 ppm zinc as ZnSO4 for 30 to 32 days increased the zinc content in the testis and sperm by 25 and 18 per cent respectively, but did not change the same in accessory reproductive tissues, e.g. epididymis, seminal vesicle and prostate. The incidence of conception from mating between normal females and zinc fed males was lower as compared to mating between normal females and control males. This observation indicated reduced fertility of the males resulting from additional zinc ingestion. Motility of the sperm collected from the epididymis (tail) of the zinc treated rats was found to be inhibited. It has been suggested that excess zinc in the sperm was responsible for their poor motility and hence a reduced fertilising capacity.
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Two hundred and six patients with rheumatoid arthritis were examined for their association with the subtypes of Gc (vitamin D binding protein). In patient groups there is 11% excess of individuals with Gc*2 allele compared to the control group, giving a relative risk of 1.55. This risk increases with the humoral status of the individual. A possible physiological basis between the association of vitamin D binding protein and rheumatoid arthritis is discussed.
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The ratio of the uptake of radioactivity in each sacroiliac joint to the uptake in the sacrum has been measured in 57 patients with early ankylosing spondylitis and in 51 control subjects. The distribution of ratios of uptake obtained in each of these two groups shows appreciable overlap, and it is shown that the specification of a 'normal range' in this sort of situation can be misleading in the interpretation of the uptake ratio obtained in a given subject. An alternative approach described here is to use Bayes' theorem, which combines a probability based on the numerical value of the measured ratio with the pretest clinical impression about the likelihood of ankylosing spondylitis to yield a post-test probability of the presence of the disease.
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The mean values of zinc in seven samples of vegetarian and seven samples of non-vegetarian household wholeday diets consumed by sedentary adult Bengalee males belonging to the middle income group were found to be 6.06 mg and 5.33 mg respectively. The average value of all fourteen diets was 5.72 mg.
The interaction between ultraviolet light and tetracycline in producing cell killing and mutation has been studied in V79 Chinese hamster cells. It has been established that these agents act independently of each other. Cycloheximide altered the response to tetracycline in the fractionation experiment: when cycloheximide was not present, fractionation of TC treatment resulted in a higher mutation yield but no change in survival level; in the presence of cycloheximide, however, mutation was greatly reduced but survival increased. The results were taken to indicate that for tetracycline action to take place, de novo protein synthesis during tetracycline treatment was necessary. Caffeine had no influence on tetracycline-induced lethality or mutagenicity. This observation was considered to suggest that tetracycline did not affect cellular repair processes.
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UV-irradiated Chinese hamster cells on post-irradiation treatment with caffeine in growth medium for 24 h gave rise to biphasic UV-survival curves. At caffeine concentrations between 0.001 and 0.1 mM, control and caffeine-grown cells had similar survival curves initially from 0 to 30 J/m2. At fluences greater than 30 J/m2, there was effectively only little further killing of caffeine-grown cells beyond that observed at 30 J/m2. At concentrations of caffeine greater than 0.5 mM, there was a gradual sensitization in the early part of the survival curve with increasing caffeine concentrations; but at fluences greater than 30 J/m2, the slopes in the survival curves decreased very much. It has been proposed that the initial sensitization observed at low UV fluences is due to the suppression of post-replication repair by caffeine. After high fluences of UV exposures in these excision-deficient cells, in the presence of caffeine, the possibility of an induced 'SOS'-like repair process has been suggested. This suggestion was supported by the observation that caffeine increased the yield of the UV-induced 8-azaguanine-resistant mutants only for the cell population exposed to UV fluences greater than 30 J/m2.