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Biomedical subjects

D G Scott

Publications and source records attributed to D G Scott.

At least 91 records · Page 5Linked to original sources
PubMed1988

Enalapril in Raynaud's phenomenon.

The effect of enalapril in the treatment of Raynaud's phenomenon was assessed in a prospective double-blind cross-over trial in 17 patients (nine primary Raynaud's, eight Raynaud's associated with scleroderma). Each patient received 20 mg enalapril daily and placebo for 3 weeks with a 2-week washout period in between. The severity and frequency of Raynaud's attacks were measured subjectively by a diary count and objectively by measurement of finger systolic pressure changes in response to cooling (cold challenge test). Enalapril was associated with a reduction in the frequency of Raynaud's attacks, especially in patients with primary Raynaud's, compared with placebo, but there was no effect on the cold challenge test. We conclude that enalapril, like other vasodilator drugs, helps the symptoms of Raynaud's phenomenon, especially in patients with idiopathic or primary disease.

Adolescent↗
PubMed1988

Individual variation in the isotype profile of anti-histone autoantibodies in systemic lupus erythematosus.

Using a solid-phase radioimmunoassay we have measured levels of anti-histone autoantibodies of the IgG, IgA and IgM heavy chain classes in 40 patients with systemic lupus erythematosus. Twenty-two patients (55%) had significantly elevated levels of at least one anti-histone isotype. Our results reveal four characteristics of the anti-histone response. (1) There is wide variation between patients in the isotype profile of anti-histone antibodies and these isotype profiles are a consistent individual characteristic. (2) There is no significant correlation between the level of IgG, IgA and IgM anti-histone in individual patients and a marked tendency for a single isotype (either IgG, IgA or IgM) to predominate in any one patient. (3) IgG anti-histone antibodies are predominantly of the IgG1 subclass. (4) Among 12 patients tested, IgG and IgA antibodies showed a preference for histones 1 and 2B whereas IgM antibodies showed no consistent preference for individual histones.

Adult↗
PubMed1987

Factor VIII related antigen in the assessment of vasculitis.

Factor VIII related antigen, an endothelial cell product, was markedly raised in systemic necrotising arteritis, reflecting disease activity, but was not raised in active cutaneous vasculitis. In rheumatoid arthritis high levels were only found in systemic vasculitis or Felty's syndrome, but in other connective tissue diseases increased levels were more frequently detected and usually related to disease activity. It did not correlate with C reactive protein. It was also raised in non-inflammatory peripheral vascular disease and after surgery and was not specific for vasculitic endothelial damage. Factor VIII related antigen may be useful in identifying and monitoring systemic necrotising and large vessel arteritis.

Antigens↗
PubMed1987

Granulomatous mastitis--a rare cause of erythema nodosum.

Granulomatous mastitis is a recently described, rare condition of unknown aetiology. It occurs in young, parous women as a tender extra-areolar breast lump and therefore needs to be differentiated from carcinoma. Histologically, a discrete granulomatous lobulitis is seen and because of morphological similarities to granulomatous thyroiditis it has been suggested it may be immunologically mediated. We present a patient in whom granulomatous mastitis presented with periarthritis and erythema nodosum, an association not previously described.

Adult↗
PubMed1987

Polyarteritis and the kidney.

We report data on 43 patients with polyarteritis affecting the kidneys. The majority (41 patients) had renal histological evidence of microscopic polyarteritis. Although most patients (30 of 43) had significant renal impairment at the time of diagnosis (serum creatinine greater than 250 mumol/l) only five had a symptom, macroscopic haematuria, that directed attention to the kidneys. In the majority of patients in whom data was available there was rapid deterioration in renal function between presentation and diagnosis. Renal function at diagnosis was worse in patients aged over 50 of whom 20 out of 29 had a serum creatinine greater than 500 mumol/l compared with only four of 14 patients aged less than 50. The prognosis was worse in patients over 50 (41 per cent died), in patients with a serum creatinine higher than 500 mumol/l (54 per cent died) and in patients treated with intravenous methylprednisolone, (four also had intravenous cyclophosphamide) (38 per cent died). The major cause of death was sepsis and the actuarial one-year survival was 62 per cent. These results suggest that our approach to treatment should be modified towards lessening immunosuppression in older patients and in patients with renal failure at diagnosis.

Adult↗
PubMed1986

Immunoglobulin-producing cells in labial salivary glands of patients with rheumatoid arthritis and systemic lupus erythematosus.

The distribution of immunoglobulin-producing cells within labial salivary glands from normal individuals (n = 7) and patients with rheumatoid arthritis (n = 10) and systemic lupus erythematosus (n = 9) was studied using morphometric and indirect immunoperoxidase methods. Cell counts revealed a significant increase in the density of IgG cells within glands from both patient groups compared with glands from normal individuals. No significant differences in the density of IgA- or IgM-producing cells between the 3 groups were observed although large individual variations were apparent. Histomorphometric studies showed an increase in the lymphoid compartment and a decrease in glandular elements within glands from the 2 patient groups. When data for all specimens were pooled a significant positive correlation was obtained between the percent area of stromal lymphoid tissue and density of IgG and IgM cells.

Adult↗
PubMed1986

Side effect profile of 200 patients with inflammatory arthritides treated with sulphasalazine.

The side effect profile of sulphasalazine was documented in 200 patients with inflammatory joint disease treated with the drug for at least 1 year. Fifty-eight percent of patients developed one or more adverse reactions and in 21.5% the drug was withdrawn. A further 28% continued taking the drug at a reduced dose. Five percent of the side effects were judged to be potentially serious. In all patients the reactions subsided on either discontinuation of the drug or reduction of the dose. Gastrointestinal (33%) and central nervous system reactions (19%) were the most common, but all were relatively minor. Neutropenia (2%), thrombocytopenia (1%) and pan-hypogammaglobulinaemia (1%) were potentially the most serious effects. The side effect profile of sulphasalazine in inflammatory joint disease appeared to be similar to that in inflammatory bowel disease, but reactions were more frequent in inflammatory joint disease. Enteric-coated sulphasalazine is a useful addition to the small number of slow acting antirheumatic drugs, and in view of its established efficacy, its level of toxicity was found to be 'acceptable' as long as patients were carefully monitored and regular blood tests were carried out.

Adult↗
PubMed1986

Takayasu's arteritis: a pathogenetic role for cytotoxic T lymphocytes?

Takayasu's arteritis is an inflammatory panarteritis of unknown aetiology affecting large elastic arteries. We examined a segment of abnormal common carotid artery removed at by-pass surgery from a 23-year-old man with typical angiographic features of Takayasu's arteritis. Using monoclonal antibodies we were able to demonstrate marked infiltration of the arterial wall with OKT8 positive lymphocytes (suppressor/cytotoxic cells) but not with OKT4 positive lymphocytes (helper cells). Studies of circulating lymphocytes showed increased numbers of "activated" cells and increased in vitro cytotoxicity against cultured human umbilical cord endothelial cells, compared to normal lymphocytes. Cellular immunological mechanisms may play an important role in the pathogenesis of Takayasu's arteritis, possibly through the direct action of cytotoxic T cells on large elastic arteries.

Adult↗
PubMed1986

An immunohistochemical study of lymphocyte subsets and expression of glandular HLA-DR in labial salivary glands from patients with symptomatic xerostomia, rheumatoid arthritis and systemic lupus erythematosus.

Lymphocyte subsets, T+6 cells and glandular expression of HLA-DR within labial salivary glands from patients with symptomatic xerostomia (n = 9), RA (n = 24) and SLE (n = 25) were studied using an immunoperoxidase method and monoclonal antibodies. The results indicate that common immune cellular reactions are involved in glandular changes irrespective of patient group and that the appearance of T+6 cells and glandular expression of HLA-DR are unlikely to play a role in initiation of lymphoid infiltration.

Arthritis, Rheumatoid↗
PubMed1985

A new assay for IgG rheumatoid factor activity and its use to analyse rheumatoid factor reactivity with human IgG isotypes.

A new assay for IgGRF activity is described which employs human IgGFc as the antigen and a radiolabelled monoclonal antibody directed against human IgG (CHI domain) as the developing antibody. Using this assay IgGRF activity against human IgG isotypes was measured and most sera from RA patients were shown to react predominantly with IgG1 and IgG2 but few reacted with IgG3 and IgG4. The same sera were tested for IgMRF to the IgG isotypes. IgG2 was the best antigen, IgG1 and IgG4 were less so and reactivity with IgG3 was the lowest. IgGRF without associated IgMRF was obtained, its specificity compared to that of IgMRF, and found to be broadly similar. With the new assay high levels of serum IgGRF were found in those RA patients with extraarticular disease but not in RA patients with synovitis alone.

Antibodies, Monoclonal↗
PubMed1985

Progressive systemic sclerosis, immunosuppression and necrotising arteritis: cause or effect?

Necrotising arteritis is rare in progressive systemic sclerosis (PSS). We report a patient with PSS who died with renal failure due to necrotising arteritis and segmental crescentic glomerulonephritis more typical of polyarteritis nodosa. Possible pathogenetic mechanisms are discussed. Renal biopsy is an important investigation in PSS, but is especially important in patients without hypertension, as other pathology needs to be excluded.

Administration, Oral↗
PubMed1985

T6 antigen-positive cells in human labial salivary glands.

The distribution of T6-positive cells in glands from three healthy individuals and 18 patients suffering from various systemic disorders was studied using OKT 6 and NA1/34 monoclonal antibodies in an indirect immunoperoxidase method on frozen sections. Although no positive cells were seen in the glands of healthy controls, 10 of the 18 biopsies from the patient-group contained T6-positive cells which were mostly within glandular epithelium. The presence of T6-positive cells appeared to correlate with lymphoid infiltration of the glands. Only one of the 8 patient biopsies showing normal or minimally-altered structure contained T6-positive cells. Thus these cells are unlikely to play a role in the normal physiological function of labial salivary glands.

Adult↗
PubMed1985

Berger disease: Henoch-Schönlein syndrome without the rash.

Identical 7-year-old twin boys each had a proved adenovirus infection at the same time. A few days later one developed florid Henoch-Schönlein purpura, severe alimentary tract symptoms, and transient joint symptoms. He had an acute nephritic syndrome, which progressed to nephrotic syndrome and renal insufficiency. Biopsy showed severe proliferative glomerulonephritis with crescents and marked deposition of IgA, IgG, C3, and fibrin. The second twin had hematuria and abdominal pain but no rash. Biopsy showed mesangial proliferative glomerulonephritis with mesangial deposits of IgA and, to a lesser extent, IgG and C3. The appearance was characteristic of Berger disease, and the subsequent clinical course has been that of symptomless microscopic hematuria and recurrent macroscopic hematuria with normal renal function. Immunologic studies have not revealed why these identical twins responded differently to the same provocation. Perhaps Berger disease may be considered a variant of Henoch-Schönlein nephritis.

Adenoviridae Infections↗
PubMed1985

Fenclofenac-induced selective IgA deficiency in rheumatoid arthritis.

A 35-year-old man with seropositive rheumatoid arthritis developed selective IgA deficiency during treatment with fenclofenac. His arthritis remained quiescent while taking the drug and following its withdrawal his condition relapsed and his serum IgA level returned to normal. This case demonstrates the association of selective IgA deficiency with remission in rheumatoid arthritis induced by fenclofenac as well as aurothiomalate and sulphasalazine. It also shows severe relapse after withdrawal of fenclofenac.

Adult↗
PubMed1985

Endothelial cell cytotoxicity in inflammatory vascular diseases--the possible role of oxidised lipoproteins.

One of the proposed mechanisms of vascular damage in connective tissue disease is the direct action of a cytotoxic serum factor inducing endothelial cell damage. The nature of this serum factor is unclear, but has been suggested to be a lipoprotein. Sera from patients with (1) systemic necrotising arteritis (polyarteritis nodosa, Wegener's granulomatosis, and necrotising arteritis associated with rheumatoid synovitis), (2) systemic or joint restricted rheumatoid disease, and (3) large vessel/giant cell arteritis have been examined for cytotoxicity to human cultured endothelial cells and azide-resistant ferroxidase-like activity (indicative of the oxidised lipoprotein content). Stored sera from patients with necrotising arteritis showed a significantly enhanced tendency to develop oxidised lipoprotein, which correlated closely with human endothelial cell cytotoxicity. Fresh sera also contained this factor, but to a lesser extent. It is argued that the cytotoxic factor detected in previous clinical studies is in part an in-vitro artefact, although its accelerated development in certain patient groups might suggest an excess of pro-oxidants that have developed in vivo.

Arteritis↗
PubMed1985

Motoric indicators of laterality and determination of lateral dominance in schizophrenia.

The literature suggests that schizophrenics exhibit reduced or reversed cerebral lateral dominance relative to normal control subjects. An hypothesis which predicted reduced or reversed cerebral laterality for schizophrenics was tested on 60 young, familially right-handed males, with 20 men in each of the following three groups: schizophrenic inpatients, nonschizophrenic psychiatric inpatient controls, and normal controls. The subjects were administered a battery of seven measures of cerebral laterality. The application of multivariate statistical techniques showed groups did not differ significantly in the degree or the direction of their cerebral lateral dominance. Also there were no significant correlations between the measures of laterality. The findings suggest that cerebral lateral dominance is not necessarily altered concomitantly with psychopathology but rather that it is a complex phenomenon which may not be reliably determined on the basis of simple behavioral characteristics.

Adolescent↗