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Biomedical subjects

F Kozin

Publications and source records attributed to F Kozin.

At least 55 records · Page 3Linked to original sources

Concurrent linear scleroderma and systemic lupus erythematosus: a report of two cases.

Two patients with linear scleroderma (en coup de sabre) developed systemic lupus erythematosus (SLE). This association has been well documented in only one previous case. The presence of high titer antibodies to ribonucleoprotein (RNP) initially led to the diagnosis of the mixed connective tissue disease. Development of more serious clinical involvement and antibodies to Sm (case 1) or native deoxyribonucleic acid (nDNA) (case 2) helped establish a diagnosis of SLE. Use of these studies in the differential diagnosis of systemic rheumatic diseases is disucssed briefly. The presence of anti-RNAP antibodies in patients with localized scleroderma may herald a more serious rheumatic disease.

Adult↗

Mechanisms of platelet response to monosodium urate crystals.

The mechanisms of urate-crystal-induced release of platelet constituents has been studied morphologically and biochemically. Urate crystals provoked an early energy-dependent release of the dense-body constituents serotonin, ADP, and ATP from washed platelets. Concurrently, platelet ultrastructure showed evidence of shape change, contractile wave, and aggregation. These are typical morphologic concomitants of platelet secretion. By 30 minutes' incubation, urate-induced platelet lysis occurred, as shown by loss of the cytoplasmic enzyme lactic dehydrogenase (LDH) and ultrastructurally by disruption of platelet membrane integrity. Cytochalasin B inhibited the urate-crystal-induced shape change, aggregation, and disruption of cell membranes. Platelet degranulation was not inhibited and the initial component of serotonin release was not affected. Cytochalasin B also abrogated crystal-induced LDH loss. Thus, the initial crystal-induced serotonin release does not depend on platelet lysis. It is concluded that urate-crystal--induced release of serotonin, ATP, and ADP represents an example of platelet secretion.

Adenosine Diphosphate↗

Toxicity of penicillamine. A serious limitation to therapy in rheumatoid arthritis.

A retrospective study of penicillamine toxicity in 156 patients yielded a high incidence of toxic reaction (62%), necessitating discontinuation of the drug therapy in 36% of the patients. Of the total group, proteinuria occurred in 14%, hematologic toxic reaction in 11%, mucocutaneous toxic reaction in 28%, and gastrointestinal intolerance in 12%.

Adult↗

Acquired angioedema associated with rectal carcinoma and its response to danazol therapy. Acquired angioedema treated with danazol.

Cases of the acquired form of angioedema have been recognized as a separate entity since 1972. Previously reported cases have been related to various hematologic malignancies. We have recently studied a patient with rectal carcinoma who manifests a complement pattern compatible with the acquired form of angioedema. No previous personal or family history of allergic disease or angioedema was present. Because the episodes of angioedema were laryngeal in location and required emergency intubation to maintain an adequate airway, a trial of danazol prophylaxis, which has been shown to be effective in hereditary angioedema, was undertaken. His beneficial response to this form of therapy is also documented.

Adenocarcinoma↗

Chronic lymphocytic leukemia--well-differentiated lymphocytic lymphoma with monoclonal IgA:IgA production by circulating lymphocytes.

A patient is described in whom morphologic features of well-differentiated lymphocytic lymphoma (WDL) or chronic lymphocytic leukemia (CLL) and immunologic features of multiple myeloma were present. Studies of isolated peripheral blood lymphocytes demonstrated de novo synthesis of IgA K, the same paraprotein that was identified in the serum. Predominant IgA synthesis by peripheral lymphocytes has not been previously shown in either WDL or CLL.

Humans↗

Gentamicin and tobramycin penetration into synovial fluid.

The penetration of gentamicin and tobramycin into the synovial fluid of 12 patients with nontraumatic joint effusions was studied. Simultaneous serum and synovial fluid specimens taken after the intramuscular or intravenous administration of an antimicrobial agent were assayed. Synovial fluid levels of antibiotic were >50% of serum levels in all subjects studied. In five patients, synovial fluid levels were equal to or exceeded simultaneous serum values. These results suggest that intra-articular injection of aminoglycoside antibiotics is not necessary in the treatment of infectious arthritis.

Anti-Bacterial Agents↗

Mixed connective tissue disease: the spectrum of radiographic manifestations.

Mixed connective tissue disease (MCTD) is a serologically distinct entity defined by a ribonuclease-sensitive extractable nuclear antigen. This unusual overlap syndrome has clinical features of scleroderma, systemic lupus erythematosus, polymyositis, and rheumatoid arthritis. In order to define the radiographic changes in MCTD, radiographs of the hands of 17 patients were studied, utilizing a fine-detail technique. Diffuse and periarticular osteopenia were found in 8 and 10 patients, respectively; soft-tissue swelling in 11; erosive changes in 9; joint-space narrowing in 7; tuft resorption and soft-tissue atrophy in 6; and subluxations in 2. In individual cases radiographs may appear normal or exhibit features of scleroderma, systemic lupus erythematosus or rheumatoid arthritis, thereby mirroring the clinical diversity of this entity.

Adolescent↗

Release of platelet constituents by monosodium urate crystals.

The release of human platelet constituents by the etiologic agent of gout, the monosodium urate crystal, is described here. In suspensions of washed platelets, response to urate crystals proceeded in two phases: A secretory phase involved the rapid active release of serotonin, ATP, and ADP with little loss of lactic dehydrogenase or beta-glucuronidase. A lytic phase involved the slower loss of all platelet constituents. Both phases were inhibited by iodoacetate plus dinitrophenol, suggesting an energy requirement. In ultrastructural studies, lysis of washed platelets which appeared to contain crystals was seen. Urate crystals were also shown to induce serotonin release and platelet lysis in citrated platelet-rich plasma. Since urate crystals are deposited at a variety of sites, urate crystal-platelet interaction in vivo is a possibility. Such interactions, leading to release of platelet constituents, might contribute to gouty inflammation or to enhanced atherogenesis.

Blood Platelets↗

Neuro-Behcet disease: two cases and neuroradiologic findings.

In two cases of Behcet disease, neurologic disorders antedated the characteristic ocular or mucocutaneous lesions by 6 to 32 weeks. Neuroradiologic investigation demonstrated expanding avascular foci in the basal ganglia, probably representing areas of infarction secondary to vasculitis.

Adult↗

Protein binding to monosodium urate monohydrate, calcium pyrophosphate dihydrate, and silicon dioxide crystals. I. Physical characteristics.

The protein adsorptive properties of monosodium urate monohydrate (MSU), silica (Si), and calcium pyrophosphate dihydrate crystals were studied by qualitative and quantitative techniques. Immunoglobulin G (IgG) was adsorbed preferentially by MSU crystals from normal human serum and demonstrated high-affinity binding isotherms when compared with several isolated proteins in solution. The physical characteristics of this reaction suggest principally an ionic mechanism, since adsorption was enhanced by decreasing pH or ionic strength. Weaker physical forces also were suggested by studies showing enhanced adsorption at lower temperatures. The following order of affinity for Si or MSU crystals was found when equal concentrations of proteins were compared: Cohn fraction II greater than lysozyme greater than beta lactoglobulin greater than bovine serum albumin greater than ovalbumin. IgG adsorption to the crystals studied may explain certain features of their biological activity. It is suggested that this phenomenon blocks the membranolytic properties of crystals and stimulates their phagocytosis through interaction with Fc receptors on the surface of the phagocytic cells.

Adsorption↗

The reflex sympathetic dystrophy syndrome. I. Clinical and histologic studies: evidence for bilaterality, response to corticosteroids and articular involvement.

Eleven consecutive patients fulfulling criteria for the reflex sympathetic dystrophy syndrome (RSDS) were studied by quantitative clinical methods, providing measurements of swelling (ring size), tenderness (dolorimeter) and functional capacity (grip strength). The predominantly affected extremity was clearly identified by these technics and its serial progress determined in six patients. Corticosteroid therapy predictably resulted in improvement of all treated patients. Greater tenderness was found in the joints than in the interjoint areas, indicating a possible accentuation of the disease process in juxta-articular tissues. Synovial biopsy specimens in four patients were abnormal, and the histology was presented in detail for the first time. All patients showed bilateral involvement during the study, providing evidence for a central neural mechanism in the RSDS.

Adult↗