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Biomedical subjects

G G Hunder

Publications and source records attributed to G G Hunder.

At least 109 records · Page 6Linked to original sources
PubMed1985

Takayasu arteritis. A study of 32 North American patients.

Thirty-two patients (26 female, 6 male) with angiographically diagnosed Takayasu arteritis were seen at the Mayo Clinic between 1971 and 1982. Racial composition of this group was 23 North American Caucasians, 4 Mexicans, 3 Orientals, 1 Native American, and 1 patient of Middle Eastern origin. Incidence of the disease in Olmsted County, Minnesota, was 2.6/million/year. Diagnosis was often delayed for long periods of time, with a median delay of 18 months. Patients had both non-vascular symptoms (arthralgias in 56%, fever in 44%, weight loss in 38%) and symptoms of vascular stenosis such as arm claudication (47%) and hypertension due to renal artery stenosis (41%). All patients had either multiple vascular bruits (94%) or absent pulses (50%). Laboratory findings included anemia (44%) and elevations of erythrocyte sedimentation rate (78%). Almost all patients had multiple sites of arterial involvement documented by angiogram with various combinations of stenosis, luminal irregularity and aneurysm formation. Response to corticosteroid treatment was usually very good, with dramatic improvement in non-vascular symptoms and return of pulses in 8 of the 16 patients with absent pulses prior to treatment. Five-year survival rate from time of diagnosis was 94%. Twelve patients underwent surgical procedures involving the carotid arteries (5 cases), subclavian artery (4 cases) and renal arteries (3 cases). Three aneurysms were resected, one had aortic valve replacement for severe aortic regurgitation, and two patients underwent transluminal angioplasty. Pathologic changes were restricted to the media and adventitial layers of the vessel wall and were indistinguishable from those of giant-cell or temporal arteritis. Takayasu arteritis is more common than previously suspected in North America, is not restricted to any one racial group, and is readily treatable with corticosteroids and surgical vascular reconstruction.

Adolescent↗
PubMed1984

An attempt to predict the response to gold therapy in rheumatoid arthritis.

In 54 rheumatoid arthritis patients undergoing conventional chrysotherapy, we prospectively sought predictors of response, using strict clinical and laboratory criteria of improvement. Forty-five patients who completed 6-12 months of therapy were classified into 3 outcome categories: group 0, not significantly improved (18 patients); group 1, improved (18 patients); and group 2, markedly improved (9 patients). Sixty-two entry variables were tested in univariate and multivariate analysis for predictor function. No continuous variable was predictive. The discrete variables HLA-A3 positivity and HLA-DR4 negativity were the best predictors of response to gold. In a multivariate analysis using these 2 univariates (A3 and DR4) plus hemoglobin, we developed a discriminant function that correctly predicted outcome in 21 of 23 patients in groups 0 and 2. We also observed that of 15 DR blank patients (10 of whom were DR4 blank), none entered remission.

Arthritis, Rheumatoid↗
PubMed1984

Respiratory tract symptoms as a clue to giant cell arteritis.

Although many manifestations of giant cell arteries are increasingly recognized, little attention has been paid to respiratory symptoms associated with this disorder. We report the cases of 16 patients with giant cell arteritis who had prominent symptoms related to the respiratory tract including cough, sore throat, and hoarseness. These symptoms were the initial finding in 10 patients and obscured the diagnosis in some instances, but resolved quickly when corticosteroids were given. It is estimated that 9% of patients with giant cell arteritis have prominent respiratory tract symptoms, which are the initial manifestation in 4%. This disorder should be considered in an older patient with a new cough or throat pain without obvious cause.

Aged↗
PubMed1983

The therapeutic impact of temporal artery biopsy.

To evaluate the clinical usefulness of temporal artery biopsy in the diagnosis of giant-cell arteritis we followed up all 134 residents of Olmsted County, Minnesota, who had temporal artery biopsies between 1965 and 1980. Initial biopsies were positive for giant-cell arteritis in 46 cases and negative in 88. A history of jaw pain or claudication and the findings of a palpably abnormal temporal artery were significantly more common in the patients whose biopsy specimens showed giant-cell arteritis. Over a median follow-up period of 70 months (range 1-192) only 8 of the 88 biopsy-negative patients had clinical courses requiring long-term, high-dose corticosteroid therapy for giant-cell arteritis. In this population-based study temporal artery biopsy correctly predicted the subsequent need for corticosteroid therapy in 94% of cases: these findings indicate that biopsy should be done before patients are committed to long-term corticosteroid therapy.

Adrenal Cortex Hormones↗
PubMed1983

Immunohistologic and cytochemical studies of temporal arteritis.

Arteritic lesions from 14 patients with temporal arteritis were studied by cytochemical and immunohistochemical methods to identify the nature of the inflammatory cell infiltrate and to demonstrate immunoglobulin deposition. The infiltrating cells typically seen were histiocytes, giant cells, monocytes, and lymphocytes. The lymphocytes were mainly T cells and the majority of them were of the helper/inducer (Leu-3a) T cell subset, as indicated by monoclonal antibody reactivity. Immunoglobulin deposits on the internal elastica were identified in only 6 patients and neutrophils were either very sparse or absent. These findings are consistent with the hypothesis that cell-mediated immunity may be important in the pathogenesis of temporal arteritis.

Acid Phosphatase↗
PubMed1983

The vasculitides.

Explore the source record for details and available documents.

Adolescent↗
PubMed1983

The coexistence of rheumatoid arthritis and giant cell arteritis.

Three cases of giant cell arteritis that developed in patients with known seropositive rheumatoid arthritis are described. The coexistence of these 2 conditions has been felt to be unusual. The diagnostic difficulties encountered when 2 such inflammatory conditions coexist are discussed.

Aged↗
PubMed1983

Intra-articular temperature: technique and reliability in an animal model.

To determine if reproducible and reliable measurements of intra-articular temperature could be performed in an animal model, surface and intra-articular measurements were studied in 30 rabbits. Anterior insertion of a thermometer probe into the joint cavity was found to be a reliable method for measuring intra-articular temperature in the rabbit knee. This method yielded temperatures with less than 0.1C variation in contralateral and serial determinations. Consistent differences in intra-articular temperatures were observed between normal knees and contralateral knees in which arthritis had been experimentally induced. Measurements of surface temperature and knee intra-articular temperature by a posterior approach, however, did not give consistent or reproducible values.

Animals↗
PubMed1983

Passive range of motion, not isometric exercise, amplifies acute urate synovitis.

The effects of passive range-of-motion and isometric exercises on acute monosodium urate-induced experimental arthritis in a rabbit model were assessed by serial intra-articular temperature measurements and synovial leukocyte counts. Passive range of motion significantly (p less than 0.05) increased both the intra-articular temperature and the synovial leukocyte count over the control values of the nonexercised joints. Isometric exercises across a joint with acute monosodium urate synovitis, however, did not significantly affect intra-articular temperature or synovial leukocyte count.

Acute Disease↗
PubMed1982

Polymyalgia rheumatica: a 10-year epidemiologic and clinical study.

Ninety-six patients with polymyalgia rheumatica were identified in Olmsted County, Minnesota, during the 10-year period 1970 to 1979. Giant cell arteritis was found in 15 of the 96 patients. The average annual incidence of polymyalgia rheumatica in the population increased from 19.8 per 100 000 in persons 50 to 59 years of age, to a maximum of 112.2 per 100 000 in persons 70 to 79 years of age. Eighty-three of the 96 patients (86%) had recovered by the end of the study. Median duration of the disease was 11 months (range, 2 to 54 months). Polymyalgia rheumatica had no effect on survival. Both corticosteroids and nonsteroidal anti-inflammatory drugs were used in treatment. Response was more rapid in patients given corticosteroids, but nonsteroidal drugs were used successfully, especially in milder cases. Relapses and adverse reactions to treatment were more frequent in patients given corticosteroids. The findings show that polymyalgia rheumatica is a relatively common disease in middle-aged and older persons and generally runs a self-limited course.

Age Factors↗
PubMed1981

Giant cell arteritis (temporal arteritis) presenting as fever of undetermined origin.

A retrospective study of the histories of 100 patients with biopsy-proven giant cell arteritis was performed. Fifteen of these patients had "fever of unknown origin" as the initial manifestation of this disease. All 15 had normal leukocyte counts; however, they had significantly lower hemoglobulin and albumin levels (P greater than 0.01) and significantly higher platelet counts, erythrocyte sedimentation rates, and alkaline phosphatase values (P congruent to 0.05) compared to the other 85 patients. In 4 patients, random temporal artery biopsies were performed despite persistently negative results from diagnostic evaluations and in the absence of any symptoms or findings suggestive of arteritis.

Aged↗
PubMed1980

Circulating immune complexes in giant cell arteritis and polymyalgia rheumatica.

Sera from 74 patients with polymyalgia rheumatica or giant cell arteritis or both were tested for immune complexes by using the Raji cell radioimmunoassay. Levels in patients with active disease were higher than in patients whose disease had become inactive. There was no difference in levels of immune complex-like materials between patients with polymyalgia rheumatica alone and those with giant cell arteritis. Density gradient analysis of one serum showed immune complex-like materials mainly in the 19S region. Immune complexes may be important in the pathogenesis of these conditions.

Aged↗