[Diagnostic significance of trocar joint biopsy. Follow-up studies after 2--7 years].
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Biomedical subjects
Publications and source records attributed to G Kolarz.
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Thirty patients with classical or definite rheumatoid arthritis were treated over a 4-week period with diftalone, a new non-steroidal antirheumatic drug. The daily dosage ranged from 500 to 1000 mg. A good objective response was achieved in 69% of the patients. Diftalone was well tolerated. Side effects were noted in 11.8% of patients on 500 mg diftalone daily and in 18.8% of cases treated with the highest dosage (1000 mg daily). The optimum daily dosage appears to be 750 mg.
Twenty-nine synovial fluids from patients with rheumatoid arthritis (RA) and 10 synovial fluids from patients with other joint diseases were investigated with regard to the presence of antibodies to denatured human collagen and of collagen-anticollagen immune complexes. 12 of the 29 RA synovial fluids showed anticollagen titres from 1:16 to 1:512 in passive haemagglutination. Only one patient in the group with no arthritis had a significant anticollagen titre of 1:32. Digestion of the synovial fluids with bacterial collagenase resulted in an anticollagen titre increase from two to four dilution steps in 9 of the RA fluids, while 6 previously negative RA synovial fluids showed anticollagen titres from 1:32 to 1:28 after digestion with collagenase. These results indicate the existence of collagen-anticollagen immune complexes in 15 of the 29 RA synovial fluids investigated.
In two patients with rheumatoid arthritis, immunoglobuline deposits in the skin were detected during D-penicillamine treatment. One patient presented with drug induced exanthema, the other with pemphigus erythematosus which was confirmed by clinical, histological, and immunofluorescent findings. During the development of the specific side-effect in one patient, an increase of ANA-titre and antibody-binding-capacity versus denaturated DNA was observed. Therefore in a prospective study of another ten patients during four months after onset of treatment with D-penicillamine, antinuclear antibodies and antibody-binding-capacity versus native and denaturated DNA were examined. The latter group of patients - without skin lesions - did not show any changes in the above mentioned parameters.
Cytochemical, biochemical and disc-elektrophoretical studies are done on a patient with Di Guglielmo-syndrom. Cytochemical tests showed the wellknown results as: activity of acid phosphatase and alpha-naphthylacetatesterase at their typical sites, deposition of PAS- and Turnbull-positive material. Biochemical findings are done on LDH, cholinesterase, alkaline and acid phosphatase, G-6-PDH and pyruvatkinase. Abnormal high level of fetal hemoglobin was found only once during the whole observation. There was also an alteration in the isoenzym pattern of the acid phosphatase. The de- or increase at the biochemical examinations, the fact of fetal hemoglobin and the variation at the isoenzymes may be due to the changing in distribution of erythropoetic and granulopoetic cells.
Bone marrow smears of 48 patients consisting of 12 normal cases, 36 patients with different haematological diseases-among them 9 cases of idiopathic thrombopenia, 4 cases of polycythaemia, and 9 cases of Hodgkin's disease - were examined cytochemically. Acid phosphatase, unspecific esterases, naphthol-AS-D-chloroacetate esterase, peroxydase, and leucin-aminopeptidase were represented; in addition the PAS reaction, fastgreen staining at pH 1.1, methyl-green pyronin staining and the lipid representation with Sudan black B were carried out. Besides those responses known from literature the different behaviour of acid megacaryocyte phosphatase in different haematological diseases must be particularly emphasized from all reactions.
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