Acute arthritis complicating rubella vaccination.
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Antistreptolysin↗
Biomedical subjects
G R Thompson
Publications and source records attributed to G R Thompson.
HLA and recurrent episodic arthropathy associated with rubella vaccination.
The frequencies of 21 HLA antigens in 33 patients who developed recurrent, episodic arthropathy after receiving the HPV-77 DK-12 rubella vaccine have been determined and compared with those of a control population. Trends toward increased frequencies of HLA antigens B12 (P = 0.02) and B14 (P = 0.04) and of the haplotype A2, B12 (P = 0.01) did not reach significance when corrections for the number of antigen determinations were included in the statistical analysis. These data show that the syndrome of recurrent arthropathy following rubella vaccination is genetically distinct from the connective tissue diseases associated with HLA-B27.
Adolescent↗
Effects of vasoactive stimuli on coronary vascular resistance in isolated perfused rabbit hearts: no vasospastic response to ergonovine with or without atherogenic diet.
The mechanism of ergonovine-provoked coronary vasospasm is poorly understood. We tested the effect of ergonovine in perfused hearts from normal and cholesterol-fed (18 weeks, 2% cholesterol diet) rabbits in a constant-flow Langendorff perfusion. Aortic perfusion pressure was monitored to measure coronary vascular resistance, and left ventricular pressure was measured with an isovolumetric balloon in the left ventricle. Control coronary vascular resistance was 1.12 +/- 0.11 mm Hg/ml/min in hearts from normal rabbits and 1.53 +/- 0.16 mm Hg/ml/min in hearts from cholesterol-fed rabbits (n = 9 each, mean +/- SEM, p less than 0.05). The cholesterol content of aortae from cholesterol-fed rabbits was markedly increased (432 +/- 85 mg/g protein vs. 14.9 +/- 8.2 in controls, p less than 0.001; for coronaries: 396 +/- 136 mg/g protein vs. 125 +/- 25, p less than 0.05). In both groups, increases in coronary vascular resistance were observed with vasopressin (40 IU/l) and phenylephrine (30 microM) and decreases with adenosine (10 microM), isoprenaline (0.1 microM) and 30 sec stop-flow (all p less than 0.05). Ergonovine maleate (10 microM) and serotonin (10 microM) did not increase coronary vascular resistance. Although in whole heart perfusion small changes in the caliber of epicardial vessels may not be detectable, changes severe enough to produce measurable changes in total coronary resistance were not found. Therefore the absence in our model of an increase in coronary vascular resistance after ergonovine is not compatible with a local direct mechanism in epicardial arterial wall, even when sensitized by a high cholesterol diet.
Animals↗
Solid phase radioimmunoassay of apolipoprotein B (apo B) in normal human plasma.
A solid phase radioimmunoassay (RIA) has been developed for apolipoprotein B (apoB), a major constituent of very low density lipoprotein (VLDL) and low density lipoprotein (LDL) in man. Antisera were prepared against apoB in goats and rabbits, coupled to bromoacetyle cellulose, and the complex was incubated with [125I] LDL. The RIA was based on the displacement of [ 1252]-LDL by unknown samples, as compared with unlabeled LDL standards, using a logit transformation to calculate results. The RIA was found to be satisfactory in terms of precision, sensitivity, reproducibility and specificity. Control subjects had mean apoB levels of 94 mg/100 ml in whole fasting plasma, of which 3.6 mg/100 ml plasma were in the VLDL, while 86 mg/100 ml plasma were in the LDL. Both the triglyceride and apoB content of VLDL, and the cholesterol and apoB content of LDL were positively correlated. It is concluded that the solid phase radioimmunoassay described in the present report provides a rapid and relatively simple means of quantitating apoB in normal human plasma.
Apoproteins↗
Lipoprotein(a) and accelerated coronary artery disease in cardiac transplant recipients.
High concentrations of serum lipoprotein(a) (Lp(a)) are associated with an increased risk of atherosclerotic vascular disease in the nontransplanted population. However, its relation with accelerated coronary artery disease (CAD) in cardiac transplant recipients has not been reported. We measured serum Lp(a) in 130 cardiac transplant recipients undergoing routine follow-up, which included annual coronary angiography. The median Lp(a) concentration in 33 patients with CAD was 71 mg/dl, which was significantly higher than the corresponding value of 22 mg/dL in the 97 patients without CAD (p = 0.0006). Multivariant analysis showed the serum Lp(a) value to be a higher significant risk factor for CAD irrespective of the other factors included in the regression analysis. Thus a high concentration of serum Lp(a) is an important, independent risk factor for the development of accelerated CAD in transplant recipients.
Coronary Artery Disease↗
Triglyceride-lowering effect of marine polyunsaturates in patients with hypertriglyceridemia.
Twenty male patients with primary hypertriglyceridemia were treated for 4 weeks with daily supplements (15 g) of oil, which provided approximately 6 g of polyunsaturated fatty acid (PUFA) either of fish or of vegetable origin. Total plasma cholesterol concentrations were unaffected, but both types of supplement increased high density lipoprotein-3 (HDL3) cholesterol concentrations. The fish, but not the vegetable, oil supplement led to a decrease in plasma triglyceride concentrations. Very low density lipoprotein (VLDL), fatty acid composition, and VLDL triglyceride kinetics were subsequently studied in five patients (four male, one female) before and after 4 weeks of therapy with 15 g of the same fish oil. The fish oil led to increases in the proportion of eicosapentaenoic acid in both the VLDL triglyceride and phospholipid fractions, but the increase was greater in the latter. In contrast, the proportion of docosahexanoic acid was increased only in the VLDL triglycerides. The decrease in plasma triglyceride concentrations that occurred with fish-oil therapy was accompanied by a reduction in the absolute catabolic rate of VLDL triglyceride, implying a concomitant change in synthetic rate; the fractional catabolic rate of VLDL triglyceride was unaltered. It is suggested that polyunsaturated fatty acids of marine origin may be therapeutically useful for hypertriglyceridemia.
Adult↗
Plasma exchange and low density lipoprotein apheresis in Watanabe heritable hyperlipidemic rabbits.
Comparison of the effects of plasma exchange using lipoprotein-deficient plasma with those of LDL apheresis using a dextran sulphate column was undertaken in two groups of Watanabe heritable hyperlipidemic rabbits pre-labelled with 3H-cholesterol. Total and HDL cholesterol were reduced more by plasma exchange but HDL cholesterol rebounded higher after LDL apheresis; rises in HDL cholesterol correlated with preceding decreases in both HDL and total cholesterol. An increase in the specific activity of HDL cholesterol occurred on the day after each procedure, being more marked after plasma exchange, and was accompanied by a decrease in the cholesterol/phospholipid ratio of HDL. These results suggest that an influx of extravascular HDL into plasma occurred after both procedures, resulting in mobilization of tissue cholesterol.
Animals↗
Normal levels of lipoproteins including lipoprotein(a) after liver-heart transplantation in a patient with homozygous familial hypercholesterolaemia.
A 33-year-old female with severe diffuse coronary artery disease and left ventricular outflow tract obstruction secondary to homozygous familial hypercholesterolaemia underwent liver and heart transplantation. During a post-operative follow-up period of 13 months, apart from one episode of cardiac rejection at 3 weeks, she has remained well and without evidence of accelerated coronary disease on angiography. By 3 months after transplantation serum total cholesterol, low density lipoprotein cholesterol, apolipoprotein B and lipoprotein(a) levels had decreased and apolipoprotein A-I and high density lipoprotein cholesterol levels had increased, all to within the normal range. These changes were accompanied by marked regression of xanthomata and were maintained at 13 months. Liver transplantation provides an effective means of correcting serum lipids in patients with homozygous familial hypercholesterolaemia and is an important adjunct to cardiac transplantation.
Adult↗
Plasmapheresis in familial hypercholesterolemia.
Twelve years' experience confirms that plasma exchange beneficially influences the course of homozygous familial hypercholesterolemia. Pilot studies with low density lipoprotein (LDL) apheresis using a dextran sulphate affinity column suggest that this procedure has advantages over plasma exchange, which it may eventually replace. Combination therapy with lovastatin and LDL apheresis is currently being assessed as a means of inducing regression of coronary lesions. Preliminary results of a pilot study in four patients with heterozygous familial hypercholesterolemia are encouraging.
Blood Component Removal↗
Genotypic and phenotypic variation in familial hypercholesterolemia.
Familial hypercholesterolemia is characterized by an increase in low density lipoprotein (LDL) cholesterol, tendon xanthomata, and premature atherosclerosis. In homozygotes, phenotypic expression of the disorder is dominated by genotypic variation at the LDL-receptor gene locus, with other influences, like gender, exerting relatively little effect. In contrast, phenotypic variation in heterozygotes is influenced not only by the nature of the underlying gene mutation but also by gender, diet, and other forms of genetic polymorphism, including the apolipoprotein E genotype.
Age Factors↗
Reiter's disease after Salmonella typhimurium enteritis.
We describe a case of Reiter's disease in an HLA-B27 positive black woman after infection with Salmonella typhimurium. Although reactive arthropathy following Salmonella infections is not unusual, Reiter's disease is rare. This may be the second such case in the English literature, and the first reported in North America.
Adult↗
Septic arthritis in a general hospital 1966-1977.
Eighty-seven patients with septic arthritis diagnosed from 1966 through 1977 are described. Thirty-three had gonococcal arthritis, of whom 31 were women. Twenty were between the ages of 20-29 years. The commonest joint involved was the wrist. Culture of synovial fluid was positive for N. gonorrhea in 11. Fifty-four patients had non-gonococcal arthritis, of whom 40 were men. The mean age was 38 years. S. aureus was the commonest organism cultured. The knee was the most frequently involved. Treatment with iv antibiotics and aspiration was usually successful.
Adolescent↗