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Biomedical subjects

H Tannenbaum

Publications and source records attributed to H Tannenbaum.

63 records · Page 4Linked to original sources
PubMedDate not supplied

Quantitative scintigraphy using radiophosphate and radiogallium in patients with rheumatoid arthritis.

Quantitative scintigraphy of the wrist, MCP, and knee joints in patients with RA was performed using Tc-99m-MDP and Ga-67 citrate. Radiopharmaceutical uptake in affected joints was compared with uptake at 2 control reference sites (juxta-articular bone and soft tissue). Following a 6-week course of therapy with Sulindac, the patients' overall assessment of disease was improved, but the results of joint/bone and joint/soft tissue ratios were variable. Improvement using Tc-99m-MDP during the first 2 weeks of NSAID therapy was noted in the minimally inflamed wrist by joint/soft tissue measurement and in the maximally affected MCP joint by joint/bone ratio. There was no change in the joint ratios employing the Ga-67 citrate radiopharmaceutical. The initial qualitative score assigned to a joint using Tc-99m-MDP was in agreement with the calculated quantitative ratio except for the knee joint. Our results suggest that quantitative scintigraphy in its present format cannot be used as a reliable indicator to monitor the course of rheumatoid arthritis during NSAID therapy and subjective measurements are still the best judge of effective treatment.

Adult↗
PubMedDate not supplied

A prospective study comparing the clinical examination of peripheral joints with radionuclide scintigraphy in patients with rheumatoid arthritis.

Fifteen patients with classical rheumatoid arthritis were evaluated prospectively on 3 occasions to determine if any additional data could be obtained by joint scintigraphy which was not found by physical examination. Clinical and scan examinations were performed simultaneously and the scans were interpreted qualitatively by a radiologist without knowledge of the clinical findings. Simultaneous evaluations of 86 shoulder, elbow, knee, ankle, 84 wrist, 420 MCP and PIP, and 430 MTP joints were recorded. Concordance was noted in 67% of the evaluations and this was significant for the MCP, PIP, elbow, shoulder, knee, MTP, ankle, but not wrist joints. In 10% of instances the clinical examination was positive when the joint scan was negative. On average, the scan was positive 23% of the time (range 5-44%), when the clinical findings were normal. However, most of these scan abnormalities were due to minimal radionuclide uptake. The scan was most useful in the detection of MTP and ankle abnormalities which had been scored clinically negative, suggesting that greater attention be devoted to the clinical examination of the RA foot by the rheumatologist.

Adult↗
PubMedDate not supplied

The leukocyte adherence inhibition assay in rheumatoid arthritis.

Peripheral blood leukocytes (PBL) from patients with rheumatoid arthritis (RA) and from control subjects were exposed to rheumatoid and osteoarthritic synovial membrane extracts. The number of nonadherent PBL in the presence of each extract was monitored in a test tube leukocyte adherence inhibition (LAI) assay. Six of 7 rheumatoid synovial extracts produced significantly greater nonadherence values when RA leukocytes were used as the test cell (36 +/- 5) compared with values obtained when control leukocytes were used (-5 +/- 3). Preincubation of LAI reactive leukocytes from RA patients with the RA synovial extracts abrogated the positive response, whereas preincubation with the OA extract had no effect. These studies indicate that leukocytes from RA subjects respond to a greater degree to extracts derived from rheumatoid synovium than to extracts derived from osteoarthritic synovium and add further support to the concept that unique substances (putative neoantigens?) are present in RA synovium.

Arthritis, Rheumatoid↗
PubMedDate not supplied

Hepatic abnormalities in adult onset Still's disease.

Five patients with adult onset Still's disease are reported. Three had abnormal liver function tests (LFT) prior to receiving salicylates. Liver biopsy in 1 of these 3 and in another with normal LFT was abnormal. The elevated LFT returned to normal with high dose salicylate therapy coincident with remission of disease activity. It is proposed that hepatic abnormalities in Still's disease frequently reflect the underlying disease and not salicylate hepatotoxicity (SH).

Adolescent↗
PubMedDate not supplied

Generalized skeletal response to 99mtechnetium methylene diphosphonate in rheumatoid arthritis.

The total body retention (TBR) and the 5- and 24-h lumbar spine to soft tissue (LS/ST) ratios of 99mtechnetium methylene diphosphonate was studied in 19 patients with rheumatoid arthritis (RA), 16 patients with metastatic tumors that did not involve the lumbar spine, 10 patients with chronic renal failure and 17 controls. The TBR was significantly higher in all groups compared to the controls. The 5-h LS/ST did not differ between any of the groups although the 24-h LS/ST ratios were significantly elevated in RA and those with chronic renal failure. The 24-h LS/ST in RA was correlated only with disease duration. The results are consistent with a generalized increase in bone turnover in RA and may explain the recognized lack of sensitivity of quantitative scintigraphic techniques in this disorder.

Adult↗
PubMedDate not supplied

Immunologic mechanisms of the tube leukocyte adherence inhibition assay in adjuvant-induced disease in rats.

In the leukocyte adherence inhibition assay (LAI), splenic leukocytes from normal and adjuvant-induced disease (AID) rats were incubated with synovial extracts obtained from AID and normal joints. The proportion of leukocytes nonadherent to the surface of a glass tube in the presence of either AID or normal synovial extract was compared and this difference was expressed as a nonadherent index (NAI). The AID rats have significantly higher NAI scores (29 +r4) than normal rats (0 +r5). Preincubation of splenic leukocytes from normal rats with sera from AID animals caused these normal cells to respond with positive NAI scores (25 +r6). The IgG fraction from AID sera was shown to be an important component in arming these normal splenic leukocytes and a dose response curve was noted. Preincubation of AID splenic leukocytes with antiserum to rat IgG abrogated the positive NAI scores, whereas antiserum to rat IgM had no effect on the NAI values. The reactive cell in the LAI assay was a mononuclear cell whose activity was removed by adherence to plastic petri dishes. We suggest that IgG plays an important role in the LAI assay and might bind to plastic adherent mononuclear cells (monocytes?), through their Fc receptor to allow these cells to react with AID synovial extracts.

Animals↗
PubMedDate not supplied

Joint imaging in regional migratory osteoporosis.

We describe 4 patients (3 males aged 54-59, 1 female aged 25) with regional migratory osteoporosis (RMO). All patients had at least 2 episodes of periarticular osteoporosis. The interval between attacks ranged from 5 months to 11 yr and attacks lasted from 3 months to 2 yr. In 2 cases septic arthritis was initially suspected. The ankle joints were affected in 3 patients, hips in 2 and knees in 2. An unusual feature in 2 patients was involvement of the small joints of the foot demonstrated by 99mTc-methylene diphosphonate (99mTc-MDP) joint imaging. Joint imaging corroborated the clinical diagnosis in 2 patients before regional osteoporosis was visible radiologically. As there are no specific laboratory features of RMO, joint imaging may be helpful in the diagnosis of suspected cases before the development of radiographic stigmata.

Adult↗