Biomedical subjects

H Zeidler

Publications and source records attributed to H Zeidler.

230 records · Page 13Linked to original sources

PubMedDate not supplied

[Time-dependent flow behavior and fibrinogen content of synovial fluid].

Normal bovine synovial fluid and synovial effusions in human non-inflammatory joint diseases do not show any decrease of viscosity for a long period of time during imposed shear loading, as is required for thixotropy. This observation is based on two different methods of measurement; the "hysteresis loop" method and the recording of the shear stress-time curve. Inflammatory synovial fluids--particularly from patients with rheumatoid arthritis and a high concentration of fibrinogen--form a visible gel after 6 to 20 hours of rest. Those gels show a hysteresis loop typical for thixotropy and a decrease of viscosity with the duration of shear loading. Due to the shearing in the rheometer precipitation occurs and fibrin clots appear. The appearance of fibrin clots induced by mechanical shear loading not known until now, can be discussed with regard to its possible participation in the symptom of morning stiffness, in the formation of rice bodies and in the destruction of joint cartilage in rheumatoid arthritis.

Animals↗

PubMedDate not supplied

[Fever in rheumatic diseases--the spectrum of causes and diagnostic guidelines].

The review presents a systematic approach to the diagnostic problem of fever in combination with inflammatory rheumatic symptoms, specifically, in regards to: actual concepts of the pathogenesis of fever in various rheumatic diseases, fever as expression of disease activity, fever as a warning sign of complications in the course of disease and its treatment (infections, drug-induced fever, fever following drug withdrawal, secondary neoplasias), fever and inflammatory rheumatic symptoms as manifestation of non-rheumatic diseases. Based on the literature and information provided by pharmaceutical companies, a survey is given on the frequency of fever as a negative side-effect of the most commonly used drugs in rheumatology.

Acute-Phase Reaction↗

PubMedDate not supplied

[Familial Mediterranean fever. Immunogenetic and rheumatologic aspects of the disease in a Turkish sibship].

A family study was performed in 24 members of a Turkish sibship with familial Mediterranean fever (FMF) with 5 patients affected in 3 generations. The well-known autosomal-recessive inheritance of the disease was masked by a pseudodominant appearance, reflecting the striking frequency of congenial marriages. The immunogenetic investigation excluded a linkage between the expression of the disease and the HLA system. The arthritis of FMF was characterized typically by monarticular attacks in large joints of the lower limb. Frequently this manifestation led to diagnostic problems, particularly at the onset of the disease. No patient presented the clinical or radiological signs of sacroileitis. An observation of the disease process up to 3 years showed a benign prognosis of FMF-arthritis in 3 of 4 patients. Neither long-lasting functional impairment nor radiological signs of erosion had to be recognized. One patient suffered from a necrosis of the femoral head, possibly caused by the recurrent inflammation of the hip joint. Laboratory findings reflected the clinical picture of relapsing acute inflammation in an uncharacteristic manner. Their diagnostic significance exists mainly for the exclusion of other diseases.

Adult↗

PubMedDate not supplied

[Effect of gold (III) on prostaglandin E2-stimulated adenyl cyclase in chick fibroblasts and osteoblasts].

Gold (III) (Au(III) up to 0.25 microM increased prostaglandin E2-sensitive chick osteoblast and fibroblast adenylate cyclase activity without affecting 5'-guanylylimidodiphosphate-stimulated enzyme activity. Au (III) at 5-50 microM inhibited hormone- and nucleotide-mediated activation of adenylate cyclase. This process is time-dependent, irreversible and can not be explained by desensitivation of the PGE2-receptor. Basal adenylate cyclase activity was not influenced by Au (III) in the given concentrations. Pretreatment of membranes with 5'-guanylylimidodiphosphate prior to incubation with Au (III) prevented the inhibitory effect of Au (III) on adenylate cyclase, similar to the incubation experiments with NEM instead of Au (III). Our data suggest that Au (III) at low concentrations unspecifically stimulates PGE2-sensitive adenylate cyclase by binding to sulfhydryl groups of the receptor protein and that Au (III) at high concentrations specifically inhibits PGE2-sensitive adenylate cyclase by binding to sulfhydryl groups of the N-Protein and/or of the catalytic unit.

Adenylyl Cyclases↗

PubMedDate not supplied

Evaluation of early diagnostic criteria including HLA-B27 for ankylosing spondylitis in a follow-up study.

Early diagnostic criteria, a combination of the HLA-B27 test with clinical data, ESR and radiological signs, were evaluated in a 5-6 year follow-up study of 77 patients with possible ankylosing spondylitis (AS) and 45 with other rheumatic diseases. 34 (44%) with possible AS at first examination developed definite AS according to the New York criteria and 29 (38%) were classified as still possible AS. From these data a sensitivity of 82%, a specificity of 68%, a positive predictive value of 50% and a negative predictive value of 91% were calculated. Therefore the early diagnostic criteria, although of limited value for the diagnosis of definite AS, may clearly define patients at risk of AS or unclassified seronegative spondylarthropathies.

Adult↗

PubMedDate not supplied

Increased frequency of HLA-Bw62 and Bw35 CREG antigens in HLA-B27 negative ankylosing spondylitis.

67 patients with ankylosing spondylitis (AS) were tissue-typed for HLA-A, -B and -C antigens. HLA-Bw62 was found in 6 of 13 (46%) HLA-B27 negative patients, compared to 9% in HLA-B27 positive AS (p greater than 0.01) and 10% in healthy blood donors (p greater than 0.001). HLA-Bw62, a split of the previous HLA-B15, belongs to the HLA-Bw35 CREG antigens, 11 of 13 (85%) of HLA-B27 negative patients had an HLA-Bw35 CREG antigen. The present results are interpreted as an indication of a direct involvement of the HLA-B locus in the pathogenesis of AS.

Adult↗

PubMedDate not supplied

[Effect of prostaglandins on in vitro electrolyte metabolism in human spongiosa].

Prostaglandins seem to be involved in the pathogenesis of juxtaarticular osteopenia in rheumatoid arthritis. Therefore the influence of prostaglandins on in vitro electrolyte metabolism of human trabecular bone was tested. Trabecular bone was prepared from femoral heads of patients who had undergone hip replacement surgery for coxarthrosis. 500 mg samples of trabecular bone were incubated in modified Eagle's minimal essential medium. Net electrolyte movements between bone and incubation medium were measured. PGE2 caused an increase in the release of calcium (Ca) and magnesium (Mg) from bone into incubation medium as compared to controls (PGE2 1 micrograms/ml: Ca = 0.87 +/- 0.09 mmol/l*, Mg = 0.44 +/- 0.03 mmol/l*; controls: Ca = 0.81 +/- 0.09 mmol/l, Mg = 0.41 +/- 0.05 mmol/l; n = 15, *p less than 0.001). The effect of PGE2 was dose-dependent and comparable to the effect of human parathyroid hormone 1-34 (hPTH 1-34). PGE2 turned out to be the most potent prostaglandin on human trabecular bone. PGE1 and PGF2 alpha had about 50% and PGF1 alpha about 40% of the potency of PGE2. PGA1 and PGA2 had no effect. The effect of PGE2 could be completely inhibited by human calcitonin (hCT), similar to the inhibition of the effect of hPTH 1-34 by hCT. The effect of PGE2 was not further enhanced by hPTH 1-34. Magnesium metabolism was affected in all experiments in the same way as calcium metabolism. Phosphate metabolism, release of alkaline phosphatase and hydroxyproline from bone into incubation medium were not affected by prostaglandins.

Aged↗

PubMedDate not supplied

Auranofin and sodium aurothiomalate in the treatment of rheumatoid arthritis. A double-blind, comparative multicenter study.

Auranofin (AF), a new gold compound, has been suggested as an alternative to parenteral gold in the treatment of rheumatoid arthritis (RA). This hypothesis has been tested within a double-blind comparative study and to date 103 patients have been enrolled. Forty-one RA patients have been treated for longer than 6 months. The patients were randomly allocated to treatment with either AF or sodium aurothiomalate (GSTM) and serial comparison of changes within the articular index, grip strength, pain, morning stiffness, and global assessment during treatment were measured. Improvement was noted within both treatment groups. Diarrhea as a side effect was most commonly seen during treatment with AF while rash often combined with pruritus was most commonly reported with GSTM; withdrawal from treatment as the result of this was nevertheless uncommon.

Arthritis, Rheumatoid↗

PubMedDate not supplied

[A cooperative model of the German Ministry of Health funded rheumatic disease centers].

The German Ministry of Health has granted since 1992 the institution of 21 multipurpose arthritis centers in 21 regions of Germany to improve the integrated care for patients with chronic rheumatic diseases. To coordinate and combine their efforts the supported rheumatic centers have joint together into a model cooperation. The basic founding for all centers aim to advance the interdisciplinary care network inside the centers, to elaborate appropriate measures of audit, to test new modalities for better care and to advance post-graduate and continuing medical education. In addition, continuing funding supports individual projects (n = 5) and since 1994 in 5 of the centers the German Ministry of Research and Technology granted the institution of integrated rheumatological research projects. The development and effects of the multipurpose arthritis center programme is evaluated by the Scientific Institute of the German Medical Association. The successful structural development of the centers and the first results of the joint efforts of the model cooperation (recommendation for surveillance of treatment with long acting antirheumatic drugs, basic documentation, data set for documentation of rheumatological out-patients) shows the promising outcome of the programme.

Ambulatory Care↗

PubMedDate not supplied

Manifestations of Chlamydia induced arthritis in patients with silent versus symptomatic urogenital chlamydial infection.

OBJECTIVES: To evaluate whether Chlamydia-infected patients with and without urogenital symptoms have similar rheumatological manifestations or whether they belong to distinct clinical groups. METHODS: In a university-based study, we examined patients with unexplained arthritis in whom other rheumatic diseases had been excluded for urogenital chlamydial infection, and we investigated the clinical and radiological manifestations of the Chlamydia-positive patients. RESULTS: Sixty of 283 patients (21%) with unexplained arthritis had urogenital chlamydial infection. The infection was asymptomatic in 30%. There was no difference in the pattern of arthritis or immunological and serological characteristics in the patients with and without symptoms of urogenital infection, respectively. CONCLUSION: The pattern of Chlamydia-induced arthritis is similar in patients with or without symptoms of urogenital chlamydial infection. To recognize CIA, it may be helpful to examine patients with unexplained arthritis for Chlamydia even though they do not have symptoms of urogenital infection.

Adult↗

PubMedDate not supplied

Undifferentiated arthritis in an early synovitis out-patient clinic.

OBJECTIVE: To describe the features of undifferentiated arthritis in an early synovitis out-patient clinic. METHODS: In a two-year prospective cohort study 320 patients with rheumatic symptoms of less than one year were investigated in an early synovitis out-patient clinic. Besides the clinical parameters, an intensive laboratory program was performed, including routine blood and serum parameters, immunological investigations (CRP, IgG,A,M,C3C4,RF,ANA, DNA, HLA B-27), and a microbiological program to search for reactive arthritis-inducing infections. RESULTS: 217 patients had inflammatory rheumatic diseases, of whom only 100 (46%) could be given a definite diagnosis, whereas 117 (54%) were considered as having undifferentiated arthritis (UA). Patients with UA had a mean age of 41 +/- 15 years, the sex-ratio was 1.8:1.0 (f/m), joint manifestations were oligoarticular in 68%, monarticular in 14%, and polyarticular in 18%. Rheumatoid factor was positive in 17%, HLA-B27 was found in 27%, and 21% of the patients had a history of recent infection. Follow up over 26 (range 4-38) months of 28 (24%) patients with UA revealed complete remission in 15 patients (54%), while 10 patients (36%) had further UA with partial remission, unchanged activity or progressive disease, and only 2 (7%) developed rheumatoid arthritis (RA) and 1 (4%) was diagnosed as having ankylosing spondylitis. CONCLUSION: Most patients with early synovitis followed at our clinic remain unclassified with a good prognosis.

Adult↗

PubMedDate not supplied

Decreased levels of a soluble form of the human adhesion receptor CD58 (LFA-3) in sera and synovial fluids of patients with rheumatoid arthritis.

OBJECTIVE: Soluble forms of adhesion molecules (sAM) can block cellular interactions and potentially prevent the adhesion of mononuclear cells to inflammatory tissue. We therefore wondered whether levels of a soluble form of the CD2-ligand CD58 (sCD58) are decreased in patients with different types of joint disease. METHODS: SCD58 concentrations were measured by an enzyme-linked immunosorbent assay (ELISA) of sera from 60 patients with rheumatoid arthritis (RA), 13 patients with osteoarthritis (OA), 16 patients with psoriatic arthropathy (PsA), 15 patients with spondylarthropathy (SpA), and 61 age-matched normal controls (NC). SCD58 was also determined in synovial fluid samples (SF) from 42 patients with RA, 12 with PsA, and 12 with SpA. Concentrations of sCD58 were correlated with clinical and laboratory measures of disease activity. Binding of biotinylated human albumin to recombinant CD58 or casein was assessed by a modified ELISA: RESULTS: SCD58 levels were significantly reduced in sera from RA patients compared to NC (p < 0.0001), OA (p = 0.019), and SpA (p < 0.0001). Normal concentrations were found in sera from patients with OA, PsA, or SpA. SF sCD58 concentrations were generally lower than serum concentrations (between 18 and 28%). RA SF had significantly lower sCD58 levels than SpA SF (p = 0.01). Reduction of serum sCD58 levels correlated significantly with the ESR (r = 0.56; p < 0.0001), CRP (r = 0.4; p = 0.003), and TJS (r = 0.47; p = 0.0001). In addition, sCD58 serum levels correlated significantly with the reticulocyte count (r = 0.47; p = 0.02) and serum albumin (r = 0.42; p = 0.002). Accordingly, biotinylated human albumin bound to recombinant CD58 in a dose dependent fashion, but not to casein. CONCLUSION: This study indicates that serum and SF sCD58 levels in patients with RA are reduced compared to the levels in normal controls and patients with OA or SpA. Decreased albumin concentrations due to systemic inflammation may lead to reduced sCD58 levels. Since sCD58 may normally mediate de-adhesion, such a reduction could result in increased T cell adhesiveness.

Arthritis, Rheumatoid↗

PubMedDate not supplied

Requirements for HLA-B*2705-binding peptides with special regard to the transporter associated with antigen processing (TAP).

OBJECTIVE: To refine the algorithms governing peptide presentation by HLA-B*2705 by analyzing: (i) the specificity of the human transporter associated with antigen processing (TAP) for HLA-B27 binding peptides; and (ii) the peptide binding affinity to HLA-B*2705. METHODS: TAP-translocation was measured with a labeled reporter peptide containing an N-linked glycosylation acceptor site in Streptolysin O-permeabilized cells for a panel of HLA-B27 binding peptides. Peptide binding affinity was determined by peptide-induced stabilization of empty HLA-B*2705 expressed by the TAP-deficient cell line T2-B27. RESULTS: Human TAP preferentially translocated analogues with residues leucine, isoleucine, methionine and arginine as the carboxy-terminal amino acids, whereas analogues with aspartic acid and serine were translocated poorly. The binding affinity to HLA-B*2705 of the poorly translocated aspartic acid and serine analogues was about 100-fold less compared to the parent HLA-B27 binding peptide. CONCLUSIONS: Human TAP shows considerable specificity for the C-terminus of potential HLA-B27 ligands. Nonamer peptides with aspartic acid and serine at the C-terminus are poorly translocated by the TAP and have low binding affinity for HLA-B*2705, and are therefore unlikely to become presented by HLA-B*2705.

ATP-Binding Cassette Transporters↗

PubMedDate not supplied

Evaluation of ELISA to detect Chlamydia trachomatis antigen in urine samples from arthritis patients.

OBJECTIVE: To determine whether examination of urine samples using ELISA allows the detection of asymptomatic C. trachomatis infection in arthritis patients. METHODS: The in vitro sensitivity of IDEIA Chlamydia ELISA to detect C. trachomatis in urine samples was determined by the investigation of serial dilutions of chlamydial elementary bodies. In a clinical study, urine samples from 402 consecutive arthritis patients (182 men and 220 women) in a tertiary care rheumatology clinic were examined for asymptomatic chlamydial infection by ELISA and the results were compared to culture and direct immunofluorescence assay (DFA, MicroTrak) of urogenital swabs. RESULTS: The in vitro sensitivity of ELISA for detecting purified elementary bodies of C. trachomatis serovar K in urine was 60 infection forming units. Twenty-three of 402 arthritis patients (6%) had asymptomatic chlamydial infection as shown by DFA and culture from urogenital smears. The ELISA method identified only 3 of 17 swab-positive patients among 271 patients when urine specimens were collected during the clinical visit, while the assay detected all 6 swab-positive patients among 131 patients when first-voided early morning urine specimens were used (p < 0.001). CONCLUSION: It is mandatory to examine only first voided early morning urine samples if ELISA is used instead of DFA or culture from urogenital swabs to detect asymptomatic chlamydial infection in arthritis patients.

Adolescent↗