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J Esdaile

Publications and source records attributed to J Esdaile.

31 records · Page 2Linked to original sources
PubMed1983

Immunoglobulin isotype in the murine response to polysaccharide antigens.

Murine antisera specific for the alpha (1 leads to 3) and alpha (1 leads to 6)-linked glucosyl determinants of dextran, as well as for meningococcal polysaccharide group C, have been examined for the distribution of their immunoglobulin classes and subclasses. Whereas the thymus-independent anti-alpha (1 leads to 3) dextran response in BALB/c mice was found to be IgM greater than IgG3 greater than IgA, thus corresponding to previously published work, neither the alpha (1 leads to 6) response in its thymus-dependent or-independent form, nor the response to purified meningococcal polysaccharide, corresponded to this pattern. No preference for any of the IgG subclasses appeared for these antigens when given as thymus-independent carbohydrates. On the other hand, thymus-dependent forms of alpha (1 leads to 6) dextran showed an IgG1 greater than IgG3 greater than IgG2 pattern.

Animals↗
PubMed1983

Radionuclide joint imaging.

Radionuclide joint imaging with the technetium-99m-labeled phosphates is a sensitive technique for the detection of inflammatory articular disease, although it is nonspecific as to the cause of the increased uptake and offers poor resolution in comparison to conventional radiography. There does not appear to be any place for the routine use of joint imaging of the peripheral joints, as there is little evidence that it benefits patient management. Scintigraphy is of benefit in the detection of osteomyelitis, Legg-Perthes' disease, and osteonecrosis, where changes may antedate roentgenologic abnormalities. Technetium-99m-phosphates may have an increasing role in the evaluation of knee and hip prosthetic joint loosening and infection, especially regarding the femoral components. Scintigraphy may be useful in excluding synovitis and allaying concern in selected patients with chronic articular pain in whom a conventional diagnostic evaluation is unrewarding. Attempts have been made to use radionuclide joint imaging to quantitate the degree of synovitis present in individual joints, particularly the sacroiliac joints. To date, reliable methods that distinguish normal from abnormal joints have not been established, although this remains an area of potential usefulness and active research. Scintigraphy with 99mTc-phosphates is useful in the detection of spinal fracture and pseudoarthrosis in individuals with ankylosing spondylitis.

Adult↗
PubMed1983

A clinical study of older age rheumatoid arthritis with comparison to a younger onset group.

The clinical features, therapy and course of disease in a group of 34 patients with older age onset rheumatoid arthritis (ORA) defined as disease onset after age 60 are compared with a group of 34 rheumatoid patients whose disease onset began at a younger age (YRA). Onset of rheumatoid arthritis (RA) beyond age 60 is not uncommon as ORA represented 33% of all RA patients seen in our rheumatic disease unit. The ORA patients had a shorter mean disease duration (p less than 0.001) and a tendency to less rheumatoid factor seropositivity (p = 0.06) despite random selection for active disease of less than 10 years' duration. Suppressive therapy was employed less frequently in ORA (p less than 0.01) than in YRA but the use of other therapeutic modalities and the last recorded functional class were similar in the 2 groups. ORA patients did have greater functional incapacity at some point in their disease course (p less than 0.01) as well as a greater frequency of weight loss (p less than 0.001) and other acute systemic features at onset than YRA patients. Seronegative ORA appeared to have a favourable disease course in comparison with seropositive ORA.

Acute Disease↗
PubMed1982

Predictive value of radionuclide joint scintigrams.

Twenty-two patients with normal or "noninflammatory" 99mtechnetium-labeled polyphosphate (TPP) peripheral joint scintigrams taken between 1974 and 1976 were reevaluated clinically. Retrospective chart review revealed that all initially had persistent polyarthralgia of more than 3 months duration. At followup, a mean of 3.6 years later, none had evidence of inflammatory joint disease, although 1 patient had systemic lupus erythematosus and 2 had polymyalgia rheumatica. A noninflammatory joint scintigram as part of a thorough rheumatologic evaluation may be a useful procedure in excluding inflammatory joint disease in selected patients with chronic persistent polyarthralgia.

Adult↗
PubMed1981

Induction and persistence of B-cell tolerance to the thymus-dependent component of the alpha(1 leads to 6) glucosyl determinant of dextran. Recovery induced by treatment with dextranase in vivo.

A direct comparison was made between thymus-dependent (TD) and thymus-independent (TI) responses in mice tolerized for (1 leads to 6) glycosyl determinants by the injection of dextran B512. Long-lasting B-cell tolerance by dextran was reversed when mice were treated with dextranase in vivo. Complete or partial reversion of tolerance with the enzyme was invariably obtained for the TI response but the TD component proved to be more resistant and dependent on the immunogen used to test the reversion. The uniformity of the spectrotype in BALB/c mice, even under conditions of partial tolerance, permitted the analysis by isoelectric focussing of serum from tolerant mice treated with dextranase and immunized with TD dextran-ovalbumin. Results showed that, with one single exception, mice thus treated produced spectrotypes no different from the pattern normally found in immune animals. The results presented suggest that at least some alpha(1 leads to 6) specific B cells, both TD and TI, persist in tolerized mice for at least 2 weeks after tolerance induction and they do not support the concept of clonal elimination for either TI or TD responses in adult mice.

Animals↗
PubMed1980

Idiopathic fibrosis of the lateral compartment of the neck.

We report a case of idiopathic fibrosis of the lateral compartment of the neck. Twenty-four years after the onset of swelling of the neck 14 years after biopsy, the patient remains only mildly sympatomatic. Histologically, it appears to be a homologue of the other idiopathic fibrosing syndromes such as retroperitoneal fibrosis, mediastinal fibrosis, sclerosing cholangitis, fibrosis of the orbit, and Riedel's struma.

Adult↗
PubMed1979

Hairy-cell leukaemia with polyarteritis nodosa.

In four patients a systemic vasculitis similar to polyarteritis nodosa developed within 2 years of the onset of hairy-cell leukaemia. Arteriographic studies in two patients revealed microaneurysms, and biopsy specimens in three patients revealed a vasculitis affecting medium-sized vessels. Blood neutrophilia and neutrophilic vascular infiltrate were absent. One patient had circulating immune complexes. Two patients responded to corticosteroids alone, one required cyclophosphamide as well as steroids, and one improved without chemotherapy. The association of vasculitis with hairy-cell leukaemia may provide insight into the pathogenesis of arteritis.

Adult↗
PubMed1979

Radionuclide joint imaging in the seronegative spondyloarthropathies.

Radionuclide joint imaging (RJI) of the peripheral and axial skeleton is a recent advance in the detection of early articular inflammation and has proven useful in establishing the extent and pattern of this involvement. The bone-seeking agents--the radiophosphates--are the radiopharmaceuticals presently favored for RJI in adults. They are more sensitive than the clinical examination in detecting inflammatory joint disease in all peripheral joints with the exception of the shoulders, elbows and knees. Radiophosphate may also be used to evaluate the axial skeletion for inflammatory involvement. The sacroiliac joints may be evaluated by a new technique, quantitative saroiliac scintigraphy (QSS). Studies to date have demonstrated that QSS is most sensitive in early sacroiliitis, a time when conventional radiography is normal or shows equivocal abnormalities. While extremely sensitive as a screening procedure for inflammatory articular disease, RJI is nonspecific diagnostically. Radiophosphate uptake by bone occurs in metabolic bone disease, osteoarthritis, trauma and juxta-articular bony abnormalities such as osteomyelitis and bone infraction. The results obtained by radionuclide joint imaging must be supplemented by the clinical findings and conventional investigations to establish a specific diagnosis.

Adolescent↗
PubMed1977

Vascular involvement in relapsing polychondritis.

Review of four cases of relapsing polychondritis (RP) seen at one hospital in the 12-year period 1963 to 1974 revealed that one patient had aortic insufficiency with large artery involvement, two others had involvement of medium and large arteries and the fourth may have had mucocutaneous vasculitis. Valvular disease has occurred in 9% of all cases of RP reported in the literature and, if vasculitis beyong the aortic root is included, 25% of cases of RP manifested inflammatory vascular disease. The frequency of pseudotumour of the orbit and cochlear-labyrinthine dysfunction is also high and may be a manifestation of vasculitis.

Aged↗
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

Reticuloendothelial system Fc receptor function in systemic lupus erythematosus.

Reticuloendothelial system Fc receptor function was measured in 10 patients with systemic lupus erythematosus (SLE) taking corticosteroids, 10 SLE patients not receiving corticosteroids and in 19 controls, 9 of whom were corticosteroid-dependent asthmatics and 10 of whom were healthy. Clearance studies were performed using autologous 51 Cr-labeled erythrocytes that had been sensitized with human IgG anti-Rh(D) [6,700 molecules/cell]. The clearance curves could be split into a fast (t1/2 fast) and a slow (t1/2 slow for any of the groups of patients. The results were correlated with serum C3, C4, DNA-binding, fluid phase 125I-Clq binding, a disease activity index, corticosteroid dose and duration of therapy with corticosteroids. The only significant correlation was an inverse correlation of C4 with the t1/2 slow in SLE patients not on corticosteroids (r=- 0.71, p less than 0.05). The t1/2 slow of the 3 SLE patients with active nephritis (86 +/- 40 min) was significantly different from the 17 SLE patients with inactive nephritis or normal renal function (37 +/- 5 min) (P less than 0.05). We conclude that there is no overall defect of Fc receptor function in our patients with SLE although there is decreased clearance in patients with active lupus nephritis.

Asthma↗
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↗