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Biomedical subjects

J Karsh

Publications and source records attributed to J Karsh.

At least 73 records · Page 4Linked to original sources
PubMed1980

Lysozyme determination in parotid saliva from patients with Sjögren's syndrome.

Lysozyme and total protein concentrations in parotid saliva were measured in 17 patients with primary Sjögren's syndrome, in six patients with Sjögren's syndrome secondary to hyperlipoproteinemia and in 14 age- and sex-matched healthy control subjects. Increased lysozyme concentrations were found only in patients with primary Sjögren's syndrome and correlated well with the presence of parotid gland enlargement. The total protein concentration in the saliva of patients with Sjögren's syndrome was not different from that of the control subjects. Parotid saliva lysozyme determination may be useful as an early adjunctive diagnostic test of primary Sjögren's syndrome.

Humans↗
PubMed1980

Quantitative determination of rheumatoid factor by an enzyme-labeled immunoassay.

The presence and quantity of rheumatoid factor (RF) in human serum were determined by an indirect enzyme-linked immunoabsorbent assay (ELISA). A human rheumatoid factor control serum, standardized against the WHO reference rheumatoid arthritis serum preparation, was used to derive a standard curve in each assay. The results of unknowns were estimated from the standard curve and reported in International Units (IU) per milliliter (ml). The ELISA assay was compared with the bentonite flocculation test. The overall coefficient of correlation between the two assays was 87%; it was 93.3% for patients with rheumatoid arthritis but only 67.5% for patients with undiagnosed conditions. The error of the ELISA assay (coefficient of variation) was generally less than 10% at both high and low concentrations of rheumatoid factor. The quantitative reproducible nature of the assay allows the detection of small variations of rheumatoid factor level and could be useful in the serial evaluation of patients.

Animals↗
PubMed1980

A quantitative enzyme immunoassay for IgM rheumatoid factor using human immunoglobulin G as substrate.

A quantitative "sandwich" enzyme-immunoassay for IgM rheumatoid factor (RF) using human immunoglobulin G as substrate covalently bound to small plastic discs is described. The findings indicate that it is a simple, sensitive, reproducible, and specific method for measuring RF activity. Test results are reported in IU/ml on the basis of the World Health Organization reference RF serum, permitting standardized reporting of this determination between laboratories using this method. Interassay and interlaboratory variability of results are less than 7%. The enzyme-linked immunosorbent assay (ELISA) results correlated well with those found by latex and bentonite flocculation titrations. A number of ELISA RF-positive specimens that were latex-negative and/or Waaler-Rose-negative were confirmed positive by inhibition of the assay with soluble aggregated human IgG, but not with nonaggregated human IgG. Comparison was made between ELISA RF results when using goat or human IgG as substrate. Human IgG was usually more reactive with RFs than was goat IgG.

Agglutination Tests↗
PubMed1979

Alpha-1-antitrypsin phenotypes in rheumatoid arthritis and systemic lupus erythematosus.

Alpha-1-antitrypsin phenotypes were determined in 37 patients with rheumatoid arthritis and 40 patients with systemic lupus erythematosus. No significant increase in non-MM phenotypes was found. It appears that alpha-1-antitrypsin phenotypes neither predispose to the development nor enhance the severity of the two rheumatic diseases.

Arthritis, Rheumatoid↗
PubMed1979

Mortality in lupus nephritis.

The principal causes of death of 68 patients with lupus glomerulonephritis were reviewed. Renal failure (40%), vascular events (25%), and infections (16%) were the predominant causes. Diffuse proliferative glomerulonephritis was associated with an increased frequency of renal failure. A bimodal pattern of early deaths due to active lupus and sepsis and late deaths from vascular events was found superimposed on a constant rate of death from renal failure.

Acute Kidney Injury↗
PubMed1979

Lymphocyte depletion by continuous flow cell centrifugation in rheumatoid arthritis: clinical effects.

Four patients with active, severe rheumatoid arthritis were subjected to the removal of circulating lymphocytes (lymphapheresis) for a 6-week period by use of a continuous flow cell centrifuge. Repetitive venous access was gained through forearm arteriovenous fistulae. In all patients the Ritchie-Camp articular index declined rapidly in the first week and more slowly therafter for a total mean drop of 61% below the initial value. The index continued to decline after lymphapheresis but exacerbation of disease activity developed at an average of 19 weeks. No significant untoward effects of the procedure were observed; occasional transfusions were required to compensate for the small, unavoidable erythrocyte loss.

Adult↗
PubMed1979

A controlled study of pneumococcal polysaccharide vaccine in systemic lupus erythematosus.

The immunogenicity and potential for disease modification of pneumococcal polysaccharide vaccine in systemic lupus erythematosus were evaluated in a controlled, double-blind study. Forty patients were randomly chosen to receive an intramuscular injection of either vaccine or placebo. Changes in mean antibody concentrations (nanograms antibody nitrogen per milliliter serum) to 12 type-specific pneumococcal capsular antigens from prevaccination to one month after vaccination were 177 to 1045 in the vaccine (P less than 0.001) and 164 to 153 in the placebo-treated patients. In the month after vaccination, neither vaccine nor placebo-treated patients had a significant change in lupus disease activity as assessed by a composite clinical, laboratory, and serologic index. We conclude that patients with systemic lupus erythematosus can be successfully immunized with pneumococcal vaccine without detectable alterations of the underlying disease.

Adolescent↗
PubMed1978

Immune complexes in psoriasis with and without arthritis.

Two different assays were employed to detect soluble immune complexes in the serum of a large group of patients with psoriasis and psoriatic arthritis. Using a Raji cell assay no evidence of complexes was found. However, with the Clq deviation method, sera from 29% of the patients with psoriasis alone and 35% of those with associated arthritis, exhibited Clq reacting material.

Antigen-Antibody Complex↗
PubMedDate not supplied

Adverse reactions and interactions with aspirin. Considerations in the treatment of the elderly patient.

Aspirin (acetylsalicylic acid) is probably the most frequently used medication, and its use is generally uneventful. However, aspirin is also noted for numerous side effects and drug interactions that can complicate the course of therapy. The elderly, especially those with complicated medical histories, are more prone to the adverse effects of salicylates and may develop gastrointestinal tract bleeding, renal insufficiency, asthma and CNS toxicity. In the clinical situation, important drug interactions can occur with concurrent use of anticoagulants, sulphonylureas, diuretics, methotrexate and antacids. In long term aspirin therapy, enteric-coated or nonacetylated forms of aspirin are associated with fewer side effects and may be better tolerated. Monitoring of therapy (especially in the higher risk patient), with frequent assessments of the clinical state and measurements of serum creatinine, electrolytes and salicylate concentrations, may diminish the likelihood of toxicity.

Aging↗
PubMedDate not supplied

Staphylococcus epidermidis septic arthritis post arthroscopy.

A 61 year-old man developed painful swelling of his right knee shortly after arthroscopy of the joint. Synovial fluid analysis revealed a polymorphonuclear leukocytosis of 51,600 X 10(6) cells/litre and culture grew Staphylococcus epidermidis. He responded favorably to 4 weeks of intravenous therapy with cloxacillin. S. epidermidis, an important cause of prosthetic joint infection, must be considered a potential pathogen in other joint infections.

Arthritis, Infectious↗
PubMedDate not supplied

Measurements of red blood cell methotrexate concentrations and lymphocyte subsets during therapy of rheumatoid arthritis.

Nine patients with rheumatoid arthritis were treated with low dose oral weekly methotrexate for 6 months. Successful therapy was not associated with changes in concentrations of total circulating lymphocytes nor with alterations of T lymphocytes in the helper-inducer, OKT4, or cytotoxic-suppressor, OKT8, subpopulations. Concentrations of methotrexate in circulating erythrocytes stabilized by 1 month of therapy and this measurement did not correlate with clinical efficacy or methotrexate toxicity in the long-term patient assessments.

Adult↗
PubMedDate not supplied

Lymphapheresis in rheumatoid arthritis. The clinical and laboratory effects of a limited course of cell depletion.

Five patients with active rheumatoid arthritis refractory to conventional therapy were treated with a limited course of lymphapheresis--6 procedures during a two week in-hospital stay. Statistically significant improvements in assessments of rheumatoid activity were apparent by 2 weeks following lymphapheresis and persisted for 10-12 weeks. An average of 2.08 X 10(10) lymphocytes were removed from the patients and lymphopenia appeared in the 4 in whom the average daily rate of removal exceeded 1 X 10(9). However, the results of laboratory testing indicate that immuno-suppression, as based on evaluations of skin test reactivity to delayed hypersensitivity antigens and on the proportion of T cells following lymphapheresis, was not required for therapy to be deemed effective.

Aged↗
PubMedDate not supplied

Histocompatibility antigen combinations in rheumatoid arthritis.

The frequencies of HLA-A, -B, -C, DR and MT lymphocyte alloantigens in clinical and serologic subsets of rheumatoid arthritis (RA) were determined in 65 Caucasian patients with definite or classical disease and compared to frequencies observed in normal individuals. The elevation in frequency of several antigens controlled by different genes in the major histocompatibility complex (MHC) suggested that combinations of antigens may be associated with RA. Significant associations were found for HLA-A1-DR4 and A1-MT2 (p less than 0.001), Bw40-DR4 (p less than 0.002) and Cw3-DR4 (p less than 0.001). The results indicate that combinations of genes in the MHC are influential in predisposing to RA.

Arthritis, Rheumatoid↗