Search PubMed⌕ Search

Biomedical subjects

J S Percy

Publications and source records attributed to J S Percy.

At least 37 records · Page 2Linked to original sources

Vertebral sclerosis in adults.

Narrowing of the intervertebral disc space with sclerosis of the adjacent vertebral bodies may occur as a consequence of infection, neoplasia, trauma, or rheumatic disease. Some patients have been described with backache and these radiological appearances without any primary cause being apparent. The lesions were almost always of 1 or, at most, 2 vertebrae and most frequently involved the inferior margin of L4. We describe 3 patients with far more extensive vertebral involvement and present the clinical, radiological, scintiscan, and histological findings. The only patient we have seen with the better known, isolated L4/5 lesion was shown on biopsy to have staphylococcal osteomyelitis. For this reason we would still recommend a biopsy of all such sclerotic vertebral lesions if they occur in the absence of other rheumatic disease.

Adult↗

Sacroiliitis detected by bone scintiscanning: a clinical, radiological, and scintigraphic follow-up study.

Twenty-four patients had abnormal sacroiliac joints detected by quantitative sacroiliac scintigraphy but no radiological evidence of sacroiliitis on original investigation. We studied them again after intervals of 12 to 36 months. Four patients developed radiological change. Two young, HLA B27-positive men had undoubted ankylosing spondylitis, and a young woman had possible ankylosing spondylitis. A middle-aged man had changes that could be attributed to post-traumatic osteoarthrosis. Of the remaining 20 cases 15 had symptoms and signs suggestive of inflammatory disease of the axial skeleton (and peripheral arthropathy in 5 cases). The sexes were affected equally (8 females, 7 males), and only 2 of the 15 were B27-positive. The response to anti-inflammatory medication was generally good to excellent, and scintiscans tended to improve. Of the remaining 5 patients, 3 had mechanical or traumatic problems, and in 2 there was no explanation for the abnormal sacroiliac scintiscan. We conclude that quantitative sacroiliac scintigraphy may detect ankylosing spondylitis prior to the develpment of radiological change and that it can identify an organic basis for backache in patients with a spondylitis-like syndrome. The clinical circumstances must be taken into account, as scintigraphic abnormalities are not diagnostic of any specific disease entity.

Adult↗

Sequential observations of in vitro responses of lymphocytes to phytohemagglutinin in patients receiving gold therapy for rheumatoid arthritis.

Forty-seven patients receiving gold therapy for rheumatoid arthritis were observed sequentially at 6-monthly intervals. When the disease was in remission, and remained so, the in vitro responses of lymphocytes to phylohemagglutinin stimulation tended to be normal. Improvement in the disease were associated with improvement in lymphocyte response and deterioration associated with depression of response. Our observations suggest that these changes are a reflection of disease activity and their relationship to gold therapy is indirect.

Arthritis, Rheumatoid↗

Liposomes: a new approach to gold therapy?

Gold sodium thiomalate (GST) can be encapsulated in egg phophatidyl choline (and cholesterol) vesicles. Leakage from vesicles at room temperature is negligible allowing storage for at least 6 days prior to use. Intravenous injection of GST encapsulated in egg phosphatidyl choline vesicles results in: 1) delayed blood clearance, 2) enhanced uptake by the liver and spleen, 3) reduced uptake by the kidney, 4) reduced 24 hr urine excretion, and 5) enhanced uptake by inflamed tissues compared to free GST given by the same route. Thus, our preliminary findings suggest that egg phosphatidyl choline vesicles may be a suitable carrier of GST for parenteral administration.

Animals↗

Role of ultraviolet light and UV DNA in the induction of skin lesions in experimental animals.

In vivo and in vitro animal experiments have been performed to clarify the role of ultraviolet light denatured DNA (UV DNA) and ultraviolet light (UVL) in the pathogenesis of the dermal lesions of human SLE. Rabbits immunized with UV DNA show deposition of immunoglobulin at the dermal-epidermal junction following exposure to UVL. We have also shown that UV DNA appears concomitantly with the antibody at the dermal-epidermal junction subsequent to the UVL exposure. Both n DNA and UV DNA have been shown to bind to the dermal-epidermal junction in vitro which could result in the persistence of these antigens at this site. These studies lend further support to the hypothesis that the release of UV DNA and its subsequent deposition at the dermal-epidermal junction may result in binding of both immunoglobulin and complement, leading to the development of histological lesions of SLE.

Animals↗

A longitudinal study of in vitro tests for lymphocyte function in rheumatoid arthritis.

In vitro tests of lymphocyte function have been performed in 61 patients with ;classical' or ;definite' rheumatoid arthritis. In vitro lymphocyte function was assessed by lymphocyte transformation responses to phytohaemagglutinin (PHA), Pokeweed mitogen (PWM), Candida antigen, and herpes simplex type I (HSV1). Follow up data were available after 6 months of treatment in 32 of these patients. Spontaneous lymphocyte transformation was assessed in all patients. Results obtained in patients with rheumatoid arthiritis were compared to those seen in a normal control population. Disease activity of patients with rheumatoid arthritis was assessed using standard clinical methods. Lymphocytes from patients with rheumatoid arthritis showed a similar degree of spontaneous transformation to that seen in normal subjects. In contrast, lymphocytes from patients with rheumatoid arthritis responded less well to PHA and Candida and HSV1 antigens when compared to normal patients. In patients with rheumatoid arthritis the response to PWM was markedly enhanced compared to normals. Clinical improvement was noted in 19 of the 32 patients seen at follow up, all of whom had received gold or penicillamine therapy. The abnormal responses of PHA and PWM seen before treatment became normal in those patients who improved clinically. The responses to Candida and HSV1 antigens not only returned to normal following treatment but were increased above those seen in normal controls. A statistically significant association was seen between clinical improvement and improvement of in vitro tests of lymphocyte function.

Antigens, Fungal↗

Effect of ultraviolet light on disease characteristics of NZB/W mice.

The development of antinuclear antiboides, proteinuria and cumulative mortality has been studied in four groups of NZB/W mice. Two groups were exposed to different amounts of ultraviolet light [UVL] and one group were bred and raised in total darkness. The fourth group served as a control. No significant difference was noted bwtween the groups in the development of antinuclear antibodies, proteinuria or in cumulative mortality. This study failed to show any major role of UVL as an environmental factor in the development of this disease.

Animals↗

Diagnosis and follow-up of children referred to a rheumatic disease unit.

Juvenile rheumatoid arthritis (JRA) has become the predominant rheumatic disease of childhood. In a survey of 292 children referred to a rheumatic disease unit over a 5-year period, 94 had JRA and only three had rheumatic fever. At follow-up, of the children with JRA, 70% were found to be in remission with little or no functional disability. Febrile onset of JRA or onset before six years of age were worse prognostic features than pauciarticular or polyarticular onset of occurrence after six years of age. Of 28 children who had either growing pains or psychogenic rheumatism, two were subsequently found to have chondromalacia patellae. None of the other children in this group for whom follow-up information was available had developed organic disease.

Adolescent↗

A comparative study of technics for the detection of antibodies to native deoxyribonucleic acid.

Antibodies to native DNA have been assessed by three separate radioimmunoassay methods: the Millipore filter technic, the Farr ammonium sulfate precipitation test, and a commercially available kit method. Although each method was found to be reliably reproducible, the different units by which results are expressed made comparison difficult because of the technical variations inherent in each test. The correlation between tests was, however, high. To allow for interlaboratory standardization, it is suggested that the assay method used be clearly specified. Results are best expressed in terms of mg of DNA bound per deciliter of test serum. It appears that the centrally standardized radioimmunoassay kit is the most convenient method by which these antibodies can be measured in routine laboratories.

Ammonium Sulfate↗

Correlation between levels of DNA antibodies and clinical disease activity in SLE.

Sera were tested from 23 patients with systemic lupus erythematosus followed over a period of 1 to 5 years. Antibodies to native DNA were measured and correlated retrospectively with clinical evidence of disease activity. The overall degree of correlation between the presence of DNA antibodies and evidence of disease activity was good (P less than 0-001). Of 206 sera tested, only 4 had a normal DNA antibody at a time when significant clinical activity was noted. In contrast, 34 sera had mild to moderately raised DNA antibody levels at times of clinical remission. Although DNA antibodies are a useful investigation in the monitoring of disease activity, changes in therapy should not necessarily be made on DNA antibody levels alone.

Alberta↗

The scintigraphic investigation of sacroiliac disease.

Bone scintigraphs obtained with both Technetium-99m polyphosphate and Technetium-99m pyrophosphate have been abnormal at the sacroiliac joints of 44 patients with definite ankylosing spondylitis (AS). Because of the normal registration of the sacroiliac joints on bone scintigraphy, it has been necessary to develop a profile-scan technique to quantify the abnormality that proves to be significantly different from the normal finding. In 17 patients with a strong clinical suspicion of AS but normal radiographs, the sacroiliac joints have frequently been abnormal. This finding is meaningful because there is a common occurence in this group of the histocompatibility antigen HL A-B27, known to be a marker of AS. We also note the frequency of abnormal sacroiliac scinitigrams in 26 patients with rheumatoid arthritis and in a group of other diseases-Crohn's disease, uveitis, psoriasis, ulcerative colitis, and Reiter's disease-all of which share some of the manifestations of AS.

Adult↗

Scintigraphic findings in ankylosing spondylitis.

A prospective study of bone scintigraphic findings has been carried out in 63 patients, firmly diagnosed as having ankylosing spondylitis. In addition to abnormal uptake of the radiotracer at the sacroiliac joints, a peripheral arthropathy has been a common finding, particularly in the proximal joints, occurring in up to 50% of patients. Increased uptake of radiotracer in the spine has also been found both diffusely and focally. Focal increases have been noted at the apophyseal joints in 40% of patients and in three patients with a sterile intervertebral diskitis, an unusual complication of this disease only diagnosed in two patients after bone scintigraphy.

Evaluation Studies as Topic↗

Psoriatic spondylitis: a clinical, radiological, and scintiscan survey.

Thirty-three per cent of patients with psoriatic spondyloarthropathy referred to a rheumatic disease unit were found to have radiological sacroiliitis. The majority of these patients had definite or probable spondylitis according to the New York criteria. Abnormal sacroiliac uptake of 99mTcPP on bone scan correlated well with the radiological finding of sacroiliitis. In addtion, eight patients with normal radiographs had an abnormal uptake of radionuclide over the sacroiliac joints, indicating sacroiliitis. Patients with sacroiliitis tended to have more severe psoriasis. Sacroiliitis occurred in association with all of the patterns of peripheral joint involvement which may occur in psoriatic arthritis. Although the HLA antigen B27 was present in only 21 percent of the total group and in 33 percent of those with sacroiliitis, 8 out of 10 with this antigen had sacroiliitis.

Adult↗

The sacroiliitis of acute Reiter's syndrome.

Sacroiliitis can be demonstrated radiologically in over one-third of patients with chronic Reiter's syndrome. We have used a bone scan technique with digital analysis which will quantitatively assess the sacroiliac joints, and have found abnormalities in 24 of 33 patients with active Reiter's syndrome. It seems likely therefore that sacroiliitis is a common feature in patients with early Reiter's syndrome and while in most patients it resolves with resolution of disease activity, in some it may persist with the development of overt radiological changes.

Acute Disease↗

The scintigraphic findings in Paget's disease of bone.

Bone scans and radiographic skeletal surveys have been done in 41 patients who had Paget's disease. The scintigraphic findings are consistent with what is known of the pathophysiology of Paget's disease. Diseased bone demonstrates increased vascularity, an increased degree of uptake of bone-seeking radiotracers and, in appropriate bones, evidence of marrow replacement. The bone scintiscan is a more sensitive indicator of the extent of polyostotic Paget's disease than conventional radiograph, demonstrating 34% more lesions. Because it reflects shorter term changes in osteoblastic activity the bone scan is of some value in providing immediate objective evidence of the therapeutic effectiveness of Mithramycin which has been used in this study in the treatment of the minority of patients with pain in Pagetoid bone. A technique for documenting alterations in uptake by diseased bone numerically is presented. Upon treatment with Mithramycin the ratio of abnormal uptake in relation to normal bone fell from 8.7 to 3.9.

Bone Marrow↗