In 182 patients with systemic lupus erythematosus (SLE), oral mucosal ulceration occurred in 47 patients (26%), was usually painless (82%), and most often involved the hard palate (89%). Oral ulceration was associated with an increase in overall clinical activity, although this was not accompanied by significant changes in the levels or titers of C3, anti-DNA antibodies, and anti-nuclear antibodies. Necrotizing vasculitis was not observed. Microscopic changes were similar to the skin lesions of SLE and immunoglobulin and complement were found in both the basement membrane and blood vessel walls.

Humans↗

PubMedDate not supplied

Hebbian-like functional plasticity in the auditory cortex of the behaving monkey.

In this study, the necessary conditions, including those related to behavior, for lasting modifications to occur in correlated activity ('functional plasticity') were examined in the behaving monkey. Previously, in-vitro studies of neuronal plasticity yielded important information about possible mechanisms of synaptic plasticity, but could not be used to test their functionality in the intact, behaving brain. In-vivo studies usually focused on analysis of the responsiveness of single cells, but did not examine interactions between pairs of neurons. In this study, we combined the two approaches. This was achieved by recording extracellularly and simultaneously the spike activity of several single cells in the auditory cortex of the behaving monkey. The efficacy of neuronal interactions was estimated by measuring the correlation between firing times of pairs of single neurons. Using acoustic stimuli, a version of cellular conditioning was applied when the monkey performed an auditory discrimination task and when it did not. We found that: (i) functional plasticity is a function of the change in correlation, and not of the correlation or covariance per se, and (ii) functional plasticity depends critically on behavior. During behavior, an increase in the correlation caused a short-lasting strengthening of the neuronal coupling efficacy, and a decrease caused a short-lasting weakening. These findings indicate that neuronal plasticity in the auditory cortex obeys a version of Hebb's associative rule under strong behavioral control, as predicted by Thorndike's "Law of Effect".

Acoustic Stimulation↗

PubMedDate not supplied

Temporal firing patterns of single units, pairs and triplets of units in the auditory cortex.

The spontaneous and acoustically driven activities of single units, pairs and triplets of units in the auditory cortex were analyzed. Data were obtained in two sets of experiments from nonbehaving awake cats and from a behaving monkey. The results of the two sets of experiments indicated that neighboring neurons usually fire independently. The weak correlations found between pairs of adjacent neurons were mostly indicative of a common input driving both units. In some cases, signs of synaptic interaction between the neurons were found. When triplets of units were considered, it was found that several independent inputs exist, even within a small group of adjacent neurons. When such small groups of neurons were studied in the behaving monkey, it was found that the temporal firing pattern of single neurons and the interactions between pairs of neurons were in some cases dependent on the behavioral state and on the sensorimotor association.

Animals↗

PubMedDate not supplied

Rheumatoid markers in the absence of arthritis.

A 45-year-old man had high titer rheumatoid factor in his serum, marked elevation of his erythrocyte sedimentation rate, and a histologically proven rheumatoid nodule in the absence of other manifestations of rheumatoid disease. These findings are most unusual and emphasize that serologic and histologic markers of rheumatoid arthritis may be present without arthritis or other disease manifestations.

Adolescent↗

PubMedDate not supplied

Low dose methotrexate in rheumatoid arthritis.

A systematic analysis of the efficacy of methotrexate (MTX) in severe rheumatoid arthritis (RA) was carried out. Twenty-one patients with severe classical RA resistant to conventional therapy were treated with 7.5 to 25 mg of oral or intramuscular MTX for 3-114 weeks (mean of 38 weeks). Eleven patients (52.4%) showed definite clinical improvement and a fall in sedimentation rate; some improvement was seen in 5 other patients (23.8%). Two patients were unresponsive. Three patients discontinued MTX, 1 because of acute hepatitis and the other 2 because of noncompliance and fear of toxicity. Abnormal liver function tests reversible with modification of therapy occurred frequently. Other side effects were minor. The results of this uncontrolled study indicate that MTX may be an effective drug for the treatment of severe RA. Double blind trials and longterm followup are needed prior to its widespread use in RA.

Adult↗

PubMedDate not supplied

The coexistence of rheumatoid arthritis and systemic lupus erythematosus: a case report and review of the literature.

We describe a patient with longstanding classical erosive rheumatoid arthritis (RA), who after many years developed the clinical and serological manifestations of systemic lupus erythematosus (SLE) including diffuse proliferative lupus nephritis. She fulfilled the ARA preliminary criteria for the classification of SLE as well as the ARA criteria for classical RA. In addition she had antibodies to native DNA, hypocomplementemia, and deposits of immunoglobulins at the dermal-epidermal junction of the non-lesional skin. The rarity of the concurrence of these 2 diseases in the same patient and the discriminating findings with tissue typing analysis suggest that this coexistence may be coincidental.

Adult↗

PubMedDate not supplied

Systemic lupus erythematosus in the younger patient: survival studies.

One hundred eighty-two patients fulfilling the American Rheumatism Association criteria for the classification of systemic lupus erythematosus (SLE) were followed prospectively. Sixty-seven had the onset of SLE before age 21, 32 before age 16, and 35 between age 16 and 20. All patients received similar therapy. Only 4 patients received cytotoxic agents. Malar blush, cellular casts, and profuse proteinuria were significantly more common in the 0-15 compared to the adult group (age 21 or older). Five-year survival was 100% for children with membranous or focal lupus nephritis and 85% for diffuse proliferative lupus nephritis.

Adolescent↗