Small spinal fractures in back pain patients.
Small fractures in the posterior elements of the spine were identified by stereoscopic radiography in 7 patients suffering from back pain. The clinical data on these 7 patients are presented.
Adult↗
Biomedical subjects
M I Jayson
Publications and source records attributed to M I Jayson.
Rheumatoid arthritis--clinical.
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Arthritis, Rheumatoid↗
The distribution of surface strain in the cadaveric lumbar spine.
The fourth lumbar vertebrae and L4-5 discs from six cadaveric lumbar spines were subjected to detailed strain gauge analysis under conditions of controlled loading. With central compression loads, maximal compressive strain was found to occur near the bases of the pedicles and on both superficial and deep surfaces of the pars interarticularis, which emphasises the importance of the posterior elements of lumbar vertebrae in transmitting load. Radial bulge and tangential strain of the disc wall were maximal at the posterolateral surface, in agreement with the fact that disc degeneration and prolapse commonly occur there. Under posterior offset loads simulating extension, both compressive and tensile strains were found to be increased on both surfaces of the pars interarticularis, which suggests that hyperextension may lead to stress fractures and spondylolisthesis. Posterior offset loads also increased the radial bulge of the posterior disc wall and tangential strain at the anterior surface of the disc. Anterior offset loads simulating flexion increased the radial bulge of the anterior disc wall and tangential strain at the posterior surface of the disc. These findings are compatible with movement of the nucleus pulposus within the disc during flexion and extension. This hypothesis was supported by post-mortem discography.
Adolescent↗
Systemic immunosuppression in marginal keratolysis.
Experience in the investigation and treatment of eleven patients with the peripheral corneal melting syndrome is described. It is considered that short-term treatment with non-corticosteroid immunosuppressive regimes should be tried in patients with severe progressive disease which may not respond to other methods of treatment.
Aged↗
Scoring of erosions in rheumatoid arthritis.
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Arthritis, Rheumatoid↗
Low tension studies of collagen fibres from ligaments of the human spine.
On polarization microscopy collagen fibres from human cadaveric anterior longitudinal, posterior longitudinal, and interspinous ligaments show a series of transmission and extinction bands. By observing changes in this pattern on rotating the polarizing stage and on rotating the fibres a crimped structure of the fibres was deduced and its parameters were calculated. From these data the force/strain behaviour of the fibres under low tension was calculated. This corresponded closely with the results from mechanical measurement. At the same time we documented alterations in the transmission and extinction patterns while under tensile load. The results suggest that it is the crimped structure that is responsible for the high extensibility of the collagen fibres under low tension. The initial extension is by deformity of the crimp segment. This avoids risk of tearing the collagen fibres.
Adult↗
Ulceration of the cornea in rheumatoid arthritis.
Five patients with melting of the cornea in association with rheumatoid arthritis are described. The arthritis was often inactive and without systemic manifestations, in contrast to that seen in association with scleritis. In 3 there was evidence of reduced tear formation, but in none was tear production absent. In 3 patients the lesions healed during treatment with azathioprine or penicillamine.
Adult↗
Xeroradiography in assessment of the rheumatoid hand.
Comparable conventional x-rays had xeroradiographs were obtained of the hands of 22 patients with rheumatoid arthritis. Each metacarpophalangeal and proximal interphalangeal joint was scored for juxta-articular osteoporosis, erosions, loss of joint space, soft tissue thickening, joint deformity, and osteophytes on a 0-3 scale. For 10 hands the films were reported again after 3 months, and each technique was reproducible. Comparison between the 2 radiographic techniques showed that overall they gave similar results, although osteoporosis was reported more frequently on conventional x-rays, and loss of joint space and synovial thickening on xeroradiographs.
Arthritis, Rheumatoid↗
Rheumatoid involvement of the lumbar spine.
On stereoscopic examination of the lumbar spines of 6 patients with rheumatoid arthritis and spinal disease we found typical rheumatoid erosions in the apophyseal joints. 2 also had severe asymmetrical disc destruction with associated involvement of the vertebral bodies and scoliosis. In one of these patients who developed Staphyloccocus aureus septicaemia, infection was localized in this part of the lumbar spine.
Adult↗
Penicillamine therapy in systemic sclerosis.
Twenty-two patients with progressive systemic sclerosis were treated with D-penicillamine in doses ranging up to 1250 mg/day for periods varying between a few months and four years. Side-effects occurred in 7 patients, necessitating drug withdrawal in 2. Cutaneous benefit occurred in 15 patients, but owing to side-effects from the drug, relapses, and development, persistence or advancement of visceral complications, an overall good result only occurred in 5. Seven patients showed improvements in joint function, but only 3 were regarded as having an overall good result. Peripheral vascular disease and visceral involvement seemed not to be influenced by D-penicillamine and sometimes appeared or advanced during treatment. Six patients died from visceral manifestations of systemic sclerosis and one from another cause. D-penicillamine is of limited value for the cutaneous features of progressive systemic sclerosis, but probably of no value for the vascular and visceral manifestations of the disease.
Adult↗
Rheumatoid arthritis and the eye.
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Arthritis, Rheumatoid↗
Serological changes in progressive systemic sclerosis.
Sera from 37 patients with scleroderma were studied for the presence of auto-antibodies. Rheumatoid factors and antibodies to smooth muscle and thyroid were seen in some patients. Ten of 31 patients (32%) had antibodies to nuclear antigens. They were not related to the extent or severity of disease but were often associated with other complications or coincidental diseases. These serological changes only occurred in the patients with progressive systemic sclerosis and did not occur in morphoea. Antibodies to double-stranded DNA were found in only one case, and neither clinical nor serological overlap with systemic lupus erythematosus were seen in this group of patients.
Antigen-Antibody Reactions↗
The organ culture of adult human articular cartilage, from patients with osteoarthrosis.
Adult human articular cartilage has been maintained in organ culture for three days. The uptake of 35SO4 has been studied over a 48-hour period. The incorporation of 35SO4 was significantly increased in osteoarthrotic cartilage compared to normal cartilage from the same joints. The uronic acid content of the osteoarthrotic cartilage was significantly reduced which reflects the proteoglycan loss in the diseased tissue. The DNA content, which is an indirect measurement of the cell population, was not significantly different in the diseased and normal cartilage.
Adult↗
D-Penicillamine does not have a lathyritic effect on the rheumatoid synovium.
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Arthritis, Rheumatoid↗
Synthesis of glycosaminoglycan in adult human articular cartilage in organ culture from patients with rheumatoid arthritis.
Hyaline cartilage was obtained from patients undergoing synovectomy of the knee joint for rheumatoid arthritis. Eroded cartilage from beneath the invading pannus and relatively normal cartilage from the same joint were maintained in organ culture for three days. During the first 48 hours in culture the explants were exposed to 35SO4 in the medium. The equivalent layers of normal and eroded cartilage were analysed for DNA uronic acid and 35SO4 incorporation. There was a decrease in the DNA and uronic acid of the eroded cartilage, although only the latter reached statistical significance. The uptake of radioactive sulphate was significantly greater in explants taken from the eroded site than from normal areas. This increase in metabolic activity could well be a protective phenomenon.
Adult↗
Surface strain distribution in isolated single lumbar vertebrae.
The surface strains of isolated single lumbar vertebrae under compressive load were examined by the techniques of brittlecoat and photoelastic analysis. Directions of principal strain components have been determined. Areas of stress concentration were found around the vertebral rims, near the pedicles, and around the foramina of the basivertebral veins.
Adult↗
Thrombocytosis in rheumatoid arthritis.
Of 75 patients with rheumatoid arthritis, 39 had a thrombocytosis and 36 normal platelet count. A highly significant relationship existed between the platelet count and disease severity and an inverse correlation with level of haemoglobin. An association appeared to exist between thrombocytosis and extra-articular manifestations of rheumatoid disease. By 75Selenomethionine labelling platelet and fibrinogen survival and turnover were determined. In 3 rheumatoid patients with thrombocytosis platelet survival was decreased and turnover increased. In these and a further rheumatoid patient with a normal platelet count there was reduced fibrinogen survival and increased fibrinogen turnover, and in addition excess fibrin degradation products were detected. The results suggest that thrombocytosis accompanies the more severe cases of rheumatoid disease and is due to a compensatory increase in platelet production associated with active intravascular coagulation.
Arthritis, Rheumatoid↗
Radiographic stereoplotting. A new technique and its application to the study of the spine.
Radiographic stereoplotting is a method for taking three-dimensional measurements from a pair of x-ray films. The x-ray technique is described, as is the stereoplotter. Using this machine it is possible to locate any point within the patient and measure the distance between that point and any other point. From this information it is possible to compute areas, volumes, and angles with great accuracy, which hitherto has been impossible using noninvasive techniques. It is planned to take measurements of the spinal canal in normal backs and in patients with nonspecific back pain, in order to try to define some of these syndromes on a structural basis. It is likely that stereoplotting has some useful application in most branches of clinical medicine, since the x-ray technology is available in any diagnostic x-ray department.
Adult↗