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Biomedical subjects

R L Kaufman

Publications and source records attributed to R L Kaufman.

At least 37 records · Page 2Linked to original sources
PubMed1989

Halo-body jacket immobilization in rheumatoid arthritis patients with cervical myelopathy.

The rehabilitation nurse may care for patients with arthritis in a variety of settings. When the patient has advanced RA, the problem of cervical myelopathy may require surgical intervention and use of the halo-body jacket immobilization orthosis. Expert pre- and postoperative management requires a knowledge of surgical nursing as well as rehabilitation nursing, in the traditional sense, to prevent complications and promote optimum recovery. When dealing with people who have lived with RA for many years, the rehabilitation nurse must continue to assess the patient's knowledge of the disease and use of self-management strategies and community resources.

Arthritis, Rheumatoid↗
PubMed1988

Antibody production by blood lymphocytes in myasthenia gravis: reduction in disease of long duration.

We measured acetylcholine receptor antibody (AchR Ab) and IgG secreted in vitro by blood lymphocytes from myasthenia gravis patients and controls. Eleven of 20 patients secreted AchR Ab. Controls did not secrete AchR Ab. IgG secretion was lower in patients who were nonsecretors of AchR Ab (351 +/- 127 ng/ml/10 days) than in secretors (3,563 +/- 949) and both groups differed from controls (1,305 +/- 353). Absence of secretion of AchR Ab and low IgG secretion correlated with long disease duration. The data suggest that nonspecific suppression of B cell mediated immune function may occur in long-standing myasthenia gravis.

Antibody Formation↗
PubMed1987

Comparison of detection of varicella-zoster virus by the Tzanck smear, direct immunofluorescence with a monoclonal antibody, and virus isolation.

A study comparing direct immunofluorescence assay using a new monoclonal antibody specific for a varicella-zoster virus glycoprotein complex, the Tzanck smear, and virus isolation for detection of varicella-zoster virus in 56 patients with clinically apparent herpes zoster is presented. Of 47 patients with clinical herpes zoster and with cultures negative for herpes simplex virus, 30 (64%) had positive Tzanck smears, direct immunofluorescence assay results were positive in 26 (55%), and cultures were positive in only 12 (26%). Both direct immunofluorescence assay and the Tzanck smear were found to be superior to culture technics; however, direct immunofluorescence assay was found to have greater specificity.

Antibodies, Monoclonal↗
PubMed1987

Erosive and subluxing cervical spine disease in patients with psoriatic arthritis.

Cervical spine involvement with psoriatic arthritis has been reported to occur in about 35% of patients and to be primarily ankylosing in nature. This previously described pattern is characterized by syndesmophytes, ankylosis and ligamentous ossification. Our study defines the incidence and clinical characteristics of a rheumatoid-like form of inflammatory cervical spine involvement. This pattern is characterized by apophyseal and odontoid erosions, and axial and subaxial subluxations. Clinical histories were obtained from 28 patients with both psoriasis and inflammatory arthritis between the years of 1971 and 1984. Cervical spine involvement was found in 75% of the group, 13/21 had ankylosing and 8/21 inflammatory characteristics. Three of our patients developed cervical myelopathy, one in the ankylosing and 2 in the inflammatory subgroup.

Arthritis↗
PubMed1985

Prosthetic synovitis: clinical and histologic characteristics.

Our study of 20 patients correlates the clinical picture of each patient with the pathology of synovial tissue obtained at the time of revision arthroplasty. While 12 patients had rheumatoid arthritis and 8 had osteoarthritis, the histopathology was identical. Additionally, while 15 of the 20 had an etiology for the revision, 5 patients were revised for pain alone with no explanation other than the synovitis. The characteristic histologic findings included lining cell hyperplasia, vascular congestion, giant cells, brightly birefringent high density polyethylene chards and cysts that represented ghosts of methyl methacrylate debris.

Arthritis, Rheumatoid↗
PubMed1984

Layoffs, an emerging reality.

Permanent reduction of the work force in a 247-bed tertiary-care hospital in Rhode Island is described. All hospital departments were directed to reduce their salary and wage budgets by a given amount. Each department submitted recommendations for reducing the budget; these were subject to approval of the hospital administration. The pharmacy staff was reduced from 24.6 full-time equivalents (FTEs) to 23.2 FTEs. Termination of employees was a last resort; affected employees were chosen carefully and were given a thorough explanation of the reasons for their termination.

Cost Control↗
PubMed1983

Reactivity of serum antibodies to the keratin layer of rat esophagus in patients with rheumatoid arthritis.

Serum antibodies reactive with the keratin layer of rat esophagus (AKA) were found in 46 of 80 (57.5%) rheumatoid arthritis (RA) patients. In contrast, AKA were present in only 7 of 82 (9.5%) patients with other types of rheumatic disorders and in 2 of 47 (4.2%) healthy subjects. AKA were not specific for RA, however, because in the former group, AKA were present in 4 of 20 (20%) systemic sclerosis patients and in 3 of 12 (25%) ankylosing spondylitis patients. AKA belong predominantly to the IgG class and are complement fixing. Although found in some RA joint fluids, AKA were not selectively concentrated in the joint fluid. Absorption of RA serum with type I human collagen or with human epidermal keratin did not remove AKA activity. The frequency of AKA in RA patients both negative and positive for DR4 was equal. There was no relationship between the frequency of AKA and the occurrence of other serum autoantibodies such as antibodies to intermediate filaments, smooth muscle, and nuclear antigens. Serum antibody reactive with human stratum corneum found in patients with psoriatic arthritis was shown to be different from AKA. Rabbit antiserum to human keratin did not inhibit the reaction of AKA against the keratin layer of rat esophagus. Autoimmunity to structural proteins including collagen, vimentin intermediate filaments, smooth muscle antigens, and keratin is a characteristic feature of RA.

Animals↗
PubMed1983

Acquired laryngeal deviation associated with cervical spine disease in erosive polyarticular arthritis. Use of the fiberoptic bronchoscope in rheumatoid disease.

Cervical spine disease in patients with erosive polyarticular arthritis often presents difficulties in endotracheal intubation at the time of surgery. After extensive experience with the use of the fiberoptic bronchoscope in such situations, the authors have identified a previously unrecognized and unanticipated tri-plane deviation in which the larynx is displaced caudally, deviated to the left, rotated to the right, and anteriorly angulated. A review of 710 consecutive fiberoptic intubations identified 15 arthritis patients with laryngeal deviation. Documentation was available in seven patients showing that the larynx was initially in a normal position, but was progressively displaced as the cervical spine disease worsened. Vertical penetration of the dens was the most significant underlying pattern of cervical spine disease. Computerized tomography with multiplanar reconstruction elucidated two patterns of deformity but was not necessary to detect the laryngeal deviation. One cause of the deviation was a scoliotic deformity of the trachea and larynx secondary to shortening of the neck resulting from the vertical penetration. The second mechanism was a rotational deformity of the cervical spine occurring from asymmetric bony erosions. Knowledge of this deformity permits it to be easily predicted preoperatively so that appropriate management can be planned.

Adolescent↗
PubMed1983

IgG rheumatoid factors and anti-nuclear antibodies in rheumatoid vasculitis.

We studied the distribution and characteristics of circulating rheumatoid factors (RF) and anti-nuclear antibodies (ANA) in 30 rheumatoid arthritis (RA) patients who had polyarthritis alone (group I), 28 RA patients with polyarthritis and extra-articular disease (group II), 28 RA patients with systemic vasculitis (group III) and 60 healthy matched controls. IgG RF occurred more frequently and in higher serum titres in group III (100%) than RA patients in group I (40%), or in group II (18%) or in normal controls (5.8%). The serum titre of IgM RF was higher in vasculitis patients than in other RA patients. ANA were found in 74% of all RA patients and although the frequency did not differ in the three patient groups, the serum titre was significantly higher in the vasculitis group. Antibodies to extractable nuclear antigen were found only in group III (18.7%). Antibodies to histones were also more prevalent in group III than in the other RA groups. The serological abnormalities in rheumatoid vasculitis differed quantitatively as well as qualitatively from other RA patients.

Antibodies, Antinuclear↗
PubMed1983

Rheumatoid cervical myelopathy: evaluation by computerized tomography with multiplanar reconstruction.

Rheumatoid cervical myelopathy was studied in 14 patients, clinically, radiographically and by computerized tomography with multiplanar reconstruction (CT/MPR). CT/MPR demonstrated significant unsuspected areas of compromise in 9 of the 14 patients, and altered the surgical procedure in 7 of these 9 patients. CT/MPR clearly identifies all levels of involvement including rotary subluxation. CT/MPR also allows assessment of the spinal nerve canal/foramen and the alignment of the foramina transversaria. CT/MPR is an essential addition to the evaluation of rheumatoid cervical myelopathy.

Adult↗
PubMed1982

Primary lymphoma of the spinal cord.

Lymphomas may occur in the central nervous system either as primary lesions or secondary to lymphomas in other sites. While lymphomas secondary to generalized lymphoproliferation may occur in either the brain or the spinal cord, primary lymphomas are found almost exclusively in the brain. Only three primary lymphomas of the cord have been reported. We recently had the opportunity to study a fourth case. Spinal cord lymphoma was not the diagnosis considered in any of these cases. Since the lesion is radiosensitive, inclusion of primary lymphoma in the differential diagnosis of obscure spinal cord tumors could result in a histological diagnosis and effective therapy.

Diagnosis, Differential↗
PubMed1981

Immune complexes and cryoproteins in ascitic fluid of patients with alcoholic liver disease.

27 paired specimens of ascitic fluid and serum obtained from patients with alcoholic liver disease were tested for cryoproteins and immune complexes by the C1q binding assay. 20 sera (74%) and ten ascitic fluid (37%) had significant amounts of cryoproteins. The cryoproteins were of the 'mixed' type of cryoglobulins consisting of IgG, IgM, IgA, C3 and C1q. The C1q binding test was positive in 17 sera (63%) and in 16 ascitic fluid (59%). Intracytoplasmic inclusions of immunoglobulin and complement were found within the ascitic fluid leukocytes by direct immunofluorescence. The presence of immune complexes in the ascitic fluid may be important in the reduction of the complement level of cirrhotic ascitic fluid.

Antibodies↗
PubMed1976

Bilateral renal dysplasia in three siblings: report of a survivor.

Three siblings, born nonconsectively to an unrelated couple, have had bilateral dysplastic kidneys. The first child had associated skeletal anomalies, the second, ureteral atresia, and the third, no other anomalies. The occurrence of dysplastic kidneys in three siblings is compatible with an autosomal recessive inheritance pattern. In addition the variety of presenting syndromes in the children suggests that variable pathogenetic mechansims were responsible for the appearance of dysplastic kidneys. The third child is alive with kidneys that markedly decreased in size over the neonatal period but is growing well at 41 months of age indicating that the presence of bilateral dysplastic kidneys does not necessarily preclude a favorable prognosis.

Abnormalities, Multiple↗
PubMed1975

Congenital malformations. Cleft palate, congenital heart disease, absent tibiae, and polydactyly.

A girl had cleft palate, micrognathia, Wormian bones, congenital heart disease, dislocated hips, absent tibiae, bowed fibulae, preaxial polydactyly of the feet, and abnormal dermal patterns at birth. She was born after a pregnancy complicated by exposure to multiple medications. This combination of malformations may represent a distinct entity unrelated to the medication or may be a complication of the intrauterine drug exposure.

Abnormalities, Drug-Induced↗
PubMed1975

An XX male: cytogenetic and endocrine studies.

A 3 year old black male with ambiguous genitalia had a 46, XY karyotype in a bone marrow culture and an intermediate buccal smear result, suggestive of a mosaic of chromatin positive and chromatin negative cells. Upon re-evaluation at age 15 years, he has a 30% positive buccal smear and a 46, XX karyotype in cultures of peripheral blood lymphocytes, skin fibroblasts, bone marrow, and testis. No Y-body fluorescence was detectable in interphase cells from the testicular biopsy or the various cultures. The testicular biopsy appeared similar to that of XXY males, and primary hypogonadism was documented by elevated LH (107 mIU/ml) and FSH (57 mIU/ml) levels in conjunction with low testosterone (142 ng/100 ml). Administration of hCG produced qualitatively normal acute responses of testosterone and estrogens. The cytogenetic data provide support for the theory that at least some XX males once had a Y-containing cell line which was subsequently lost.

Adolescent↗