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Biomedical subjects

R Luukkainen

Publications and source records attributed to R Luukkainen.

88 records · Page 5Linked to original sources
PubMed1978

Gold treatment at an early stage of rheumatoid arthritis.

The progression of erosive X-ray changes over a period of 5--6 years was evaluated in 39 patients exposed to a mean dose of 2030 mg aurothiomalate during the maintenance period. The cause for the low dose was the initial high incidence of side-effects. The progression of erosions was highest in patients with the low dose of gold in the initial stages of the disease. The best result in preventing development of erosions was achieved in patients with the high dose of gold in the early phase of the disease. It appears that gold treatment prevents the progression of the erosoins. The earlier the inception of treatment, the better the result.

Adult↗
PubMed1977

Effect of gold treatment on the progression of erosions in RA patients.

The progressive of erosive X-ray changes over a period of 5-6 years was evaluated in RA patients with a low or high dose of gold during the follow-up period. The "low gold" group included 18 patients whose treatment was discontinued because of side effects at a mean dose of 254 mg of Myocrisin. The "high gold" group included 32 patients who received a mean dose of 1858 mg of Myocrisin. Both the number of eroded joints in the hands and feet and the X-ray stage had deteriorated more in the "low gold" group. The inter-group difference was statistically significant. Thus, gold treatment has a retarding effect on the progression of erosions in RA patients.

Adolescent↗
PubMed1977

Effect of gold on progression of erosions in rheumatoid arthritis. Better results with early treatment.

The advance of radiological destruction in 57 patients with definite rheumatoid arthritis was observed for 5-6 years. In all patients gold treatment was started 2-36 months after the onset of the disease. In 18 patients gold was discontinued because of side-effects of other reasons before reaching the total dosage of 500 mg, while the remaining 39 patients received a mean dose of 2030 mg of natriumaurothiomalate. The advance of the radiological destruction was statistically significantly less marked in patients treated with the full gold therapy. The earlier the treatment was initiated, the better was the result.

Adolescent↗
PubMed1977

Some characteristics of RA patients with and without side effects due to gold treatment.

Gold treatment was initiated in 98 patients suffering from early-stage rheumatoid arthritis. In 30 patients side effects due to gold therapy were seen during the first follow-up year: proteinuria in 6, allergic symptoms in 23, and thrombocytopaenia in one patient. The serum IgM level was higher in patients with side effects. None of the 33 other parameters studied showed any significant differences between patients with or without side effects.

Adult↗
PubMedDate not supplied

Structures of three new homotyrosine-containing microcystins and a new homophenylalanine variant from Anabaena sp. strain 66.

A hepatotoxic strain of cyanobacterium Anabaena sp. 66 was isolated from a hepatotoxic water bloom sample in Lake Kiikkara, Finland. Four cyclic heptapeptide hepatotoxins were isolated and purified by HPLC from cultured cells of this organism. The structures of three new homotyrosine (Hty) containing toxins, [Dha7]microcystin-HtyR (Dha = dehydroalanine) (1), [D-Asp3,Dha7]microcystin-HtyR (2), and [L-Ser7]microcystin-HtyR (3), were assigned, based upon amino acid analyses using both a Waters Pico Tag HPLC system and chiral capillary GC, 1H NMR, fast atom bombardment mass spectrometry (FABMS), and collisionally induced tandem FABMS. A new homophenylalanine (Hph) variant of 1, [Dha7]microcystin-HphR (4), was also obtained as a minor component. Compound 3 is most likely a biosynthetic precursor of 1. The four new toxins did not have an N-methyl group at the dehydroamino acid or its precursor unit.

Amino Acid Sequence↗
PubMedDate not supplied

Periarticular corticosteroid treatment of the sacroiliac joint in patients with seronegative spondylarthropathy.

OBJECTIVE: To evaluate the efficacy of periarticular corticosteroid injection of the sacroiliac joint (SIJ) in patients with seronegative spondylarthropathy in a double blind, controlled study. METHODS: 20 patients with seronegative spondylarthropathy and clinical sacroiliitis entered the study. In 10 patients one affected SIJ was treated with periarticular injection of 1.5 ml (40 mg/ml) methylprednisoloneacetate and 1.5 ml (20 mg/ml) lignocaine (MP group), whereas 10 patients received 1.5 ml isotonic sodium chloride and 1.5 ml (20 mg/ml) lignocaine (non-MP group). Clinical assessment at the onset of the study and after two months follow-up included the patients' estimation of pain in the SIJ by the visual analogue scale (VAS) and by a pain index which was calculated from tenderness and stressing tests on the SIJ. RESULTS: At the two months follow-up examination the VAS (p = 0.02) and the pain index (p = 0.01) had improved significantly in the MP group compared with the non-MP group. CONCLUSION: The results of our study indicate that the periarticular injection of methylprednisolone may be effective in the treatment of clinical sacroiliitis in patients with seronegative spondylarthropathy.

Adult↗
PubMedDate not supplied

Mononuclear cell response to enterobacteria and Gram-positive cell walls of normal intestinal microbiota in early rheumatoid arthritis and other inflammatory arthritides.

OBJECTIVE: To study whether enterobacteria and Gram-positive bacterial cell walls (BCW) derivedfrom normal intestinal microbiota are involved in the etiopathogenesis of early rheumatoid arthritis (RA). METHODS: Peripheral blood mononuclear cells (PBMC) and synovial fluid mononuclear cells (SFMC) were isolatedfrom patients with early RA (the average duration of 5 months) and the controls (other types of inflammatory arthritis). The mononuclear cell proliferation and tumor necrosis factor-alpha (TNF-alpha) responses to heat-killed Salmonella enteritidis (SE). Yersinia enterocolitica (YE), and Escherichia coli (EC), and to Gram-positive BCW derived from four common intestinal indigenous bacteria, Eubacterium aerofaciens (EA), Eubacterium limosum (EL), Lactobacillus casei (LC), and Lactobacillus fermentum (LF), and a BCW derived from a pathogen, Streptococcus pyogenes (SP) were investigated. RESULTS: 39% or 56% of patients with early RA showed significant proliferation responses by PBMC or SFMC against enterobacteria, respectively. In other types of arthritis, corresponding figures were 59% or 66%. When BCW were used as antigens, 8.1% or 23% of patients with early RA showed proliferation responses by PBMC or SFMC, respectively. In other types of arthritis the corresponding figures were 7.5% or 35%, respectively. However, TNF-alpha production by SFMC stimulated by EA BCW, SE, YE or EC, was significantly higher in early RA than in other types of arthritis. CONCLUSION: These results suggest that SFMC reacting with enterobacteria or BCW exist in some patients with early RA, but also in other types of inflammatory arthritis. Intestinal bacterial agents may play a role in the etiopathogenesis of RA, but the effect appears to be non-specific.

Adolescent↗
PubMedDate not supplied

Prevalence of Sindbis-related (Pogosta) virus infections in patients with arthritis.

OBJECTIVE: To determine the role of Pogosta virus as a triggering infection in non-specific arthritis. METHODS: Serum samples of 142 patients with acute arthritis were screened for the evidence of Pogosta virus infection. Serological tests for Chlamydia trachomatis, salmonella, parvovirus B19, and Borrelia burgdorferi were also carried out. As verified later, 78 of the patients had rheumatoid arthritis and 63 seronegative poly- or oligoarthritis, while one had systemic lupus erythematosus. RESULTS: In the early stage of the joint symptoms 4 patients with rheumatoid arthritis, 1 with seronegative polyarthritis and 1 with systemic lupus erythematosus had recent Pogosta virus infection. Four of them had probably had Pogosta disease at the time of the onset of arthritis. In 11 patients with a diagnosis of seronegative arthritis, serological evidence of preceding infection due to salmonella or Chlamydia trachomatis was found, strongly suggesting classical reactive arthritis in these cases. CONCLUSIONS: Our study suggests that also a Sindbis virus infection may be associated both to an acute joint inflammation as a part of Pogosta disease or chronic arthritis. At present, this possibility still needs further research.

Adolescent↗
PubMedDate not supplied

Association of tumour necrosis factor a, b and c microsatellite polymorphisms with clinical disease activity and induction of remission in early rheumatoid arthritis.

OBJECTIVE: To study the associations of tumor necrosis factor (TNF) a, b and c microsatellite markers with 1) the clinical disease activity and 2) the induction of remissions in patients with early rheumatoid arthritis (RA) treated with two treatment strategies. METHODS: In the FIN-RACo (FINnish Rheumatoid Arthritis Combination therapy) trial of two years, 195 patients with recent-onset RA were randomly assigned to receive either a combination (COMBI) (sulphasalazine, methotrexate, hydroxychloroquine, and prednisolone) or a single (SINGLE) (initially sulphasalazine with or without prednisolone) disease modifying antirheumatic drug (DMARD) therapy. TNF a, b and c microsatellite and HLA-DRB1 typings were carried out in 165 (79 COMBI; 86 SINGLE) study completers. RESULTS: At baseline the 28 joint disease activity scores (DAS28) of the patients positive for TNFa2, a13 or b1 microsatellite markers were significantly higher than in the other patients. In the SINGLE patients the DAS28 improved comparably in patients with (n = 31) or without (n = 53) the TNFb1 marker (NS), while the DAS28 of the TNFb1-positive COMBI patients (n = 22) improved significantly more than that of the TNFb1-negative cases (n = 57) (p = 0.014). Respective 31.8% (7/22) and 28.1% (16/57) of the COMBI patients with or without TNFb1 allele achieved remission at one year. The corresponding figure in SINGLE patients were 0% (0/31) and 20.8% (11/53) (p = 0.006). At two years the remission frequencies in the TNFb1+/TNFb1- patients in the COMBI and SINGLE were 50.0%/38.6% and 9.7%/22.6%, respectively. CONCLUSION: Early TNFb1+ RA patients have more active disease but respond more favourably to COMBI treatment than the patients without this microsatellite allele. The finding may be of clinical relevance for the choice of DMARDs in early RA.

Adolescent↗
PubMedDate not supplied

Synovial fluid acid phosphatase in seropositive and seronegative arthritides.

Synovial fluid acid phosphatase was investigated in 82 arthritic patients with hydropsy in a knee joint. 39 of the patients were seropositive and 43 seronegative. 36 of the seropositive group had erosive rheumatoid arthritis. The mean synovial fluid acid phosphatase in the seropositive group, 11.6 U/l (SD +/- 8.4), was significantly higher (p less than 0.001) than in the seronegative group, 6.5 U/l (SD +/- 4.8).

Acid Phosphatase↗
PubMedDate not supplied

Activity of arthritis.

Factor analysis was used in clarifying the picture of joint inflammation. 376 arthritis patients were examined at the onset of the disease and after three years. The six factors produced are interpreted to represent six components of joint inflammation, namely the anaemic factor, the factors of clinical joint inflammation gammaglobulin activity, complement activity and acute phase, and the factor of alfa-beta globulin activity. The factor structure remained quite similar during the follow-up. This would indicate that there are certain basic aspects of inflammation which remain fairly stable from year to year.

Adult↗
PubMedDate not supplied

The prediction of radiological destruction during the early stage of rheumatoid arthritis.

A total of 107 patients with definite rheumatoid arthritis of no longer than six months' duration were observed for three years. The radiological destruction of the hand and foot joints after the follow-up time was compared with 65 anamnestic, clinical, laboratory and radiological variables at the onset of the disease. Of the individual variables, early radiological changes in the joints showed the best correlation with the progress of joint destruction. Grip strength, ESR, serum iron, serum C1 esterase inhibitor, rheumatoid factor and old age also had prognostic value. In multiple regression analysis 15 variables explained about 50% of the variance in the progress of joint destruction.

Arthritis, Rheumatoid↗
PubMedDate not supplied

Effect of antimicrobial treatment on chronic reactive arthritis.

In a double-blind study comprising 36 patients the effect of a three-month course of ciprofloxacin on chronic reactive arthritis was evaluated. At the end of the follow-up period 6 months after stopping the therapy, arthralgia, pain at movement and morning stiffness had decreased significantly compared to the values before the treatment in the ciprofloxacin group, whereas the Ritchie index and ESR showed a significant decrease in the control group. We conclude that further studies are necessary before the value of prolonged ciprofloxacin treatment of chronic reactive arthritis can be established.

Adult↗
PubMedDate not supplied

HLA frequencies in HLA-B27 negative patients with reactive arthritis.

The purpose of the present work was to find out whether there is an HLA type common to the patients who, in spite of being B27 negative, have developed reactive arthritis (ReA). We compared the HLA-antigens of 25 HLA-B27 negative ReA patients to those of healthy control persons. No statistically significant differences were observed in the HLA-A, B, C, DR and DQ antigen frequencies between the patients and the control group. The frequency of DR4 was slightly lower in the patients than in the controls, although this difference was not statistically significant. On the other hand, 18/25 (72%) of the B27-negative ReA patients experienced a chronic or prolonged course of the disease. These findings indicate that DR4 does not contribute to the chronicity of ReA in the same way that it is known to do in rheumatoid arthritis (RA) or Lyme arthritis. They do not support the hypothesis that some other HLA-antigen, in addition to HLA-B27, could have a predisposing or protective effect in ReA.

Adolescent↗
PubMedDate not supplied

Antibodies to streptococcal cell wall in psoriatic arthritis and cutaneous psoriasis.

OBJECTIVE: To evaluate the possible role of streptococcal cell wall antigens in the development of psoriatic arthritis. METHODS: IgM, IgA and IgG class serum antibodies against peptidoglycan-polysaccharide (PG-PS) and peptidoglycan (PG), both from group A streptococcus, were measured in patients with psoriatic arthritis (PA), non-arthritic psoriasis (NAP), rheumatoid arthritis (RA) and in healthy controls, using ELISA. RESULTS: Both groups of psoriatic patients had elevated IgA levels specific to streptococcal PG-PS. No association with the severity of the skin disease or with the different subsets of PA was detected. Higher concentrations of IgG against the two streptococcal preparations was observed in PA than in RA. Analysis of antibody levels in patients with recent onset arthritis showed lower concentrations of IgM antibodies against streptococcal as well as control antigens in early than in late PA, whereas an overall increase of specific IgA and IgG antibodies was observed in early RA. CONCLUSION: The results suggest chronic mucosal stimulation of lymphocytes by long-lived streptococcal antigens in patients with psoriasis, without any difference observed between PA and NAP. The differences between recent onset versus established PA and RA could reflect a distinct immunopathology in the two arthritides.

Adult↗