Homozygous missense mutation in the lamin A/C gene causes autosomal recessive Hutchinson-Gilford progeria syndrome.
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Adolescent↗
Biomedical subjects
C Chattopadhyay
Publications and source records attributed to C Chattopadhyay.
Splenic infarction in a patient with Wegener's granulomatosis.
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Adult↗
Suprascapular nerve block for the treatment of frozen shoulder in primary care: a randomized trial.
BACKGROUND: Frozen shoulder is a common problem in general practice, but its treatment is difficult since none of the currently used therapies are proven to be effective. AIM: To assess the effectiveness of suprascapular nerve block to relieve pain and improve range of movement, and its suitability for use in primary care. This small study by a single practitioner aims to justify a larger multicentred trial. METHOD: A randomized trial of 30 patients to compare a single suprascapular nerve block with a course of intra-articular injections. Patients' pain levels and ranges of movement were assessed over a 12-week period. RESULTS: Suprascapular nerve block produced a faster and more complete resolution of pain and restoration of range of movement than a series of intra-articular injections. These differences were confirmed by statistical analysis using the Mann-Whitney U-test (P < 0.01 for pain levels and P < 0.05 for range of abduction and external rotation.) CONCLUSIONS: This study suggests that suprascapular nerve block is a safe and effective treatment for frozen shoulder in primary care, and justifies a larger multicentred trial using independent blinded assessment. Such a study should include a third group treated by suprascapular nerve block without steroid; a more comprehensive assessment of patient debility.
Anesthetics, Local↗
HLA associations in subjects with rheumatoid arthritis and bronchiectasis but not with other pulmonary complications of rheumatoid disease.
We have examined HLA-DR, DQA and DQB variants in 72 controls, 153 subjects with RA without extra-articular features and in subjects with the rheumatoid pulmonary complications of interstitial fibrosis (23) peripheral airways disease (13) and in 41 subjects with RA and bronchiectasis. Subjects with RA alone showed the expected association with HLA-DR4 (79%) but those with RA and co-existent pulmonary fibrosis were less likely to be DR4 positive (61%). No other HLA-DR variants were significantly increased in the different disease groups. HLA-DQB1*0501 which types serologically as DQw1 was increased in subjects with RA and peripheral airways disease as compared to rheumatoid subjects with normal lung function, but these differences were not statistically significant. DQB1*0601 was increased in subjects with bronchiectasis with or without RA (but only significantly so in RA-BR subjects) DQB1*0301, DQB1*0201 and DQA1*0501 frequencies were also increased in subjects with RA and bronchiectasis as compared to those with RA alone.
Aged↗
Bronchiectasis and rheumatoid arthritis: a clinical study.
OBJECTIVES: To examine the relation between rheumatoid arthritis (RA) and bronchiectasis (BR). METHODS: Disease activity, outcome, extra-articular manifestations, and laboratory features were compared in 32 patients with BR and RA (RA-BR group), 32 matched patients with RA without BR (RA group), and 31 patients with BR but without arthritis (BR group). RESULTS: In 30 of the 32 (94%) patients with RA-BR, BR preceded RA. There was no functional or radiological difference between the RA-BR and RA groups, and except for xerophthalmia, which was more common in patients with RA-BR than patients with RA, there was no difference in extra-articular or laboratory features. CONCLUSIONS: Bronchiectasis does not lead to a more aggressive disease course in RA and, despite the recognised association, BR is not an extra-articular manifestation of rheumatoid disease.
Adult↗
DQw7 and the C4B null allele in rheumatoid arthritis and Felty's syndrome.
DQ beta and C4 null alleles have been defined in patients with rheumatoid arthritis, Felty's syndrome, and in control subjects. Comparison of DR4 positive subjects shows that rheumatoid disease without extra-articular features has no preferential associations with either DQ beta or C4 null variants. In Felty's syndrome there are significant associations with both the class II major histocompatibility complex (MHC) DQw7 allele (86% of DR4 positive patients with Felty's syndrome and 53% of DR4 positive controls) and the class III MHC C4B null allele (50% of patients with Felty's syndrome and 20% of DR4 positive controls). DQw7 and the C4B null allele are in linkage disequilibrium and the B44-Bf *S-C4A*3-C4B*Q0-DR4-DQw7 haplotype accounts for five of 24 DR4 positive haplotypes assigned in subjects with Felty's syndrome. The results were not accounted for by articular disease severity and suggest that articular and extra-articular forms of rheumatoid disease may be immunogenetically heterogeneous.
Alleles↗
Bone cysts and haemodialysis-related amyloidosis.
Carpal tunnel syndrome and arthropathy are frequent complications of long-term haemodialysis. Both are associated with cystic lesions of bone and are related to synovioarticular deposition of a new type of amyloid derived from circulating beta 2-microglobulin. Retrospective analysis of the radiographic skeletal surveys of all 58 patients on haemodialysis for 6 or more years revealed one or more cystic bone lesions in 36% of patients. Radiographic analysis indicated that a number of these cysts were due to hyperparathyroid bone disease or joint degeneration, but a majority showed features suggesting an arthropathy of another aetiology. We present evidence that the development of these latter cysts in an individual on long-term dialysis is an indicator of the presence of synovioarticular amyloidosis of the beta 2-microglobulin type. The radiographic characteristics and development of these cysts, which we believe are due to bony infiltration from synovioarticular amyloid are described.
Adult↗
The shoulder pain syndrome and soft-tissue abnormalities in patients on long-term haemodialysis.
Fifteen patients on long-term haemodialysis were studied. Twelve patients were symptomatic and ten of these patients had shoulder pain. Eleven patients had associated carpal-tunnel syndrome. A statistically significant correlation was observed between the soft-tissue abnormalities of the hands, carpal-tunnel syndrome and the shoulder pain. Radiological changes were also common and were noted in 14 patients; cysts and erosions were the commonest. The shoulder joint was the most commonly involved joint. No obvious correlation existed with either raised parathormone or calcium levels. The possible role of beta 2-microglobulin and associated amyloidosis in the causation of this syndrome is discussed.
Adult↗
Diffuse alveolitis on a small dose of penicillamine.
A 60-year-old man with seropositive rheumatoid arthritis developed rapidly progressive dyspnoea and bilateral pulmonary infiltrates on short exposure to 50 mg penicillamine daily. He made a satisfactory recovery following cessation of penicillamine therapy and the addition of prednisolone. This case has been reported to the Committee on Safety of Medicines and we would like to emphasize that the possibility of penicillamine-induced lung disease should be recognized, even on a small dose of short duration.
Arthritis, Rheumatoid↗
Maternal mortality in Riyadh, Saudi Arabia.
The maternal mortality in the Maternity and Children Hospital, Riyadh, during the years 1978-1980 was 52 per 100 000 births, when the total births were 55 428. This is higher than the rate reported from the hospitals in developed countries but lower than rates reported by the university hospitals of developing countries such as India, Thailand and Nigeria. Haemorrhage, associated disease, pulmonary embolism and infection, in that order, were the main causes of maternal deaths. The main avoidable factor was failure by the patient to seek the medical care. Much could be done in reducing deaths due to haemorrhage by improving blood transfusion facilities in the peripheral hospitals. Adequate health education, especially of rural women and their midwives, is a crucial factor in improving the maternal death rate for the country as a whole.
Abortion, Spontaneous↗
Concanavalin A induces suppressor cell activity in both T gamma and T non-gamma cells: most of the suppressor cells do not carry HLA-DR antigens.
Concanavalin A (Con A) stimulation of T lymphocytes for 48 h induced a dose-dependent increase in the percentage of T gamma cells, and proliferation of these cells was dependent on pre-existing T gamma cells. Con A stimulation also induced a dose-dependent increase in suppressor cell activity as measured in a Con A/mixed lymphocyte culture assay. Removal of T gamma cells before stimulation with Con A did not influence suppressor cell activity, whereas depletion of T gamma cells after Con A stimulation significantly reduced the suppression. Treatment of T lymphocytes with monoclonal anti-HLA-DR antibodies and complement significantly increased the percentage of T gamma cells and also increased the suppressor cell activity, both when the cells were treated before and when they were treated after Con A stimulation. Similarly, increased suppressor cell activity was also seen when T mu cells were removed. The results indicate that Con-A-induced suppressor cells are recruited from both T gamma and T non-gamma cells and also suggest that most of the Con-A-induced suppressor cell activity is exerted by HLA-DR-negative cells.
Animals↗
Evidence for altered immunoregulation in rheumatoid arthritis.
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Antibody Formation↗
Con A-induced suppressor cell activity and T-lymphocyte subpopulations in peripheral blood lymphocytes of patients with rheumatoid arthritis and juvenile rheumatoid arthritis.
Suppressor cell activity was investigated in peripheral blood lymphocytes from twenty patients with rheumatoid arthritis (RA) and twenty patients with juvenile rheumatoid arthritis (JRA) using a concanavalin A/mixed lymphocyte culture assay. The mean suppression in the RA patients was slightly reduced compared with the suppressor cell activity in adult controls (25 +/- 5% suppression compared with 37 +/- 5%; P less than 0.05, Student's t test), whereas the JRA patients had normal suppressor cell activity (mean 46 +/- 5% versus 43 +/- 5% in healthy children matched for age and sex). The RA patients had normal proportions of T-cell subpopulations, 13.3% T gamma cells and 49.8% T mu cells, compared with 13.8% and 58.0% in controls. The JRA patients, however, had a significantly reduced mean percentage of T gamma cells, 6.6%, compared with 13.8% in healthy children (P less than 0.05, Mann-Whitney U-test). The mean percentage of T mu cells was 53.7%, versus 56.2% in the controls. The relation between suppressor cell activity and suppressor cells enumerated by membrane markers is discussed.
Adult↗
Excessive suppressor T-cell activity of the rheumatoid synovial tissue in X-linked hypogammaglobulinaemia.
Patient K.L. with X-linked hypogammaglobulinaemia showed excessive suppressor T-cell activity both in the lymphocytes from the rheumatoid synovial tissue and in the peripheral blood lymphocyte compartment. This was in marked contrast to the findings in the lymphocytes from synovial tissue of patients with classical rheumatoid arthritis (RA), which were clearly deficient in suppressor T-cell activity. These findings further support the existence of distinctly different pathogenetic mechanisms in the two types of rheumatoid inflammation. It also demonstrates that patients with X-linked hypogammaglobulinaemia may have excessive suppressor T-cell activity not only in their peripheral blood lymphocytes but also in local chronic inflammatory tissue such as the rheumatoid joint inflammation.
Adolescent↗
Spontaneous release of leucocyte migration-inhibitory factor by mononuclear cells eluted from rheumatoid synovial tissue.
Spontaneous leucocyte migration-inhibitory factor (LIF) was assayed by an indirect system in which mononuclear cells (MNC) eluted from rheumatoid synovial tissues or isolated from peripheral blood of normal donors were cultured without antigen. The supernatants from these cultures and control supernatants, heated to 80 degrees C for 30 min to destroy the LIF activity, were used in the test. In seven out of eleven rheumatoid arthritis patients the eluted synovial MNC produced LIF spontaneously, whereas none of the twelve normal blood donors showed any such production. The ability to show spontaneous LIF production was primarily seen in the joint tissues from sero-negative patients.
Arthritis, Juvenile↗
Demonstration of anti-rubella antibody-secreting cells in rheumatoid arthritis patients.
In the present study we describe a plaque-forming cell assay using erythrocytes coated with viral antigen, which detected anti-viral antibody-secreting cells against various viral antigens. These anti-viral antibody-secreting cell were studied in normal individuals with known viral infections and in rheumatoid arthritis patients. Rubella anti-viral antibody-secreting cells were present after induction in the peripheral blood of eight out of ten patients. No plaques were seen before induction. Synovial tissue of seven patients out of ten showed rubella-antigen-specific plaques before induction. In all three patients tested, the numbers of plaques increased after induction. The peripheral blood of only one patient showed plaque-forming cells against mumps virus and cytomegalovirus (CMV) antigen. No other patients showed any plaque against CMV, respiratory syncytial virus, mumps virus, measles virus, adenovirus, and varicella zoster virus antigens. The method appears to be promising in studying viral antibody-secreting cells in human immunopathology.
Antibodies, Viral↗
Lack of suppressor cell activity in rheumatoid synovial lymphocytes.
Lymphocytes were eluted from the synovial tissue of seventeen patients with rheumatoid arthritis (RA) and one with ankylosing spondylitis. In eight of these patients immunoglobulin production by synovial lymphocytes in the presence and absence of pokeweed mitogen was studied. In nine patients T lymphocytes were isolated from the eluted cells, and the T helper and suppressor cell functions were evaluated in an allogeneic co-culture system. Peripheral blood lymphocytes (PBL) from twenty-eight normal donors were also studied for comparison. Immunoglobulin produced by synovial lymphocytes was higher than in PBL of normal donors. However, the stimulation index of synovial tissue lymphocytes was lower. Most of the normal donors had suppressor cell activity in their peripheral blood, whereas in synovial tissue lymphocytes a statistically significant number of patients did not have any suppressor cell activity. In contrast, the synovial tissue lymphocytes showed helper activity not differing significantly from that of the T lymphocytes from peripheral blood of normal individuals.
Adolescent↗
Rheumatoid synovial lymphocytes lack concanavalin-A-activated suppressor cell activity.
Synovial lymphocytes eluted by enzyme treatment from eleven patients with rheumatoid arthritis (RA) were investigated for the presence of concanavalin A (Con A)-activated suppressor cell activity as compared with that of peripheral blood lymphocytes of twenty normal donors. In addition, two patients with psoriatic arthritis and juvenile rheumatoid arthritis (JRA) were also investigated. Synovial lymphocytes from the eleven RA patients showed a mean augmentation of 28 +/- 13.30, and thus clearly lacked suppressor activity, whereas the mean suppression in the lymphocytes from the twenty normal donors was 13 +/- 14.40. Synovial lymphocytes from one patient with JRA and one with psoriatic arthritis showed a normal suppressor activity.
Arthritis, Juvenile↗