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Biomedical subjects

D Land

Publications and source records attributed to D Land.

11 recordsLinked to original sources
PubMed1998

Injection of the rheumatoid knee: does intra-articular methotrexate or rifampicin add to the benefits of triamcinolone hexacetonide?

OBJECTIVE: Does the addition of 600 mg rifampicin or 50 mg methotrexate improve pain relief after injection of the rheumatoid knee with 20 mg triamcinolone hexacetonide (TH)? METHODS: Eighty-two patients on stable therapy were allocated at random to receive intra-articular TH alone, TH and methotrexate (TH+M) or TH and rifampicin (TH+R). Pain was recorded by a weekly chart and analysed using the area under the curve (AUC), periods of total pain relief and duration of effect. Examinations and microwave thermography were performed by an independent meteorologist at baseline, 3 and 6 months. RESULTS: Using the AUC, pain was significantly better in the TH+R group compared with TH alone (P=0.039, Mann Whitney U). The median duration of improved pain scores was 13.5 weeks with TH alone, 10 with TH+M and 19 with TH+R. Examination and microwave thermography revealed improvements compared with baseline, but there were no significant differences between the groups. Eleven of 28 patients treated with TH + R developed a flare of post-injection pain. CONCLUSIONS: Whilst the addition of rifampicin improved pain relief, the occurrence of pain after injection remains a problem. Measures to minimize this are needed when TH+R is used.

Aged↗
PubMed1988

Oesophageal ischaemia in motility disorders associated with chest pain.

The cause of chest pain in diffuse oesophageal spasm and "nutcracker" oesophagus is not clear. Spasm of the oesophageal muscle itself is probably not the cause, because pain and spasm are frequently not coincident. It is suggested instead that oesophageal ischaemia may be the cause of the pain, since the rewarming rate of the oesophagus after a standardised cold challenge was significantly longer in 9 patients with these motility disorders than in 21 normal controls. As rewarming time in other sites correlates with blood flow, these results are consistent with the hypothesis that the oesophagus is ischaemic in these patients.

Adult↗
PubMed1988

Decreased oesophageal blood flow in patients with Raynaud's phenomenon.

Cold-induced vasospasm seen in systemic sclerosis (SS) and Raynaud's phenomenon (RP) has previously been thought to be limited to peripheral skin sites. However, the oesophageal problems seen in SS cannot be sufficiently explained by connective tissue damage/abnormal motility alone. We wondered if temperature dependent ischaemia could occur in the oesophageal microcirculation. We have measured oesophageal temperature variation following oesophageal cold challenge: 50 ml of water at 7 degrees C and 17 degrees C, with 37 degrees C used as control, were introduced into the mid-oesophagus at a rate of 2 ml/s. Temperature was recorded using a thermocouple probe 5 cm above the gastro-oesophageal junction. The test was performed on 14 SS patients, eight patients with Raynaud's disease and 21 controls. The control's rewarming pattern followed a simple exponential curve. This did not vary with temperature or after repeated challenge. In the SS patients the time constant was significantly longer after cold challenge.

Adult↗
PubMed1987

Odorous urine following asparagus ingestion in man.

The production of odorous urine after the ingestion of asparagus has been shown to occur in 43% of 800 volunteers investigated. This characteristic is reproducible over a 12-month-period and has been shown to remain with individuals for virtually a lifetime. Family studies suggest that the ability to produce the odorous urine is inherited as an autosomal dominant trait.

Female↗
PubMed1987

Microwave thermography--an index of inflammatory joint disease.

Microwave thermography is a technique measuring microwave emission from sites of inflammation. Microwaves have a wavelength of around 10 cm and are therefore able to penetrate clinically useful depths of up to 4 cm directly measuring tissue thermal radiation. A microwave detector was applied to the study of joint inflammation in rheumatoid arthritis and in a normal control group. Fifty-two knees were scanned using the detector and a microwave thermographic index was calculated for each knee. A strong correlation was found between the microwave thermographic index, and the clinical and laboratory parameters measured. This technique was found to be reproducible, quick, simple to use at the bedside without a controlled environment and, since it measures internally emitted radiation, is inherently safe.

Arthritis, Rheumatoid↗
PubMedDate not supplied

[Early detection of arthrotic changes in animal experiments and clinical medicine].

With arthroscopy cartilage changes are being detected more and more frequently which must be classified as early arthrosis. Similar changes (stage II) could be induced in 17 rabbits 6 weeks after lateral meniscectomy. Extraction (4M-GuHcl) and gel chromatography (Sepharose 2B) of 35S-proteoglycans resulted in typical elution profiles. Aggregates were remarkably, monomers slightly reduced, and a third population of nonaggregated proteoglycans increased. In 81 patients undergoing knee arthroscopy 98 small cartilage biopsies were taken from standardized regions and analysed biochemically. Elution profiles were correlated to anamnestic and clinical data (Wilcoxon-test, cluster analyses). Irrespective of the grade of osteoarthrosis (OA) the ratio of aggregated and nonaggregated 35S-proteoglycans varied. Almost half of the samples from macroscopically "normal" cartilage revealed a depression of aggregates. No correlation to anamnestic or clinical data was found. The profiles probably represent different metabolic stages in developing OA. By analysis of 35S-proteoglycans in cartilage biopsies it seems possible to detect early metabolic changes at the onset of osteoarthrosis.

Adult↗