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Biomedical subjects

G V Gordon

Publications and source records attributed to G V Gordon.

14 recordsLinked to original sources
PubMed1994

Arthritis of the cervical spine.

Neck pain often occurs in the absence of neurologic findings, and the diagnostic dilemma of the clinician is to determine if there is a definable lesion. Radiographically, the cervical spine is commonly involved, especially in persons older than 50 years. Excluding soft-tissue inflammation and spasm, osteoarthritis is the most common rheumatic disease of the cervical spine. Radiculopathy and myelopathic involvement from disk, foraminal, or spinal canal impingement are all sequelae of this disease. Other diseases, such as DISH, rheumatoid arthritis, and ankylosing spondylitis, can affect the spine as well. Assessment of the integrity of the atlantoaxial joint is important in avoiding neurologic compromise.

Arthritis↗
PubMed1992

Longterm drug therapy for rheumatoid arthritis in seven rheumatology private practices: I. Nonsteroidal antiinflammatory drugs.

The probability of continuation of a particular nonsteroidal antiinflammatory drug (NSAID) over 5 years was estimated for 1,775 courses taken by 532 patients with rheumatoid arthritis treated in 7 rheumatology private practices. Similar results were seen for 15 different NSAID--48% of courses were continued at 12 months, 36% at 24 months, and 20% at 60 months. Only acetylated salicylates, other than plain aspirin, were continued significantly longer than any of the other NSAID. The probability of continuation of plain aspirin was similar to other NSAID, including nonacetylated salicylates and nonsalicylate NSAID. The first NSAID taken by an individual patient was continued only marginally longer than the 4th NSAID taken by the same patient. While most NSAID courses were not continued for long periods, 20% were continued for longer than 5 years, suggesting effective longterm results in this minority of courses.

Anti-Inflammatory Agents, Non-Steroidal↗
PubMed1991

Arthritis of the lumbar spine.

Many types of arthritis can disturb the normal lumbar anatomy. This review intentionally omits many endocrine, metabolic, and genetic disorders that ultimately lead to breakdown of cartilage. Osteoarthritis remains the most common cause of sustained back pain as well as one of the most compensable disabilities in the United States. As so many other authors have noted, more scientific investigation is needed, and funding is imperative to effect significant changes.

Arthritis↗
PubMed1984

Autopsy study correlating degree of osteoarthritis, synovitis and evidence of articular calcification.

Inflammation has been suggested as a component in the osteoarthritic process. We have examined 150 knees at autopsy to correlate the degree of osteoarthritis (OA) with synovial inflammation, and with radiographic or pathologic evidence of calcification as a possible source of crystal induced inflammation. Roentgenographic evidence of calcification and histologic finding of synovial reaction (proliferation or inflammation) were seen more frequently (p less than .05) in the knees of patients with more advanced OA. Perichondrocytic staining for calcium and phosphorus was seen in 93% of patients with severe OA and in only 24% of those with normal or minimal OA. Calcium hydroxyapatite crystals were identified by electron microscopy in perichondrocytic and other areas in 8 of 15 cartilage samples with moderate to severe OA and in none with normal appearing cartilage. In advanced OA, there were bone fragments embedded in cartilage and synovium. Although the pathogenetic sequences are uncertain, we speculate that calcium hydroxyapatite (and pyrophosphate) crystals and/or bone shards can contribute to both synovitis and cartilage degeneration.

Adult↗
PubMed1981

Rheumatoid vasculitis.

Today, we cannot conclude comments on the treatment of immune-complex disease without paying our respects to therapeutic plasmapheresis and leukapheresis. Numerous centers are beginning to examine the value of removing either plasma or lymphocytes from patients with many rheumatic diseases. Efficacy appears to be established in hyperviscosity diseases (Waldenstrom's), myasthenia gravis, Goodpasture's syndrome, RH sensitized pregnant mothers, and thrombotic thrombocytopenic purpura. In active rheumatoid arthritis, it is a useful short-term tool but hardly cost effective. Although it would appear to be an advance from the medieval concept of purging out the "evil humors," pheresis for rheumatoid vasculitis must be considered a limited research tool, which may teach us something about mechanism of action. The mechanical removal of immune complexes by pheresis probably requires additional remittive or immunosuppressive therapy to prevent rebound in immune complex production. Effort now need to be directed to the agents that initiate production of immune complexes. Once the host's antibody system is so stimulated, we often find ourselves trying to close the barn door after the horse is long gone.

Adrenal Cortex Hormones↗
PubMed1981

Eosinophilic fasciitis. A case report and review of the literature.

Eosinophilic fasciitis (EF) is a newly appreciated disease whose hallmarks are local areas of hidebound and puckered skin with peripheral eosinophilia. It looks similar to progressive systemic sclerosis and morphea but often lacks positive antinuclear antibodies (ANA) and Raynaud's phenomenon. Contractures over joints may develop; several cases of coincident aplastic anemia have been reported. Deep skin biopsy of involved skin reveals lymphocytes, plasma cells and occasionally eosinophils. Unlike scleroderma, EF improves with the administration of corticosteroids.

Adult↗
PubMed1980

Ultrasonic evaluation of popliteal cysts.

Ultrasonography was used to examine 42 patients who were complaining of popliteal and suprapatellar pain. When clinically indicated, patients also underwent phlebography, arthrography, and posterior synovectomy. In 17 patients, Baker's cysts were demonstrated by ultrasonogram. Of these 17 patients, four had confirmation of the cysts by arthrography. One patient had simultaneous deep venous thrombosis, proved by phlebography and arthrography. Five patients underwent posterior synovectomy, and the surgical specimens closely correlated with the dimensions predicted by ultrasonography. Internal echoes within the cysts correlated at surgery with either necrotic debris or organized hematoma. To our knowledge, this study is the first series where surgical correlations have been made with the ultrasonographic observations. Ultrasonography of the knee and surrounding area is a useful, painless, and relatively inexpensive method, with several advantages over arthrography.

Cysts↗
PubMed1979

Articular manifestations of polymyositis and dermatomyositis.

Nine patients with polymyositis or dermatomyositis associated with arthritis without antinuclear antibodies have been studied. In eight patients a mildly inflammatory nonerosive arthritis occurred coincident with early manifestations or before the appearance of symptomatic muscle disease. Hands, wrists and knees were prominently involved. This arthritis responded to corticosteroids given for the myositis. One patient had erosive arthritis and periarticular calcifications associated with acute inflammation that seemed to diminish with colchicine therapy. Synovial biopsy specimens showed surface fibrin deposition, focal loss of lining cells and mild inflammation--findings similar to those in scleroderma. By electron microscopy tubuloreticular structures were found in vascular endothelium in synovium, as in other tissues in polymyositis. All patients surprisingly had pulmonary manifestations suggesting the possibility that the condition in this group of patients may represent a distinctive subset of polymyositis.

Adult↗
PubMed1979

Management of gout.

Although the traditional oral colchicine regimen is often used for the acute attack, the intravenous route has advantages. Indomethacin, phenylbutazone, oxyphenbutazone and the newer nonsteroidal anti-inflammatory agents, such as ibuprofen, naproxen and fenoprofen, are quite successful. For chronic management of hyperuricemia, it is helpful to distinguish between overproducers of uric acid, for whom allopurinol is the rational therapy, and underexcreters of uric acid, for whom probenecid or sulfinpyrazone is indicated.

Allopurinol↗
PubMed1979

Baker's cysts and true thrombophlebitis. Report of two cases and review of the literature.

We describe two patients who had knee pain and were found to have the unusual combination of a Baker's cyst and true thrombophlebitis. Since Baker's cysts can dissect along the gastrocnemius, they can cause leg pain and simulate thrombophlebitis, but they do not require anticoagulation therapy. Most of the literature implies that the two syndromes are mutually exclusive; however, our cases lend support to the fact that a dissecting popliteal cyst does not rule out the possibility of thrombophlebitis. Venography should be performed if there is any doubt as to the diagnosis.

Aged↗
PubMedDate not supplied

Electron microscopic study of depot corticosteroid crystals with clinical studies after intra-articular injection.

Depot corticosteroid crystals and their in vivo handling after intra-articular injection have not been studied by electron microscope (EM). We therefore injected 20 mg of either prednisolone tebuate or triamcinolone hexacetonide into knee joints of 7 patients with osteoarthritis and painful effusions. Six patients had a rise in the synovial fluid leukocyte counts, but only 1 patient had clinical evidence of a post-injection flare. Scanning and transmission EM revealed intra- and extracellular crystals 24 hours and 1 week after the initial injection. These combined EM studies provide an adjunct to compensated polarized microscopy in differentiation of depot steroid from other crystals.

Adrenal Cortex Hormones↗
PubMedDate not supplied

The effects on synovial permeability and synovial fluid leukocyte counts in symptomatic osteoarthritis after intraarticular corticosteroid administration.

The mode of action of intraarticularly administered corticosteroids was studied. Fifteen patients with osteoarthritis and painful effusions had one knee injected with normal saline, triamcinolone hexacetonide 20 mg or prednisolone tebuate 20 mg. Fifteen millicuries of 99mTc-labeled albumin was given intravenously before and at various time intervals after the injection of the depot corticosteroid or saline. Whole blood and synovial fluid (SF) samples were used for blood to SF count rate ratio determinations. SF white blood cell counts (WBC) were also performed. The results indicated that intraarticular depot corticosteroids decreased synovial permeability and caused increases in the SF WBC. Moreover, decreases in pain and knee swelling correlated better with a decrease in vascular permeability, as assessed by the count ratio, than with SF leukocytosis.

Adrenal Cortex Hormones↗