OBJECTIVE: To define the cytokine profile within rheumatoid subcutaneous nodules, and to determine whether the destructive inflammatory process in this lesion displays features of a lymphocyte-driven Th1 or Th2 granuloma. METHODS: Subcutaneous nodules excised from 10 patients with rheumatoid arthritis were examined. Transcripts for interleukin 1beta (IL-1beta) IL-2, IL-4, IL-5, IL-10, IL-12, IL-13, IL-15, IL-18, and for tumor necrosis factor alpha (TNFalpha) and interferon-gamma (IFNgamma) were detected by reverse transcription-polymerase chain reaction of extracted RNA. RESULTS: Nine of 10 nodules contained transcripts for IFNgamma. We observed no evidence for the expression of IL-2, IL-4, or IL-5 among the lymphokine genes analyzed. Transcripts for TNFalpha, IL-1beta, IL-10, IL-15, and IL-18 were present in all 10 nodules. Transcripts for IL-12 were present in all but one nodule. Expression of IL-13 messenger RNA was observed in only 5 nodules. CONCLUSION: The cytokine profile within the rheumatoid nodule (i.e., presence of IFNgamma but not IL-2, and prominent expression of IL-1beta and TNFalpha together with IL-12, IL-18, IL-15, and IL-10) is similar to the profile of cytokines in the synovial lesion of rheumatoid arthritis, which is generally accepted as being attributable to a Th1-mediated inflammatory mechanism. Our results suggest that damage to affected synovial membrane or subcutaneous tissue is caused by the same inflammatory mechanisms, and that the nodule is a Th1 granuloma.

Aged↗

PubMed2003

A laser-aligned method for anthropometry of hands.

We have developed a laser-aligned measuring device to facilitate the measurement of linear hand dimensions. Our objective has been to make a simple, clinically applicable device for anthropometry of the hands in patients with arthritis in order to gauge the progression of hand deformities. The system provides an alternative to the use of rules, tapes, photogrammetry and least-squares devices which have previously been applied to hand measurements. The system delivers results which are not significantly different from those measured with rules and callipers and has a similar level of accuracy. The use of laser pointers for alignment facilitates measurements which necessitate picking the highest point of the hand. The device is portable and simple to use in the clinic. We have used it to measure hand dimensions in normal subjects and patients with arthritis. However, the system could equally well be used to facilitate measurement of other objects with an irregular surface profile.

Adult↗

PubMed2003

The deleted in colorectal carcinoma (DCC) gene 201 R --> G polymorphism: no evidence for genetic association with autoimmune disease.

The product of the deleted in colorectal carcinoma (DCC) gene has a role in apoptosis and is a positional candidate for IDDM6, the putative chromosome 18q12-q23 autoimmune disease locus. We hypothesised that a nonconservative substitution (DCC 201 R --> G; nucleotide (nt) 601 C --> G), located in an extracellular immunoglobulin-like domain of DCC, is an aetiological determinant of autoimmunity. We tested this hypothesis by genetically testing the nt 601 C --> G polymorphism for association with three autoimmune phenotypes in a large population-based case-control study. There was no evidence for association of DCC nt 601 C --> G with autoimmune disease in cohorts comprising 2253 subjects with rheumatoid arthritis, type I diabetes and Graves' disease, and 2225 control subjects, from New Zealand and the United Kingdom. Furthermore, using the transmission disequilibrium test, there was no significant evidence for biased transmission of the nt 601 C --> G polymorphism to probands within a 382 family type I diabetes affected sibpair cohort from the United Kingdom. Thus, the DCC 201 R --> G polymorphism does not appreciably influence risk of developing the autoimmune diseases tested.

Adult↗

PubMed2002

Vestibulo-ocular, optokinetic and postural function in humans with rheumatoid arthritis.

The present study investigated vestibulo-ocular reflex (VOR), optokinetic reflex (OKR) and postural function in patients with rheumatoid arthritis (RA). Compared with controls, no differences in gaze-holding, VOR gain or phase, OKR slow phase velocity (SPV) or quick phase amplitude, optokinetic afternystagmus SPV or duration, or latency to the illusion of circularvection, were found. RA patients did exhibit greater sway in the leftward direction (P<0.01), however, this was no greater in the conditions of the Clinical Test of Sensory Interaction and Balance that increase reliance upon vestibular information. We conclude that RA patients do not exhibit substantial deficits in visual-vestibular function.

Aged↗

PubMed2002

Changing patterns of hospital admissions for patients with rheumatic diseases.

AIMS: To audit trends in hospital admission of patients with rheumatic diseases to a rheumatology unit. METHODS: Numbers of admissions for 1990-1999 were reviewed. Notes of patients admitted in 1993, 5, 7 and 9 were reviewed for principal diagnosis and other data. RESULTS: There was a 75% decline in admissions during the study period. There was a significant fall in admissions for control of active rheumatoid arthritis which declined from 53% to 21% of total admissions (p=0.004). CONCLUSIONS: In the last decade in Otago there has been a substantial decrease in patient admissions for treatment. This was mainly due to decreased admissions for treatment of flares of rheumatoid arthritis and its complications. Determining if this was due merely to more rigorous admission criteria or improved effectiveness of treatment of rheumatoid arthritis will be important for guiding decisions on healthcare services for patients with rheumatic diseases.

Chi-Square Distribution↗