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Biomedical subjects

K D Muirden

Publications and source records attributed to K D Muirden.

At least 55 records · Page 3Linked to original sources
PubMed1987

A comparison of changes seen on radiographs of rheumatoid arthritis patients in Australia and in China.

To test the hypothesis that rheumatoid arthritis in patients in China is milder in severity than that in patients in a western country, a comparison was made of 2 series of consecutive outpatients with definite or classic rheumatoid arthritis who were attending referral centers in Melbourne, Australia and Shanghai, China. This paper reports the findings on radiographs of the wrists and hands. Making allowances for age and duration of disease, changes were more frequent and severe in the Australian patient series, particularly at the metacarpophalangeal joints.

Adult↗
PubMed1987

Chondrocyte-derived cells and matrix at the rheumatoid cartilage-pannus junction identified with monoclonal antibodies.

In the cartilage-pannus junction of 14 patients with rheumatoid arthritis (RA) and seven patients with osteoarthritis (OA), monoclonal antibodies to keratan sulphate (KS) and chondroitin sulphate (CS) stained a transitional fibroblastic zone (TFZ) within the pannus in nine RA patients and one OA patient. In three patients this was clearly localised to the cytoplasm of cells in this zone, but in all remaining cases KS and CS could be demonstrated in the surrounding matrix. This area was distinguished from adjacent pannus which contained many blood vessels and cells positive for MHC Class II antigen. Specific markers for glycosaminoglycans have been employed to demonstrate that chondrocyte-derived cells and matrix contribute to the changes seen at the cartilage-pannus junction in RA-affected joints.

Adult↗
PubMed1986

Platelet releasing activity in sera of patients with rheumatoid vasculitis.

Platelet releasing activity was found in sera fractionated by 30% ammonium sulphate in seven of 11 patients with systemic rheumatoid vasculitis, two of 16 patients with cutaneous rheumatoid vasculitis, and three of 18 patients with clinically uncomplicated rheumatoid arthritis. Serial studies in three patients suggest a key role of platelet activation by serum factors in the pathogenesis of systemic rheumatoid vasculitis. IgG rheumatoid factor or IgG containing immune complexes, or both, may be responsible for this platelet releasing activity.

Arthritis, Rheumatoid↗
PubMed1986

A comparison of rheumatoid arthritis in Australia and China.

A comparison was made of two series of consecutive outpatients with a presumptive diagnosis of rheumatoid arthritis (RA) attending referral centres in Melbourne and Shanghai. No significant differences were observed in disease onset, course, presence of antinuclear antibodies (ANA), or seropositivity. In the Australian series there was a higher frequency of nodules, Raynaud's phenomenon, carpal tunnel syndrome, and 'classical' in comparison with 'definite' disease, and a lower frequency of lymphadenopathy and hepatomegaly. Joint tenderness and soft tissue swelling tended to be more marked in the Chinese series, while deformity and limited range of movement were less severe. Drug therapy was similar overall but influenced by drug availability. Peptic ulceration was recorded in 28% of the Australian series but in only 6% of the Chinese; although 25% of the Chinese were receiving antacids and 6% antiulcerants. X-rays of hands and feet showed more severe disease in the Australian series. The older age group and longer duration of the disease in the Australian patients, who had more chronic and less active disease, may have influenced some of these results.

Anti-Inflammatory Agents↗
PubMed1986

Genetic markers in rheumatoid arthritis relationship to toxicity from D-penicillamine.

In a 3-centre study involving 144 patients with rheumatoid arthritis (RA), a relationship between side effects from D-penicillamine and HLA antigens, allotypic markers of the IgG heavy chain (Gm) and allotypes of complement components Bf, C4A and C4B was sought. There was a significant association between proteinuria induced by D-penicillamine and the antigens DR3 and B8. However, the presence of DR2 seemed to protect against the development of proteinuria. Thrombocytopenia from D-penicillamine was significantly associated with HLA-A1 and DR4; 15 of 23 patients who possessed both antigens developed thrombocytopenia (p less than 0.001 uncorrected, approximate relative risk (RR) = 5.5). A null complement allele located at the C4B locus (C4BQO) was also associated with thrombocytopenia from D-penicillamine (p less than 0.005, RR = 17.3). Our study confirms the findings from other series which indicate that there is a genetic predisposition for the development of proteinuria from D-penicillamine in RA and suggests that this may also be the case in D-penicillamine induced thrombocytopenia.

Arthritis, Rheumatoid↗
PubMed1985

Rheumatic pain in a Philippine village. A WHO-ILAR COPCORD Study.

In initiating a community oriented programme for the control of rheumatic disease (COPCORD), 1685 people of all ages from a rural area in the Philippines were questioned by primary health care workers (PHW) for limb and spinal rheumatic pain and disability. The total complaint rate was 15.3% for men and 18.5% for women. For those 15 years and older the age adjusted rheumatic pain rates for pain present at the time of survey were 28.4% for the Philippines and 22.6% for Lawrence's UK population. The most common rheumatic pain sites in this community were knee, lumbar spine, neck and the trapezius muscle. The disability rate was 4.5% for those 15 years and older. One quarter of those with pain had received medical attention and the remainder, herbal treatment, massage, various faith and/or self-treatment methods.

Adolescent↗
PubMed1985

Defective reticuloendothelial system C3b mediated clearance in rheumatoid arthritis and vasculitis.

C3b receptor mediated clearance by the reticuloendothelial system (RES) was tested in vivo using autologous C3b coated, technetium labelled erythrocytes in patients with rheumatoid arthritis (RA) and rheumatoid vasculitis. Diminished C3b mediated erythrocyte clearance was found in all patients with rheumatoid vasculitis and some patients with active RA. Normal C3b mediated clearance was found in some patients with previous vasculitis, in remission when tested. These results are consistent with the hypothesis that acquired dysfunction of RES C3b receptors is implicated in the pathogenesis of rheumatoid vasculitis.

Adolescent↗
PubMed1984

Further look at dextropropoxyphene with or without paracetamol in the treatment of arthritis.

The analgesic effects of dextropropoxyphene and paracetamol and that of a combination of the two drugs were assessed in 24 patients who suffered from either rheumatoid arthritis or osteoarthritis. Dextropropoxyphene, which had a marginal effect on pain score, led to a more significant effect on patient well-being, particularly when it was the first drug given in the sequence. The addition of paracetamol had more of a negative than a positive effect on pain score and well-being.

Acetaminophen↗
PubMed1984

Stimulation of glycosaminoglycan production and lysosomal activity of human synovial cells in culture by low environmental pH.

Glycosaminoglycan production, acid hydrolase activity, proliferation, and morphology were examined in human synovial cells subjected to low environmental pH. The amount and the molecular size of newly synthesised glycosaminoglycan (GAG) were increased without significant change in the rate of cell proliferation. Lowered pH produced an increase in the size of cytoplasmic organelles. Some of these possessed ultrastructural features of lysosomes, but others were clearly nonlysosomal and were of uncertain identity. Intracellular activity of the lysosomal acid hydrolase N-acetyl-beta-glucosaminidase (NAG) was not altered by low pH, but a marked increase occurred in extracellular NAG activity, indicating enhanced release.

Acetylglucosaminidase↗
PubMed1984

The distribution of enzyme inhibitors in the joint in rheumatoid and experimental arthritis.

The enzyme inhibitors alpha 2 macroglobulin (alpha 2M) and alpha antitrypsin (alpha 1AT) have been demonstrated previously in the pannus-cartilage junction area in 12 patients with rheumatoid arthritis (RA). These deposits were present in both inflammatory cells and in the cartilage matrix. As the tissue studied came from far advanced disease removed at the time of joint replacements, the initial phase of cartilage destruction was studied in a carrageenin-induced arthritis in rabbits. Sequential studies indicated that loss of proteoglycan from cartilage was necessary before alpha 2M penetrated the matrix. Explant cultures of synovial tissue from RA and osteoarthritis (OA) joints released an inhibitor of neutrophil elastase and plasminogen activator which was neither alpha 2M nor alpha 1AT. Synovial tissue (and cartilage) enzyme inhibitors may have important implications in relation to protective mechanisms within the joint in RA and OA over and above the effect of plasma inhibitors.

Animals↗
PubMed1983

Study of enzyme inhibitors in the rheumatoid pannus-cartilage area.

Immunoperoxidase studies were carried out on the pannus-cartilage junction (PCJ) of patients with rheumatoid arthritis (RA) and psoriatic arthritis to investigate the distribution of the enzyme inhibitors alpha 2 macroglobulin (alpha 2 M) and alpha 1 antitrypsin (alpha 1 AT). Comparisons were made with the equivalent synovial cartilage junctional area in osteoarthritis (OA). In all 12 patients with RA, prominent deposits of alpha 2 M and alpha 1 AT were found within the PCJ whereas in OA patients and the case of psoriatic arthritis fewer or no deposits were seen. Inhibitors were localised in pannus synovial lining cells, perivascular inflammatory cells, macrophage and fibroblast-like cells invading the cartilage as well as along the junctional cartilage matrix and in the adjacent pannus-free cartilage. Deposits of immunoglobulins were found in similar areas to enzyme inhibitors. The presence of enzyme inhibitors at the PCJ suggests that this area is not unprotected against enzymatic attack. Thus the concept that pannus is a prime area for cartilage damage because aggressive, invasive cells release destructive enzymes in an environment free from inhibitors should be reviewed.

Arthritis↗
PubMed1983

Observations on rheumatic disease in Polynesia and the Philippines.

Two different types of study of rheumatic disease in the southwest Pacific are outlined. The Philippines study of a rural developing population is primarily oriented to intervention rather than causation, but before intervention can be effectively planned, information on the frequency and causes of rheumatic complaints is necessary. The Tokelauan investigation is a comprehensive prospective study of the total population with full medical examination of each subject allowing hypotheses to be tested concerning genetic and environmental variables.

Adolescent↗
PubMed1983

Medical management of rheumatoid arthritis with emphasis on the Western Pacific Region.

There are regional differences in the prevalence and severity of Rheumatoid Arthritis in the Asian and Western Pacific Regions. Medical management of the condition will depend very much on the assessment of disease activity. Non-steroidal anti-inflammatory drugs in full dosage should always be the first choice of treatment. Their popularity however varies from country to country depending partly on the availability and partly on the cost structure that the Department of Health has been able to negotiate with the manufacturer.

Adrenal Cortex Hormones↗