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L Ekerot

Publications and source records attributed to L Ekerot.

31 records · Page 2Linked to original sources
PubMed1982

Protease inhibitors in rheumatoid synovial fluid. Analyses of electrophoretic homogeneity and protease inhibitory capacity.

Paired plasma and synovial fluids from 17 patients with seropositive rheumatoid arthritis were examined for electrophoretic homogeneity/heterogeneity and enzymic inhibitory capacity of the protease inhibitors. The high degree of saturation (approximately 90%) of the polyvalent protease inhibitor alpha 2-macroglobulin in the rheumatoid synovial fluid contrasts sharply with the low saturation of alpha 1-anti-trypsin. The inhibitory reactivity of the non-complexed fraction of both of these dominating antiproteases was retained (approximately 85-90%). Thus, a selective inactivation of synovial alpha 1-antitrypsin could not be demonstrated. alpha 1-Anti-chymotrypsin revealed electrophoretic homogeneity in all synovial fluids. Electrophoretic heterogeneity of the plasmin inhibitor antiplasmin was detected in the majority of synovial fluids indicating plasmin activation. The existence of a protease-antiprotease imbalance in the rheumatoid joint was indicated by the high degree of saturation of alpha 2-macroglobulin and a cleavage of C3 in rheumatoid synovial fluids.

Arthritis, Rheumatoid↗
PubMed1982

The elimination of alpha 2-macroglobulin complexes from the arthritic joint. An experimental study in dogs.

The polyvalent protease inhibitor, alpha 2-macroglobulin, may counteract a protease-mediated rheumatoid joint destruction. The elimination of the complexed inhibitor from joints was analysed in inflamed and noninflamed conditions of the knee joints in dogs. The arthritis was immunologically induced. The fate of intra-articularly injected radioactive alpha 2-macroglobulin complexes was studied by external measurements, analyses of blood, lymph and urine, and by autoradiographic and immunohistologic methods. The results indicate that the elimination of complexes was accelerated by inflammation and joint movements with a half-life shorter than 2 hours in acute arthritis. In addition to absorption into the synovial membrane and degradation in macrophage-like cells, the process of clearance included elimination of complexes via the blood and the lymph capillaries of the joint and subsequent degradation in cells belonging to the reticuloendothelial system in the lymph nodes and the liver. The degradation products were excreted in increasing amounts in the urine. Referring to the earlier recognized high degree of saturation of synovial fluid alpha 2-macroglobulin in rheumatoid arthritis, the finding of a rapid articular clearance of alpha 2-macroglobulin complexes suggests a pronounced release of endoproteases under clinical conditions.

Animals↗
PubMed1982

Immunoreactive granulocyte elastase in rheumatoid synovial fluid and membrane.

A specific radioimmunoassay (RIA) was utilized to determine granulocyte elastase in the synovial fluid of a series of 45 rheumatoid joints in 39 patients. The average concentration was approximately 340 micrograms/l, exceeding that of the paired serum sample in all but 6 cases. No correlation was noted in synovial fluid between its content of granulocyte elastase and the total number of white blood cells. The concentrations in sera from rheumatoid patients with non-steroidal anti-inflammatory agents and controls were equivalent. Non-inflammatory exudates contained low concentrations of elastase. The immunoreactive granulocyte elastase in rheumatoid synovial fluid was bound to alpha 1-antitrypsin suggesting release of the enzyme in its active form. An uptake of elastase-containing complexes by macrophage-like cells in the synovial membrane was demonstrated by immunohistochemical staining of tissue using antiserum against granulocyte elastase. The concentrations of immunoreactive granulocyte elastase in the free synovial fluid of rheumatoid arthritic joints presumably only faintly reflect the situation concerning the target substrates.

Adolescent↗
PubMed1982

Immunoreactive alpha 2-macroglobulin in rheumatoid synovial membrane.

alpha 2-Macroglobulin was demonstrated immunohistochemically in macrophage-like cells of rheumatoid arthritic synovial tissue. It is concluded that these intracellular deposits probably represent phagocytosed protease-alpha 2-macroglobulin complexes. A contributing local production of alpha 2-macroglobulin is, however, not excluded by the present findings.

Adult↗
PubMed1982

The elimination of alpha 2-macroglobulin complexes from the arthritic joint. A clinical study in rheumatoid arthritis.

A phagocytic uptake of labeled elastase-alpha 2-macroglobulin complexes by macrophage-like synovial lining cells was demonstrated in rheumatoid arthritics. The appearance and distribution of these phagocytically active cells were similar to those containing immunoreactive alpha 2-macroglobulin. It was concluded that these deposits represented phagocytosed alpha 2-macroglobulin complexes and that the elimination of complexes from the arthritic joint at least partly was effected via local phagocytosis.

Aged↗
PubMed1981

Idiopathic avascular necrosis of the scaphoid. Case report.

Avascular necrosis may affect a number of different bones. In the wrist necrosis of the lunate (Kienböck's disease) is a well known entity. A rarely seen but analogous condition may, however, also affect the scaphoid (Preiser's disease). The mechanism producing ischemia is unknown, although in most cases the initiating event is mostly likely loss of blood supply by a mechanical insult. Two cases of idiopathic avascular necrosis of the scaphoid are reported, manifested by insidious wrist pain and progressing roentgenologic changes. Despite early diagnosis and prolonged immobilization irreversible collapse of the affected bone could not be prevented.

Adult↗
PubMed1981

Malignant hemangioendothelioma of metacarpal bones.

Malignant hemangioendothelioma is a tumour of vascular origin with wide distribution in various organs and tissues of the body. However, it is seldom localized primarily in bone. In this report our experience with a case of primary multifocal malignant hemangioendothelioma of the metacarpal bones is reported. Because of the focal pattern of malignancy excisional biopsy failed to give the diagnosis which was not established until the tumour was radically removed.

Adult↗
PubMed1981

Tuberculosis of the hand. Case report.

Three patients with tuberculosis of the hand are reported. In each patient the onset and course of the disease was insidious and the diagnosis was obscured by lack of systemic symptoms and the absence of other foci of infection. The diagnosis was established only after open biopsy and synovial tissue culture. The wounds healed without complications even prior to appropriate chemotherapy. Combined conservative and surgical treatment resulted in definitive cure of the local manifestation in two of the patients.

Adult↗
PubMed1981

Hemangioma of the lunate (Klippel-Trénaunay syndrome). Case report.

An intraosseous hemangioma of the lunate was diagnosed as the cause of wrist complaints. At angiography considerable arteriovenous shunting within the bone was shown. Replacement of the lunate by a SILASTIC implant relieved the pain. The intraosseous hemangioma, however, appeared to be only a part of more wide-spread disease which fulfilled the criteria for a Klippel-Trénaunay syndrome.

Adult↗
PubMed1980

Restoration of the digital tendon sheath. A new concept of tendon grafting.

The repair of flexor tendons which have been divided within the digital sheath remains an unsolved problem. Adhesions occur at would sites and points of tendon trauma. It is well known that an intact digital canal prevents formation of adhesions. Previous studies in chickens have shown that autologous tendon sheath tissue can successfully be transplanted from one digit to another with preserved vitality and that by this technique the continuity of an injured tendon sheath can be restored. The present series represent a clinical application of this new concept. 40 patients with flexor tendon injuries within the critical zone in the finger were treated by the use of a two-stage tendon grafting procedure. In the first stage operation the continuity of the tendon sheath was restored by transplantation of autologous synovial tissue. In the second procedure 3 months later a conventional tendon grafting was performed. Using the criteria of Boyes & Stark (1971) successful results were obtained in 88%. It can be concluded that the present method of tendon grafting provides a favourable recipient bed and improved gliding conditions.

Adolescent↗
PubMed1977

Postanesthetic ulnar neuropathy at the elbow.

In the present study 19 patients with postanesthetic ulnar nerve lesions treated during the period 1973--76 are reviewed. The lesions were localized to the cubital tunnel region and appeared subsequent to recent, otherwise uncomplicated operative procedures commonly performed under general anesthesia. Mechanical factors caused by malpositioning of the arm during the course of anesthesia and operation resulted in direct, compressive nerve injury. Hypermobility of the nerve was found to be a predisposing local factor. The roentgenologic configuration of the postcondylar groove showed considerable variability and did not correlate with the location of injury. The potential risk positions with the arm in either prolonged extreme elbow flexion or with applied surface pressure over the cubital tunnel region must be avoided in placing the patient on the operating table.

Adult↗
PubMedDate not supplied

Protease inhibitors in rheumatoid synovial fluid: a quantitative analysis.

The concentrations of the main endogenous inhibitors of granulocyte proteases (anti-leukoprotease, alpha 1-antitrypsin, alpha 1-antichymotrypsin, and alpha 2-macroglobulin) were estimated in paired samples of synovial fluid and serum/plasma from seropositive rheumatoid arthritics and controls. Rheumatoid synovial fluid contained significantly higher levels of all inhibitors except antileukoprotease. The influence of the synovial membrane on these concentrations was taken into account by comparing the ratio between the observed concentration and that predicted from a certain regression curve fitted to a set of non-inhibitory reference proteins of extra-articular origin (orosomucoid, albumin, and ceruloplasmin). Divergences were interpreted as the net result of intra-articular production or consumption of the inhibitor in question. The results suggested a consumption of antileukoprotease and alpha 1-antitrypsin in the rheumatoid joint, while the increased levels of alpha 1-antichymotrypsin and alpha 2-macroglobulin probably reflected the altered trans-synovial membrane protein flux with some reservation for alpha 2-macroglobulin.

Adult↗