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Biomedical subjects

L Kvarnes

Publications and source records attributed to L Kvarnes.

8 recordsLinked to original sources
PubMed1991

Immunopathology of subcutaneous rheumatoid nodules.

Nodules obtained from five patients with classical seropositive rheumatoid arthritis were studied by an immunofluorescence technique using polyclonal antibodies to IgG, IgA, IgM, C3c, and fibrin, and monoclonal antibodies to the terminal (C5b-9) complement complex (reaction with a neoantigen in C9 revealed during activation), DR antigens, T cells, macrophages, and interdigitating cells. In all instances the central necrotic areas stained strongly for fibrin and more weakly for IgG, IgA, IgM, C3, and terminal complement complex. The surrounding palisading cells reacted with antibodies to DR and macrophages. In the peripheral granulomatous tissue most of the lymphocytes reacted with the antibodies to T cells, whereas various amounts of the larger mononuclear cells were stained by antibodies to DR antigens, macrophages, and interdigitating cells. In all instances the walls of some of the smaller vessels in the granulomatous tissue stained for fibrin, C3, and terminal complement complex. Plasma cells were not seen except for scattered IgM cells in one nodule. These results support the view that the palisading cells are derived from macrophages, and indicate that there is vasculitis with activation of C3 and the terminal complement pathway in the granulomatous tissue.

Arthritis, Rheumatoid↗
PubMed1989

Inflammatory synovial T cells in different activity subgroups of patients with rheumatoid arthritis and juvenile rheumatoid arthritis.

Mononuclear cells were eluted from synovial membranes of 39 patients with rheumatoid arthritis and 12 patients with juvenile rheumatoid arthritis. A considerable cell loss, about 50% or more, was seen during the various isolation steps. The CD4/CD8 ratio just after enzyme treatment (stage I) was significantly higher than at later stages, i.e. after removal of adherent cells (stage II, p less than 0.05) and after Isopaque Ficoll gradient centrifugation (stage III, p less than 0.01). This indicates a selective loss of CD4+ cells during isolation. In addition, stages I and II had higher CD4/CD8 ratios than peripheral blood of normal controls (p less than 0.01 and p less than 0.03), but not significantly higher than in peripheral blood of patients (p greater than 0.05). The CD4/CD8 ratio in eluted synovial membrane cells did not differ between patients with high and patients with low disease activity (p greater than 0.05). No correlation was found between any of the CD4/CD8 ratios and individual disease activity variables. Furthermore, a laboratory activity index and a disease outcome index were determined for each patient and no correlation was found between these indices and the CD4/CD8 ratios.

Adolescent↗
PubMed1986

Interleukin 1 activity produced by human rheumatoid and normal dendritic cells.

Dendritic cells (DC) from the synovial inflammatory tissue and peripheral blood of patients with rheumatoid arthritis and from the peripheral blood of normal blood donors were compared with the autologous monocytes for their capacity to produce and release interleukin 1 (IL-1). Synovial DC often spontaneously released higher amounts of IL-1 activity than unstimulated and lipopolysaccharide-stimulated peripheral blood DC and monocytes. The IL-1 production by both DC and monocytes increased after stimulation with bacterial lipopolysaccharide. In contrast with synovial DC the peripheral blood DC from both patients with rheumatoid arthritis and normal controls released less IL-1 activity than peripheral blood monocytes did. Inhibition with an antiserum to IL-1 revealed that IL-1 production is important for the accessory activity of the peripheral blood DC. Thus human DC from inflammatory sites and peripheral blood produce IL-1 activity.

Arthritis, Rheumatoid↗
PubMed1985

Osteoarthritis of the carpometacarpal joint of the thumb. An analysis of operative procedures.

This paper presents a clinical review of patients operated by different procedures for disabling osteoarthritis of the carpometacarpal joint of the thumb. Fusion of the joint resulted in pain relief, and the patients achieved a stable thumb with excellent strength. Although a minor loss of thumb motion was noted, this was not considered a problem. Excision of the trapezium gave good results with respect to pain relief, but there was loss of thumb stability and strength. Implant arthroplasty with a silicone prosthesis appeared to give a painfree, stable and mobile thumb, but there was loss of power. In conclusion, arthrodesis is the method of choice if reduction of strength is to be avoided.

Aged↗
PubMed1985

Shoulder synovectomy.

The technique and results of synovectomy of the shoulder joint in rheumatoid arthritis with a mean follow up time of 5.3 years (1-16 years) is described. The original method included resection of acromion after loosening of the deltoid muscle and splitting of the rotator cuff. Since 1981 the simpler approach of Neer without resection of acromion has been used (for synovectomy as well as for prosthetic replacement) with an easier postoperative management and equally good results. Only in 6 of 54 shoulders a total replacement prosthesis has been inserted later, an indication of the lasting good effect of synovectomy, even in advanced cases where an additional debridement was necessary. The best results are obtained in early cases. Radiographic changes are late, indications should be based more on clinical findings. Access to good training facilities is mandatory.

Acromion↗
PubMed1985

Shoulder replacement arthroplasty.

Since 1973 64 shoulders in 56 patients have had a prosthetic replacement at the Oslo Sanitetsforening Rheumatism Hospital, the semi-constrained prosthesis of Lettin/Stanmore was used in 13 cases, the non-constrained prosthesis of Engelbrecht/St. Georg in 10 cases and Neer's type II prosthesis in 41 cases. An evaluation of the results is given. The minimal muscular loosening recommended by Neer is facilitating the postoperative training. The best results regarding function and pain reduction have been obtained by the Neer prosthesis, but the lack of cranial support ("fornix humeri") and the ovalization of the head seem to be responsible for some cases of upward migration of the head of the prosthesis. The ideal prosthesis should be non-constrained and come with different lengths of the neck and at least in two sizes of the head and several sizes of the stem. The glenoid socket should provide a cranial support facilitating the centering. Special problems are met with in juvenile rheumatoid arthritis. A best possible reconstruction of the rotator cuff and the deltoid is mandatory, requiring good technical skill.

Adult↗
PubMed1984

Naproxen suppositories in postoperative pain and swelling after joint surgery. A comparative, double-blind study.

Altogether 105 rheumatic patients, 35 in each of three groups, took part in a double-blind parallel study comparing naproxen (Naprosyn, Syntex) 500 mg suppositories with oxyphenbutazone (Tanderil, Geigy) 250 mg suppositories and placebo in postoperative pain and swelling after joint surgery. Medication was administered twice daily for 3 1/2 days, starting the night before operation. Ketogan (Ketobemidonhydrochloride, 3 dimethylamino-1-diphenylbuten-(1)-hydrochloride) injections and Paralgin Forte (Paracetamol, codein phosphate) tablets were allowed as escape medication. Each day clinical assessments including pain-score, oedema-score and circumference of operated joint were performed and amount of escape medication recorded. A physical test was performed on day seven after operation. No statistically significant difference between groups was observed for most parameters. In general the tendency for all parameters seems to favour naproxen. For pain-score the difference was significant (p = 0.02) in arthrodesis/arthroplasty patients day 1 and for need for Ketogan injections (p less than 0.001) in all patients day 0. Only two side effects were recorded during the study. In the present study no significant difference between the groups could be observed for most parameters measured. The tendency seems to favour naproxen, but a larger number of patients will be needed to investigate whether this observation is of significance.

Adult↗