Biomedical subjects
Publications and source records attributed to R Fadilah.
The association between the CREST (calcinosis, Raynaud phenomena, oesophageal hypomotility, sclerodactyly and telangiectasia, variant of systemic sclerosis and chronic lymphocytic leukaemia is described in three patients. The present description raises the possibility that the association of chronic lymphocytic leukaemia and systemic sclerosis is non-random.
The state of leukocyte adhesiveness/aggregation (LAA) in the peripheral blood has been employed as a marker of inflammation. In the present study we examined patients with varying intensities of inflammation caused by respiratory tract infections to further investigate the reliability of the state of LAA for the detection and assessment of the severity of disease activity. The study includes 140 controls, 46 patients with upper respiratory tract infection, 30 with bronchitis, 27 with suspicion of pulmonary infiltrate, and 39 with small and 18 with large pulmonary infiltrate. Assessment was based on assuming an increasing severity of inflammation from the 1st to the 6th diagnostic category and by making use of discriminant analysis. It was found that the state of LAA proved to be the best variable to classify the patients into their diagnostic category (F to enter 27), followed by erythrocyte sedimentation rate at the 1st h (F to enter 20.8) and total white blood cell count (F to enter 8.3). These studies were followed by animal experimentation. A highly significant correlation (p = 0.005) was found between the state of LAA in the peripheral blood and the degree of pulmonary leukostasis in a model of endotoxemia in rabbits. These results suggest that the state of LAA is not an epiphenomenon and represents the tendency of the white blood cells to stick to the endothelium which facilitates their migration into the tissues.
Local deep microwave hyperthermia (LDMWH) may be considered as a therapeutic tool for joint diseases because it has the advantage of heating the target organ e.g. synovium, while sparing the adjacent tissues, as demonstrated in animals. The effect of this new microwave device has been evaluated on seven rheumatoid arthritis patients with knee effusion. The hyperthermia apparatus consists of a 915 MHz power source with a cooling system to the skin. LDMWH was operated for one hour, twice a week for two weeks. Intra-articular knee temperature reached the level of 40.6 +/- 1.1 degrees C within 15 minutes, raised to 41.2 +/- 0.7 degrees C after 30 minutes and to 41.3 +/- 0.9 degrees C at one hour. The skin temperature over the heated knee joints remained at 24.3 +/- 1.1 degrees C during treatment. All patients noted a sensation of warmth in the treated knee. Aspiration of synovial fluid was performed before and immediately after each treatment. Walking time was improved (p = 0.04) and significant decrease in pain (p = 0.01) was noted following treatment. Synovial fluid leukocyte count and prostaglandin E2 level, knee circumference and range of motion did not change. Severity of pain, walking time, knee circumference and range of motion remained stable in the six weeks following the last hyperthermia application. No adverse reaction could be observed. These results suggest LDMWH to be safe and successful as an adjuvant treatment of chronic inflammatory joint effusions.
Superficial heating of the joint is widely used in various rheumatic conditions and is considered as decreasing the intra-articular temperature. This study shows that heating the joint with hot pack significantly increases the articular temperature from 35.2 +/- 1.5 degrees C (mean +/- SD) to 36.4 +/- 1.0 degrees C (p less than 0.001), while intra-cavity temperature of the contralateral unheated knee joint did not change significantly. Since such elevation of temperature of one degree C is liable to enhance the inflammatory process, the use of superficial heating has to be carefully reconsidered in acute and chronic inflammatory joint diseases.
Pulmonary infection due to mycobacterium avium complex has been considered exceedingly rare, with only 50 case reports in the literature until 1982. However, during the past decade the dissemination of the acquired immune deficiency syndrome has been accompanied by a marked increase in the frequency of reported infections due to this agent, although infection in the noncompromised host remains rare. We describe an 80-year-old man who was not immunocompromised but who was infected with mycobacterium avium complex.
This study centers on the question of whether the phenomenon of leukocyte aggregation, which is typical to inflammatory conditions, is pathogenic per se. We examined patients and laboratory animals in whom the presence of aggregated leukocytes in the peripheral blood was documented by direct visualization and where, despite the presence of aggregated leukocytes, neither the patients nor the laboratory animals showed clinical or pathological evidence for leukoembolization. Our in vitro findings about the reversibility of the phenomenon of leukocyte aggregation help to explain the above-mentioned observations as well as the well-known daily clinical experience that, despite complement activation and other aggregatory stimuli, there is no clinical or pathological evidence for leukoembolization.
There is now a growing body of clinical evidence suggesting a therapeutic approach to cancer and prostatic hypertrophy by using hyperthermia. It is proposed that such a hyperthermic modality can produce thermal synovectomy in inflammatory arthritis. Heating the joint cavity up to 42 deg C can inhibit the enzymatic effect of collagenase, oxygenase, and other enzymes playing a role in the inflammatory process. If this hypothesis is correct, therapeutic intervention using hyperthermia may offer hope for the treatment of isolated inflammatory joint diseases.
Heating the joint to high temperatures using a microwave device may inhibit metabolic activity of the synovial tissue and enable higher penetration of antiinflammatory drugs into the joint cavity. To measure the temperature distribution of local thermotherapy, the hind joints of eight rabbits were heated by a 915 MHz microwave power source, using a special applicator. Temperatures of 44.0 +/- 2.8C, 36.1 +/- 3.8C, 39.6 +/- 2.3C, and 35.2 +/- 1.5C were measured after heating in the joint cavity, cartilage, muscle, and skin, respectively. The only significant increase in the temperature was recorded in the heated joint cavity (p less than 0.01). This new microwave device can be a therapeutic tool in treating joint diseases because of its advantage of heating the target organ only, eg, synovium, while sparing the adjacent tissues.