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Biomedical subjects

R K Jacoby

Publications and source records attributed to R K Jacoby.

36 records · Page 2Linked to original sources
PubMed1981

Immune complexes in early arthritis. L Detection of immune complexes before rheumatoid arthritis is definite.

Fifty-three patients with early arthritis were studied longitudinally for up to 3 years. During this time, 24 developed sufficient features for definite rheumatoid arthritis (RA) to be diagnosed. The other (arthralgia patients) differed from the RA patients as, in the majority, C-reactive protein and ESR were normal and anti-nuclear antibodies or rheumatoid factors were rarely found. Moreover, in time their signs and symptoms improved or disappeared. Circulating immune complexes were detected in both groups of patients by the platelet aggregation test whereas complexes detected by abnormal Clq-binding activity were found mainly in the RA patients. Platelet-aggregating complexes were usually present in the first samples studied and disappeared in the arthralgia patients with recovery from their symptoms. In the RA patients, Clq-binding complexes appeared simultaneously or later than platelet-aggregating complexes but both tests were positive several months before RA could be diagnosed. These results suggest that immune complexes are one of the first immunological abnormalities to appear in patients with arthritis. Although the constituent antigen and antibody of complexes detected by either test are unknown, their possible nature is discussed.

Adolescent↗
PubMed1980

Effect of homologous synovial membrane on adult human articular cartilage in organ culture, and failure to influence it with D-penicillamine.

Adult human articular cartilage has been maintained in organ culture for 8 days, and the culture medium, which was changed on alternate days, was pooled. Normal and rheumatoid cartilage was obtained from patients and 4 types of culture were prepared: (1) cartilage alone; (2) cartilage + D-penicillamine; (3) cartilage + homologous synovium; (4) cartilage, synovium, and D-penicillamine. The hexosamines and hexuronic acid were measured in the cartilage explants and in the medium. The quantity released was divided by the amount measured in the original cartilage explant and the different culture variables were compared. D-penicillamine did not alter the release of cartilage proteoglycan, but the addition of synovium did. The rheumatoid cartilage released significantly more proteoglycan than normal cartilage whether or not homologous synovium was present.

Adult↗
PubMed1977

The hallux and rheumatiod arthritis.

The purpose of this report is to consider involvement of the great toe by rheumatoid arthritis, defining significant deformities, describing clinical patterns and discussing the pathomechanics of these findings, in what is an ongoing disease. 200 consecutive patients admitted to hospital with classical or definite rheumatoid arthritis were screened for pain or deformity of the great toe. Feet that had undergone previous surgery or had other underlying pathology were excluded from the series. 194 feef were found to have halluceal involvement. Although hallux valgus was the commonest deformity it was found in combination with other significant deformities in many cases. Hallux rigidus was an important lesion in this series as was interphalangeal hyperextension. Other important lesions encountered were metatarsus primus varus and medial rotation of the toe; their relationship to hallux valgus is discussed.

Arthritis, Rheumatoid↗
PubMed1976

The organ culture of adult human articular cartilage, from patients with osteoarthrosis.

Adult human articular cartilage has been maintained in organ culture for three days. The uptake of 35SO4 has been studied over a 48-hour period. The incorporation of 35SO4 was significantly increased in osteoarthrotic cartilage compared to normal cartilage from the same joints. The uronic acid content of the osteoarthrotic cartilage was significantly reduced which reflects the proteoglycan loss in the diseased tissue. The DNA content, which is an indirect measurement of the cell population, was not significantly different in the diseased and normal cartilage.

Adult↗
PubMed1976

The great toe as a clinical problem in rheumatoid arthritis.

Two hundred consecutive in-patients with rheumatoid arthritis were examined for pain or deformity of the feet, and of the great toe in particular. Some abnormality occured in 196 feet and the deformities observed are presented. The symptoms that arise from these deformities are mainly derived from ill-fitting shoes, and the need for suitable foot-wear is emphasized. Two hitherto un-named entities are described namely Hallux tortus and chisel toe, since they give rise to their own shoe-fitting problems.

Arthritis, Rheumatoid↗
PubMed1976

Synthesis of glycosaminoglycan in adult human articular cartilage in organ culture from patients with rheumatoid arthritis.

Hyaline cartilage was obtained from patients undergoing synovectomy of the knee joint for rheumatoid arthritis. Eroded cartilage from beneath the invading pannus and relatively normal cartilage from the same joint were maintained in organ culture for three days. During the first 48 hours in culture the explants were exposed to 35SO4 in the medium. The equivalent layers of normal and eroded cartilage were analysed for DNA uronic acid and 35SO4 incorporation. There was a decrease in the DNA and uronic acid of the eroded cartilage, although only the latter reached statistical significance. The uptake of radioactive sulphate was significantly greater in explants taken from the eroded site than from normal areas. This increase in metabolic activity could well be a protective phenomenon.

Adult↗
PubMed1976

Radiographic stereoplotting. A new technique and its application to the study of the spine.

Radiographic stereoplotting is a method for taking three-dimensional measurements from a pair of x-ray films. The x-ray technique is described, as is the stereoplotter. Using this machine it is possible to locate any point within the patient and measure the distance between that point and any other point. From this information it is possible to compute areas, volumes, and angles with great accuracy, which hitherto has been impossible using noninvasive techniques. It is planned to take measurements of the spinal canal in normal backs and in patients with nonspecific back pain, in order to try to define some of these syndromes on a structural basis. It is likely that stereoplotting has some useful application in most branches of clinical medicine, since the x-ray technology is available in any diagnostic x-ray department.

Adult↗
PubMed1976

The effect of hydrocortisone acetate on adult human articular cartilage.

Living adult human articular cartilage has been maintained in tissue culture for eight days. Cartilage explants were cultured in one of three concentrations of hydrocortisone acetate or as control explants without this drug. The concentrations of hydrocortisone used were 0.01 microng/ml, 0.1 microng/ml and 1.0 mg/ml. The amount of proteoglycan shed into the medium was measured and no significant difference was found between the explants exposed to hydrocortisone and those that were not. These results suggest that hydrocortisone does not have a catabolic effect on the proteoglycan of articular cartilage. The widely held view that intra-articular corticosteroid injection causes cartilage damage, must remain in doubt.

Adolescent↗
PubMed1975

The foot in chronic rheumatoid arthritis.

The feet of 200 consecutive admissions with classical or definite rheumatoid arthritis were studied. 104 were found to have pain or deformity. Clinical involvement of the joints was seen more often than radiological joint damage in the ankle, but the reverse was the case in the midtarsal joints. The metatarsophalangeal joints were involved most frequently both clinically and radiologically. Sixty per cent of the patients required modified shoes but only a third of these had received them. The need for more shoes is clear, and although this is a highly selected group of patients they were all under specialist care. The increased expenditure on special footwear would benefit the patient, firstly by improving ambulation, and secondly perhaps by reducing the number of operations necessary. Hallux valgus was very common and occurred with similar frequency to disease in the other metatarsophalangeal joints. Although not exclusive to rheumatoid arthritis, hallux valgus must have been caused for the most part by the rheumatoid arthritis and if so, then it is suggested that the provision of suitable shoes for patients may be less costly than subsequent surgical treatment.

Ankle Joint↗
PubMed1975

Organ culture of adult human articular cartilage. I. The effect of hyperoxia on synthesis of glycosaminoglycan.

Adult human articular cartilage was maintained in organ culture for eight days in 20 per cent and 95 per cent oxygen. The higher oxygen tension proved to be lethal to the cartilage, whereas the mean number of surviving chondrocytes in 20 per cent oxygen was 91 per cent of the total. Specimens were cultured with radioactive sulfate (Na235SO4) for two days and the uptake of sulfate (DPM) at 95 per cent oxygen was significantly lower than at 20 per cent oxygen. There was a positive correlation between DPM and uronic acid, and between DPM and DNA (p less than 0.001), but not between DPM and dry weight.

Animals↗
PubMed1975

Organ culture of adult human articular cartilage. II. The differential rate of glycosaminoglycan synthesis in layers of articular cartilage matrix.

Adult human articular cartilage was maintained in culture for three days and labelled with 35SO4 for the first 48 hours. The explants were sectioned horizontally on the cryostat, and the sections from the top, middle, and deep layers analyzed separately. Autoradiographs were prepared from every twentieth section. The DNA content in each of the three layers was of the same order, but the sulfate uptake and uronic acid content were considerably reduced at the surface. It is suggested that the chondrocytes synthesize matrix appropriate to the layer in which they lie.

Autoradiography↗
PubMed1973

Onset, early stages, and prognosis of rheumatoid arthritis: a clinical study of 100 patients with 11-year follow-up.

One hundred patients with "definite" or "classical" rheumatoid arthritis were followed in a hospital clinic from within one year of the onset of the arthritis. The average interval between onset and first attendance was 3.7 months. Onset was commoner in the winter, transient prodromal symptoms being noted in 23, with possible precipitating factors in 14. The serum rheumatoid factor test was positive at some time in 88.The patients were reassessed between eight and 14 years later. Seventeen died during this period, five possibly as a result of the disease or its treatment.The remaining patients had improved as a whole in terms of the blood sedimentation rate, haemoglobin, titre of the rheumatoid factor test, and status of the disease, but there was an overall deterioration in functional capacity. Both the rheumatoid factor titre and the functional capacity at an earlier review could be directly correlated with the outcome, but other factors were not found to influence the ultimate prognosis.

Adult↗