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V Kyle

Publications and source records attributed to V Kyle.

26 records · Page 2Linked to original sources

Isolation and analysis of immune complexes from sera of patients with polymyalgia rheumatica and giant cell arteritis.

Serum samples were obtained from patients with polymyalgia rheumatica (PMR: n = 10) or giant cell arteritis (GCA; n = 7), or both. Samples were taken either before treatment or within one week of starting prednisolone. Immune complexes (IC) were concentrated by polyethylene glycol (PEG) precipitation then purified with either IgG anti-C1q-Sepharose or IgG anti-C3c-Sepharose. Complex components were separated by sodium dodecyl sulphate (SDS) gradient polyacrylamide gel electrophoresis then transferred to nitrocellulose by Western blotting. Identification of proteins was carried out using specific antisera. All the IC contained IgM (mu chain), some contained IgA (alpha chain), and IgG (gamma chain). C1r, C1s, C1q, C3, C4, and C reactive protein (CRP), where tested, were found in most but not all IC. The occurrence of properdin, factor B, alpha 2 macroglobulin (alpha 2M), factor H (beta 1H), C1 esterase inhibitor, and C4 binding protein was also investigated. Immune complexes in PMR and GCA differed from those previously characterized in rheumatoid arthritis (RA)1 purified by anti-C1q-Sepharose which contained immunoglobulins and C1q only. No properdin or factor B were detected in RA IC purified with either anti-C1q-Sepharose or anti-C3c-Sepharose.

Aged↗

Assessment of inflammation in the rheumatoid knee joint: correlation between clinical, radioisotopic, and thermographic methods.

Standard clinical methods of assessing joint inflammation are being supplemented increasingly by radioisotopic and thermographic studies. However, the correlation between these different methods has not been firmly established. In the quantification of synovitis by infrared thermography we have shown that the heat distribution index (HDI) based on thermal pattern is more reliable and is less affected by diurnal variations in joint temperature than the commonly used thermographic index, which is based on average skin temperature values. In 20 patients with rheumatoid arthritis whose knees were being treated with intra-articular steroid we obtained 184 serial paired observations over a period of 24 weeks for clinical assessment, HDI, and 99mTc pertechnetate uptake. We found significant correlations (p less than 0.001) between the three methods of assessment (except for pain and HDI (p = 0.116)).

Adult↗

Polymyalgia rheumatica/giant cell arteritis in a Cambridge general practice.

The aim of this study was to establish the incidence and prevalence of polymyalgia rheumatica/giant cell arteritis in general practice. Patients with this disorder, whether previously diagnosed or not, were ascertained by using a questionnaire administered by interview, and all received full clinical and laboratory assessment. A total of 579 patients aged 65 and over was seen, and 19 (33/1000) had been diagnosed or developed symptoms within the previous eight years. Thus the calculated annual incidence in those aged 65 and over was about 4/1000. The figures from this first large scale study of polymyalgia rheumatica/giant cell arteritis in general practice are much higher than those from studies carried out in hospital. The questionnaire was effective in both identifying known cases of polymyalgia rheumatica/giant cell arteritis and detecting new cases. As this is a treatable disorder, it is important that doctors become aware of how common it is in elderly people.

Aged↗

Prostaglandin E1 vasospastic disease and thermography.

This is the first study to show a quantitative thermographic difference between patients with Raynaud's syndrome and normal controls after cold stress testing. An improved thermographic response to cold stress testing after treatment of Raynaud's syndrome with PGE1 has also been shown for the first time. Discriminant analysis of the change in temperature of a finger after cold stress, and the mean thermal gradient along the finger during rewarming, clearly separated patients from controls. After treatment with PGE1 the patients' discriminant values moved into the normal range. Symptomatic improvement after PGE1 correlated well with thermographic improvement, and both persisted for up to 12 weeks.

Adult↗

Yttrium-90 therapy and 99MTc pertechnetate knee uptake measurements in the management of rheumatoid arthritis.

Twenty-eight knees with chronic arthritis and effusion were treated with intra-articular 90Y. Synovial activity was assessed by measuring 99mTc pertechnetate uptake. There was a significant difference in uptake between controls and patients. Those who had a good response to 90Y (15 patients) showed a significant decrease in uptake, not seen in those who failed to respond. The pattern of 90Y distribution was examined and appeared to correspond to areas of increased synovial activity; these patterns and their significance have not been previously reported. Factors which could help to predict response to 90Y are discussed.

Aged↗

Cytidine deaminase may be a useful marker in differentiating elderly onset rheumatoid arthritis from polymyalgia rheumatica/giant cell arteritis.

OBJECTIVE: PMR/GCA is a relatively common inflammatory disease in the elderly population. Clinical differentiation from a polymyalgic onset of RA in the elderly can be difficult. We have examined in a preliminary study the hypothesis that serum cytidine deaminase (CD) may be valuable in the differential diagnosis of these disorders. METHODS: CD was assayed by a spectrophotometric method in 20 patients with active PMR/GCA, both before and after treatment with prednisolone, and was compared with serum CD levels in 20 patients with active RA. RESULTS: CD levels were within the normal range (< 10 units/ml) in 36 of the 40 samples from patients with PMR/GCA: The mean CD in pre-treatment samples was 8.64 units/ml (SD 7.09), and after treatment 7.20 units/ml (SD 3.53). The mean serum CD in the RA patients was 21.33 units/ml (SD 8.94), significantly higher than in PMR/GCA (p < 0.0001). CONCLUSION: Serum CD levels were significantly different when proven PMR was compared with established, long-standing RA. Therefore, serum CD could be a useful diagnostic marker for differentiating PMR/GCA from active RA in older patients.

Age of Onset↗