PubMed · 1589638
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T Abe. 1992. [Hyperventilation--central neurogenic hyperventilation].. https://pubmed.ncbi.nlm.nih.gov/1589638/
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OBJECTIVE: To standardize outcome measures in systemic lupus erythematosus (SLE). Three indices were identified which could adequately describe outcome (disease activity, damage from disease, and health status); we describe here the development of the Disease Activity Index. METHODS: Twenty-four variables were identified as important factors in a disease activity index. These were used to generate 574 patient profiles, which were rated on a disease activity scale of 0-10 by 14 rheumatologists. A second rating of 10 of the profiles yielded scores that were not significantly different from the first, indicating that experienced clinicians can reliably make global estimates of disease activity. Multiple regression models were used to estimate the relative importance of the 24 clinical variables in the physicians' global rating of disease activity. These were estimated on a "training set" of 75% of physicians' ratings, and then validated on a "testing set," consisting of the remaining 25% of physicians' ratings. RESULTS: The explanatory power of the models in the training set was high (R2 = 0.93). The models' regression coefficients for the organ systems were simplified for easier use in clinical practice. This generated a "weighted" index of 9 organ systems for disease activity in SLE, the SLEDAI, as follows: 8 for central nervous system and vascular, 4 for renal and musculoskeletal, 2 for serosal, dermal, immunologic, and 1 for constitutional and hematologic. The maximum theoretical score is 105, but in practice, few patients have scores greater than 45. The SLEDAI predicted well the physicians' ratings in the testing set (Pearson's correlation coefficients = 0.64-0.79). CONCLUSION: The SLEDAI is a validated model of experienced clinicians' global assessments of disease activity in lupus. It represents the consensus of a group of experts in the field of lupus research.
The intermediate filament distribution pattern in cells and tissues of vertebrates reflects their differentiation or functional specialization state, their histogenesis, and their malignant transformation. In the case of cytokeratins, the characteristic epithelial intermediate filaments representing a complex group of about 30 polypeptides, extensive attention has been given to their expression in diverse epithelial and epithelioid cells. However, little is known about their distribution during fetal development and in neuroectodermal cells. This review specifically focuses on the data concerning cytokeratin expression in intracranial and intraspinal tissues, as expressed alone or as coexpressed with other intermediate filament proteins. Furthermore, the expression pattern of individual cytokeratin polypeptides was investigated by immunocytochemistry in diverse human and animal tissues using a broad panel of monoclonal antibodies. Only the cytokeratins typical of simple epithelia with the primary keratin pair 8/18 as a significant component have been detected in neuroectodermal tissues such as the choroid plexus and ciliary body epithelia, the retinal pigment epithelium, the subcommissural organ, and the ependymal cell clusters in fetal pineal gland (only in humans) as well as in various "unspecialized" ependymal cells of brain ventricles and spinal cord ependyma. Focal cytokeratin 19 expression in rat ciliary body and ventricle ependyma represents a rare exception. In addition, a group of intracranial and intraspinal tissues with controversial histogenesis express solely the cytokeratins 8 and 18: endocrine pituitary cells, arachnoid cells, and corneal endothelium. In most cases of tissues with neuroectodermal derivation, coexpression of cytokeratins and vimentin, or triple expression of cytokeratin, vimentin, and GFAP (fetal and neonatal choroid plexus of humans, rat and guinea pig ependymal cells in the neighborhood of the subcomissural, folliculostellate cells of human and guinea pig pituitary) is detectable. The coexpressions are discussed in the light of several hypotheses based on morphological and functional data concerning intermediate filament protein expression. Both the occurrence of more than one intermediate filament protein and the individual cytokeratin composition in the corresponding tumors of neuroectodermal origin reflect, in principle, the patterns found in their normal tissues. In the fetal neuroectodermal tissues studied, the cytokeratin pair 8/18 is the first one to be expressed during embryonic development.(ABSTRACT TRUNCATED AT 400 WORDS)
Immunohistochemical staining for factor XIIIa, a transglutaminase, revealed a variety of positively stained cells in human fetal tissues. Factor XIIIa-positive cells were most numerous in the dermis and connective tissues. Numerous large, stellate cells in placental villi, decidua, and chorionic membranes also expressed factor XIIIa at 7-9 weeks gestational age, before the onset of fetal hematopoiesis. There was heterogeneity in the staining for factor XIIIa in the early and late fetal tissues, in both rounded and in dendritic cells. In preparations of consecutive sections and in double-labelling experiments, some cells expressed both factor XIIIa and certain monocyte markers and were identified in close association with blood vessels and lymphoid organs in the late fetus and in the placental villi at the end of gestation. Other rounded and dendritic cells expressed factor XIIIa but not monocyte markers, and were found in adult and fetal connective tissues at all gestational ages. These results suggest that there are two factor XIIIa-positive cell populations. One population is present at all developmental stages, does not express monocyte markers, and probably differentiates in situ from primitive mesenchyme. The other population appears mainly after the onset of fetal hematopoiesis, coexpresses some monocyte markers, is HLA-DR positive and may be capable of antigen presentation.