Bibliography March 2002

  1. AGARWAL V, MISRA R, AGGARWAL A: Immune complexes contain immunoglobulin A rheumatoid factor in serum and synovial fluid of patients with polyarticular juvenile rheumatoid arthritis. Rheumatology (Oxford) 2002, 41:466-467.
    Organism:Department of Clinical Immunology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow 226014, India
    Internet : PM:11961181

  2. ARGYROPOULOU MI, FANIS SL, XENAKIS T, EFREMIDIS SC, SIAMOPOULOU A: The role of MRI in the evaluation of hip joint disease in clinical subtypes of juvenile idiopathic arthritis. Br.J.Radiol. 2002, 75:229-233.
    Organism:Departments of Radiology, Orthopaedics and Paediatrics, University of Ioannina, 45110 Ioannina, Greece
    Abstract:     The purpose of this study was to evaluate the role of MRI in the assessment of hip joint involvement in clinical subtypes of juvenile idiopathic arthritis (JIA). 28 patients (mean age 12.5 years) with JIA (oligoarthritis 8, polyarthritis 13, systemic arthritis 7) were examined with T(2) weighted turbo spin echo and T(1) weighted spin echo (plain and contrast enhanced) sequences. The severity of joint involvement was evaluated using an MR grading score: grade 1=no contrast enhancement; grade 2=focal synovial contrast enhancement; grade 3=diffuse synovial contrast enhancement; grade 4=grade 3+diffuse synovial thickening; grade 5=grade 4+villonodular synovial thickening; and grade 6=grade 5+cartilage and subchondral bone erosions. MRI was abnormal in 57.1% of cases (25% of oligoarthritis, 53.8% of polyarthritis and 100% of systemic arthritis). Clinical examination was positive in 32.1% of cases and was associated with higher MR grades (mean 4.6, SD 1.34) compared with a negative clinical examination, which was associated with lower MR grades (mean 1.78, SD 1.13) (p<0.001). Patients with active disease (mean grade 3.9, SD 2) had higher MR grades than those with inactive disease (mean grade 2.1, SD 1.4) (p<0.01). The MR grades were different in the three clinical subtypes: oligoarticular (mean 1.5, SD 1.06); polyarticular (mean 2.38, SD 1.55); and systemic (mean 4.85, SD 1.21) (F:12.3, p<0.001), with a significant difference between systemic arthritis and oligoarthritis, and between systemic arthritis and polyarthritis (p<0.001). MRI of the hip might be considered for inclusion in the study protocol of patients with JIA since it reveals joint involvement at early stages and provides a detailed evaluation of the extent of joint disease
    Internet : PM:11932215

  3. BERK AT, KOC c, UNSAL E: Uveitis in juvenile arthritis. Ocular Immunology and Inflammation 2001, 9:243-251.
    Organism:A.T. Berk, Huseyin Zeren Cad., Urla Berk Sitesi 143, Urla/Izmir
    Abstract:     Purpose: To evaluate the clinical features of and determine the risk factors for uveitis in patients with juvenile arthritis. Methods: The prevalence and clinical characteristics of uveitis were studied retrospectively in 90 children diagnosed with arthritis. Patients with uveitis were compared with those who did not have eye involvement. Results: Uveitis was diagnosed in 11 patients (12.2%). Of these, seven (63.6%) had oligoarticular, two (36.4%) had polyarticular, and one (9.1%) had systemic-onset juvenile rheumatoid arthritis (JRA). One patient (9.1%) was diagnosed with enthesitis-related arthritis (ERA) (9.1%). The prevalence of uveitis was significantly higher in patients with oligoarticular JRA. The mean age at onset of arthritis in the uveitis patients was 4.39 years, which was significantly lower than in the non-uveitis group. There was no gender difference in the risk of developing uveitis. Antinuclear antibodies (ANA) was positive in seven (63.6%) of the 11 uveitis patients, confirming ANA as a significant determinant for uveitis in juvenile arthritis. Rheumatoid factor was not found to be a risk factor. One (9.1%) of the 11 patients developed serious sight-threatening complications during the follow-up period. Conclusion: This study confirmed that oligoarticular onset, ANA positivity, and young age are risk factors for developing uveitis in patients with juvenile arthritis. Gender was not found to be a determining factor. Prompt treatment of uveitis effectively decreased the prevalence of visual impairment
    Internet : tulin.berk@deu.edu.tr

  4. BINGHAM SJ, SNOWDEN J, MORGAN G, EMERY P: High dose immunosuppressive therapy and stem cell transplantation in autoimmune and inflammatory diseases. International Immunopharmacology 2002, 2:399-414.
    Organism:Rheumatology and Rehabilitation Research Unit, University of Leeds, 36 Clarendon Road, Leeds, LS2 9NZ UK^E-Mail: s.bingham@leeds.ac.uk

  5. BRINKMAN DMC, TEN CATE R, VOSSEN JM, SMEETS TJM, KRAAN MC, TAK PP: Decrease in synovial cellularity and cytokine expression after autologous stem cell transplantation in patients with juvenile idiopathic arthritis. Arthritis And Rheumatism 2002, 46:1121-1123.
    Organism:Dr. D.M.C. Brinkman, Leiden University Medical Center, Leiden

  6. CESUR S, IFTC c, KURT H, OZCAN M: An atypical Juvenile Chronic Myelocytic Leukemia patient with skin rashes, vasculitis and arthritis. Cancer Research, Therapy and Control 2002, 11:219-221.
    Organism:Dr. S. Cesur, Ankara Universitesi, Tip Fak. Infek. Hastal. Anab. Dali, 06100 Sihhiye-Ankara
    Abstract:     Juvenile Chronic Myelocytic Leukemia (JCML) with skin rashes and arthritis is rarely seen. Sometimes the primary symptoms and findings of a patient suggesting JCML may not be accompanied by the typical clinical and laboratory findings however. We here would like to publish a very rare case of CML with skin rashes, vasculitis and arthritis
    Internet : cesur@medicine2.ankara.edu.tr

  7. FLATO B, SMERDEL A, JOHNSTON V, LIEN G, DALE K, VINJE O, EGELAND T, SORSKAAR D, FORRE O: The influence of patient characteristics, disease variables, and HLA alleles on the development of radiographically evident sacroiliitis in juvenile idiopathic arthritis. Arthritis And Rheumatism 2002, 46:986-994.
    Organism:Dr. B. Flato, Center for Rheumatic Diseases, Rikshospitalet University Hospital, 0027 Oslo
    Abstract:     Objective. To assess the frequency of sacroiliitis and the radiographic and clinical outcome in juvenile idiopathic arthritis (JIA) and determine patient characteristics, early disease variables, and genetic markers that predict development of sacroiliitis. Methods. We performed a retrospective cohort study of 314 (79%) of the 400 JIA patients first admitted to the hospital between 1980 and 1985. The participants were examined after a median disease duration of 14.9 years (range 11.7-25.1). Radiographs of the sacroiliac joints, hips, ankles, and tarsi were obtained and studied in a blinded manner by 2 radiologists. The presence of HLA-DRB1 and DPB1 alleles was determined by genotyping and that of HLA-B27 by serologic testing. Variables relating to the onset and course of the disease were obtained by chart reviews. Results. Twenty (6%) of the JIA patients developed radiographic sacroiliitis according to the New York criteria. In 9 patients (45%), sacroiliitis had not been demonstrated before the followup examination. At followup, spinal flexion (lateral and anterior) was reduced in 70-75% of patients with sacroiliitis and in 30-35% of those without sacroiliitis. Compared with the JIA patients without sacroiliitis, those with sacroiliitis more frequently had inflammatory back pain, enthesitis, radiographic changes in the hips and calcanei, erosions of any peripheral joint, and uveitis. Predictors of sacroiliitis were HLA-B27, absence of DPBI*02, hip joint involvement within the first 6 months, and disease onset after age 8 years. The following factors were more common among patients in whom sacroiliitis developed than in other JIA patients: DRBI*04, male sex, family history of ankylosing spondylitis, psoriasis, inflammatory back pain, and enthesitis within the first 6 months. Conclusion. In the current study, radiographically evident sacroiliitis had developed in 6% of JIA patients after a median disease duration of 14.9 years. HLA-B27, absence of DPBI*02, late onset of disease, and early hip involvement were predictors of sacroiliitis
    Internet : berit.fiato@rikshospitalet.no

  8. FLEISCHMANN R, IQBAL I, NANDESHWAR P, QUICENO A: Safety and efficacy of disease-modifying anti-rheumatic agents: focus on the benefits and risks of etanercept. Drug Saf 2002, 25:173-197.
    Organism:Radiant Research-Dallas, Dallas, Texas, USA
    Abstract:     The traditional approach to the treatment of rheumatoid arthritis (RA) has been the use of nonsteroidal anti-inflammatory drugs usually in combination with a disease-modifying antirheumatic drug (DMARD) such as hydroxychloroquine, gold, sulfasalazine, methotrexate, leflunomide or cyclosporin. Each of these DMARDs has its own distinct toxicities but has also been shown to be effective in reducing signs and symptoms of disease and to some extent, reduce radiological progression. Within the past 10 years, the combination of several traditional DMARDs has been shown to have increased efficacy over monotherapy without a significant increase in toxicity in a majority of studies. Recently, the US Food and Drug Administration has approved infliximab, a chimeric monoclonal antibody to tumour necrosis factor (TNF)-alpha in combination with methotrexate, for the treatment of signs and symptoms of RA, delay of radiological progression of disease and improvement of physical function while anakinra, an interleukin-1 receptor antagonist, has been approved for the treatment of the signs and symptoms of RA either as monotherapy or in combination with methotrexate. Etanercept is the first biological response modifier approved for use in RA in the US. Double-blind, randomised controlled studies have shown etanercept to be effective therapy in patients with RA who have had inadequate response to DMARDs, in combination with methotrexate, and as early monotherapy. Similar results were seen in juvenile and psoriatic arthritis in DMARD nonresponders. Open-label studies have shown efficacy in adult Still's disease, ankylosing spondylitis, progressive systemic sclerosis, Wegener's granulomatosis and chronic uveitis. Safety issues are a concern because of the ubiquitous role of TNF. To date the only consistent adverse event seen with etanercept has been injection site reactions. Infections occur at the same rate and with the same frequency as the placebo population. There should be caution, however, with using etanercept in patients with a serious infection, or recurrent infections or patients with untreated or latent tuberculosis. As of yet there has not been seen an increase of malignancies. Rare neurological and haematological events have been noted. Etanercept has been a significant addition to the armamentarium of medications for the treatment of RA, juvenile and psoriatic arthritis. Preliminary data show that it may be well tolerated and effective in other rheumatic diseases in which there is over production of TNFalpha
    Internet : PM:11945114

  9. FRANCIOTTA D, MARTINO G, ZARDINI E, FURLAN R, BERGAMASCHI R, GIRONI M, BERGAMI A, ANGELINI G, BENEDETTI FD, PIGNATTI P, MOSCATO G, COSI V: Caspase-1 levels in biological fluids from patients with multiple sclerosis and from patients with other neurological and non-neurological diseases. Eur.Cytokine Netw. 2002, 13:99-103.
    Organism:Foundation Neurological Institute C Mondino, via Palestro 3, I-27100 Pavia, Italy
    Abstract:     In multiple sclerosis (MS), pathological white matter damage in the central nervous system is sustained by immune-inflammatory response. Caspase-1 plays a pivotal role in immune-mediated inflammation, as it regulates the cellular export of IL-1beta and IL-18. We carried out a preliminary in vitro study of the kinetics of extracellular caspase-1 release. We then measured caspase-1 levels in paired serum and cerebrospinal fluid (CSF) samples of 75 MS patients, 15 healthy subjects, and patients with other neurological diseases. Paired synovial fluid and serum samples of patients with juvenile idiopathic arthritis, and paired sputum and serum samples of asthma patients were also studied. Mean serum caspase-1 concentrations did not differ between groups. Caspase-1 was detected in the CSF of patients with acute, but not stable, MS [7.5 (SEM) 0.9 pg/ml; test's sensitivity, 56% and specificity, 100%]. Its levels correlated with pleocytosis. The highest mean caspase-1 levels were found in the arthritic synovial fluids (945.5 126.6 pg/ml, which correlated with erythrocyte sedimentation rate), and in the sputum samples (370.1 71.0 pg/ml, which correlated with the number of macrophages in the sputum). On condition that caspase-1 is determined in the fluids pertaining to the disease-specific inflammatory sites, its level is a reliable marker of ongoing immune-inflammatory response. The enzyme measurement in CSF can also help define state-trait in MS
    Internet : PM:11956027

  10. GATTORNO M, VIGNOLA S, FALCINI F, SABATINI F, BUONCOMPAGNI A, SIMONINI G, PICCO P, PISTOIA V: Serum and synovial fluid concentrations of matrix metalloproteinases 3 and its tissue inhibitor 1 in juvenile idiopathic arthritides. Rinsho Ganka 2002, 29:826-831.
    Organism:Dr. M. Gattorno, 2nd Division of Pediatrics, Rheumatology Unit, G. Gaslini Institute for Children, Largo G. Gaslini 5, 16147 Genoa
    Abstract:     Objective. Matrix metalloproteinases (MMP) are a large family of proteolytic enzymes involved in the remodeling of extracellular matrix during tissue resorption in idiopathic arthritides. We investigated serum and synovial fluid (SF) concentrations of MMP-3 and its tissue inhibitor (TIMP-1) in juvenile idiopathic arthritides (JIA). Methods. Sera from 45 patients with active, 15 patients with inactive JIA, and 15 healthy controls were evaluated by ELISA for MMP-3 (stromelysin-1), TIMP-1, and soluble p75 tumor necrosis factor receptor (sTNFR). Paired SF concentrations were evaluated in 19 patients with JIA. Results. MMP-3 serum concentrations were significantly higher in patients with active poly- and oligoarticular JIA versus inactive patients (p = 0.04 and p = 0.02, respectively) and healthy controls (p < 0.001 for both). Serum MMP-3, but not TIMP-1, concentration displayed a variable degree of correlation with clinical and laboratory variables of disease activity and with p75 sTNFR concentrations (r = 0.37, p = 0.005). SF MMP-3 concentrations were 30-300 times higher than those found in paired sera (p < 0.001, Wilcoxon rank test). A clear inversion of MMP-3/TIMP-1 ratio was observed when sera (median 0.31, range 0.02-1.5) were compared with the corresponding SF samples (5.3, range 4.9-5.5; p < 0.001). Conclusion. MMP-3 (stromelysin-1) is clearly overexpressed in SF of patients with JIA. An inadequate counter-expression of TIMP-1 may represent a crucial event for the development and perpetuation of tissue damage
    Internet : marcogattorno@ospedale-gaslini.ge.it

  11. HEIJNEN CJ, ROUPPE vd, V, VAN DE PM, KAVELAARS A: Cytokines regulate alphaSUB1-adrenergic receptor mRNA expression in human monocytic cells and endothelial cells. J.Neuroimmunol. 2002, 125:66-72.
    Organism:C.J. Heijnen, Laboratory for Psychoneuroimmunology, Department of Immunology, University Medical Center Utrecht, Lundlaan 6, 3584 EA Utrecht
    Abstract:     The family of adrenergic receptors (AR) plays a central role in regulation of the activity of many organ systems. Consequently, regulated expression of the various subtypes of AR is an important mechanism in maintaining homeostasis. Previously, we have shown that alphaSUB1-AR triggering of peripheral blood mononuclear cells from patients with juvenile chronic arthritis results in increased IL-6 production. In contrast, alphaSUB1-AR agonists do not alter cytokine production by cells of healthy individuals. The aim of the present study was to investigate whether pro-inflammatory cytokines can regulate the expression of mRNA encoding AR of the alphaSUB1-family. We show that human THP-1 monocytic cells express mRNA encoding of two of the three cloned subtypes of alphaSUB1-AR: alphaSUB1b-AR and alphaSUB1d-AR mRNA. The cytokines TNF-alpha and IL-1beta decrease level of mRNA for alphaSUB1d-AR in THP-1 monocytic cells. In contrast, alphaSUB1b-AR mRNA levels are not affected by these two cytokines. Interestingly, IL-1beta and TNF-alpha induce the expression of alphaSUB1a-AR mRNA in THP-1 monocytic cells. In human umbilical vein endothelial cells (HUVEC), IL-1beta and TNF-alpha decrease both alphaSUB1b-AR and alphaSUB1d-AR mRNA levels in HUVEC. alphaSUB1a-AR mRNA is not detectable in HUVEC. IL-6 and IL-8, two other pro-inflammatory cytokines tested in this study, do not change alphaSUB1-AR subtype levels in HUVEC or monocytic cells. Our data demonstrate that TNF-alpha and IL-1beta can regulate expression of alphaSUB1-AR mRNA and that cytokine regulation of alphaSUB1-AR expression is subtype- and tissue-specific. (c) 2002 Elsevier Science B.V. All rights reserved
    Internet : c.heijnen@wkz.azu.nl

  12. HELDERS PJ, VAN DER NJ, NIEUWENHUIS MK: Splinting the juvenile arthritic wrist: a clinical observation. Arthritis Rheum. 2002, 47:99-103.
    Organism:University Medical Center and Children's Hospital, Utrecht, The Netherlands
    Internet : PM:11932885

  13. HOFFMAN EB, ALLIN J, CAMPBELL JA, LEISEGANG FM: Tuberculosis of the knee. Clin.Orthop. 2002, 100-106.
    Organism:Department of Orthopaedics, University of Cape Town, and The Maitland Cottage and Red Cross Children's Hospital, Cape Town, Republic of South Africa
    Abstract:     Fifty-two children with tuberculosis of the knee treated from 1979 to 1999 were reviewed retrospectively. The radiologic appearance of the joint at presentation was predictive of the outcome. Ninety-two percent of the patients had Stage 1 or Stage 2 involvement (synovitis) with or without bony erosions, but had a normal joint space. Treatment with antituberculous chemotherapy without synovectomy had an excellent or good result in all patients with Stage 1 or Stage 2 disease, and there was no difference in outcome whether the knee was immobilized or mobilized. Patients with Stage 3 and Stage 4 disease who had a narrow joint space (arthritic) at presentation had a fair or poor result. In patients with monoarthritis of the knee with nonspecific histologic features and a negative culture, the differential diagnosis between tuberculosis and pauciarticular juvenile rheumatoid arthritis is problematic. The histologic evaluations of biopsy specimens of the synovium of 25 knees from 25 patients were reviewed for synovial lining hyperplasia. The sensitivity for the 17 knees that subsequently were diagnosed as having juvenile rheumatoid arthritis was only 53%. Deoxyribonucleic acid from 13 consecutive joints was subjected to polymerase chain reaction for Mycobacterium tuberculosis infection with only 40% sensitivity for tuberculosis
    Internet : PM:11964637

  14. KAHNBERG K-E, HOLMSTROM H: Augmentation of a retrognathic chin. I. Use of HTR-polymer(R) implants in a long-term prospective clinical and radiographic study. Scandinavian Journal of Plastic and Reconstructive Surgery and Hand Surgery 2002, 36:65-70.
    Organism:K.-E. Kahnberg, Department of Oral Surgery, Faculty of Odontology, Goteborg University, SE 405 30 Goteborg
    Abstract:     A total of 37 patients have had chin augmentation procedures with HTR-polymer(R) implants. Indications were mandibular retrognathia in connection with dentofacial deformities in 13 and the remaining 24 had a normal occlusion. Three patients with micrognathia also had juvenile rheumatoid arthritis. The patients have been followed for at least one year and in 17 cases up to five years both clinically and radiographically. Cephalometric measurements of the effects and stability of augmentation showed that chin augmentation has highly predictable results, and few side-effects

  15. KOTANIEMI K: Uveitis in juvenile idiopathic arthritis. Acta Ophthalmol.Scand. 2002, 80:226
    Internet : PM:11952495

  16. KOZAK T: Hematopoietic stem cell transplantation in the treatment of autoimmune diseases. Wiener Klinische Wochenschrift 2002, 114:7-13.
    Organism:Department of Clinical Hematology, University Hospital Kralovske Vinohrady, 50, Srobarova, 100 34, Prague Czech Republic^E-Mail: kozak@fnkv.cz

  17. NIKITINA ZL, CIMDINA I, RUMBA I, DABADGHAO P, SANJEEVI CB: Major histocompatibility complex class I chain related (MIC) A gene, TNFa microsatellite alleles and TNFB alleles in juvenile idiopathic arthritis patients from Latvia. Hum.Immunol. 2002, 63:418-423.
    Organism:Department of Molecular Medicine (LNZ, PD, CBS), Karolinska Institutet, Karolinska Hospital, Stockholm, Sweden
    Abstract:     In order to analyze involvement of major histocompatibility complex class I chain-related gene A (MICA) and tumor necrosis factor a (TNFa) microsatellite polymorphisms as well as TNFB gene in juvenile idiopathic arthritis (JIA), we studied 128 patients divided into groups according to clinical features [monoarthritis (n = 14), oligoarthritis (n = 58), polyarthritis (n = 50), and systemic (n = 6)], and 114 age- and sex-matched healthy controls from Latvia. DNA samples were amplified with specific primers and used for genotyping of MICA and TNFa microsatellite. Typing for a biallelic NcoI polymerase chain reaction RFLP polymorphism located at the first intron of TNFB gene was done as follows: restriction digests generated fragments of 555bp and 185bp for TNFB*1 allele, and 740bp for TNFB*2 allele. The results were compared between cases and controls. We found significant increase of MICA allele A4 (p = 0.009; odds ratio [OR] = 2.3) and allele TNFa2 (p = 0.0001; OR = 4.4) in patients compared with controls. The frequency of allele TNFa9 was significantly decreased (p = 0.0001; OR = 0.1) in patients with JIA. No significant differences of TNFB allele frequency were found. Our data suggest that MICA and TNFa microsatellite polymorphisms may be used as markers for determination of susceptibility and protection from JIA
    Internet : PM:11975986

  18. OU L-S, SEE L-C, WU C-J, KAO C-C, LIN Y-L, HUANG J-L: Association between serum inflammatory cytokines and disease activity in juvenile idiopathic arthritis. Journal of developmental and behavioral.pediatrics 2002, 21:52-56.
    Organism:Dr. J.-L. Huang, Div. of Allergy Asthma/Rheumatology, Department of Pediatrics, Chang Gung Children's Hospital, 5-7 Fu-Hsin Street, Kweishan, Taoyuan
    Abstract:     Circulating interleukin-1beta (IL-1beta), IL-6, tumour necrosis factor-alpha (TNF-alpha), osteocalcin, and conventional parameters of inflammation were examined serially in 14 children with juvenile idiopathic arthritis (JIA) to determine any correlation with the disease activity. Serum IL-1beta was undetectable in all JIA patients. Serum IL-6, white blood cell counts, platelet counts, erythrocyte sedimentation rate and C-reactive protein levels were significantly elevated in the active phase of JIA, whereas hemoglobin levels were significantly lower. Osteocalcin levels were decreased and TNF-alpha increased in active JIA status, but these differences showed no statistical significance. We concluded that inflammatory cytokines play an important role in JIA. Monitoring IL-6 in children with JIA is useful in determining disease activity and response to therapy. These findings confirm earlier reports
    Internet : long@adm.cgmh.org.tw

  19. SAWHNEY S, MURRAY KJ, AL MATAR M, CABRAL DA, PETTY RE: Isolated tuberculosis monoarthritis mimicking juvenile rheumatoid arthritis [3] (multiple letters). Rinsho Ganka 2002, 29:857-860.
    Organism:S. Sawhney, Pediatric Rheumatology Unit, Great Ormond Street Hospital, London

  20. SNORRASON E, MURRAY J: Treatment of arthritis disorders, rheumatoid arthritis and manifestations associated with rheumatoid disorders. Official Gazette of the United States Patent and Trademark Office Patents 2002, 1256:No
    Organism:Stigahlid 80, 105 Reykjavik Iceland
    Abstract:     The present invention relates to the use of pharmaceutically acceptable cholinesterase inhibitors for the preparation of a pharmaceutical composition for the treatment or prophylaxis of arthritic disorders, including osteoarthritis, rheumatoid arthritis and other rheumatoid diseases such as Juvenile Arthritis, Systemic Lupus Erythematosis, Sjogren's Syndrome, Progressive Systemic Sclerosis, Polymyositis, Dermatomyositis, Ankylosing Spondilitis, Reiter's Syndrome, Psoriatic Arthritis, Relapsing Polychondritis, Relapsing Panniculitis, Crohn's Disease, Ulcerative Colitis, Heredity Complement Deficiencies, Collagen Vascular Diseases, Felty's Syndrome, rheumatological manifestations associated with bacterial and viral endocarditis or myocarditis and other rheumatological manifestations such as anaemia of chronic disorders. The invention also relates to a novel method of treatment or prophylaxis of such diseases and manifestations. Preferably, the cholinesterase inhibitors are selected from a group of nicotinic acetylcholinesterase inhibitors such as galantamine (the name of this drug was previously spelled galanthamine)

  21. TRAN N, MYERS LK, KANG AH: Autoimmunity to type II collagen in juvenile rheumatoid arthritis (JRA). Journal of Investigative Medicine 2002, 50:121A
    Organism:University of Tennessee and VA Medical Center, Memphis, TN USA

  22. WRENGER E, ROCKEN C, DIETZMANN J, GROTE H-J, ROESSNER A, NEUMANN KH: Ambulatory treatment with intravenous norepinephrine in a patient with end stage renal disease and generalized AA amyloidosis. Amyloid 2002, 9:47-51.
    Organism:Dr. E. Wrenger, Division of Nephrology, Department of Internal Medicine, Otto-von-Guericke-University, Leipziger Str. 44, D-39120 Magdeburg
    Abstract:     A 35-year-old man with juvenile rheumatoid arthritis and generalized AA amyloidosis of 10 years duration developed end stage renal failure. Following appendectomy, the patient experienced progressive circulatory failure which required IV treatment with norepinephrine. All attempts to discontinue IV norepinephrine failed, each leading to recurrent life-threatening hypotension. Finally, a central venous port with a portable mechanical infusion pump system was implanted supplying a continuous norepinephrine infusion. The patient then became independently mobile and could be discharged. For three months, the patient was monitored as an outpatient and treated by ambulatory intermittent hemofiltration. Finally, the patient suffered from a hemorrhagic infarction of the small bowel due to postoperative adhesions and died shortly after surgery. At autopsy, advanced generalized AA amyloidosis was found. Amyloid deposits had almost entirely replaced the cortex and the medulla of the adrenal glands. It can be speculated that the requirement of exogenous norepinephrine may be in part due to an adrenal insufficiency whereas it was initially considered as being only related to cardiac involvement. A continuous ambulatory treatment with catecholamines could be a possible treatment - at least temporarily - in amyloid cases in which all other attempts have failed to prevent chronic life-threatening hypotension
    Internet : Eike.Wrenger@medizin.uni-magdeburg.de

  23. ZEGGINI E, THOMSON W, ALANSARI A, OLLIER W, DONN R: Tumour necrosis factor receptor II polymorphism and juvenile idiopathic arthritis. Rheumatology (Oxford) 2002, 41:462-465.
    Organism:ARC/EU, Stopford Building, Oxford Road, Manchester M13 9PT, UK
    Abstract:     OBJECTIVES: Juvenile idiopathic arthritis (JIA) is a complex polygenic disorder. The encouraging outcome of anti-tumour necrosis factor (TNF) treatment, as well as serological studies, has implicated TNF and its receptors (TNFRI and TNFRII, or TNFRSF1B) in the pathogenesis of JIA. The purpose of this study was to investigate the exon 6 TNFRII single nucleotide polymorphism (SNP) in a well-defined UK cohort of JIA patients, using case-control association analysis. METHODS: A total of 435 patients, spanning seven JIA subgroups, and 261 healthy individuals were screened for the polymorphism using the polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) method. RESULTS: No significant differences were observed between the SNP allelic or genotypic frequencies of patients and controls, or between JIA subgroups. CONCLUSIONS: This TNFRII exon 6 SNP does not seem to be associated with susceptibility to JIA
    Internet : PM:11961180