Light and electron microscopic analysis of liver biopsy samples from rheumatoid arthritis patients receiving long-term methotrexate therapy.

OBJECTIVE: We study liver damage in forty-two patients with rheumatoid arthritis (RA) using light (LM) and electron microscopy (EM) and assess histological changes after four years of treatment with methotrexate (MTX). PATIENTS AND METHODS: liver biopsies (LB) were taken before and after four years of treatment. Patients received weekly doses of between 7.5-15 mg of MTX. RESULTS: Fourteen per cent of the baseline LB presented mild perisinusoidal fibrosis (Roenigk IIIA) and the rest a lower Roenigk grade; EM identified an increase in collagen fibers in the Disse spaces in 50% of baseline LB. Neither microscopy technique revealed histological progression in any of the sequential LB. Variables that correlated with histological abnormalities were patient's age, length of evolution of the disease, alcohol consumption and biochemical data (gammaglutamate transferase and albumin); the cumulative dose of MTX was not correlated with worse histological findings. Correlation between the two microscopy techniques was good, though EM was more sensitive than LM for the detection of fibrosis. CONCLUSIONS: RA patients present with liver damage before treatment with MTX. The alterations are mild. At low doses MTX treatment is safe. In addition to the recommendations of the American College of Rheumatology, other factors associated with liver impairment are patient's age and length of evolution of the RA.

The clinical spectrum of remitting seronegative symmetrical synovitis with pitting edema. The Catalán Group for the Study of RS3PE.

OBJECTIVE: To describe the clinical and laboratory features and outcome of patients with remitting seronegative symmetrical synovitis with pitting edema (RS3PE). METHODS: A retrospective multicenter study of patients with RS3PE fulfilling the following criteria: (1) bilateral pitting edema of both hands, (2) sudden onset of polyarthritis, (3) age > 50 years, (4) seronegative for rheumatoid factor (RF). RESULTS: 27 patients with RS3PE were included, mean age 71.7 years (58-92), 18 men (66.6%) and 9 women (33.3%). Relevant history was noted in 2 patients with polymyalgia rheumatica. Main clinical features were polyarthritis and edema of both hands. Polyarthritis involved metacarpophalangeal joints in 22 patients (81.5%), proximal interphalangeal joints in 19 (70.4%), wrists in 15 (55.5%), shoulders in 13 (48%), elbows in 3 (11.1%), knees in 9 (33.3%), and ankles in 7 (25.9%). All patients were RF negative. Antinuclear antibodies were positive at low titer in 8 patients. Erosions were present in one patient. Two patients developed T lymphoma and one myelodysplastic syndrome. CONCLUSION: RS3PE is a heterogeneous syndrome the clinical history, presence of erosions, and evolution to hematological diseases in our patients suggest that RS3PE may not be a distinct clinical entity.

Hydatid disease. An unusual cause of chronic monarthritis.

We describe a patient with granulomatous synovitis secondary to osseus hydatid disease that manifested with chronic monarthritis, eosinophilia, and urticaria.

[Septic arthritis induced by pyogenic germs in patients without parenteral drug addiction. Analysis of 44 cases]. / Artritis séptica inducida por gérmenes piógenos en pacientes sin adicción a drogas por vía parenteral. Análisis de 44 casos.

BACKGROUND: The aim of this study was to evaluate the clinical-microbiological characteristics presented in the area of influence of the Hospital de Bellvitge-Prínceps d'Espanya, of articular infection induced by pyogenic germs in patients without intravenous drug addiction. METHODS: All the cases of microbiologically confirmed articular infection in patients without intravenous drug addiction diagnosed during the period of 1981-1990 were evaluated by protocol. RESULTS: Five cases (11%) with gonococcal arthritis and 39 cases (89%) of non gonococcal arthritis were observed with Staphylococcus aureus being the causal germ in 27 cases. Sixty percent of the patients presented one or more predisposing factors for the appearance of infectious arthritis. Monoarticular involvement was seen in 84% of the cases. At the time of diagnosis fourteen patients presented radiological signs compatible with septic involvement, with the isotopic study with 99mTc being positive in the 27 cases in which it was carried out. Delay in diagnosis was of 20 +/- 25 days. Functional results were considered as satisfactory in 57% of the cases. CONCLUSION: In the area of influence of the Hospital de Bellvitge-Prínceps d'Espanya, the prevalence of gonococcal arthritis is low. Gram positive germ are the most frequent causal agents in all the age groups studied. Gammagraphy with 99mTc presented high profitability in the diagnosis of articular infections. The functional results observed were not optimal and improvement of the same probably requires a shortening in the time of delay in diagnosis.

[Antiphospholipid syndrome in patients with ankylosing spondylitis. Presentation of 2 cases]. / Síndrome antifosfolípido en pacientes afectos de espondilitis anquilosante. Presentación de dos casos.

Antiphospholipid antibodies (APA) have been described not only in systemic lupus erythematosus but also in several inflammatory diseases of the connective tissue, some infections, neoplasms, in pregnancy and even in apparently healthy individuals. Arterial and venous thrombosis are some of the clinical manifestations most frequently associated with APA. Two patients with ankylosing spondylitis with antiphospholipid antibodies are presented. The first patient developed a infarct in the pons as a complication at 34 years of age, with high titres of anticardiolipin antibodies as the only factor predisposing a cerebral vascular accident. The second patient had deep vein thrombosis with the presence of circulating anticoagulant. These are the first cases of antiphospholipid syndrome associated to ankylosing spondylitis in the literature.

The design of a monopole radiator to investigate the effect of microwave radiation in biological systems.

The design of a microwave monopole radiator, using a hollow hypodermic needle, is described. This radiator has two unique features. It allows both i) irradiation of deep biological structures by simple needle injection and ii) simultaneous chemotherapic treatment of tissue. The matching characteristics of the monopole in saline solutions are given.

The properties of bird feathers as converse piezoelectric transducers and as receptors of microwave radiation. II. Bird feathers as dielectric receptors of microwave radiation.

The characteristics of bird feathers as receptors of microwave fields were investigated in the 10- to 16-GHz region. Experiments were conducted coupling the specimen (feather) to a length of waveguide which served, together with other microwave components, as a primary detector. Microwave power radiation patterns were measured both in the presence and in the absence of the specimen. Results indicated a substantial increase in the microwave power collected in the forward direction and a decrease of the radiation pattern beam width when the feather was present. Fruthermore, some experiemental evidence indicated the possibility of inducing piezoelectric effects in the specimen by audiofrequency pulse-modulated microwave fields. These results are important in view of (i) the fundamental role that feathers play in the life of birds and (ii) the influence of environmental factors on bird behaviour.

Microwave radiometry and its potential applications in biology and medicine: experimental studies.

This paper presents experimental data on : (1) the natural emission of microwave radiation by biological systems, and (2) the effect of drugs as well as microwave radiation on specimen microwave emission. Experiments were conducted on guinea pigs, mice, rabbits, and human subjects. The results were obtained with two different radiometers, one of the correlation type and one of the Dicke type, operating in the X-band at about 9 GHz with a sensitivity of approximately 0.1 degrees K. The results demonstrate the feasibility of this technique and suggestions are made for its use in bilogy, medicine, and in the field of biocommunications.

The properties of bird feathers as converse piezoelectric transducers and as receptors of microwave radiation. I. Bird feathers as converse piezoelectric transducers.

An investigation was made of the properties of bird feathers as piezoelectric transducers in the audiofrequency range and as dielectric receptors of electromagnetic radiation in the microwave region. In the first case, cartridges of the ceramic and magnetic type and an electromagnetic transducer probe were used as detecting devices. Results show piezoelectric resonances in the 1 to 20-kHz region for the calami of feathers.