MANAGER: a multi-user computer scheme for management of laboratory staff working hours.

To administer a flexible-working-time system in a busy medical microbiology department, without increased administrative workload, a set of programs was produced for computer monitoring of staff time-keeping records. The programs--initially written to facilitate management and minimise clerical work, and extended to encompass all staff absences--are collectively called MANAGER. They allow efficient management of working hours and staff absences, using a multi-user laboratory computer. The programs were all written in MUMPS and evolved in-house, but could be developed for any multi-user laboratory computer system.

Significance of antikeratin antibodies in rheumatoid arthritis.

Antikeratin antibodies (AKA) were found in the sera of 59% (121/204) of patients with rheumatoid arthritis (RA). There was a significantly higher incidence of AKA (73%) in male patients compared with females (53%) and a correlation between AKA positivity and IgM rheumatoid factor was found. Antibody reactivity was positively associated with the presence of nodules, antinuclear antibody, C-reactive protein and disease severity. AKA would appear to have possible prognostic significance in patients with RA.

Serum antibodies to type II collagen in rheumatoid arthritis: comparison of 6 immunological methods and clinical features.

A collaborative study of 75 selected patients with rheumatoid arthritis (RA) employing 6 different methods for the detection of antibodies to type II collagen showed highly significant correlations between all the assays. The radioimmunoassays showed a greater sensitivity than either the passive haemagglutination or immunofluorescent techniques, and when the native collagen molecule was heat-denatured a higher number of patients showed increased antibody levels. In 33 patients the measurement of serum antibody levels to human, bovine, and rat native type II collagen showed a lack of species specificity, indicating that heterologous collagens can be employed in these assays. A retrospective analysis of the clinical, laboratory, and radiological features in the 41 patients with raised antibody levels and the 34 patients with normal antibody levels showed very few differences, but there was a significantly lower incidence of subcutaneous nodules (24% versus 56%) in patients with raised antibody levels. This study emphasizes the need to standardize assays for the measurement of serum antibody levels to native type II collagen. More extensive studies will be required before the clinical significance of these antibodies can be fully established.

Anti-collagen antibodies in sera from rheumatoid arthritis patients.

Anti-cartilage antibodies, demonstrable by immunofluorescence, were found in 3.3% of rheumatoid arthritis patients. In most of these patients antibodies to type II collagen were detected. In specificity studies on these anti-collagen antibodies, they appeared to be type specific, showing no reaction with collagen types I and III. Denatured type II collagen reacted much less well than native type II, but isolated peptides from different regions of the collagen molecule were differentiated by individual sera. Removal of the glycoside side chains from native type II collagen had no effect on its antigenicity. The findings suggest that these patients produce highly specific antibodies which react with the triple helix of type II collagen.

Anti-cartilage antibody.

Antibody to cartilage has been demonstrated by indirect immunofluorescence on rat trachea in the serum of about 3% of 1126 patients with rheumatoid arthritis. Titres ranged from 1:20 to 1:640. The antibody was not found in 284 patients with primary or secondary osteoarthritis or in 1825 blood donors, nor, with the exception of two weak reactors, in 1314 paraplegic patients. In most cases the antibody appears to be specific for native type II collagen. Using this as an antigen in a haemagglutination test 94% of anti-cartilage sera were positive, whereas among 100 rheumatoid control sera there were only three weak positives. More than 80% of patients with antibody had some erosion of articular cartilage, but there was no correlation with age, sex, duration of disease, nor any recognisable clinical event or change.