Intra-articular rheumatoid nodule of the knee joint.

A 44-year-old woman with a long-standing history of classical rheumatoid arthritis had an intra-articular rheumatoid nodule of the knee joint. The history, symptoms, and signs of this case were, however, almost identical to those cases previously reported. This entity has a classic presentation and distinct findings on examination which distinguish it from other intra-articular lesions of the knee.

Naproxen and aspirin in rheumatoid arthritis: a multicenter double-blind crossover comparison study.

One hundred nineteen adults with active definite or classical rheumatoid arthritis were studied in a multicenter double-blind crossover study of naproxen (500 mg/day) and aspirin (3.6 Gm/day). Each drug was given in sequence for a six-week study period. Patients already receiving corticosteriod and/or gold therapy were maintained at constant dose throughout the study, but analgesics and other nonsteroidal antiinflammatory agents were discontinued at baseline. Objective and subjective evaluations by both investigator and patient were carried out at two-week intervals. No significant difference in global evaluation of efficacy or individual measures of efficacy was observed between aspirin and naproxen therapy, although physicians' global evaluation tended to favor naproxen. Sedimentation rate was lower on aspirin (naproxen 43.1 mm/hr; aspirin 38.7 mm/hr; P=0.02). Naproxen, 250 mg twice daily, was significantly better tolerated than aspirin, 900 mg four times daily. Mild, moderate, and severe side effects were less frequent with naproxen. The incidence of heartburn was significantly lower on naproxen, and significantly fewer patients terminated their six-week study period on naproxen than on aspirin. There were no significant deviations from baseline values in hematocrit, white cell or differential counts, or in tests of renal and hepatic function during the course of the study.

Deficiency of coenzyme Q 10 in gingival tissue from patients with periodontal disease.

The specific activities of the succinate dehydrogenase-coenzyme Q(10) reductase in gingival tissue from patients with periodontal disease have been compared with the corresponding specific activities of normal human periodontal tissue. The gingival biopsies from patients having diseased periodontal tissue showed a deficiency of coenzyme Q(10), in contrast to those of the normal periodontal tissue which showed no deficiency. The presence or absence of a deficiency of coenzyme Q(10) in the succinate-coenzyme Q(10) enzyme system is appraised by determining the specific activity in the absence and again in the presence of exogenous coenzyme Q(3). An increase in specific activity of this mitochondrial enzyme system in the presence of exogenous coenzyme Q(3) reflects the mitochondrial deficiency of coenzyme Q(10). Such increases ranged from 38-120% and averaged 81% for the individuals with periodontal disease, and were highly significant statistically. These data correlate with clinical studies in Japan that have indicated a therapeutic benefit of the administration of coenzyme Q(7) to many patients with severe and destructive periodontal disease and with the benefit of administration of hexahydrocoenzyme Q(4) to one such patient in the current work.