[Role of obesity in the development of osteoarthrosis and concomitant diseases].

AIM: To specify the association between obesity and the frequency of concomitant states, fat metabolic disturbances, and progressive osteoarthrosis (OA) at various sites. SUBJECTS AND METHODS: The study included 298 patients with manifest knee and hip osteoarthrosis in whom the body mass index (BMI) and waist and hip circumferences were measured calculating the waist-hip index. The association of these indices with the severity of OA and the development of concomitant states was analyzed. RESULTS: Both women and men were found to have overweight and first-second-degree obesity at equal ratios - 61.6 and 59%, respectively. There was an evident rise in the prevalence of cardiovascular diseases (arterial hypertension, coronary heart disease) and diabetes mellitus with a higher BMI. Stages II-III gonarthrosis was predominant (97.1%) in the obesity group (BMI 30.0-35.0 or greater). With a BMI of > 40, X-ray stages III-IV OA were revealed in 83.3% of the patients. CONCLUSION: Our findings support the important role of obesity as a risk factor in the development of OA. Fat metabolic disturbances also make a considerable contribution in the development of concomitant states and in the progression of OA of both knee and hand joints.

[Characteristics of manifestation of myocardial pathology at the cellular-molecular level under experimental conditions and in rheumatic heart diseases].

By applying the microelectrode technique the character of membranous potentials of pathologically changed cells of the myocardium in experiments and in rheumatic disease was studied. Experimental investigations were carried out on an original model of tonsillogenic myocardiodystrophy reproduced in rabbits through a prolonged mechanical stimulation of receptors in the peritonsillar region. The iono-molecular disturbances in the myocardial cells manifested themselves in reduced duration of the action potential, of its refractory period and in the decreased rate of the excitation conduction along the myocardium. The educed changes in the electrical activity of the myocardium cells depend upon the deranged work of slow sodium-calcium pumps associated with the sarcoplasmatic reticulum and testify to deviation, to a certain extent, from the normal of all the myocardium functions, viz. conduction excitability and contractility. The similar nature of electrophysiological changes in the myocardium cells in experiments and in rheumatic disease are a proof of the unity of pathogenetic mechanisms of cardiac lesions at the cellular-molecular level.

[Possibilities for using the analytical ultracentrifugation method for determining circulating immune complexes in rheumatic diseases]. / Vozmozhnosti ispol'zovaniia metoda analiticheskogo ul'tratsentri-fugirovaniia dlia opredeleniia tsirkuliruiushchikh immunnykh kompleksov pri revmaticheskikh bolezniakh.

Analytical ultracentrifugation was used to study circulating immune complexes in 78 patients suffering from different rheumatic diseases. Using this method immune complexes were mostly detectable in patients with rheumatoid arthritis. This correlated with the disease activity, roentgenological stage of articular involvement, development of the systemic manifestations associated with rheumatoid vasculitis. Demonstration of immune complexes by analytical ultracentrifugation was found to correlate on the whole with the presence in sera of high titers of rheumatoid factors and immune complexes according to the PEG method data.

[The characteristics of the course of rheumatoid arthritis combined with thyroid pathology]. / Osobennosti techeniia revmatoidnogo artrita, sochetaiushchegosia s patologiei shchitovidnoi zhelezy.

As many as 28 patients with associated rheumatoid arthritis (RA) and thyroid pathology were examined. Comparison with the control group of RA patients (n = 100) revealed a number of the clinical characteristics: the lack of severe destructive lesions of the joints, bone ankyloses, aseptic necroses of the head of the femur, a higher percentage of the development of secondary amyloidosis of the kidneys, attesting to the presence of a definite pathogenetic interrelation between these diseases.

[Hypothalamo-pituitary-thyroid system in patients with rheumatoid arthritis]. / Sosotoianie sistemy gipotalamus-gipofiz-shchitovidnaia zheleza u bol'nykh revmatoidnym artritom.

AIM: Study of the function of the hypothalamus-pituitary-thyroid system in rheumatoid arthritis (RA) MATERIALS AND METHODS: Three hundred and fifty patients with RA of different forms, stages, and intensity were examined. The blood and synovial fluid (SF) levels of thyroid-stimulating hormone (TSH), thyroxine (T4) and triiodothyronine (T3) were measured by immunoradiometric assay. RESULTS: Patients with RA were found to have higher T4 levels (in articular rheumatism, there was its negative correlation with the intensity of the process and in the presence of systemic manifestations of RA, there was a positive correlation). Blood T5 levels with higher RA intensity tended to increase in patients untreated with glucocorticosteroids. Blood TST concentrations showed an upward tendency which correlated with the intensity and stage of RA. Changes were also revealed in SF TST, T4, T3 levels. CONCLUSION: The changes in the secretion of TSH, T4, T3 in patients with RA are caused by this pathological process and those in their SF levels affect the course of articular inflammation.

[Functional state of the endocrine glands and the immune system in patients with juvenile rheumatoid arthritis]. / Funktsional'noe sostoianie zhelez vnutrennei sekretsii i immunnogo statusa bol'nykh iuvenil'nym revmatoidnym artritom.

A total of 35 patients aged from 5 to 12 years old suffering from the articular, visceral or polyarticular form of juvenile rheumatoid arthritis (JRA) were examined. The functional state of the endocrine glands were determined by means of appliances intended for radioimmunological study. To characterize the immune status of patients the conventional methods of investigation were used. The analysis of the material showed that all the patients with JRA had disorders in the system: hypophysis--adrenal cortex, the system: hypophysis-thyroid gland and pancreas suffer to the least degree. Disorders were mostly marked in patients with the articular- visceral form of JRA and those with a protracted course of the disease (two or more years). Relationship between hormonal and immune parameters was revealed.

[The function of the bronchial system in patients with rheumatoid arthritis]. / Sostoianie bronkhial'noi sistemy u bol'nykh revmatoidnym artritom.

The authors studied the functional indices of the bronchopulmonary system in 23 patients with rheumatoid arthritis. The vital capacity of the lungs (VCL), indices of bronchial patency: relation of the forced exhalation volume during the 1st second to VCL (FEV/VCL), the rate of the air flow of the forced exhalation when recording the curve the flow-volume (FEV)--peak (Vpeak), the rate in decreasing lung volumes, in 25, 50 and 75% of the whole volume of the forced exhalation (V25, V50, V75). VCL was not decreased in any of the cases, FEV1/VCL comprised 80.04 +/- 44%, Vpeak--110.30 +/- 3.30% of the norm. On the basis of these data a conclusion was made that the patency of the major bronchi was normal. V75 was decreased in 13 out of 23 patients; on the average it comprised 73.78 +/- 4.96% of the norm that significantly differs from the results obtained in healthy individuals (87.1 +/- 1.96 of the norm). An isolated decrease in terminal rates of FEV indicates the reduction of the patency of the minor respiratory ducts. A decrease in V75 was observed more often and was the more marked the longer the duration of the disease. There are no distinct connections between the pathological changes in the minor bronchi condition and the indices of the activity of the inflammatory process and humoral immunity: ESR the level of total protein, alpha 2-globulins, gamma-globulins, rheumatoid factor, circulating immune complexes.

[Anomalous sedimentation schlieren diagrams of the blood in patients with rheumatic diseases as an indicator of the presence of reversibly dissociating immune complexes]. / Anomal'nye sedimentatsionnye shliren-diagrammy syvorotki krovi bol'nykh revmaticheskimi bolezniami kak indikator prisutstviia obratimo dissotsiiruiushchikh immunnykh kompleksov.

Circulating immune complexes (CIC) are of considerable importance in the pathogenesis of rheumatoid diseases. The study of CIC has so far been restricted to their stable forms. This paper presents the data of ultracentrifugation showing that sera from rheumatoid patients often contain special population of reversibly dissociating CIC. It is noted that antibodies forming such kinds of CIC might either be present in significant excess, as compared to antigens, or possess low affinity.