Craniofacial dysostosis, hypertrichosis, genital hypoplasia, ocular, dental, and digital defects: confirmation of the Gorlin-Chaudhry-Moss syndrome.

We report clinical, orofacial and radiological manifestations in a 4-year-old girl and a 33-year-old female with the Gorlin-Chaudhry-Moss (GCM) syndrome. Typical findings in the GCM syndrome are short stature, stocky body build, midface hypoplasia, small eyes, downslanting palpebral fissures, conductive hearing loss, highly arched and narrow palate, malocclusion, abnormally shaped teeth, oligodontia, microdontia, low scalp hairline, hypertrichosis of scalp, face, trunk and limbs and genital hypoplasia. Radiological features include premature synostosis of the coronal suture, brachycephaly, and maxillary under-development.

[The effect of feeding mangel-wurzels on blood beta-hydroxybutyrate level of milk-producing cows].

The effect of feeding dairy cattle mangel-wurzels on the serum increased concentration of beta-hydroxybutyrate was investigated in serum is normally indicative of an increased catabolism of fats in the liver as a result of an energy shortage. Feeding cattle large amounts of mangel-wurzels can cause the serum beta-hydroxybutyrate concentration to increase above normal reference values, thus seemingly indicating that there is a (sub)clinical acetonaemia. In fact the increased concentration of beta-hydroxybutyrate is probably the result of an increased production of butyrate in the rumen.

Antigen-activated T cells inhibit cartilage proteoglycan synthesis independently of T-cell proliferation.

Previously we have shown that blood mononuclear cells (MNC) obtained from patients with rheumatoid arthritis (RA) have the capacity to induce depletion of proteoglycans (PG) in human cartilage explants. This was observed especially after stimulating MNC with mycobacterial antigens, rather than with the mitogen Concanavalin A (Con A). We have now co-cultured cartilage explants in the presence of T-cell clone A2b obtained from the rat model of adjuvant arthritis (AA).

Influence of steroid hormones on proliferation of peripheral blood mononuclear cells in patients with rheumatoid arthritis.

Sex steroids are believed to modulate the immune system in rheumatoid arthritis (RA). Since receptors for sex steroids are present on T-lymphocytes, which are thought to play a major role in the pathogenesis of RA, it is suggested that gonadal steroids can mediate their immunomodulating effect directly on T-lymphocytes. Recently a specific method for activating T-lymphocytes with immobilized anti-CD3 monoclonal antibodies was described.

Estrogens and rheumatoid arthritis.

Epidemiological and immunological evidence has suggested that female sex hormones may play a role in the etiology and course of autoimmune diseases such as rheumatoid arthritis (RA). In this review the present clinical data with regard to estrogens and RA are discussed, with emphasis on the possible preventive effect of oral contraceptives on the incidence of RA and on the possibility of using estrogens as adjuvant therapy in RA. It is concluded that oral contraceptives may mitigate or postpone the onset of RA slightly, but that estrogens are not able to alleviate the symptoms of RA.

Encephalocraniocutaneous lipomatosis and oculocerebrocutaneous syndrome. A differential diagnostic problem?

The authors describe a female patient with unilateral malformations of skin, cerebrum and eye. The symptoms consisted of local skin hypoplasia, skin appendages and lipomatous tissue; cysts, hypoplasia and lipomatosis of the brain; and ocular malformations. In the newborn period the symptoms led to the diagnosis of oculocerebrocutaneous (OCC) syndrome.

Effects of different regimes of corticosteroid treatment on calcium and bone metabolism in rheumatoid arthritis.

A clinical study of 30 patients with rheumatoid arthritis was undertaken in order to assess the acute effects of corticosteroids on calcium and bone metabolism. The patients were randomly divided into 3 groups. The first group was not treated with corticosteroids, the second group was treated with 3 oral pulses of 100 mg prednisolone and the third group received 3 intravenous pulses of 1000 mg methylprednisolone (MP) on alternate days during one week.

Demonstration of calf abnormalities by magnetic resonance imaging in polyarteritis nodosa.

A 36-year-old Caucasian woman presenting with persisting painful calves after a flu-like illness was diagnosed as having polyarteritis nodosa. Magnetic resonance imaging of the lower legs showed abnormal signal intensity of the outer muscle groups with sparing of the central located muscles. The good clinical response to oral prednisone was supported by improvement of MRI.

Intermittent hydrostatic compressive force stimulates exclusively the proteoglycan synthesis of osteoarthritic human cartilage.

In paired observations the in vitro proteoglycan turnover was studied of human normal and osteoarthritic cartilage in the absence and presence of intermittent hydrostatic compressive force. Shortly after collection, osteoarthritic cartilage showed a higher proteoglycan synthesis rate than normal cartilage, whereas after culture the reverse was found. Exposure during culture to hydrostatic intermittent compression of a low physiological magnitude enhanced the proteoglycan synthesis rate for osteoarthritic cartilage, whereas normal was unaffected by this hydrostatic intermittent compression.

Local changes in proteoglycan synthesis during culture are different for normal and osteoarthritic cartilage.

Proteoglycan synthesis of mild-to-moderate osteoarthritic human knee cartilage was compared with that of normal cartilage of the same donor. Immediately after cartilage was obtained, the synthesis rate of proteoglycans was higher for osteoarthritic cartilage than for normal cartilage. Proteoglycan synthesis was then located, for both normal and osteoarthritic cartilage, in the middle and deep zone.

The impact of endpoint measures in rheumatoid arthritis clinical trials.

In clinical trials on the effectiveness of disease-modifying antirheumatic drugs (DMARDs) in patients with rheumatoid arthritis (RA), it is common to apply a large number of endpoint measures. This practice has several disadvantages. To determine which endpoint measures are most valuable, reports of 32 clinical trials on six DMARDs were reviewed.

Neuro-musculo-skeletal manifestations in primary Sjögren's syndrome.

Primary Sjögren's syndrome is a systemic autoimmune disorder whose main characteristics are dryness of the eyes and mouth, caused by lymphocytic infiltration of the exocrine glands. Patients may also show signs of extraglandular involvement of lung, liver, kidney and vessel walls, as well as of the central and peripheral nervous systems, muscles and joints. This article presents a review of the literature on extraglandular involvement of the peripheral and central nervous systems, muscles and joints.

Pain and disability in osteoarthritis: a review of biobehavioral mechanisms.

Pain and disability are cardinal symptoms in osteoarthritis. The literature is reviewed in order to identify causes of these symptoms at the articular, kinesiological, and psychological level. It is concluded that pain and disability are associated with degeneration of cartilage and bone (articular level), with muscle weakness and limitations in joint motion (kinesiological level), and with anxiety, coping style, attentional focus on symptoms, and possibly depression (psychological level).

Human osteoarthritic cartilage is synthetically more active but in culture less vital than normal cartilage.

The proteoglycan turnover of human osteoarthritic (OA) cartilage was compared to that of normal (N) cartilage. The cartilage was obtained postmortem from human femoral knee condyles. Short term cultures were compared to longterm cultures, and proteoglycan synthesis rate, content and release determined.

MCA/MR syndrome in two female siblings: new entity or variant examples of Coffin-Lowry versus Atkin-Flaitz syndromes?

We report two sisters with mental retardation, coarse facial features, telecanthus, flat malar region, prominent lower lip, kyphoscoliosis, and tapering fingers. Although these patients' phenotypes showed considerable overlap with the Coffin-Lowry and the Atkin-Flaitz syndromes, their overall picture makes these diagnoses controversial.

Eosinophilic fasciitis presenting with a reactive hepatitis.

We report a patient with eosinophilic fasciitis, reactive hepatitis and splenomegaly. Administration of prednisone resulted in normalization of liver enzymes and spleen-size and an improvement of his clinical condition. These uncommon manifestations are only part of the broadening clinical spectrum, which is discussed briefly.

Nocardia asteroides pneumonia complicating low dose methotrexate treatment of refractory rheumatoid arthritis.

Low dose methotrexate is used increasingly often in the treatment of rheumatoid arthritis. Severe complications due to toxicity of the lung or bone marrow occur infrequently. This report describes a 71 year old woman with longstanding rheumatoid arthritis who developed pleuritis, a pulmonary infiltrate, and pancytopenia during treatment with low dose methotrexate.

Insulin increases sodium reabsorption in diluting segment in humans: evidence for indirect mediation through hypokalemia.

To examine the mechanism of renal sodium (Na) and potassium (K) retention during insulin infusion, seven healthy volunteers underwent clearance studies without (time control) and with insulin infusion (40 mU bolus, followed by 1 mU/kg/min for 150 min). Maximal free water clearance and fractional lithium clearance (FELi) were used to analyze renal sodium handling. Insulin decreased Na excretion (from 189 +/- 25 to 121 +/- 19 mumol/min, P less than 0.

Role of TNF alpha, in relation to IL-1 and IL-6 in the proteoglycan turnover of human articular cartilage.

In both young and old human articular cartilage explants, TNF alpha induced a concentration-dependent, reversible suppression of the proteoglycan (PG) synthesis. Young cartilage was more sensitive to TNF alpha than old cartilage: 50% suppression of PG synthesis was reached at a TNF alpha concentration of 5 U/ml for young and 30 U/ml for old cartilage, whereas at 10(3) U/ml the PG synthesis of young cartilage was blocked and that of old cartilage suppressed by 80%. These inhibition levels of PG synthesis resulted in 25% PG depletion of the explants after 8 days of culture.

Recognition of human 60 kD heat shock protein by mononuclear cells from patients with juvenile chronic arthritis.

A postulated mechanism for autoimmune disorders is that the immunoreactivity develops against bacterial antigens which show a high degree of sequence homology with mammalian proteins. The mycobacterial 65 kD heat shock protein (hsp) has been implicated in several forms of arthritis. Substantial amounts of the human 60 kD homologue (hsp60) were produced by insertion of the gene into Escherichia coli.