Work disability in rheumatoid arthritis: effects of disease, social, and work factors.

We explore here the relative contribution of selected disease, social, and work-related factors to disability status in a population of persons with rheumatoid arthritis. Our study differs from previous studies in that it is limited to one diagnostic entity, yet at the same time evaluates a broad range of social and work-related factors in disability. One hundred-eighty persons with rheumatoid arthritis sampled from 19 socially diverse practice settings were given a structured survey about their medical and work histories and social backgrounds.

Chemical characterization, synthesis and distribution of proteinase inhibitor in newborn rat epidermis.

A protein solubilized in Tris-HCl/saline buffer from keratinized cells of newborn rat epidermis exhibited inhibitor activity to papain and ficin, but not to trypsin, cathepsin D and pepsin. This protein was purified from keratinized cells as well as nonkeratinized and germinative cells by means of IgG affinity chromatography. The inhibitors extracted from all cell layers were immunologically identical and had a molecular weight of approximately 12,500 +/- 500.

A controlled experiment to evaluate the use of a time-oriented summary medical record.

A randomized single-blind experiment was done in a medical subspecialty clinic in order to determine whether a flow-sheet type of summary medical record could validly serve as a means to communicate clinical information in the absence of the traditional medical record. Two groups of outpatient physician-patient encounters were compared: In the 68 study encounters (Group S), physicians were given a flow-sheet summary record with the option to receive the standard medical record if they desired; in the 27 control encounters (Group C), physicians were given the standard medical record plus the flow-sheet summary record. Fifty-nine per cent of study-group physicians did not choose to receive the full medical record.

Comparative studies of keratins isolated from psoriasis and atopic dermatitis.

Keratin proteins were extracted from scales of normal skin, clinically active psoriatic lesions, and atopic dermatitis. Filaments prepared by in vitro assembly upon dialysis of the proteins against a low ionic strength buffer were comparatively characterized by electron microscopy, SDS gel electrophoresis, and amino acid analysis. Filaments formed using keratin obtained from the skin of normal individuals were thin and wavy, whereas those formed using keratin isolated from the scales of psoriatic patients were straight and showed a tendency to assemble side by side.

Light-scattering studies of cation-stimulated filament assembly of newborn rat epidermal keratin.

Effects of CaCl2 on in vitro polymerization of keratin extracted from cornified cells of newborn rat were investigated by means of light-scattering and supramolecular structures. Elongation and parallel assembly of filaments occurred with addition of CaCl2 to dialyzed keratin solutions and was detected by an increase in light-scattering intensity. Nonfibrous aggregates which occurred in higher buffer concentrations and in lower pH were also recorded as intensity increased.

A potent contact allergen of Phacelia (Hydrophyllaceae).

The major contact allergen of Phacelia crenulata (Hydrophyllaceae) has been identified as geranylhydroquinone. A maximization test of geranylhydroquinone showed this to be a potent sensitizer comparable in degree to poison oak/ivy urushiol. Comparative patch testing on humans with urushiol established that the phacelia allergen does not cross-react with poison oak or ivy.

Eosinophil response in guinea pig skin to a low molecular weight eosinophil chemotactic factor extracted from livers of mice with schistosomiasis.

A low-molecular weight eosinophil chemotactic factor (ECF-G), isolated and partially purified from livers of mice with schistosomiasis, was injected intradermally into guinea pigs. Biopsies obtained were studied for inflammatory cell accumulation in the injected sites and compared with those in the control sites injected with phosphate buffered saline. Tissue eosinophilia was seen as early as 1 hr after injection of ECF-G, but not in the control site.

Detection of a fibrous component in keratohyalin granules of newborn rat epidermis.

Keratohyalin granules of frozen newborn rat epidermis were stained histologically and immunohistochemically and studied by light and electron microscopy. They showed a variety of reactivity to eosin, hematoxylin, uranyl acetate and rabbit monospecific antikeratin IgG. We found that good preservation of ultrastructure can be obtained from quickly frozen skin, and filamentous components remain after extraction of tissue substances by 0.

Perception of relative velocity: a revision of the hypothesis of relational determination.

The conventional formulation of the hypothesis of relational determination asserts that the perceived relative velocities of two or more objects depend upon their relative rates of displacement with respect to stationary referents in the visual field. Experiment 1 showed that this formulation is too restrictive by demonstrating the transposition-of-velocity effect under conditions in which two light spots moved in the absence of static visible contours and traversed unequal path lengths. Experiment 2 showed that angular velocity per unit of relative angular extent, and not relative linear or perceived extent, of the respective motion paths influences perceived relative velocity in nonarticulated space.

Problems associated with the management of pregnancies in patients with systemic lupus erythematosus.

Eighty-three percent of 24 pregnancies in patients with systemic lupus erythematosus studied retrospectively terminated in normal children. Fifty-four percent of patients had clinical and serological disease exacerbations during pregnancy or in the post-partum period, as contrasted with 4% in the 6 months prior to pregnancy. The presence of significant renal disease and SLE activity in the 6 months prior to pregnancy correlated with exacerbations.

Sesquiterpene lactone dermatitis. Cross-sensitivity in costus-sensitized patients.

Thirteen costus-sensitive patients were patch tested with 38 sesquiterpene lactones of five different classes over a two-year period. Cross-reacting agents fell into two chemical categories: (1) those that resembled the primary sensitizer, and (2) those belonging to different skeletal classes. An exocyclic methylene group conjugated to a gamma-lactone was present in both chemicals that cross-reacted and those that did not.

Toward an epidemiology of work disability.

The indirect cost of illness due to lost wages exceeds the cost of medical services by a large margin. Social characteristics of persons with physical impairment are more important than the characteristics of their medical condition in predicting whether disability will lead to work loss. Public policy toward disability currently emphasizes the "human capital" with which persons with impairments confront the labor market; this study suggests a new emphasis on social characteristics of the workplace.

Effects of trace elements in polymerization of keratin proteins and destruction of the filaments by processing techniques for electron microscopy.

Keratin extracted from keratinized cells of newborn rats polymerizes into filaments in vitro and this polymerization has been shown to be greatly stimulated by addition of divalent cations. In this study we investigated the optimum conditions for filament formation by use of CaCl2, ZnCl2, and GdCl3, a trivalent lanthanide. It was found that a concentration about 10 times higher was required for elongation and formation of wider filaments with CaCl2 when compared with that for ZnCl2, GdCl3 caused enhanced polymerization with an even lower concentration.

Fibrin deposition and clearance in chronic granulomatous inflammation: correlation with T-cell function and proteinase inhibitor activity in tissue.

Patterns of fibrin deposition were investigated by immunofluorescence microscopy in livers of thymus intact (TI) and athymic (AT) mice infected with Schistosoma mansoni. Thrombin and fibrinolysis inhibitor activity in tissue extracts also were measured. In TI mice fibrin was detected perivascularly by 6 weeks after infection and at 8 weeks it was found over the granulomas as they developed.

In vitro studies of poison oak immunity. II. Effect of urushiol analogues on the human in vitro response.

Studies were performed to ascertain the effect of urushiol analogues on the in vitro lymphocyte blastogenesis elicited by urushiol in peripheral blood lymphocytes taken from individuals sensitized to poison oak or ivy. Urushiol is a mixture of alkylcatechols composed of a catechol ring coupled to mono-, di-, or tri-unsaturated C-15 or C-17 carbon side chains. Each of these two moieties, catechol ring and side chain, was tested for its role in eliciting reactivity.

In vitro studies of poison oak immunity. I. In vitro reaction of human lymphocytes to urushiol.

Poison oak, ivy, and sumac dermatitis is a T-cell-mediated reaction against urushiol, the oil found in the leaf of the plants. This hapten is extremely lipophilic and concentrates in cell membranes. A blastogenesis assay employing peripheral blood lymphocytes obtained from humans sensitized to urushiol is described.

Thallous ion is accumulated by potassium transport systems in Escherichia coli.

The accumulation of 204T1+ by Escherichia coli occurs primarily via either of two K+ transport systems called Kdp and TrkA. T1+ influx is inhibited and T1+ efflux is stimulated by the addition of K+ to the assay medium. Mutants defective in both the Kdp and TrkA systems accumulate little T1+.

Immunochemical comparison of histidine-rich protein in keratohyalin granules and cornified cells.

(1) Combination of techniques for extraction and purification of histidine rich protein established by several investigators were employed for comparison of histidine-rich protein in granular cells and cornified cells of newborn rats. (2) Histidine-rich protein extracted from the same cell fraction by two different techniques either in 1 M potassium phosphate buffer (Ugel) or in 4 M urea (Dale) showed identical elution profiles on CM 52 cellulose ion exchange chromatography and the same SDS polyacrylamide gel electrophoretic patterns. (3) Histidine-rich protein from granular cells contained polypeptides of larger molecular sizes than those in histidine-rich protein from cornfield cells, although amino acid composition of the two histidine-rich protein was non-distinguishable (histidine residue was more than 7%).

The thorax as the initial site for systemic relapse in malignant melanoma: a prospective survey of 324 patients.

Thirteen of 324 patients with malignant melanoma followed during a 24 month period experienced dissemination. The thorax was the initial site for relapse in 12, all of whom were asymptomatic. Ten gave no evidence of extrathoracic disease.