Medical science in the light of the Holocaust: Departing from a post-war paper by Ludwik Fleck.

In scholarly debates, Ludwik Fleck's post-war paper 'Problemy naukoznawstwa [Problems of the Science of Science]', published in 1946, has been taken unanimously to illustrate the epistemology expounded in his monograph Genesis and Development of a Scientific Fact. The paper has also been seen to support parts of the received view of Fleck, notably that he manufactured an anti-typhus vaccine while imprisoned in Buchenwald. However, a different narrative emerges when comparing Fleck's paper with other accounts, also published in 1946 and written by other prisoners alluded to by Fleck in his paper.

Medical ethics in the wake of the Holocaust: departing from a postwar paper by Ludwik Fleck.

In 1948 Ludwik Fleck published a paper in Polish discussing the use of humans in medical experiments, thereby addressing his peers. Though the paper has so far not been translated or studied, it has been taken to indicate Fleck's deep commitment to ethical questions, notably the question of informed consent. In being written by a former victim of the Nazi policy and a survivor of the Holocaust also acting as an expert witness in the trial of the IG Farben in Nuremberg, the paper is of interest.

The reading of scientific texts: questions on interpretation and evaluation, with special reference to the scientific writings of Ludwik Fleck.

Ludwik Fleck is remembered for his monograph published in German in 1935. Reissued in 1979 as Genesis and development of a scientific fact Fleck's monograph has been claimed to expound relativistic views of science. Fleck has also been portrayed as a prominent scientist.

Ro/SS-A and La/SS-B antibody level variation in patients with Sjögren's syndrome and systemic lupus erythematosus.

To examine both possible correlations between anti-Ro/SS-A and anti-La/SS-B levels and their correlation with clinical disease activity in patients with Sjögren's syndrome (SS) or systemic lupus erythematosus (SLE), an ELISA was developed using purified recombinant Ro 60 kDa, Ro 52 kDa and La antigens. The ELISA was used for testing sequential serum samples from 16 patients with either SS or SLE. The patients were followed for periods between 15 and 128 months, and 3-15 serum samples per patient were analysed and compared with clinically apparent disease activity at the time of sampling in 14 patients.

Behçet's disease: a review and a report of 12 cases from Sweden.

In a retrospective study of 12 patients with Behçet's disease, more than half were found to originate from the Near East, where the prevalence of the disease is known to be high. The immigrant patients were all males, whereas 3 of the 5 patients with Swedish ancestry were females. Certain differences emerged between the two groups, including different sex ratio and absence of HLA B5 association and pathergy skin reaction among the Swedish patients.

IgG and IgM anti-snRNP reactivity in sequentially obtained serum samples from patients with connective tissue diseases.

Sequentially obtained serum samples from 30 patients with connective tissue disease positive for antibody to ribonucleoprotein (RNP) were examined to determine the specificities of IgG and IgM antibodies to snRNP during the disease course using immunoblotting of nuclear extracts. The antibody patterns were correlated with disease activity. The patterns of antibody to snRNP of individual patients were mainly stable during the study but changes in levels of antibody to snRNP were seen corresponding to changes in clinical activity.

Clinical manifestations and anti-(U1)snRNP antibodies: a prospective study of 29 anti-RNP antibody positive patients.

Twenty-nine anti-RNP positive patients were followed prospectively with a mean observation time of 65 months (29-120 months). The clinical course was correlated to the presence of IgM and IgG anti-(U1)snRNP antibodies as revealed by immunoblotting from sequentially obtained sera. There was a striking dissociation between the fluctuating course, with the appearance of new manifestations followed by remissions, and the stability of the anti-snRNP antibody specificities where an appearance or a disappearance of anti-snRNP specificities was a rare phenomenon.

A clinical, serological, and histopathological study of myositis patients with and without anti-RNP antibodies.

Twenty-nine patients with myositis, including 10 with polymyositis (PM), 6 with dermatomyositis (DM), and 13 with myositis associated with a connective tissue disease (CTD), were followed up for a mean observation time of 49 months. The 13 patients with CTD-associated myositis were further separated by the presence or absence of anti-RNP antibodies. The functional disability at diagnosis was pronounced without differences between the groups.

Clinical course of patients with anti-RNP antibodies. A prospective study of 32 patients.

Thirty-two patients with high and low anti-RNP antibody titers were followed prospectively during a mean observation of 65 months. The following 4 titer patterns were observed: persistently high, low increasing to high, high decreasing to low and persistently low titers. At first admission, 17 of the 23 patients with high anti-RNP titers did not fulfill the criteria of defined connective tissue diseases (CTD).

Pregnancy outcome in patients with high titer anti-RNP antibodies. A retrospective study of 40 pregnancies.

In a retrospective study the outcome of 40 pregnancies in 20 women with a high titer of anti-RNP antibodies was evaluated. In the 18 pregnancies that occurred after disease onset, transient proteinuria was noted in 3 and transient thrombocytopenia in 2. Deep venous thrombosis was observed in one patient.

Restricted dose and duration of corticosteroid treatment in patients with polymyalgia rheumatica and temporal arteritis.

To analyze whether corticosteroids in low doses during limited time periods could be safely used in the treatment of patients with polymyalgia rheumatica (PMR) or temporal arteritis (TA) the records of 91 patients diagnosed between 1980 and 1987 were reviewed. The mean initial prednisolone dose was in patients with PMR 18 mg/day and the mean duration of treatment was 17 months. In patients with TA the mean initial dose was 31 mg/day and the mean duration of treatment 16 months, and in all the corticosteroid treatment was terminated within 24 months.

Recombinant 70-kD protein used for determination of autoantigenic epitopes recognized by anti-RNP sera.

A panel of high- and low-titre anti-RNP-positive patient sera was tested for reactivity with human snRNP proteins. The U1 snRNP-specific 70-kD peptide was found to be the most prominent RNP antigen recognized by high-titre anti-RNP sera, mainly found in patients with mixed connective tissue disease (MCTD). The reactivity with the 70-kD protein was further analysed with recombinant fusion proteins containing different segments of the protein.

Variation of MHC class I and II antigen expression in relation to lymphocytic infiltrates and interferon-gamma positive cells.

The occurrence of MHC antigens on epithelial cells in lip salivary glands obtained from patients with various connective tissue diseases and from bone marrow recipients was studied. The amount of infiltrating lymphocytes correlated to an increase in MHC class I and II antigen expression, but not to diagnosis or glandular function. Interferon-gamma + infiltrating cells were scanty.

Lymphocytic infiltrations of lip salivary glands in bone marrow recipients. A model for the development of the histopathological changes in Sjögren's syndrome?

By use of a PAP staining technique, the immunohistopathology in repeated biopsies from the lip salivary glands (LSGs) from patients undergoing bone marrow transplantation (BMT) was studied. In the previously normal LSGs, focally arranged lymphocytes and adjacent epithelial DR-expression appeared within 12 weeks post BMT, reaching a maximum between 26 and 52 weeks post BMT. Two years post BMT, lymphocytic infiltrates and epithelial DR-expression were still present in half of the specimens but were not seen in the remaining ones.

Lymphocytic infiltrates and epithelial HLA-DR expression in lip salivary glands in connective tissue disease patients lacking sicca: a prospective study.

Focal lymphocytic infiltrations indistinguishable from what has been described in Sjögren's syndrome (SS) were found in lip salivary gland (LSG) biopsies in 15 of 80 patients with various connective tissue diseases (CTDs) lacking sicca. During a 4-year follow-up period, none of the patients developed symptoms or signs of decreased lacrimal or salivary gland function. Focal lymphocytic infiltrates of LSGs seemingly unrelated to glandular function are to be found in patients' various CTDs and therefore the diagnostic value of a positive LSG biopsy in this context has to be questioned.

Studies on the specificity of the immunohistopathological changes of the salivary glands in Sjögren's syndrome.

Recently focal lip salivary gland lymphocytic infiltrates, identical to those found in Sjögren's syndrome, has been described in myasthenia gravis, bone marrow transplant recipients and various connective tissue diseases, in the latter conditions without relation to the salivary gland function. In the bone marrow transplant recipients, the lymphocytic infiltrates were shown to be potentially reversible. The findings are summarized, the relation between histopathological alterations and organ functions and the diagnostic specificity of focal lymphocytic infiltrates in lip salivary glands are discussed.

Lymphocytic infiltration and HLA-DR expression of salivary glands in bone marrow transplant recipients: a prospective study.

Lymphocytic infiltration and epithelial HLA-DR expression of lip salivary glands were studied by means of an immunohistoenzymatic staining technique in patients undergoing repeated lip salivary gland biopsies before, and 12, 26, 52 and 104 weeks after bone marrow transplantation (BMT). Within 12 weeks of transplantation, lymphocytes, mainly of the anti-Leu3a+ T 'helper' phenotype, were seen infiltrating the salivary glands of all the patients, reaching a maximum between 26 and 52 weeks. Epithelial HLA-DR expression, present at the 12th week after BMT, was seen close to the lymphocytic infiltrates in all the specimens.