[Indications and results of surgical therapy of rheumatic diseases].

The indication to synovialectomy is present in chronic inflammatory articular processes, which cannot be sufficiently controlled by an optimal medicamentous treatment of a duration of 6 months. It is urgent, when the synovialitis is connected with the danger of a damage of tendons and nerves. An essential restriction by the age of the patients or the activity of the process does not exist.

[Unusual joint complications in sickle cell anemia].

It is reported on the casuistics of a 23-year-old Lebanese who since his eighth year suffered from joint swellings and occasional attacks of jaundice. By the proof of false forms of erythrocytes and by the haemoglobin electrophoresis a homozygous sickle cell disease could be ascertained. Peculiarities of the clinical picture were among others changes of the bones of high degree (osteolyses of vertebral bodies, of the head of the right humerus and the heads of the two femurs) was well as of the knee-joints in form of ankyloses.

[Diagnostic strategy in rheumatology].

Nowadays, rheumatology is primarily understood as arthrology. In special diagnostics at first an articular process is to be ascertained or excluded, the arthralgia is to be separated from the objectifyable arthritic syndrome and this must be more enclosed by simple findings of the anamnesis and the physical examination. The tentative diagnosis which is present after this already in the vast majority of cases must be confirmed by aimed laboratory and X-ray diagnostics.

[Progression of rheumatoid arthritis].

In order to recognize courses with high and low progression in rheumatoid arthritis deviating from former approach the values of a locomotor function test were used which do not belong to the dispersion region for the adequate classes of duration of a disease. With the help of a material of an electronic data processing study of 1,000 cases with ascertained diagnosis correlations between high progression and, among others, following criteria could be ascertained: male sex, old age, early beginning of the disease, manual trades, unfavourable functional values and very much changed laboratory values including high titres of the rheumatoid factor. In this method there was no relation to the duration of the disease, as it was existing with other methods of the determination of progression which were comparatively included into the investigation.

[The clinical and prognostic importance of IgM rheumatoid factors].

On a total of 1000 subjects diagnosed as having rheumatoid arthritis it was possible to positively correlate the proportion of seropositivity of IgM rheumatoid factors and/or higher titer values to the following clinical characteristics: Male sex; existence, severity, and symmetry of articular alterations determined by morphological x-ray examinations; unfavorable functional values; high inflammatory activity; involvement of various organs; and high rate of progress. So far as this particular clinical picture is concerned, the detection of rheumatoid factors must, therefore, be considered unfavorable to a prediction or conclusion regarding the course of disease, whereas seronegative forms may be regarded as relatively benign.

[Results and experiences in the immunosuppressive therapy of rheumatoid arthritis].

An analysis of the results of treatment-in five different hospitals and with such immunosuppressants as cyclophosphamide, azathioprine, and trenimone - of 550 patients with rheumatoid arthritis showed an overall rate of improvement of 36%. Cyclophosphamide, because of the relatively small number of side effects and the excellent therapeutical results obtained, proved to be much better than the other two immunosuppressive agents. Also, because the dosage required is comparatively low, patients over procreative age could be included in the program of treatment with immunosuppressants.

Comparative morphological studies on adjuvant arthritis induced in the extremities of rats, mice, and golden hamsters by intracutaneous injection of Freund's complete adjuvant.

Forty rats, 60 mice, and 60 golden hamsters were administered complete Freund's adjuvant by intracutaneous injections in an attempt to produce the clinical picture of arthritis. 90% of the rats, 25% of the mice, and 40% of the golden hamsters developed swollen extremities similar to those observed in rats affected by adjuvant arthritis. 12 animals of each of the 3 species included in this investigation, which showed macroscopically visible swellings of their extremities, were used for comparative histological studies in order to find out whether the swellings of the extremities of mice and golden hamsters are real inflammations of joints and identical with rat adjuvant arthritis.