Immunopathology of subcutaneous rheumatoid nodules.

Nodules obtained from five patients with classical seropositive rheumatoid arthritis were studied by an immunofluorescence technique using polyclonal antibodies to IgG, IgA, IgM, C3c, and fibrin, and monoclonal antibodies to the terminal (C5b-9) complement complex (reaction with a neoantigen in C9 revealed during activation), DR antigens, T cells, macrophages, and interdigitating cells. In all instances the central necrotic areas stained strongly for fibrin and more weakly for IgG, IgA, IgM, C3, and terminal complement complex. The surrounding palisading cells reacted with antibodies to DR and macrophages.

Inflammatory synovial T cells in different activity subgroups of patients with rheumatoid arthritis and juvenile rheumatoid arthritis.

Mononuclear cells were eluted from synovial membranes of 39 patients with rheumatoid arthritis and 12 patients with juvenile rheumatoid arthritis. A considerable cell loss, about 50% or more, was seen during the various isolation steps. The CD4/CD8 ratio just after enzyme treatment (stage I) was significantly higher than at later stages, i.

Interleukin 1 activity produced by human rheumatoid and normal dendritic cells.

Dendritic cells (DC) from the synovial inflammatory tissue and peripheral blood of patients with rheumatoid arthritis and from the peripheral blood of normal blood donors were compared with the autologous monocytes for their capacity to produce and release interleukin 1 (IL-1). Synovial DC often spontaneously released higher amounts of IL-1 activity than unstimulated and lipopolysaccharide-stimulated peripheral blood DC and monocytes. The IL-1 production by both DC and monocytes increased after stimulation with bacterial lipopolysaccharide.

Rheumatoid arthritis at the base of the thumb treated by trapezium resection or implant arthroplasty.

A clinical review is presented of patients with disabling rheumatoid arthritis at the base of the thumb treated by resection of the trapezium or by implant arthroplasty. Both methods resulted in good relief of pain, and the patients experienced better hand function. There were no great differences in results between the two methods.

Osteoarthritis of the carpometacarpal joint of the thumb. An analysis of operative procedures.

This paper presents a clinical review of patients operated by different procedures for disabling osteoarthritis of the carpometacarpal joint of the thumb. Fusion of the joint resulted in pain relief, and the patients achieved a stable thumb with excellent strength. Although a minor loss of thumb motion was noted, this was not considered a problem.

Shoulder replacement arthroplasty.

Since 1973 64 shoulders in 56 patients have had a prosthetic replacement at the Oslo Sanitetsforening Rheumatism Hospital, the semi-constrained prosthesis of Lettin/Stanmore was used in 13 cases, the non-constrained prosthesis of Engelbrecht/St. Georg in 10 cases and Neer's type II prosthesis in 41 cases. An evaluation of the results is given.

Shoulder synovectomy.

The technique and results of synovectomy of the shoulder joint in rheumatoid arthritis with a mean follow up time of 5.3 years (1-16 years) is described. The original method included resection of acromion after loosening of the deltoid muscle and splitting of the rotator cuff.

Naproxen suppositories in postoperative pain and swelling after joint surgery. A comparative, double-blind study.

Altogether 105 rheumatic patients, 35 in each of three groups, took part in a double-blind parallel study comparing naproxen (Naprosyn, Syntex) 500 mg suppositories with oxyphenbutazone (Tanderil, Geigy) 250 mg suppositories and placebo in postoperative pain and swelling after joint surgery. Medication was administered twice daily for 3 1/2 days, starting the night before operation. Ketogan (Ketobemidonhydrochloride, 3 dimethylamino-1-diphenylbuten-(1)-hydrochloride) injections and Paralgin Forte (Paracetamol, codein phosphate) tablets were allowed as escape medication.

Non-union of the carpal navicular.

An analysis of methods of treatment with special regard to compression screw osteosynthesis. During the years 1965 to 1980 a total of 96 patients was treated with different types of procedure for non-union of the carpal navicular. The location and type of the fractures confirms previous reports that the chances of healing of proximal and oblique fractures of the navicular are poor.

Rupture of the ulnar ligament of the metacarpophalangeal joint of the thumb.

We have operated on 51 old injuries with abduction instability of the metacarpophalangeal joint of the thumb. The time from injury to operation was 8 weeks to 5 years. Ligament repair was made in 29 cases.