The use of lidocaine to reduce the pain of myochrysine injections for children with juvenile rheumatoid arthritis.

Myochrysine (gold sodium thiomalate, GSTM) injections are the therapy of choice for children with refractory juvenile rheumatoid arthritis. In this single blinded study 8 children receiving GSTM were asked to rate their discomfort after a total of 185 injections of GSTM to which were added in random fashion either 0, 0.1, or 0.

Coronary arteritis in mice following the systemic injection of group B Lactobacillus casei cell walls in aqueous suspension.

We describe the induction of an asymmetric, focal, inflammatory coronary arteritis by a single intraperitoneal injection of group B Lactobacillus casei cell wall fragments in various inbred mouse strains. This coronary arteritis resembles the arteritis which is responsible for the 1-2% fatality rate among children with mucocutaneous lymph node syndrome. Coronary arteritis developed in 18 of 26 C57BL/6, 14 of 26 A/J, 7 of 15 Balb/c, and 8 of 15 C3Heb/FeJ mice injected.

Confusion of a poststreptococcal syndrome complicated by uveitis with mucocutaneous lymph node syndrome.

This article describes the case of a 13-year-old black male who fulfilled the diagnostic criteria for mucocutaneous lymph node syndrome (MLNS), but developed severe posterior uveitis. Because severe posterior uveitis is not reported in MLNS, the patient's diagnostic evaluation was repeated and a markedly elevated antistreptolysin O titer detected. Since severe posterior uveitis is known to complicate streptococcal infection, we concluded this was the more likely etiology of the child's illness.

Bacterial cell wall composition, lysozyme resistance, and the induction of chronic arthritis in rats.

Bacterial cell wall induced arthritis is an experimental model of chronic erosive synovitis in which arthritis is induced in rats by a single injection of an aqueous suspension of cell wall fragments from selected Gram-positive bacteria. To understand better the Gram-positive bacterial cell wall characteristics necessary for the induction of chronic arthritis we tested the arthritogenicity of five Gram-positive bacteria which were (1) lysozyme resistant and contained a polyrhamnose peptidoglycan side chain moiety, (2) lysozyme resistant, but had little or no rhamnose in the peptidoglycan, polysaccharide, or (3) neither lysozyme resistant, nor contained rhamnose in their peptidoglycan, polysaccharide. All of the lysozyme resistant cell walls tested induced acute arthritis, but only those cell walls which were both lysozyme resistant and contained rhamnose in their polysaccharide side chain were able to induce chronic arthritis.

Antibodies to nonhistone nuclear antigens and antilymphocyte antibodies among children and adults with systemic lupus erythematosus and their relatives.

Antibodies to nonhistone nuclear antigens are found with increased frequency in the serum of patients with systemic lupus erythematosus (SLE) and their first degree relatives. We measured the prevalence of ANA and antibodies against DNA, RNP, Sm, SSA, and SSB as well as antilymphocyte antibodies (ALA) in the serum of 24 patients with childhood onset SLE and 94 of their first degree relatives and compared the prevalence of these same antibodies in 8 patients with adult onset SLE and 33 of their first degree relatives. Antibodies against DNA, RNP, and Sm occurred more frequently in the serum of adult onset SLE patients.

Peanut lectin binding sites in transitional cell carcinoma of the urinary bladder.

Peanut lectin (PNA) binds to D Gal B (1-3) D Gal NAc which is the purported antigenic determinant of the so-called T blood group antigen (TAg). We used PNA in an indirect immunofluorescent technique to study TAg in transitional cell carcinomas of the bladder (TCC). All 14 control tissues failed to express TAg, whereas all controls (100%) expressed TAg on the cell membrane after prior treatment with neuraminidase.

Polyarthritis in rats following the systemic injection of Lactobacillus casei cell walls in aqueous suspension.

Postdysenteric Reiter's syndrome and the arthritis associated with jejunal bypass surgery for obesity suggest that the gastrointestinal tract is a possible source of bacterial products capable of initiating chronic inflammatory arthritis. Lactobacillus casei, a common component of the enteric flora, has a cell wall structure similar to that of arthritogenic streptococci. In this study we have demonstrated that a single intraperitoneal injection of an aqueous suspension of the cell walls of Lactobacillus casei induces a dose-dependent, chronic, symmetric, erosive, peripheral polyarthritis in inbred LEW/N female rats.

Bacterial endocarditis complicating systemic lupus erythematosus.

Culture proven bacterial endocarditis occurred in 6 of 571 patients with systemic lupus erythematosus (SLE) admitted to the National Institutes of Health (NIH). Although 4 of the patients had a murmur noted on examination prior to developing endocarditis, only one of the 6 had a recognized valvular abnormality. Bacterial endocarditis followed dental procedures in 2 of the 6 patients; no precipitating events were recorded in the remaining 4.

Etiology of diabetic impotence.

We evaluated 31 male diabetics for sexual dysfunction. Patients were examined by an endocrinologist, psychologist or psychiatrist, urologist and neurophysiologist. Evaluation was done by penile blood pressure, pudendal nerve latency, psychologic testing and laboratory tests, including serum testosterone levels.

Colchicine use for familial Mediterranean fever. Observations associated with long-term treatment.

Of 85 patients with familial Mediterranean fever receiving continuous prophylactic colchicine therapy, 62 (73 percent) have had a significant reduction in the severity and frequency of their attacks. All 62 have been observed for three years or more, for a total of 4,680 patient-months and a mean duration of 75.5 months.

Cardiac and autonomic nervous system effects of L-alphacetylmethadol (LAAM).

The effects of 1-alphacetylmethadol (LAAM) on heart rate and force of contraction of isolated guinea-pig hearts and on release of tritium from sympathetic nerves were investigated. In vitro perfusion with LAAM depressed resting heart rate and right ventricular pressure. Nerve stimulation-induced tritium overflow was inhibited in a concentration related manner by LAAM.

The association of antinuclear antibodies, antilymphocyte antibodies, and C4 activation among the relatives of children with systemic lupus erythematosus.

We studied 31 children with systemic lupus erythematosus (SLE) and 108 first-degree relatives of the children to determine if HLA type, familial relationship to patient, or gender influenced the familial aggregation of SLE and the serologic and serum complement abnormalities associated with SLE. There were no significant relationships between the presence of antinuclear antibodies (ANA), antilymphocyte antibodies (ALA), or circulating immune complexes. Furthermore, there was no correlation between the occurrence of ANA, ALA, or circulating immune complexes with HLA type or relationship to patient.

Stereotypy and striatal dopamine receptor changes with 1-alpha-acetylmethadol (LAAM).

Narcotics like morphine and methadone produce effects on striatal dopaminergic mechanisms as evidenced by changes in a stereotyped behavior induced by apomorphine and binding or radioactive ligands to dopamine (DA) receptors. LAAM may replace methadone in the treatment of narcotic addiction. We investigated the effect of LAAM on apomorphine induced stereotypy and the binding of 3H-spiroperidol to dopamine receptors isolated from mouse and guinea pig striata.

The role of antibodies directed against double-stranded DNA in the manifestations of systemic lupus erythematosus in childhood.

The specificity of antibodies directed against dsDNA for SLE in a childhood population was tested by analyzing sera from 62 children with lupus and 283 children with other known or suspected autoimmune diseases. The role of these antibodies in the manifestations of SLE was then examined by correlating dsDNA Ab titer with clinical manifestations in 311 sera from 20 children followed for a mean of 51 months. Antibodies to dsDNA were found to be highly specific for SLE.

Recurrent urinary calculi associated with toluene sniffing.

A young man who presented initially with a ureteral stone was found to have toluene-induced renal tubular acidosis. Persistent toluene sniffing resulted in recurrent calculi and life-threatening hypokalemic paralysis. The pathophysiology, classification and treatment of renal tubular acidosis are discussed.

Serum complement abnormalities in the antinuclear antibody-positive relatives of children with systemic lupus erythematosus.

Serum C3, C4 and total hemolytic complement (CH50) levels were measured for 21 children with systemic lupus erythematosus (SLE) and 81 first degree relatives. The mean serum C4 and CH50 levels of the 12 relatives with antinuclear antibodies (ANA( were depressed to levels equal to those of the index cases. A similar depression was not found for C3, nor was there a depression of C3, C4, or CH50 in the relatives without ANA.

Naloxone-reversible analgesic action of SKF 525-A in mice.

SKF 525-A, given i.p. to mice at doses from 50 to 100 mg/kg, had analgesic activity approximately 40% the analgesic potency of d-propoxyphene HCl, a chemically similar narcotic.