Evaluation of the effectiveness of long-term dispensary observation and treatment of patients with osteoarthrosis deformans

During 1979-1984, 240 outpatients aged 30 to 65 years suffering from primary osteoarthrosis deformans with primary involvement of the knee joints were followed up. One of the dispensary groups consisted of 180 patients with osteoarthrosis deformans without synovitis, the other one of 60 patients with associated osteoarthrosis and synovitis. Prolonged follow up and repeated multiple modality treatment inhibited the progression of the pathological process, reduced the clinical and functional disease manifestations permitting the patients' work fitness to be preserved.     

The relation between the level of antibodies to the glycosaminoglycans of the cartilage in patients with osteoarthritis and the efficacy of treatment with chondroprotectors]

AIM: To improve the efficacy of osteoarthrosis (AO) treatment by chondroprotectors by defining individual indications for their use, based on the initial level of antibodies to cartilaginous glycosaminoglycans (GAG) in the blood serum. MATERIALS AND METHODS: Anti-GAG were detected by indirect solid-phase enzyme immunoassay. The antigen was a sulfated GAG preparation GAG-polysulfate (arteparon) manufactured by Luitpold-Werk (Germany). Sera of 110 OA patients were tested. Fifty of them were treated by rumalon, 20 with arteparon, and protocols of 40 patients included no chondroprotectors. RESULTS: The highest levels of anti-GAG were found in OA patients with multiple involvement of the joints, rapidly progressing disease, and secondary synovitis. The titer of antibodies increases with disease duration and in patients with the roentgenological stage of OA, reaching the maximum by 10-15 years of disease or by stage III. Efficacy of chondroprotectors was lower at lower levels of antibodies to cartilaginous GAG. CONCLUSION: Chondroprotector therapy of patients with initially high levels of antibodies to GAG is unadvisable, for it can lead to exacerbations, specifically, to secondary synovitis.     

Trolox-derivative antioxidant protects against methanol-induced damage

Summary— This paper reports data on the effect of a new antioxidant, U-83836E, on the lipid peroxidation and antioxidant status of liver, red blood cells (RBCs) and blood serum of rats intoxicated with methanol (3.0 g/kg body weight). Methanol administration slightly increased the levels of peroxidation products in the liver, and markedly increased them in RBCs and serum. In contrast, glutathione-peroxidase, glutathione-reductase activity, reduced glutathione concentration and total antioxidant status were decreased. The use of U-83836E, containing a trolox ring, appeared to be beneficial in reducing lipid peroxidation products and in partially in preventing the decrease in glutathione and antioxidant enzymes induced by methanol in liver and serum. These results show that antioxidant U-83836E may partially prevent methanol toxicity.     

Evaluation of oxidative stress parameters in blood of patients with laryngeal carcinoma.

OBJECTIVES: In this study, plasma lipid peroxidation as assessed by thiobarbituric acid reactive substances and erythrocyte antioxidant status markers namely CuZn superoxide dismutase, glutathione peroxidase, glutathione and plasma levels of vitamin C and E were investigated in 20 patients with larygneal carcinoma and 15 healthy controls. DESIGN AND METHODS: Lipid peroxidation was observed to be significantly higher (0.01 > p > 0.001) in the larynx carcinoma group in comparison to the healthy controls. Both stage I + 11 and stage III carcinoma patients were observed to have significantly higher thiobarbituric acid reactive substances than the control group. A significant difference was found in plasma vitamin E level between the control group and stage I + 11 and stage III carcinoma patients (p < 0.01, 0.05 > p > 0.02, respectively). RESULTS: Our findings reveal the presence of increased lipooxidative damage in laryngeal carcinoma patients, but no change with respect to the endogenous antioxidant components-GSH, GSH Px, and CuZn SOD.     

Evidence of oxidative and nitrosative stress in patients with cervical squamous cell carcinoma

BACKGROUND: We conducted a study to evaluate reactive oxygen species (ROS) and reactive nitrogen species (RNS) simultaneously together with the antioxidant status in patients with cervical carcinoma. METHODS: We measured lipid peroxidation product, including malondialdehye (MDA), nitric oxide (NO) products, including nitrite (NO(2)(-)), nitrate (NO(3)(-)) and total nitrite (TNO(2)(-)) and antioxidant enzymes in 45 patients with cervical cancer and compared them against 30 healthy controls. RESULTS: Plasma as well as erythrocyte MDA and plasma NO levels was higher (p<0.001) in cervical cancer as compared to healthy controls. Antioxidant enzymes, Superoxide dismutase (SOD), catalase (CAT) and glutathione peroxidase (GPx) activities, were decreased (p<0.001) whereas glutathione S-transferase (GST) activity was increased (p<0.001) in cervical cancer patients. Lipid peroxidation and NO products accumulation correlated significantly with a deranged antioxidant system. CONCLUSIONS: We demonstrated a possible involvement of both oxidative and nitrosative stress, as evidenced by increased lipid peroxidation and NO levels with altered antioxidant defense system in the pathogenesis of cervical cancer.     

Effects of vitamin E supplementation on blood antioxidants levels in patients with Behçet’s disease

Behçet’s disease (BD) is known for many years, yet its etiology remains unknown. In BD, the increased production of reactive oxygen species from activated neutrophils may reduce concentrations of antioxidant vitamins and enzymes in plasma and red blood cells (RBC). Vitamin E is an important fat soluble antioxidant and its role on antioxidant parameters of BD is unclear. The study was undertaken to evaluate the role of vitamin E on lipid peroxidation (MDA) levels, antioxidant vitamin and enzyme concentrations in plasma and RBC in patients with BD. There were three groups i.e., control, patient and treatment groups with twenty-five subjects in each. Nonsmoking patients with BD, patient group, was compared with an equal number of healthy control subjects (control group). Blood samples were taken from both control and patient groups and then oral vitamin E was daily supplemented to the patients with BD for six weeks (treated group). At the end of six weeks, blood was taken from the treated group once more.

RBC and plasma MDA levels, serum neopterin, complement system (C₃ and C₄), ASO, CRP, rheumatoid factor, plasma lipoprotein (a), total cholesterol concentrations and erythrocyte sedimentation rate were higher in the patient group than in the control group, but they were lower in the treatment group than in the patient group. While vitamins A, E and β-carotene concentrations in plasma, catalase, glutathione peroxidase activities and reduced glutathione levels in RBC and plasma were lower in patient group than in the controls, they were found to be higher in the treatment group than in the patient group.

These results provide some evidence for a potential role of increased lipid peroxidation and decreased enzymatic and non enzymatic antioxidants in BD by its inflammatory character and vitamin E which may strengthen the antioxidant defense system, and may contribute to the treatment of BD.     

Causes of pain in the knee joint

Pain in the knee joint is one of the commonest complaints for which people seek an advice of different medical specialists. The aim of this study was to elucidate the cause of pain in patients with the alleged diagnosis of "osteoarthrosis" and to develop the relevant diagnostic algorithm. The study included 214patients aged from 35 to 85 years with a pain level of at least 40 mm by the visual analog scale (VAS). Results of physical and X-ray examination provided indications for further studies that were performed by ultrasonographic (40.1%), arthroscopic (52.3%), and MRT(64.2%) techniques. One third of the patients were aged women with the body mass index > 40.1 and stage 3 osteoarthrosis (OA) in whom pain was attributable to primary osteoarthrosis. The remaining patients had pain of other origin. Ultrasound studies revealed rupture of the internal lateral ligament in 3, "pes anserinus" tendinitis in 5, and synovitis in 53 patients. MRT demonstrated traumatic and degenerative meniscal tear in 102 and rupture of the anterior cruciate ligament in 7 patients. Grade 3-4 chondomalacia of the femoral condyle was diagnosed in 24 patients. There was excellent (98.6%) agreement between MRT diagnosis and arthroscopic data on lesioned intra-articular structures, articular cartilage, and subchondral bone. Arthroscopy revealed traumatic and degenerative meniscal tear in 85% patients, injured anterior cruciate ligament in 8%, signs of synovitis in 52.6%, chondromalacia of the femoral condyle in 57.6%, and isolated pathology of patellofemoral articulation in 33% of the patients.     

The effect of vitamin E supplementation on antioxidant enzyme activities and lipid peroxidation levels in hemodialysis patients

BACKGROUND: This study has been undertaken to investigate the possible alterations of oxidant/antioxidant status in uremic patients undergoing hemodialysis (HD) and the effects of vitamin E supplementation. METHODS: Erythrocyte antioxidant enzyme activities [glutathione peroxidase (GSHPx), superoxide dismutase (SOD) and catalase (CAT)] and thiobarbituric acid reactive substance (TBARS) concentrations as a measure of lipid peroxidation in HD patients have been determined and compared with healthy controls. The patient group consisted of 36 uremic patients 21-75 years of age undergoing maintenance HD three times weekly for an average of 41 months. The efficiency of Vitamin E therapy in dialysis patients was also assessed by re-evaluating antioxidant status of the same patients after supplementation of the vitamin E in a dosage of 600 mg/daily for 14 weeks. RESULTS: A significant decrease in the activities of erythrocyte SOD, CAT and GSHPx and a significant increase in TBARS concentrations were found in patient group compared to control group (p<0.001). A significant correlation between GSHPx activities and duration of HD therapy was also observed (r=-0.46, p<0.01). Vitamin E supplementation caused an increase in GSHPx and SOD activities and a decrease in TBARS concentrations. A slight but not significant increase in CAT activity was also observed by Vitamin E. CONCLUSIONS: The results suggest the presence of an oxidative activity and the possible preventive role of Vitamin E therapy in uremic patients undergoing HD.     

Lipid peroxidation and antioxidant status in experimental diabetes.

Oxidative stress is currently suggested as a mechanism underlying diabetes. The present study was designed to evaluate the oxidative stress related parameters in streptozotocin-induced diabetes in rats using different complementary approaches: susceptibility to in vitro oxidation (lipid peroxidation induction in liver homogenate, red blood cells hemolysis), blood antioxidant status (total antioxidant capacity by two approaches), and plasma isoprostane measurement, a new marker of lipid peroxidation in vivo. We have shown that induced liver thiobarbituric acid reactive substances increased after 4 weeks of diabetes, in spite of increased liver vitamin E content. Red blood cells hemolysis was significantly delayed after 4 weeks of diabetes. Plasma antioxidant capacity (AOC) tended to increase after 4 weeks of diabetes and was correlated with plasma vitamin E levels. Total antioxidant activity (TAA) significantly decreased after 1 week and a significant correlation was observed with plasma albumin levels. Plasma isoprostane (8-epiprostaglandinF2alpha) concentrations were not modified significantly 1 week or 4 weeks after the induction of diabetes. Levels of vitamin E in the diet and changes in its distribution among the body seems to play an important role in the development of oxidative stress during diabetes and its consequences.     

Effects of vitamin E supplementation on blood antioxidants levels in patients with Behçet's disease

Behçet’s disease (BD) is known for many years, yet its etiology remains unknown. In BD, the increased production of reactive oxygen species from activated neutrophils may reduce concentrations of antioxidant vitamins and enzymes in plasma and red blood cells (RBC). Vitamin E is an important fat soluble antioxidant and its role on antioxidant parameters of BD is unclear. The study was undertaken to evaluate the role of vitamin E on lipid peroxidation (MDA) levels, antioxidant vitamin and enzyme concentrations in plasma and RBC in patients with BD. There were three groups i.e., control, patient and treatment groups with twenty-five subjects in each. Nonsmoking patients with BD, patient group, was compared with an equal number of healthy control subjects (control group). Blood samples were taken from both control and patient groups and then oral vitamin E was daily supplemented to the patients with BD for six weeks (treated group). At the end of six weeks, blood was taken from the treated group once more.RBC and plasma MDA levels, serum neopterin, complement system (C₃ and C₄), ASO, CRP, rheumatoid factor, plasma lipoprotein (a), total cholesterol concentrations and erythrocyte sedimentation rate were higher in the patient group than in the control group, but they were lower in the treatment group than in the patient group. While vitamins A, E and β-carotene concentrations in plasma, catalase, glutathione peroxidase activities and reduced glutathione levels in RBC and plasma were lower in patient group than in the controls, they were found to be higher in the treatment group than in the patient group.These results provide some evidence for a potential role of increased lipid peroxidation and decreased enzymatic and non enzymatic antioxidants in BD by its inflammatory character and vitamin E which may strengthen the antioxidant defense system, and may contribute to the treatment of BD.     

Antioxidant potential of vitamins A, E and C in modulating oxidative stress in rat brain

Background: Stress is known to affect synaptic plasticity, dendritic morphology and induces neurotoxic damage in humans, probably through generation of free radicals. Both ex vivo antioxidant vitamins and in vivo free radical scavenging enzymes exist. In the present study, restraint stress induced pro-oxidant status of rat brain was evaluated in terms of measurement of glutathione (GSH), lipid peroxidation (thiobarbituric acid reactive substances, TBARS) and free radical scavenging enzymes activities. The efficacy of antioxidant vitamins A, E and C alone and in combination was also evaluated in modulating inherent antioxidant system in stressed rats. Methods: Rats were treated with vit A, E and C alone (15 mg/kg of body weight) and in combination vitamins (E and C) prior to and after 6 h of restraint stress exposure. Both nonstressed and stressed rats were handled simultaneously. Pro-oxidant status of brain tissue was evaluated by determining the levels of GSH, TBARS and activities of superoxide dismutase (SOD), glutathione-S-transferase (GST) and catalase (CAT). Results: Restraint stress induced a decrease in the level of GSH and the activities of SOD, GST and catalase, while the levels of TBARS were found elevated. Both pre-stress and post-stress vitamin treatments (either alone or combined) resulted in alteration of these parameters towards their controls values with a relative dominance by latter. Vitamin E was found most effective in restoring inherent antioxidant system, no additive effect was observed in combined vitamin treatment as expected. Conclusion: Immobilization of rats generated oxidative stress in rat brain, by decreasing the activities of SOD, GST, catalase and glutathione levels, while increasing the lipid peroxidation. Post stress vitamin E treatment was found most effective than vitamins A and C in enhancing the levels of glutathione and activities of SOD, GST and catalase and decreasing lipid peroxidation. Thus vitamin E can be given as a nutritional supplement for scavenging free radical generated in the brain tissues in order to reduce oxidative stress.     

Clinical aspects and classification of primary osteoarthrosis deformans

The authors reported the results of investigation of 70 patients with osteoarthrosis deformans followed up for 3-10 yrs. They defined 3 variants of a course of the disease: with rapid progression, slow progression, without noticeable progression. These variants differed in disease spreading, the frequency of arthrotic synovitis and the presence of hereditary predisposition. Signs of erosive arthrosis of the distal and proximal digital hand joints were noted in 12 patients with nodular polyosteoarthrosis. A characteristic signs in this group of patients was hereditary predisposition combined with local vegetative-vascular disorders and a strain on the digital hand joints, and degenerative affection of the cervical spine with the radicular syndrome.     

Efficacy of polyvinylpyrrolidone solutions of various concentrations in patients with rheumatic diseases of the joints

Twenty-six experimental animals, 93 patients with osteoarthrosis (OA) and 30 patients with rheumatoid arthritis (RA) were examined. Intraarticular injection of both 15% and 20% polyvinylpyrrolidone (PVP) solutions suppressed the development of experimental arthrosis in rabbits, which manifested in a decrease of the degenerative changes in the cartilaginous tissue of the joints. The clinical examination has demonstrated that the use of different concentrations of PVP produces an equally marked effect in OA. In the group of RA and OA patients given placebo the time-course of changes in the clinical data was pronounced less powerfully. PVP turned out to be effective in secondary synovitis, to influence the immunologic responses occurring in synovitis, and to exert a beneficial action on the rheological properties of the synovial fluid. The drug is completely eliminated from the articular cavity and the body during 5 days.     

Lipid peroxidation and antioxidant defense in patients with severe herpetic infection

Lipid peroxidation and antioxidant defense were studied in 42 patients with severe herpetic infection. The higher plasma and red blood cell levels of intermediate (trienic conjugates) and end (Schiff's bases) lipid peroxidation products were revealed during remission and disease recurrences. At the same time, there were increases in the content of ceruloplasmin in the plasma and in that of superoxide dismutase and catalase in the red blood cells. In the patients with herpetic infection, there were different correlations between the values of lipid peroxidation and antioxidant defense, which were absent in the group of donors. There was a direct correlation between the level of oxidation of intermediate products (ketodienes) of neutral lipids in the plasma and the concentrations of ceruloplasmin and negative correlations with red blood cell superoxide dismutase in patients in remission. There were negative correlations between the red blood cell level of oxidation of intermediate phospholipid peroxidation products and the concentration of ceruloplasmin.     

膝关节退行性骨关节病中滑膜改变的MRI表现

目的：探讨膝关节退行性骨关节病中滑膜改变的MRI表现。材料和方法：回顾性分析20例经手术和关节镜证实的膝关节退行性骨关节病的MRI表现,重点观察其滑膜的改变。结果：MRI表现有关节滑膜水肿20例;关节积液20例;关节滑膜增生13例;滑膜增生骨化1例;滑膜性关节游离体1例。结论：在膝关节退行性骨关节病中,关节滑膜的改变是其重要的表现之一,其在MRI上可得到良好的显示,对临床治疗有重要价值。     

Chemopreventive efficacy of ginger, a naturally occurring anticarcinogen during the initiation, post-initiation stages of 1,2 dimethylhydrazine-induced colon cancer

BACKGROUND: Ginger (Zingiber officinale Rosc) is a natural dietary component, which has antioxidant and anticarcinogenic properties. We investigated the effect of ginger on the initiation and post-initiation stages of 1,2-dimethylhydrazine (DMH)-induced colon carcinogenesis in male Wistar rats. METHODS: Rats were given a weekly subcutaneous injection of DMH (20 mg/kg body weight) in the groin for 15 weeks. Ginger (50 mg/kg body weight/everyday p.o.) was given to the rats at the initiation, post-initiation stages of carcinogenesis. The activity of lipid peroxidation was studied by measuring the formation of thiobarbituric acid reactive substances (TBARS), lipid hydroperoxides (LOOH) and conjugated dienes (CD), and the antioxidant status by measuring superoxide dismutase (SOD), catalase (CAT), glutathione peroxidase (GPX), glutathione-S-transferase (GST), glutathione reductase (GR), reduced glutathione (GSH), vitamins C, E, and A concentrations in the circulation of 1,2-dimethylhydrazine-induced experimental colon cancer. RESULTS: In the presence of a known colon carcinogen, DMH, plasma lipid peroxidation (TBARS, lipid hydroperoxides and conjugated dienes) and cancer incidence were significantly increased whereas enzymic (GPx, GST, GR, SOD and CAT) and non-enzymic antioxidant concentrations (GSH, vitamins C, E, and A) were decreased as compared to control rats. The number of tumors as well as the incidence of cancer was significantly decreased on treatment with ginger. In addition, ginger supplementation at the initiation stage and also at the post-initiation stages of carcinogenesis significantly reduced circulating lipid peroxidation and significantly enhanced the enzymic and non-enzymic antioxidants as compared to unsupplemented DMH-treated rats. CONCLUSIONS: Ginger supplementation suppresses colon carcinogenesis in the presence of the procarcinogen DMH.     

Erythrocyte malondialdehyde release in vitro: a functional measure of vitamin E status

The definition for a sufficient vitamin E level has often been based on population studies that established the normal range of values for fasting plasma or serum vitamin E and more recently for vitamin E to total lipid ratios. These endpoints for vitamin E replacement strategies may not be readily achievable, particularly in the cholestatic patient for whom it is often impossible to reach and sustain normal levels even with massive doses of vitamin E. Vitamin E is believed to function as an antioxidant in vivo protecting membranes from lipid peroxidation. Malondialdehyde (MDA), a product of polyunsaturated fat peroxidation, was measured as the thiobarbiturate derivative in the supernatant following incubation of erythrocytes in hydrogen peroxide. The two different incubation conditions described here and the subsequent measurement of MDA appear to provide a sensitive functional assessment of vitamin E status. The clinical utility of this assay, which requires just 1.5 to 2.0 ml of whole blood, was demonstrated by comparing the percent of total MDA released from individuals regarded as vitamin E sufficient by conventional methods with vitamin E deficient subjects. The release of MDA from erythrocytes from vitamin E deficient subjects was clearly greater (44.1 +/- 18.8% vs 2.0 +/- 1.8%) than for control subjects (p less than 0.001).     

The effect of vitamin E therapy on plasma and erythrocyte lipid peroxidation in chronic hemodialysis patients

The effect of vitamin E therapy on plasma and erythrocyte (RBC) lipid peroxidation was investigated in patients undergoing chronic hemodialysis. Before vitamin E therapy, both plasma and RBC lipid peroxidation values of chronic hemodialysis patients were significantly higher than those of healthy controls. Treatment with vitamin E (300 mg/day) for 1 month resulted in a significant decrease of lipid peroxidation. Vitamin E therapy may be a promising approach to prevent peroxidation of membrane lipids in chronic renal failure.     

Oxidant-antioxidant status in patients with oral squamous cell carcinomas at different intraoral sites

OBJECTIVES: To compare the extent of lipid peroxidation and the status of antioxidants in tumor and venous blood of patients with oral squamous cell carcinoma (OSCC) at different intraoral sites. DESIGN AND METHODS: Twenty four patients with OSCC at different intraoral sites and an equal number of age- and sex-matched reference subjects were chosen for the study. The concentrations of lipid peroxides and reduced glutathione (GSH) and the activities of the antioxidant enzymes superoxide dismutase (SOD), catalase (CAT), glutathione peroxidase (GPx) and glutathione-S-transferase (GST) were estimated in tissues and blood. RESULTS: Diminished lipid peroxidation in tumor tissue was accompanied by decreased activities of SOD and CAT with increase in GSH and GSH-dependent enzymes. In contrast, enhanced lipid peroxidation with decrease in antioxidants was observed in the venous blood of OSCC patients. CONCLUSION: No significant differences in lipid peroxidation and antioxidant levels were observed between patients with OSCC at different intraoral sites. However, our results revealed differences between the tumor and blood with respect to their susceptibility to lipid peroxidation and antioxidant status.     

Oxidative stress and antioxidant status in Saudi asthmatic patients

ObjectivesAsthma is a chronic inflammatory airway disorder associated with recruitment of inflammatory cells. This study aims to clarify the role of oxidative stress and antioxidant status in the deterioration accompanied asthma.Design and methodsVitamin E, Vitamin C, superoxide dismutase (SOD), glutathione peroxidase (GPx), reduced glutathione (GSH), total antioxidant status together with the concentrations of lipid peroxides, total nitrates and oxidative DNA damage (8-oxodeoxyguanine) were determined in plasma or whole blood of 47 Saudi asthmatic patients and compared to age-matching control samples.ResultsThe present study showed that asthmatic patients have significantly decreased levels of GSH, α-tocopherol, GPx, total antioxidant status and higher levels of SOD, lipid peroxides, total nitrate and 8-oxo-dG. Vitamin C recorded more or less similar levels in both groups.ConclusionAlteration of the selected measured parameters confirms that oxidative stress and defective antioxidant status could represent the primary causative factor in the pathogenesis of asthma.