Enhanced inflammatory reactivity in the pathogenesis of spondyloarthropathies

Pathogenesis of seronegative spondyloarthropathies such as ankylosing spondylitis and reactive arthritis is not known. Growing evidence indicates that microbial structures such as Chlamydia antigen and Yersinia antigen are present in the inflamed joints of patients with reactive arthritis. Microbial antigens can activate the host's inflammatory mechanisms. After the activation, the course of inflammation can be postulated to be affected by the host factors responsible for amplification of the inflammatory reaction and elimination of the foreign structures. Thus, the amplification, whether strong, moderate, or weak, may contribute to the degree of inflammatory tissue injury in patients with seronegative spondyloarthropathies. This review will discuss the role of increased inflammatory reactivity in the pathogenesis of HLA-B27 associated spondyloarthropathies, with special reference to reactive arthritis triggered by yersinia enteritis.     

Structure Determination of 2,2-Diallyl-3-(3-methylureido)-1-propanol,an Unusual Product of Sodium Borohydride Reduction of Barbituric Acids

Sodium borohydride reduces the imide carbonyl groups of 5,5-diallyl-1-methyl-barbituric acid (1) at position 4 to a methylene group and at position 6 to a primary hydroxy group which has been verified by analysis of the high resolution ¹H-NMR and mass spectra of the product 3 .     

Functions of polymorphonuclear leukocytes in early rheumatoid arthritis

We carried out a prospective study on clinical variables and functions of polymorphonuclear leukocytes (PMNs) of 20 patients with early rheumatoid arthritis (RA) and compared the results with the presence of erosions before treatment and at a one-year follow-up. Migration of PMNs determined by agarose and filter assays and respiratory burst of PMNs determined by luminol-enhanced chemiluminescence (CL) test were studied both before starting RA-modifying treatment and 6–12 (mean 7.3) months later. PMNs of the patients without erosions at one year, as compared to the patients with erosions, showed significantly depressed migration into filter and significantly depressed CL responses toN-formyl-methionyl-leucyl-phenylalanine, both before starting the treatment and at 7.3 months. Although causality remains uncertain, the results suggest that depressed functional capacity of PMNs is associated with low risk of joint destruction in early RA.     

Long-term persistence of selective IgA deficiency in healthy adults

A follow-up study of 204 healthy blood donors with IgA deficiency, identified between 1971 and 1980, was carried out. Sera were initially screened by a double diffusion method and 182 were retested by a more sensitive haemagglutination inhibition method. A reexamination was performed in 1990 and, again, in 1991–1992 using an enzyme immunoassay (EIA) developed for the measurement of very low concentrations of IgA. The median follow-up period was 19 years, and in 159 (78%) subjects no serum IgA could be detected in any of the measurements. In 42 (21%) subjects, serum IgA was detectable (>0.18 mg/L), but the level was below the lower limit of the reference range for adults (800 mg/L) and remained relatively constant. Three subjects showed minute amounts of IgA by EIA (0.2–3 mg/L) in one of the follow-up samples in 1990–1992, but the level was below the detection limit of the EIA (0.05 mg/L) in the other sample. Thus, not only does primary IgA deficiency appear to be permanent, but also lower than normal serum IgA levels remain the same in healthy adults.Portions of this work were presented in poster form at the XIVth Meeting of the European Society for Pediatric Hematology and Immunology in Oulu, Finland, September 7–10, 1993.     

The Effects of Interventions to Prevent Substance Use Among Adolescents: A Systematic Review

The aim of this systematic review is to describe and evaluate the effects of interventions used for preventing or reducing substance use among adolescents under 18 years of age. Studies (N = 27) available in CINAHL and PubMed from 2007 to 2010 were included. Results showed that family-based interventions and combined interventions have significant outcomes for substance use among adolescents. Similarly, school-based interventions were effective in providing knowledge about substance use, which eventually reduced the substance use. Further research should be conducted in different cultures as well as on computer-based interventions targeting both genders.     

Book Reviews

Prevalence of AA amyloid in rheumatoid arthritis (RA) is still unclear. The objective of this retrospective study was whether dedicated re-examination of autopsy tissues from RA patients increases the detection rate of amyloid compared to routine examination. Amyloid was re-examined in tissue samples and detection rate compared with original reports of 369 consecutively autopsied RA patients and 370 non-RA patients matched for sex, age, and year of autopsy between 1952 and 1991. Re-examination of 90% of the 739 cases showed doubling of the prevalence of amyloid compared with the original reports: from 18 to 30% in RA and from 2 to 4% in non-RA patients. In RA patients, cardiac amyloid was as frequent as renal amyloid. In RA patients with amyloid at re-examination, amyloidosis had been diagnosed before autopsy in 37%, and these patients had more inflammation and longer disease duration than RA patients without amyloid. Only 56% of RA patients with renal amyloid were known to have proteinuria. In conclusion, this autopsy study shows that amyloid in RA is a common finding which remains frequently undetected. In patients with active and long-lasting RA, a systematic search for amyloid may enable early diagnosis of amyloidosis, which will require effective suppression of inflammation.     

Timing of developmental stages in permanent mandibular teeth of Finns from birth to age 25

OBJECTIVE: The aim was to provide radiographic data on postnatal development of the 8 mandibular teeth to serve as reference norms in clinical dentistry, forensic dentistry, anthropology, and research. MATERIAL AND METHODS: Developmental stages of teeth were assessed from a total of 2795 radiographs, mostly panoramic, of 1970 Finns (966 M and 1004 F) from birth to age 25. The grading was based on Demirjian's 8 mineralization stages and the crypt stage. RESULTS: Timing of development in individual mandibular teeth is presented in two ways: as age at attainment of each developmental stage and as age of subjects in a developmental stage. Initiation of mineralization was visible in 1st molars at 0.20 years, in central incisors at 0.22 years, lateral incisors at 0.37 years, and canines at 0.56 years of age. Timing was usually earlier in girls than in boys. Differences were greatest in canines, where females were advanced by 1.74 years at the closure of the apex. Root development in 3rd molars showed an opposite trend, where apical closure was 1.19 years earlier in men. In 3rd molars, age at apical closure in females was 21.50 years, among the highest reported. In general, the early developmental stages had the shortest duration and the last stages the longest. CONCLUSION: Timing of postnatal development of individual mandibular teeth in Finns resembled developmental schedules reported for other Caucasian population groups. Any differences were mostly small and inconsequential.