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| 2. |
- Geborek, Pierre, et al.
(författare)
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Direct assessment of synovial blood flow and its relation to induced hydrostatic pressure changes
- 1989
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Ingår i: Annals of the Rheumatic Diseases. - : BMJ. - 1468-2060 .- 0003-4967. ; 48:4, s. 281-286
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Tidskriftsartikel (refereegranskat)abstract
- A method for measuring synovial blood flow changes using the laser Doppler technique is described. Mean blood flow and mean pulse amplitude decreased by 50-70% in relation to the reference level when the intra-articular hydrostatic pressure in effusive knee joints of patients with rheumatoid arthritis was increased. As an increase of intra-articular pressure of as little as 20 mmHg decreased synovial blood flow significantly it is suggested that hypoxia may occur in vivo during joint use in the presence of an effusion. This may be of aetiopathogenetic importance for tissue destruction and the persistence of chronic synovitis.
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| 3. |
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| 4. |
- Geborek, Pierre, et al.
(författare)
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Joint capsular stiffness in knee arthritis. Relationship to intraarticular volume, hydrostatic pressures, and extensor muscle function
- 1989
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Ingår i: Journal of Rheumatology. - 0315-162X. ; 16:10, s. 1351-1358
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Tidskriftsartikel (refereegranskat)abstract
- Increased intraarticular hydrostatic pressure (Pia) may inhibit juxtaarticular muscle function, obstruct blood supply to joint structures and promote anoxic joint destruction in chronic arthritis. Joint capsular stiffness together with synovial fluid volume determines Pia at rest. Seventeen knee joints with effusive arthritis and different degrees of radiological cartilage involvement in 13 patients with chronic arthritis were examined. Since capsular elastance was difficult to standardize, we introduce a measure of joint capsular stiffness where the intraarticular volume yielding a pressure of 50 mm Hg (V50) is used. After normalization of injected volumes according to the V50, pressure volume curves became similar. Intraarticular hydrostatic pressure and maximal voluntary isometric extensor torque were measured simultaneously, while altering the intraarticular fluid volume in 9 knee joints. In 5 of these, quantified electromyography (EMG) of the vastus medialis and lateralis portion of the quadriceps muscle was also monitored. Progressive inhibition of extensor torque and EMG was found as the intraarticular pressure volume was increased in both intact and destroyed joints. No difference in inhibition was found for the 2 portions of quadriceps muscle tested. Increased intraarticular hydrostatic pressure Pia levels between 200 and 1150 mm Hg were observed during maximal voluntary activation of extensor muscles. The reproducibility was good for all variables studied. In a few instances evidence of intraarticular compartmentalization was found at low volumes. We conclude that the V50 is a convenient expression of capsular stiffness. Furthermore, increasing Pia caused by joint effusion inhibits knee extensor muscle function and impairs synovial blood flow. Awareness of these relations will facilitate more rational therapeutic approaches in chronic arthritis.
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| 5. |
- Geborek, Pierre, et al.
(författare)
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Measurement of synovial fluid volume using albumin dilution upon intraarticular saline injection
- 1988
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Ingår i: Journal of Rheumatology. - 0315-162X. ; 15:1, s. 91-94
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Tidskriftsartikel (refereegranskat)abstract
- A simple method for measuring synovial fluid (SF) volume is described. The degree of dilution of SF albumin after intraarticular injection of a defined volume of saline was used to calculate residual SF volume. Good correlation between calculated and aspirated SF volume was found for knee joint exudates. The method is simple, requires no radioactive tracer and should be useful in quantitative studies involving SF pathophysiology. Interestingly, the major portion of the SF could be directly aspirated, since residual volumes were small in comparison.
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| 6. |
- Geborek, Pierre, et al.
(författare)
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Mononuclear cells recovered from inflammatory synovial membrane using fine-needle biopsy
- 1988
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Ingår i: Rheumatology International. - 1437-160X. ; 8:3, s. 101-105
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Tidskriftsartikel (refereegranskat)abstract
- A simple technique for fine-needle aspiration biopsy from the synovial membrane of arthritis knee joints preceded by lavage of the joint cavity is described. The procedure was atraumatic, well accepted, and could be performed on outpatients. Cells originating from the synovial membrane were obtained in 12 of 17 knees using a 1.2-mm cannula. The yield was 6.0 x 10(3) to 135 x 10(3) mononuclear cells. The cell populations could be expanded by stimulation with antigen and mitogen. The described fine-needle biopsy technique is of value when repeated sampling of synovial membrane cell populations is desired.
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| 7. |
- Geborek, Pierre, et al.
(författare)
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Synovial fluid acidosis correlates with radiological joint destruction in rheumatoid arthritis knee joints
- 1989
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Ingår i: Journal of Rheumatology. - 0315-162X. ; 16:4, s. 468-472
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Tidskriftsartikel (refereegranskat)abstract
- Metabolic variables in samples of synovial fluid (SF) from 33 rheumatoid arthritis (RA) knees were analyzed. These variables were correlated with radiological destruction and SF proteoglycan concentrations. SF acidosis correlated with radiological involvement (rs = 0.62, p less than 0.002), but not with proteoglycan concentrations. A weak correlation was found between SF acidosis and granulocyte concentrations (rs = 0.37, 0.02 less than p less than 0.05). Metabolic variables covaried as expected. Samples from right and left knees from the same patients correlated regarding cellular and metabolic variables. Our results indicate insufficient nutritional supply in RA joints with increasing radiological involvement.
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| 8. |
- Saxne, Tore, et al.
(författare)
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Difference in cartilage proteoglycan level in synovial fluid in early rheumatoid arthritis and reactive arthritis.
- 1985
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Ingår i: The Lancet. - 1474-547X. ; 2/8447:8447, s. 127-128
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Tidskriftsartikel (refereegranskat)abstract
- Cartilage proteoglycans were measured, by the use of an enzyme-linked immunosorbent assay, in synovial fluids obtained from 109 unselected patients attending an outpatient rheumatology clinic because of inflammation of the knee. The content of proteoglycans in synovial fluid was inversely related to the degree of joint destruction shown on X-ray. The proteoglycan concentrations in knee-joint exudates were higher in patients with reactive arthritis than in patients with rheumatoid arthritis having synovitis of corresponding duration and lacking radiological evidence of cartilage destruction. The measurement of proteoglycan levels may therefore be useful in differentiating between the two conditions.
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| 9. |
- Saxne, Tore, et al.
(författare)
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Human arthritic synovial fluid influences proteoglycan biosynthesis and degradation in organ culture of bovine nasal cartilage.
- 1988
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Ingår i: Collagen and Related Research. ; 8:3, s. 233-247
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Tidskriftsartikel (refereegranskat)abstract
- The influence of synovial fluid and serum from patients with inflammatory joint disease on proteoglycan metabolism was studied in organ culture of bovine nasal cartilage. Proteoglycan biosynthesis, i.e. incorporation of [35S]-sulphate, was reduced after addition of synovial fluid from rheumatoid arthritis and reactive arthritis patients. Also some rheumatoid arthritis sera but no reactive arthritis serum reduced the biosynthesis compared to control sera. Proteoglycan degradation, i.e. release of proteoglycans prelabelled with [35S]-sulphate, as well as release of proteoglycans determined by chemical methods, was highest under the influence of rheumatoid arthritis synovial fluid. This effect appears to represent an activity truly stimulating degradation, since added control serum did not prevent the effect. The lowest proteoglycan degradation was observed in culture medium only. Addition of synovial fluid compared to addition of control serum did not increase proteoglycan degradation in freeze-killed cartilage indicating that the effect requires living cells. The findings are consistent with the presence in synovial fluid of mediators stimulating the chondrocytes both to activate proteoglycan degradation and to reduce proteoglycan biosynthesis
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| 10. |
- Saxne, Tore, et al.
(författare)
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Preleukemic syndrome simulating SLE
- 1982
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Ingår i: Acta Medica Scandinavica. - 0001-6101. ; 212:6, s. 421-424
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Tidskriftsartikel (refereegranskat)abstract
- A 70-year-old man presented with symmetrical arthritis and arthralgias, Raynaud's phenomenon, pleurisy, fever, maculopapular erythema, leuko- and thrombocytopenia, anemia, antinuclear antibodies and hypocomplementemia. His bone marrow morphology was normal. During therapy with corticosteroids he developed pulmonary tuberculosis which responded well to tuberculostatic treatment. Approximately one year after onset of his initial symptoms, myeloblasts were seen in the blood and a few weeks later the bone marrow showed a myeloblastic leukemia. The patient did not respond to cytostatic treatment and died six weeks later. Although this patient presented symptoms suggesting the diagnosis of SLE, in retrospect his condition probably represented an unusual type of preleukemic syndrome
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