Abstract The results of 111 ulnar head resections are presented. The indication for operation was pain in 90% of cases. Post-operatively pain was relieved or reduced in 87% and function improved in 75%. In only 7% did post-operative wrist deformity occur. These were associated with disease severity rather than the operative technique.
The concurrence of rheumatoid arthritis (RA) and systemic lupus erythematosus (SLE) has been reported infrequently. Eleven patients are described here with both RA and SLE, in whom the diagnoses were separated by one to 24 years. Because of the difficulty in diagnosing RA occurring subsequent to SLE, only patients with classical RA as their initial diagnosis were included. Further difficulties arise because arthritis is common to both diseases and may be deforming in SLE, antinuclear antibodies (ANA) are not uncommon in RA, and rheumatoid factor (RF) may be seen in SLE. Nonetheless, judicious application of the American Rheumatism Association (ARA) criteria allows both diagnoses to be made in the individual patient. In our patients there was erosive arthritis in nine, rheumatoid nodules in five, and urinary abnormalities in 10. Serological evidence of RA and SLE with positive RF and ANA and raised DNA antibodies was universal, all patients had haematological evidence of SLE, and all but one decreased serum complement levels. These cases suggest that the concurrence of RA and SLE is not as rare as previously considered and may occur more often than expected by chance alone.
Glycolysis by brain tissue in the presence of oxygen is greatly increased by low concentrations of various narcotics. Maximum glycolytic rate, equal to or exceeding the normal rate of anaerobic glycolysis, occurs when the oxygen uptake is about 50 per cent inhibited by the drug. The rate of glycolysis is lowered again, and the oxygen uptake further depressed, by higher concentrations of drug. Anaerobic glycolysis is unaffected or slightly accelerated by low drug concentrations but is inhibited by concentrations greater than those which cause maximum aerobic glycolysis. The concentrations at which these effects occur vary from drug to drug. The effects on glycolysis and respiration are reversible at low concentrations but irreversible at concentrations which inhibit glycolysis. Pentobarbital exerts similar effects on the metabolism of testis and kidney tissue. Oxygen uptake is increased in the presence of succinate, ascorbate or glutathione in the presence or absence of drug. Succinate does not affect the aerobic glycolysis produced by pentobarbital; ascorbate and glutathione reduce it. Convulsant drugs tested do not markedly affect respiration or glycolysis except at relatively high concentrations.
Abstract Control of immune complex formation is important to limit disease resulting from their deposition in tissues. Any inhibition of immune complex solubilisation is thus significant in the pathogenesis of immune complex diseases. More than half of our patients with various rheumatic connective tissue diseases were demonstrated to have serum inhibition of immune complex solubilisation (12/16 rheumatoid arthritis, 22/37 systemic lupus erythematosus, 16/29 primary Sjogren's syndrome, and eight of nine with mixed connective tissue disease). This serum inhibitory activity did not correlate well with serum levels of IgM rheumatoid factor or circulating immune complexes, and its nature remains to be elucidated. (Aust NZ J Med 1986; 16: 445–451.)
Inter-relationships of biochemical and immunological tests of liver function have been studied in a prospective study of 216 patients with rheumatoid arthritis (RA), 32 patients with Sjogren's syndrome, and 27 patients with the sicca syndrome, and these results have been compared with those obtained 289 patients with osteoarthrosis or with a form of seronegative polyarthropathy. In general the prevalence of abnormalities in serum alkaline phosphatase, bromsulphthalein excretion, smooth muscle antibody, and mitochondrial antibody in the former three groups was higher than in patients with osteoarthrosis. Patients with Sjogren's syndrome with RA had a higher prevalence of abnormalities of bromsulphthalein excretion, salivary duct antibody than patients with the sicca syndrome. Patients with RA had a higher pervalence of rheumatoid factor than those with the sicca syndrome. Patients with a positive smooth muscle or mitochondrial antibody were found to have a higher prevalence of hepatomegaly and splenomegaly, of abnormal liver function tests, of other autoantibodies, and of histological abnromalitis of liver than those in whom these tests were negative.
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