Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: EC:3.4.25.1 (proteasome)
 28,817 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

PIP joints, MCP joints and wrists of 80 patients with rheumatoid arthritis were operated on with late synovectomy. The rate of recurrence of local synovitis was about 5%, which contrasted favourably with a considerably higher rate of progression of bony erosions. The loss of range of movement was small to moderate. Pain was alleviated in most cases. The possibility of forecasting the results by preoperative parameters was limited. It was concluded that the main indication for late synovectomy of the hand was alleviation of pain. The prophylactic effect on joint destruction seemed to be both slight and unpredictable.
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PMID:Late synovectomy of the hand in rheumatoid arthritis. 98 95

We have proposed an alternate assignment criterion for rheumatoid arthritis (RA), pain on squeezing the MCP or MTP joints. The performance of this criterion has been evaluated in 90 patients with RA and in 122 patients with other rheumatological disorders (non-RA). The proportions of patients with various numbers of sites positive (from 0 to 4) were assessed according to diagnosis; most patients with RA had at least one site positive, in comparison to non-RA where most patients had no sites positive. The diagnostic performance of 2+ or 3+ sites was similar, but 3+ is probably preferable because this simultaneously indicated both symmetry and hand and foot involvement. In conclusion, the lateral MCP/MTP squeeze performs well in comparison to many other existing clinical criteria for RA and could substitute for non-independent features (e.g. swelling and arthritis). It is easier to elicit than searching for pain and/or tenderness as fewer sites have to be examined and inter-observer variation was less than with many other clinical criteria.
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PMID:The lateral metacarpophalangeal/metatarsophalangeal squeeze: an alternative assignment criterion for rheumatoid arthritis. 203 Nov 55

A comparative evaluation of existing assignment criteria for rheumatoid arthritis has been undertaken as a preliminary to exploring how simpler and more efficient standards could be developed. The performances of alternative formulations of individual criteria have been evaluated, and the various criteria have been assessed singly and in combination. The two individual criteria giving rise to the greatest difficulty are morning stiffness and pain and/or tenderness, with its optional formulation. An alternative criterion, pain in at least three sites on squeezing the MCP or MTP joints, performed well. Taken in combination, better epidemiological discrimination was achieved with the threshold for the 1958 ARA criteria midway between 'definite' and 'classical' disease, with six criteria fulfilled. Most of the discriminatory power of these criteria stemmed from inclusion of radiographic and serological characteristics, which is scarcely surprising. The Rome criteria for Inactive RA and the New York criteria for RA, which were derived from them, achieved better discrimination, which suggests ways in which improvements in assignment criteria might be approached. The 1987 revision of the ARA criteria achieves disappointingly little, as important difficulties have not been resolved.
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PMID:A review of assignment criteria for rheumatoid arthritis. 240 39

Due to its exposed position, the MCP joint of the thumb is particularly vulnerable to dislocations and fracture dislocations. Depending on the direction of the injuring force, injuries to the ulnar, radial, and volar aspect of the joint can occur. If high-grade lesions are not identified and treated appropriately during their acute phase, marked instability with associated long-term disability due to weakness and pain in pinch and grip can result. In the absence of a reliable method for diagnosing the Stener lesion, surgical repair of acute, third-degree lesions on the ulnar side of the joint remains the treatment of choice. In the presence of chronic instability, a variety of effective soft tissue reconstructive measures are available. The fact that both acute and chronic injuries enjoy a favorable prognosis with operative repair is due to the fact that operative intervention reliably restores stability to the joint. Mild to moderate loss of motion at the joint is well tolerated functionally. For this reason, arthrodesis remains an exceptionally satisfactory salvage for failed soft tissue reconstructions.
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PMID:Dislocations and fracture dislocations of the metacarpophalangeal joint of the thumb. 327 79

Resection arthroplasty using Swanson silicone prosthesis was performed in 74 MCP-joints in 22 patients, all with rheumatoid arthritis. Follow-up at 2 (1-7) years showed complete pain relief in 15 patients and considerable improvement in hand function; the average range of motion was unchanged but extension was improved and ulnar deviation and volar displacement were reduced. Complications included fracture of four implants, two superficial infections, one hematoma and one skin necrosis.
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PMID:Silastic arthroplasty in rheumatoid MCP-joints. 370 38

Two types of assessment were used in our evaluation of the long-term results of excisional MCP arthroplasty in the rheumatoid hand: a standard surgeon-patient assessment, and a functional test model applied to 17 rheumatoid hands before and after operation.The surgeon-patient overall assessment at the time of follow-up indicated satisfaction with the results in 15 of 17 hands, whereas the occupational therapists' objective functional testing indicated a less positive end result - improvement in 6 of the 17 hands and worsening in 8.The discrepancy need not negate the validity of either finding but would suggest that factors other than function as measured give patient satisfaction. These include such features as pain relief, ability to put on gloves again and improved appearance.
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PMID:Functional results of excisional arthroplasty for the rheumatoid hand. 454 89

We report 20 cases (13 male and 7 female), mean age 21 years) of juxta-articular osteoid osteoma. The distribution of affected joints was as follows: hip joint (7 cases), knee joint (2 cases), ankle joint (2 cases); iliosacral joint (2 cases), lumbar spine (2 cases), carpus (2 cases), shoulder (1 case), second metacarpal (MCP; 1 case) and first metatarsal (MTP; 1 case). The duration between the onset of symptoms and diagnosis varied from 8 months to approximately 4 years. In juxta-articular osteoid osteoma, the clinical picture and the radiographic findings are often atypical, and this may lead to misdiagnosis and delayed definitive treatment. In young patients with persistent undiagnosed pain, the possibility of an osteoid osteoma should be considered. When the clinical picture is suggestive but radiological findings are negative, we must proceed to further investigation with bone scintigraphy and computed tomography. These examinations should be repeated 1 year after the onset of symptoms because initially negative findings may become positive at a later date. When the diagnosis of an osteoid osteoma is confirmed, surgical excision leads to complete relief of the symptoms.
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PMID:Osteoid osteoma in the differential diagnosis of persistent joint pain. 755 9

Ulnar subluxation of the extensor digitorum communis tendon at the MCP joint occurs infrequently in the nonrheumatoid patient and is secondary to one of four reported etiologies: traumatic, spontaneous, congenital, or epileptic. If symptomatic, patients may present with pain, swelling, a sensation of the tendon "snapping", "catching", "locking", or the inability to fully extend the MCP joint. Conservative and operative interventions have been recommended as treatment options. In the acute traumatic dislocation (less than ten days post injury), satisfactory results may be obtained with simple splinting with the MCP joint in extension. Patients who have failed conservative management or have a more chronic or degenerative dislocation may require surgical correction. The successful surgical repair must meet two requirements: (1) the tendon must be accurately aligned over the MCP joint to diminish the forces causing the dislocation to occur, and (2) the repair must be able to withstand the ulnar forces incurred during flexion of the joint. Realignment of the extensor tendon and direct repair of the radial sagittal band may be sufficient in acute traumatic, congenital, or spontaneous cases if the tissue is sufficient. In chronic dislocations or in cases with atrophic or degenerative tissue, reconstruction with augmentation of the radial restraints to the extensor hood is advised.
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PMID:Ulnar subluxation of the extensor digitorum communis tendon: a case report and review of the literature. 782 Jul 44

16 patients with rheumatoid arthritis underwent Swanson silastic arthroplasty in 60 MCP-joints. After 7 (5-10) years only 8 patients had pain relief, 7 were satisfied, and 13 implants had fractured. We conclude that the effects of Swanson silastic arthroplasty deteriorate with time.
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PMID:Silastic arthroplasty in rheumatoid MCP-joints. 60 joints followed for 7 years. 797 91

Low level laser therapy (LLLT) is a relatively new and increasingly popular form of electrotherapy. It is used by physiotherapists in the treatment of a wide variety of conditions including RA despite the lack of scientific evidence to support its efficacy. A randomized, double-blind and placebo-controlled study was conducted to evaluate the efficacy of LLLT. The patient sample consisted of chronic RA patients with active finger joint synovitis. Forty RA patients with involvement of some or all of MCP or PIP joints were recruited. Following random allocation they received either active or placebo laser three times a week for 4 weeks. Measurements were taken prior to entry, after the treatment, 1 month and 3 months at follow-up. The groups were well matched in terms of age, sex, disease duration and severity. Few significant differences were noted in grip strength, duration of morning stiffness, joint tenderness, temperature of inflamed joints, range of movement or pain either within or between groups. Using these irradiation parameters the efficacy of LLLT is ineffective.
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PMID:Low level laser therapy is ineffective in the management of rheumatoid arthritic finger joints. 816 79


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