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 28,634 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Rheumatoid arthritis remains a chronic disabling disorder in which medical and surgical intervention may provide amelioration but not cure. In this study a cohort of 123 rheumatoid patients were followed for a period of 10 years from the time of prescription of their initial second-line agent. The workload involved in managing articular, extra-articular and intercurrent disease in these patients has been documented and outcome in relation to continued use of 'disease modifying' therapy evaluated. At 10 years 24 patients (20 per cent) had died and 7 (5 per cent) were not traced; of the 92 (75 per cent) who were assessed, three had become wheelchairbound, two for reasons other than rheumatoid arthritis. Seventy-one per cent of patients required joint surgery, 36 per cent management of peptic ulcer and 45 per cent experienced major episodes of sepsis. Analysis of the results in the 92 patients who were evaluated at 10 years showed significant improvement in Ritchie articular index, pain score, morning stiffness, haemoglobin, platelets, ESR, total globulins, IgG and IgM. Grip strength and Lee functional index showed a trend towards deterioration which did not reach significance. Sixty-seven (73 per cent) of the 92 patients remained on a second- or third-line agent at 10 years (median duration of treatment 107 months); 25 (27 per cent) were not receiving such therapy (median duration of second- and third-line therapy 13 months). The group remaining on treatment showed significant improvement similar to that of the total study group. Those not on treatment improved only for articular index; Lee functional index deteriorated significantly. There was a correlation between area under the curve for ESR over 10 years and radiological progression of disease in hands (r = 0.29, p = 0.026) and in knees and hips (r = 0.3748, p = 0.012) over the 10 year period. Radiographic score correlated well with Lee functional index at the outset and at 10 years and also with the change in the radiographic score over the 10-year period. Unlike the results of previous studies, there was no morbidity from vertebral collapse; this may be related to the low dose of corticosteroids in this cohort (seven patients received systemic corticosteroids). Thus while the aim of treating patients for prolonged periods with second- or third-line therapy was achieved in the majority with no overt evidence of cumulative toxicity, sustained medical and surgical intervention was and will be needed in order to minimize disability in these and other patients with rheumatoid arthritis.
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PMID:Rheumatoid arthritis: workload and outcome over 10 years. 194 27

In comparison with myoglobin and human and Glycera dibranchiata hemoglobins, the heme distal side amino acid exchanges within the heme environment of elephant tetrameric hemoglobin (Hbe) only slightly affect the electronic and ESR spectra of Hbe(III) and Hbe(II) derivatives, several of which were prepared and characterized by optical and ESR spectroscopy. Addition of 2,3-bisphosphoglycerate [Gri(2,3)P2] or inositol hexakisphosphate to Hbe(II)NO causes tension in the Fe-N(proximal His) bond, although the behaviour differs in detail from that of HbA(II)NO. There are two equilibrium states of Hbe having significantly different kinetics for the Hbe(III)----Hbe(II) reaction of Hbe(III)NO. This autoreduction occurs in the form of two parallel processes, which collapse into one intermediate rate in the presence of Gri(2,3)P2. The temperature dependences of the rates enable deduction of delta H0 and delta S0 for the linked equilibrium, and yield linear Eyring plots for Hbe(III)NO, from which activation parameters were estimated on the basis of a previously described mechanism.
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PMID:Spectroscopic and kinetic aspects of Elephas maximus hemoglobin. 215 90

A patient with gout and schizophrenia is described who during a schizophrenic paroxysm with paranoid-hypochondriac-hallucinatory syndrome attempted to commit suicide and took 200 tablets milurit (20 g). He developed the picture of acute intoxication with nausea, vomiting, profuse diarrhea, abdominal pain, flushing, temperature, collapse manifestations, hepatomegaly, direct hyperbilirubinemia, elevated transaminase, leukopenia, accelerated ESR. After reanimation and infusion therapy, the patient recovered within 4 days and 2 weeks later all blood indices reached the limits of the norm.
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PMID:[Acute allopurinol (milurit) poisoning]. 402 4

Glomerular barrier function was evaluated in 12 healthy human volunteers and in 16 proteinuric patients in whom the nephrotic syndrome was associated with alteration of glomerular epithelial cells alone (minimal change nephropathy [MCN]) or in combination with focal glomerular sclerosis (FGS). We determined the glomerular sieving coefficient for each of nine narrow dextran fractions (Einstein Stoke radius [ESR] = 30 to 46 A), and directly measured, or indirectly estimated, values for the determinants of glomerular ultrafiltration. These quantities were then subjected to analysis based on an hydrodynamic theory of solute transport through an isoporous membrane. The results indicate that relative to normal subjects, effective pore radius is reduced from 59 to 55 and 53 A in McN and FGS, respectively; while the ratio, pore area to pore length (a measure of pore density) is correspondingly reduced from 21.7 X 10(6) to 10.1 X 10(6) and 4.7 X 10(6) cm. respectively, We suggest that collapse of the anionic glomerular membrane matrix in these proteinuric disorders may lead to pore shrinkage and reduced pore density, but that reduced electrostatic repulsion of anionic albumin (ESR = 36 A) facilitates its permeation into Bowman's space. The qualitatively similar disorder of glomerular barrier function in MCN and FGS is consistent with a unitary pathogenesis, but may represent a nonspecific response to depletion of glomerular polyanion.
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PMID:The nature of the glomerular injury in minimal change and focal sclerosing glomerulopathies. 617 43

Die Kelders Cave 1, first excavated under the direction of Franz Schweitzer in 1969-1973, was re-excavated between 1992 and 1995 by a combined team from the South African Museum, SUNY at Stony Brook, and Stanford University. These renewed excavations enlarged the artefactual and faunal samples from the inadequately sampled and less intensively excavated lower Middle Stone Age (MSA) layers, increased our understanding of the complex site formation processes within the cave, enlarged the hominid sample from the MSA deposits, and generated ESR, TL, and OSL dates for the MSA layers. Importantly, these new excavations dramatically improved our comprehension of the vertical and lateral characteristics of the MSA stratigraphy. Surface plotting of the MSA layers has led to the identification of at least two major zones of subsidence that significantly warped the layers, draping some along the eroding surface contours of major blocks of fallen limestone roof rock. A third zone of subsidence is probably present in the older excavations. Dramatic roof falls of very large limestone blocks occurred at least twice-once in the middle of Layer 4/5 where the roof blocks were only slightly weathered after collapse, and at the top of Layer 6 where the blocks weathered heavily after collapse, producing a zone of decomposed rock around the blocks. Many of the sandy strata are cut by small and localized faults and slippages. All of the strata documented by Schweitzer's excavations are present throughout the exposed area to the west of his excavated area, where many of them thicken and become more complex. Layer 6, the thickest MSA layer, becomes less diagenetically altered and compressed to the west.
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PMID:Middle Stone Age stratigraphy and excavations at Die Kelders Cave 1 (Western Cape Province, South Africa): the 1992, 1993, and 1995 field seasons. 1062 96

The nucleophilic substitution reaction by gas-solid contact has been investigated. When 9-thienothienylfluoren-9-ol derivatives were coground with dichlorodicyanoquinone (DDQ) and then exposed to methanol vapor, the corresponding 9-methoxyfluorenes were obtained in 15-70% yields. Throughout the whole procedure the solid state was retained. The generation of a radical cation in the coground solids via charge-transfer interaction between the substrate alcohol and DDQ was suggested by the ESR spectrum. The mechanism involving the collapse of the radical cation to generate a proton, which acts as a catalyst to afford the carbocation, was deduced based on the electrochemical oxidation of the substrate in solution. The propagation of the substitution reaction in the solid state has been shown for the carbocation upon contact with methanol vapor. The crystalline inclusion compounds of 9-thienothienylfluoren-9-ol derivatives incorporating methanol as a guest were exposed to HCl gas. This gas-solid reaction also led to the formation of the corresponding methoxy compounds maintaining the solid state. Through this work a new consequence of solid-state cogrinding is deduced.
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PMID:Solid-state solvolysis of thiophene-substituted trityl-type alcohols: nucleophilic substitution induced by gas-solid contact. 1143 99

Luminescence, induced by dehydration and by wetting with hydrazine and unsymmetrically substituted hydrazine, and related ESR spectra have been observed from several kaolinites, synthetically hydrated kaolinites, and metahalloysites. The amine-wetting luminescence results suggest that intercalation, not a chemiluminescence reaction, is the luminescence trigger. Correlation between hydration-induced luminescence and g = 2 ESR signals associated with O(-)-centres in several natural halloysites, and concurrent diminution of the intensity of both these signal types as a function of aging in two 8.4 angstroms synthetically hydrated, kaolinites, confirm a previously-reported relationship between the luminescence induced by dehydration and in the presence of O(-)-centres (holes, i.e., electron vacancies) in the tetrahedral sheet. Furthermore, the ESR spectra of the 8.4 angstroms hydrate showed a concurrent change in the line shape of the g = 4 signal from a shape usually associated with structural Fe in an ordered kaolinite, to a simpler one typically observed in more disordered kaolinite, halloysite, and montmorillonite. Either structural Fe centres and the O(-)-centres interact, or both are subject to factors previously associated with degree of order. The results question the long-term stability of the 8.4 angstroms hydrate, although XRD does not indicate interlayer collapse over this period. Complex inter-relationships are shown between intercalation, stored energy, structural Fe, and the degree of hydration which may be reflected in catalytic as well as spectroscopic properties of the clays.
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PMID:Luminescence and ESR studies of relationships between O(-)-centres and structural iron in natural and synthetically hydrated kaolinites. 1154 70

L-Ascorbic acid 2-[3,4-dihydro-2,5,7,8-tetramethyl-2-(4,8,12-trimethyltridecyl)-2H-1-benzopyran-6-yl-hydrogen phosphate] potassium salt (EPC-K(1)) is a conjugate of vitamin C and vitamin E that is water-soluble and stable at room temperature. EPC-K(1) has been developed as a hydroxyl radical (.OH) scavenger and antioxidant. In a previous tooth whitening experiment, it was accidentally found that tooth (dentin) blocks were dissolved by EPC-K(1) with H(2)O(2). In the current study, high concentrations of EPC-K(1) (2.5, 25 mM) with 3% H(2)O(2) dissolved and caused the collapse of dentin blocks. Similar concentrations of EPC-K(1) without 3% H(2)O(2), however, dissolved the dentin blocks without collapse over a 3-week period. In these cases, a.OH-like signal was detected using an ESR spin-trapping method. The volume of calcium in solution (including the dentin block) increased on the addition of EPC-K(1) in a concentration-dependent manner. In addition, the calcium : phosphorus ratio changed from 2 : 1 in sound dentin to 1 : 2 in the collapsed dentin block. High concentrations of EPC-K(1) are therefore considered to have calcium chelating and dentin dissolving activity. The dentin dissolving activity was enhanced when EPC-K(1) was used with H(2)O(2). EPC-K(1) had no protective effect when used in tooth whitening with H(2)O(2).
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PMID:Dentin is dissolved by high concentrations of L-ascorbic acid 2-[3,4-dihydro-2,5,7,8-tetramethyl-2-(4,8,12-trimethyltridecyl)-2H-1-benzopyran-6-yl-hydrogen phosphate] potassium salt with or without hydrogen peroxide. 1518 28

Prolonged spiking fever, an evanescent salmon-colored rash, arthralgia or arthritis, leukocytosis and organ dysfunction are characteristic of adult onset Still's disease (AOSD). A 25-year-old woman with fever lasting over 3 weeks presented to our clinic. The patient had a spiking fever, sore throat, tender lymph nodes, a fine pink-colored skin rash, arthralgia, myalgia with a high ESR, ferritin and elevated hepatic enzymes. NSAID and prednisolone were prescribed for AOSD with SIRS. After 4 days of therapy, with mild confusion, the patient went into status epilepticus lasting several hours and died after cardiovascular collapse. There has been only one case of status epilepticus associated with AOSD in the medical literature. Here we report a case of AOSD with SIRS complicated by fatal status epilepticus.
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PMID:A case of adult onset Still's disease with systemic inflammatory response syndrome complicated by fatal status epilepticus. 1830 88

A hydrogen molecule entrapped in the cages of icy hydrogen hydrate is confined in host water framework and thus behaves unlike pure solid or liquid hydrogen. The gamma-irradiated hydrogen radicals are for the first time observed from ESR and solid-state MAS 1H NMR spectra to stably exist in the icy hydrate channels without any collapse of the host framework, confirming the chemical shift consistency of ionized hydrogen derivatives. We discuss the confined icy hydrate channels, which can act as potential storage sites for simultaneously imprisoning both molecular and ionized hydrogen and further as icy nanoreactors.
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PMID:Spectroscopic observation of atomic hydrogen radicals entrapped in icy hydrogen hydrate. 1857 30


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