Surface Erosions Research Articles

ARTICULAR DAMAGE IN SJOGREN’S DISEASE

Objective. To give clinical and x-ray characteristics of joint syndrome in Sjogren's disease. Methods. 150 patients with Sjogren's disease were included. Clinical and retrospective radiological examinations were performed. Progression of hands and feet joints radiological damage was assessed using Larsen's scale. Results. Arthralgia was present in 76%, light morning stiffness - in 42,7% (more often lasting less then 20 min), Al the admission arthritis was noted in 16,7%. Hand small joints damage was prevalent. 36% of patients had history of arthritis. Its development was accompanied by purpura in one third of cases. Painful hand joint contractures were noted in 9,3%, diffuse hands oedema in 4,6%, ulnar deviation of the metacarpophalangeal joints in 0,7%, Jaccoud's arthropathy in 0,7%. Single surface erosions of hands were revealed at the X-ray examinations in 7 patients (4,7%). Early development of osteoarthrosis was noted. Larsen index ranged from 0 to 29 at the first and from 0 to 37 at the second examination (after 4.7 years). Conclusion. Joint syndrome in Sjogren's disease is characterized by light morning stiffness of short duration, arthritis which is usually not erosive and more often affects small joints оГ hands. Painful joint contractures and diffuse hands oedema are less frequent.

Type-Ip colon cancer bearing surface erosions where we had a great difficulty in establishing the cancerous depth diagnosis

A 75-year-old male turned out positive for the fecal occult blood test without any complaints. A pedunculated but broad-based lesion measuring about 10mm and lacking in mobility was discerned in the sigmoid colon, the top of which assumed an asymmetric and expansive growth. The surface looked uneven and reddened causing haemorrhagic fragility resulting in the formation of depressed erosions and nodules, which was deduced to be indicative of sm2 or deeper cancer. Barium enema likewise revealed no mobility. The entire lesion comprised VI pit, and VN pit was also discerned in depressed portions. Pathologically, well to moderately differentiated cancer (high grade atypia) without adenoma component, cancerous depth sm1, ly0, v0, cut end (－) , interstitial permeation from the bottom of glands present. Despite the features indicative of sm2 or deeper, the lesion resulted in minimally invasive sm1. The present case cautioned us not to make an over-diagnosis between mucosal and sm2 cancer in that there actually exists the limitation or the very difficulty in the clinical diagnosis concerned.

ARTHROSCOPY IN DIAGNOSTICS OF GONARTHROSIS

Aim: Analysis of arthroscopy importance of knee joints for characteristics of stage of cartilage destruction and synovitis in gonarthrosis cases. Material and methods: Arthroscopical study included 24 gonarthrosis pts (I-III degree by A.Larsen) by STORZ ” apparatus with photoinstrumental set. Six basic zones of knee joint were analyzed: patella, trochlear are, a lateral and medial articular tibial and femoral surfaces. Criteria of assessment included presence and distribution of cartilage damage according to 5 degrees: normal cartilage (0), fibrillar cartilage (I degree), surface fissures and/or surface erosions (2 degree), deep cartilage tissures and/or erosions baring subchondral bone (3 degree), baring subchondral bone (4 degree). Synovitis intensity was analyzed by three degrees: low, moderate or high. Results: It was determined that in different zones of knee joint the character and depth of cartilage destruction is not the same. In 100% of patients with gonarthrosis independently of radiological stage there were changes in patellar cartilage. Pathology' of articular cartilage in the area of lateral condyle of the femur in the lateral and medial areas of the tibia was found in the I-st, Il-nd and Ill-d stages with the same incidence. Development of fissures of cartilage was found in all gonarthrosis stages and even in the 1-st stage the incidence was the same as in the 111-d disease degree. Erosions were found in more than a half of pts with the I-st and Il- nd stages of gonarthrosis (57% and 67% correspondingly). Even in the I-st gonarthrosis stage in all areas of knee joint excluding lateral articular surface of the tibia changes characteristic for the Ill-d degree of cartilage destruction were found with different frequency. Incidence of subclinical synovitis according to arthroscopy data in the /, 11, III radiological stages of gonarthrosis was 57%, 33.5% and 100% correspondingly. Fissures and erosions were found in all pts with expressed synovitis. Conclusion: In our study no correlation was found between the stage of cartilage destruction (according to arthroscopy data) and early (1 and 11) radiological gonarthrosis stages: Ill-d stage of gonarthrosis is corresponding with the Ill-d stage of cartilage destruction.

Hydrophilic bile salts protect bile duct epitheliumduring cold preservation: A scanning electron microscopy study

Prolonged graft preservation is associated with postoperative bile duct strictures after liver transplantation. We previously showed that hydrophilic bile salts mitigate bile duct preservation injury in a pig model. Because this injury occurs at the epithelial level, scanning electron microscopy was performed to further characterize this effect in vitro. Swine livers were harvested after the intravenous infusion of 1 of 3 solutions: saline (n = 7), tauroursodeoxycholate ([TUDC] hydrophilic; n = 4), or taurodeoxycholate ([TDC] hydrophobic; n = 4). Livers were perused with University of Wisconsin solution. The bile ducts were flushed retrograde, and the liver was stored at 0°C to 1°C for 20 hours. Bile duct samples were obtained at the time of harvest and 8, 12, 16, and 20 hours thereafter. In saline-infused controls at time 0, the epithelium was intact and composed of uniform cuboidal cells covered with fine regular microvilli. There were no spaces between individual cells. After 8 to 12 hours of preservation, cells were more irregular in shape, with loss of cell-cell contact. The cell surfaces showed fewer microvilli. Surface erosions suggested loss of cell-wall integrity. TUDC was protective, evidenced by normal-appearing cells with uniform microvilli after 16 hours. In contrast, TDC accelerated the injury process, causing cell-surface erosions, blebs, and loss of microvilli as early as time 0. Scanning electron microscopy is an excellent tool to study injury to bile duct epithelium. This study supports the hypothesis that hydrophilic bile salts protect bile ducts during preservation. To determine whether treatment with hydrophilic bile salts can prevent postoperative stricture, in vivo transplantation studies are needed.

Hydrophilic bile salts protect bile duct epithelium during cold preservation: a scanning electron microscopy study.

Prolonged graft preservation is associated with postoperative bile duct strictures after liver transplantation. We previously showed that hydrophilic bile salts mitigate bile duct preservation injury in a pig model. Because this injury occurs at the epithelial level, scanning electron microscopy was performed to further characterize this effect in vitro. Swine livers were harvested after the intravenous infusion of 1 of 3 solutions: saline (n = 7), tauroursodeoxycholate ([TUDC] hydrophilic; n = 4), or taurodeoxycholate ([TDC] hydrophobic; n = 4). Livers were perfused with University of Wisconsin solution. The bile ducts were flushed retrograde, and the liver was stored at 0 degrees C to 1 degrees C for 20 hours. Bile duct samples were obtained at the time of harvest and 8, 12, 16, and 20 hours thereafter. In saline-infused controls at time 0, the epithelium was intact and composed of uniform cuboidal cells covered with fine regular microvilli. There were no spaces between individual cells. After 8 to 12 hours of preservation, cells were more irregular in shape, with loss of cell-cell contact. The cell surfaces showed fewer microvilli. Surface erosions suggested loss of cell-wall integrity. TUDC was protective, evidenced by normal-appearing cells with uniform microvilli after 16 hours. In contrast, TDC accelerated the injury process, causing cell-surface erosions, blebs, and loss of microvilli as early as time 0. Scanning electron microscopy is an excellent tool to study injury to bile duct epithelium. This study supports the hypothesis that hydrophilic bile salts protect bile ducts during preservation. To determine whether treatment with hydrophilic bile salts can prevent postoperative stricture, in vivo transplantation studies are needed.

Gastritis and gastropathy of childhood.

Gastritis and gastropathy of childhood.

Erosive peripheral polyarthritis in ancient Japanese skeletons: A possible case of rheumatoid arthritis

The antiquity of rheumatoid arthritis (RA) is still in dispute, due to the difficulty of conclusively differentiating peripheral polyarthritis, especially from spondyloarthropathy, in archaeological populations. In view of the importance of genetic factors in developing spondyloarthropathy and of the far lower prevalence of the disease in modern Japanese, a rarity of peripheral polyarthritis would be anticipated in the ancient Japanese population, given that RA had not been present there. One hundred and sixty adult Japanese skeletons of the late and final Jomon period (3400–2400 years bp) were examined to find peripheral polyarthritis. There was one male skeleton with peripheral polyarthritis, showing marginal and surface erosions in the joints of the hands, feet, ankle and zygoapopheseal joints of the thoracic vertebrae. RA is suggested as the most probable cause of this pathology. This report raises the significance of further studies to consider whether more cases than anticipated exist in skeletal populations that would have been resistant to developing spondyloarthropathy. Copyright © 1999 John Wiley & Sons, Ltd.

Erosive peripheral polyarthritis in ancient Japanese skeletons: A possible case of rheumatoid arthritis

The antiquity of rheumatoid arthritis (RA) is still in dispute, due to the difficulty of conclusively differentiating peripheral polyarthritis, especially from spondyloarthropathy, in archaeological populations. In view of the importance of genetic factors in developing spondyloarthropathy and of the far lower prevalence of the disease in modern Japanese, a rarity of peripheral polyarthritis would be anticipated in the ancient Japanese population, given that RA had not been present there. One hundred and sixty adult Japanese skeletons of the late and final Jomon period (3400–2400 years bp) were examined to find peripheral polyarthritis. There was one male skeleton with peripheral polyarthritis, showing marginal and surface erosions in the joints of the hands, feet, ankle and zygoapopheseal joints of the thoracic vertebrae. RA is suggested as the most probable cause of this pathology. This report raises the significance of further studies to consider whether more cases than anticipated exist in skeletal populations that would have been resistant to developing spondyloarthropathy. Copyright © 1999 John Wiley & Sons, Ltd.

Characterisation of interfacial reaction in (AI2O3)p/6061 aluminium alloy composite

The interfacial characterisation of aluminium alloy 6061 reinforced with Al2O3 particles was carried out using scanning and transmission electron microscopy on interfacial sections and by X-ray diffraction on the reaction products extracted by electrochemical dissolution. The value of these combined techniques in elucidating the interfacial reaction mechanisms was demonstrated. Single crystals of MgAl2O4, of octahedral shape, were observed at the (Al2O3)p/Al interfaces together with surface erosions of (Al2O3)p which formed around the MgAl204 crystals. In the heat treated composite a reduction in precipitate density in the alloy matrix was observed in the vicinity of the (Al2O3)p. Based on the experimental observations and thermodynamic considerations, the MgAl2O4 crystals which formed at the surface of the (Al2O3)p are believed to grow by consuming A12O3.

Pathogenesis of aphthoid ulcers in Crohn's disease: correlative findings by magnifying colonoscopy, electron microscopy, and immunohistochemistry.

The mechanism of ulceration in Crohn's disease remains unknown. To clarify the role of the follicle associated epithelium (FAE) of colonic lymphoid nodules in the formation of ulcers in Crohn's disease. After identification of colonic lymphoid nodules and aphthoid lesions by magnifying colonoscopy, 76 biopsy specimens were obtained from 10 patients with Crohn's disease and three patients with colonic lymphoid hyperplasia. This study correlated magnifying colonoscopic, electron microscopic, and immunohistochemical findings of biopsy specimens. In Crohn's disease, scanning electron microscopy of lymphoid nodules surrounded by a red halo without visible erosions by magnifying colonoscopy, showed surface erosions 150-200 microns in size. These lymphoid nodules with red halos had small erosions either light microscopically or electron microscopically in 18 of 21 specimens (86%). Correlation of scanning and transmission electron microscopy showed residues of FAE including M cells at the edges of the erosions. In immunohistochemical studies, HLA-DR antigen was limited in M cells of FAE in the patients with lymphoid hyperplasia without inflammatory bowel disease. In Crohn's disease patients in remission, however, HLA-DR antigen was strongly expressed over the entire FAE of lymphoid nodules with a red halo endoscopically, while the expression was weak and irregular in the mucosa surrounding the lymphoid nodules. HLA-DR was strongly expressed in the entire inflamed colonic mucosa in the active stage. The red halo appearance surrounding lymphoid follicles seems to precede visible aphthoid ulcers and suggests that ulcerations in Crohn's disease originate from FAE, possibly related to its physiological role as a portal of entry for potentially pathogenic agents.

Starch urea formaldehyde matrix encapsulation of solid agrochemicals. II. Release mechanism and release modeling

AbstractBased on experimental observation, a mechanism is proposed to describe the release of carbofuran from a starch‐UF matrix. A simple mathematical model is developed to describe the diffusion‐controlled release of a solid insecticide from a porous starch‐UF matrix undergoing both volume and surface erosions. The model is tested with the release data collected for different matrices and with different pH values of the environmental liquid. The comparison between the model predictions and data is found to be reasonably good. The model describes the release process at different pH values by accounting for the influence of pH on the erosion rates.

Erosive osteoarthritis: Is it a separate disease entity?

Erosive osteoarthritis (EOA) characteristically involves the hands of middle-aged women. The diagnosis is essentially radiological and depends upon the presence of articular surface erosions. This study investigates whether this radiological feature is a marker of a specific clinical entity. From a series of 500 consecutive patients attending a rheumatology clinic with symptomatic limb joint osteoarthritis, 24 were identified by radiological criteria to have EOA. These were age-sex matched with 24 patients from the same series who presented with osteoarthritis of the hand. Those with EOA had nearly twice as many radiographically abnormal joints in the hands as the controls (274: 144). This was almost entirely due to an increase in distal (134: 68) and proximal (79: 24) interphalangeal joint involvement, 71% of which were erosive. Erosions were found apart from the hands in both elbows of one patient with EOA. Otherwise only minor differences were present between the two groups in terms of distribution and incidence of osteoarthritic changes. There were no distinguishing serological or other clinical differences. This study has demonstrated that erosions in EOA are associated with more severe hand disease but are not apparently a marker of a separate disease entity. EOA appears to be an aggressive acute form of hand osteoarthritis and may represent the hand equivalent of similar forms of osteoarthritis in the shoulder, hip and knee.

The Influence of Weight-Bearing Exercise on Articular Cartilage of Meniscectomized Joints

Unilateral medial meniscectomy was undertaken in 29 purebred adult merino sheep. Arthrotomy (without meniscectomy) was conducted in 11 animals, and six were used as nonoperated controls. All animals were followed with either three- or six-month active or passive postoperative management. Active animals traversed a total of 360 km after three months and 1040 km after six months. The passive group was housed in pens allowing limited weight-bearing exercise. After death, morphologic changes were recorded and cartilages from the medial and lateral joint regions were examined for water, collagen, and proteoglycan (as hexuronate) content. Proteoglycan aggregation and extractability under nondissociative (0.4 molar GuHCl) and dissociative (4.0 molar GuHCl) conditions were also determined. The collagen content of the medial cartilage of the passively maintained meniscectomized animals was reduced, relative to external controls. Although proteoglycan content was elevated in medial cartilage of the passive group three months postoperatively, these levels returned to the control range after six months. However, low-salt (0.4 molar GuHCl) extractability of proteoglycans still remained high. All cartilages of control and meniscectomized joints showed an elevation of proteoglycan content in the active groups three months postoperatively. The cartilages in the medial region of meniscectomized animals showed the largest increase, but these levels declined after six months. Proteoglycan aggregation and water content were still elevated relative to controls six months postoperatively. The collagen levels in the three-month or six-month actively maintained meniscectomized group were not distinguishable from control values. Morphologically, joints of the passively and actively maintained animals showed focal surface fibrillation and erosions. However, in the active group, osteophytes were common and well developed six months postoperatively. These studies indicate that, while weight-bearing exercise after meniscectomy appears to be beneficial to the quality of the cartilaginous matrix, it is also accompanied by osteophytosis and cartilage hyperplasia.

The Value of Rectal Biopsy in Distinguishing Self-limited Colitis from Early Inflammatory Bowel Disease

When a patient presents for the first time with acute diarrhoea, it can be difficult to distinguish acute self-limited colitis from idiopathic inflammatory bowel disease. This study was designed to determine whether detailed interpretation of rectal histology can enable this distinction to be made early in the course of the illness. Seventy-two rectal biopsies, taken at the time of presentation from patients with undiagnosed colitis, were reviewed independently by two observers without access to clinical information. Distorted crypt architecture, crypt atrophy, basal lymphoid aggregates and dense lymphocytic infiltrates each emerged as features with a 76 to 86 per cent probability of predicting idiopathic inflammatory bowel disease, but their discriminant value was limited by inter-observer disagreement (16-29 per cent). Isolated basal giant cells, epithelial surface erosions and epithelioid granulomas were found to be the most reliable histological features in the early diagnosis of idiopathic inflammatory bowel disease, and their interpretation was associated with the lowest inter-observer disagreement (6 per cent).

Aspirin-induced gastric injury in the rat: histologic changes and sucralfate cytoprotection.

The effect of pretreatment with intragastric sucralfate on aspirin acid-induced gastric mucosal lesions in the rat was studied. The finding by others that sucralfate is cytoprotective and that this cytoprotective effect probably is mediated, at least in part, by stimulation of endogenous prostaglandin synthesis was confirmed. In addition, a time course study revealed that the maximum cytoprotective effect was present 1 min after sucralfate administration and persisted for at least 6 hr. Microscopic evaluation of histologic sections revealed that sucralfate significantly decreased aspirin-induced deep mucosal erosions (those extending into the parietal cell area) but not superficial mucosal damage. Superficial mucosal damage (surface cell injury and erosions involving the mucous neck cell area) could not be detected grossly. The lesions seen grossly were deeper erosions involving the parietal cell area of the mucosa.

Surgical orthodontics and the temporomandibular joint: I. Superior repositioning of the maxilla

Ten randomly selected adults who had undergone orthodontic treatment and isolated superior repositioning of the maxilla for vertical maxillary excess (VME) were evaluated clinically and radiographically (mean, 48.7 months postsurgery) for signs and symptoms of masticatory and temporomandibular joint dysfunction. The patients ranged from 18 years to 37 years of age (mean, 26.2 years) when evaluated. A three-part evaluation of the subjects was performed. This consisted of an anamnestic evaluation (previous medical history), a clinical examination, and a radiographic evaluation. The anamnestic evaluation revealed that, prior to surgery, facial pain was reported by one patient and was not present in any of the patients upon follow-up examination. We believed that the pain was not related to the masticatory musculature and/or the temporomandibular joint. No patients reported pain or sounds in their joints preoperatively, while 30 percent ( 3 10 ) of the patients related a history of temporomandibular joint sounds immediately after release of intermaxillary fixation, which subsequently was reported to have resolved in all instances without treatment. Clinical examination of the temporomandibular joints at the time of recall evaluated mandibular movements and the presence of pain or sounds during joint function. These examinations revealed that clinical measures of mandibular movements were somewhat reduced relative to normal. All patients were free of temporomandibular joint and masticatory muscle pain during function, upon contralateral masticatory loading, and upon palpation. Fifteen percent ( 3 20 ) of the joints examined demonstrated sounds (popping or crepitation) via auscultation. Masticatory loading in the contralateral premolar region did not induce noise in any of the joints examined. Cephalometric laminagraphic radiographs were obtained of each of the twenty temporomandibular joints with the mandible in three positions; maximum intercuspation, mandibular rest position, and maximal opening. Numerous anatomic relations were quantified from these radiographs. However, only three parameters (condylar position, movement, and evidence of arthrosis) were compared to normative data available in the literature. These comparative data suggested that persons who had undergone orthodontic treatment in conjunction with superior maxillary repositioning demonstrated (1) a relatively retropositional condyle within the fossa and (2) reduced condylar movement during maximal mandibular opening. Two of twenty temporomandibular joints demonstrated radiographic evidence of arthrosis; one condyle demonstrated articular surface erosions, and another exhibited articular surface sclerosis. The overall incidence of arthrosis was not much greater than normal, with 20 percent ( 4 20 ) of the joints demonstrating a reduced interarticular joint space. Overall, the clinical findings revealed a low incidence of pathologic masticatory muscle and temporomandibular joint symptoms and signs compared to normative data in the literature. However, the cephalometric laminographic findings suggest the need for prospective evaluation of the temporomandibular joints in persons undergoing surgical-orthodontic correction of vertical maxillary excess.

The gastric mucosal response to acetylsalicylic acid in the ferret

An electron microscopic investigation was undertaken on adult fasted ferrets in order to clarify the acute gastric mucosal, morphologic response to orally ingested acetylsalicylic acid. A single, clinically relevant dose (10 mg/kg) was administered and gastric surface responses were studied by scanning electron microscopy, and differential early, cytologic responses of the glandular cells were evaluated by transmission electron microscopy. Gastric bleeding was derived from minute, surface erosions morphologically indistinct from stress-type erosions. Parietal cells underwent drug-specific changes and chief cells, nonspecific degenerative changes. Mucous epithelial cells were disrupted only in localized regions, and tight junctions between surface epithelial cells remained intact. The order of decreasing cellular sensitivity to this acute (10–45 min) exposure to HCl-acidified aspirin solution was: parietal cells, chief cells, and surface epithelial cells. Argentaffin cells and mucous neck cells were resistant.

Rib lesions in rheumatoid disease.

Extra-articular osseous manifestations of rheumatoid disease have been described in the vertebral bodies (Seaman and Wells, 1961), in the femoral necks (Mather, 1954; Slocumb, Ferguson, Mayne and Hunder, 1967), and in the vault of the skull (Schlesinger, Forsyth, White, Smellie and Stroud, 1961). Bone biopsy in all these cases showed evidence of granulomatous necrosis and the lesions were considered to be true rheumatoid granulomata arising in bone. In addition, Kreel and Urquhart (1963) described surface erosions of bone in relation to adjacent rheumatoid skin nodules. These authors considered the bone erosions in their cases to be the result of pressure from the skin nodule. Alpert and Feldman (1964) described eight cases of rib erosions occurring in patients with long standing rheumatoid disease. Symmetrical involvement of the superior surfaces of the posterior aspects of the 3rd, 4th and 5th ribs was the most common manifestation. The lesions took the form of deep notches with a maximum width of 9 mm ...