Response and remission criteria based on DAS were useful in a study of patients with RA who were managed essentially as in clinical practice. The criteria used showed construct and criterion validity, although discriminant validity could not be shown. The application of valid criteria for response and remission in clinical practice may be a useful aid in the evaluation of treatment effects and in making treatment decisions for individual patients.

Between 1985 and 1987 a total of 521 people underwent temporal artery biopsy with no histological evidence of arteritis in Göteborg, Sweden. Two-hundred-and-twenty people were diagnosed as having polymyalgia rheumatica (PMR). Among the patients without PMR 30% had rheumatic, 17% malignant and 14% infectious disorders. The annual incidence of PMR with negative biopsy was 17/100,000 and for the population over 50 yr it was 50/100,000. We found an increased mortality in vascular diseases among men with PMR in the first 2 yr after diagnosis with 13 observed deaths compared to the expected six (P < 0.01). There was also a tendency toward an increased mortality among the women with 16 observed deaths compared to the expected 11 (not statistically significant). The mortality in malignant diseases was not increased.

Our study indicates that in patients with AS, pulmonary involvement is not only common but also starts in the early stage of the disease. HRCT was significantly sensitive in detecting lung involvement, especially in pulmonary aspect symptomatic patients with AS. Therefore, we strongly suggest that HRCT should be the first choice rather than chest X-ray or PFT for detecting pleuropulmonary pathology in early AS patients.This study brings up a possibility that pleuropulmonary tissue is an independent primary target in AS. Confirmation of this possibility with further studies creates an opportunity of preventing a major morbidity and mortality condition with early initiation of effective treatment in patients with AS in the future. References1. Khan AM. Clinical features of ankylosing spondylitis. In Hochberg MCSilman AJSmolen JSWeinblatt ME, Weisman MH, editors. Rheumatology. Spain: Mosby, 2003: 1161-81. 2. Kaprove RE, Little AH, Graham DC, Rosen PS. Ankylosing spondylitis. Survival in men with and without radiotherapy. Arthritis Rheum 1980;23:57-61. 3. Smith PG, Doll R. Mortality among patients with ankylosing spondylitis after a single treatment course with X-rays. Br Med J 1982;284:449-60. 4. Braun J, Pincus T. Mortality, course of disease and prognosis of patients with ankylosing spondylitis. Clin Exp Rheumatol 2002;20 (Suppl 28), S16-22. 5. Casserly IP, Fenlon HM, Breatnach E, Sant SM. Lung findings on high-resolution computed tomography in idiopathic ankylosing spondylitis -correlation with clinical findings, pulmonary function testing and plain radiography. Br J Rheumatol 1997;36:677-82. 6. Turetschek K, Ebner W, Fleischmann D, Wunderbaldinger P, Erlacher L, Zontsich T, et al. Early pulmonary involvement in ankylosing spondylitis: assessment with thin-section CT. Clin Radiol 2000;55:632-6. 7. Senocak O, Manisali M, Ozaksoy D, Sevinc C, Akalin E. Lung parenchyma changes in ankylosing spondylitis: demonstration with high resolution CT correlation with disease duration. Eur J Radiol 2003;45:117-22. 8. Souza AS Jr, Muller NL, Marchiori E, Soares-Souza LV, de Souza Rocha M. Pulmonary abnormalities in ankylosing spondylitis: inspiratory and expiratory high-resolution CT findings in 17 patients.

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Objective. To investigate T cell receptor (TCR) VJV, (and in selected cases, J,) usage in CD4+ and CD8+ peripheral blood lymphocytes of patients with giant cell arteritis (GCA), before and after treatment, as well as to analyze the HLA types of these patients.Methods. Flow cytometry, with 10 anti-TCR V-specific monoclonal antibodies (MAb), was used. To analyze J, usage by cell populations expressing certain V,, we used the polymerase chain reaction (PCR) technique, with V,-and Cp-specific primers, Southern blotting of PCR products, and subsequent hybridization with radiolabeled J,-specific probes. HLA typing was performed using the microlymphocytotoxicity technique.Results. Seven of the 9 GCA patients had increased anti-TCR V MAb reactivities (interpreted as T cell expansions), which in many cases, correlated with clinical signs of disease. A strict preference for particular Jp segments was found in 3 of 3 expanded CD4+ T cell populations.Conclusion. T lymphocytes expressing specific antigen receptors are implicated in the pathogenesis of GCA.