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Fifteen to twenty percent of patients with juvenile rheumatoid arthritis (JRA) have positive latex fixation tests (LFT), whereas approximately 46% have previously been demonstrated to have hidden rheumatoid factors (RF), i.e., 19s IgM RF which can be detected by the LFT after acid separation of the IgM-containing fraction from serum. In this study, hidden RF were found in 59% of patients with seronegative JRA by use of a complementdependent hemolytic assay. The median titer of JRA patients was l :42, and in healthy and disease controls it was 1 :7. The difference was significant at P < 0.001. When data from patients with active disease were analyzed separately, the median titer for polyarticular JRA was l :97 and for pauciarticular JRA, 1 :91. The differences due to active disease were significant at P < 0.001 and P < 0.005, respectively.The results demonstrate that the hemolytic assay is more sensitive than the LFT in determining the presence of hidden RF, and activity of disease correlates well with high hemolytic R F titers.

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Neurologic disease is reported to occur in just 10% of patients with mixed connective tissue disease (MCTD). Most commonly, this is manifested by mild trigeminal neuralgia. This report details the clinical and neuropathologic findings of transverse myelitis in a patient with MCTD. Neurologic features include progressive areflexic paraplegia with loss of bowel and bladder function. Neuropathologically there was thinning of the thoracic cord, widespread loss of axons and myelin sheaths, reactive astrocytosis, macrophage formation, vascular thickening with perivascular chronic inflammatory cell infiltration, and calcium deposits. This case demonstrates that severe neurologic disease unresponsive to therapy can occur in MCTD.

A connective tissue growth model based on the regeneration of rabbit calcaneal tendon following surgical excision is described. Tissues allowed to regenerate for various periods of time from two days to 240 days were studied histologically and compared with mature tendon.Rabbit calcaneal tendon regenerating for 14 days or longer was found to represent a rapidly grown, normal connective tissue obtainable in quantities sufficient for biochemical microanalysis and thus to provide a valuable connective tissue growth model. By allowing growth to proceed for 56 days, the model could be used to provide normal tissue morphologically approximating mature tendon.