A 21-year-old female, treated with triamcinolone for tendinitis in the oblique muscles of both forearms, developed a skin atrophy, localized around the injection points. The patient was followed over a period of more than five years during which a partial remission of the skin changes was observed. A synopsis covering local use of steroids for various diseases is given.
In 20 consecutive rheumatoid arthritis patients, 14 women and 6 men, age 26-76, average 62 years, the concentration of the recently found "primary plasmin inhibitor" and phase proteins was estimated in plasma and synovial fluid. In 12 patients a complex between the inhibitor and plasmin could be demonstrated by crossed immunoelectrophoresis into immunoglobulins against the primary plasmin inhibitor and immunoglobulin against plasminogen. Only free inhibitor was found in corresponding plasma. All plasminogen present in synovial fluid could be activated to plasmin upon addition of urokinase (24 nM/I). In those patients where enzyme-inhibitor complex in synovial fluid was present, a higher concentration of phase proteins in synovial fluid was found, indicating an increased degree of inflammation despite identical scores in the Lansbury clinical index in the From the
In a prospective study of old, terminally ill patients who died from various conditions in a general hospital ward, the autopsy established a very high incidence of silent myocardial infarction. Acute myocardial infarction (AMI), clinically not suspected, was demonstrated at autopsy in 20 of 39 cases. 13 AMIs involved only the subendocardial layers. Severe coronary artery stenosis was three times as frequent among the AMI patients as among the others, but recent coronary artery thrombosis was observed in one case only. Clinical and laboratory observations failed to establish the diagnosis of AMI prior to death.
Pigmented villonodular synovitis (PVS) was diagnosed in 25 patients during the period 1950--76. Twenty-two of the patients were re-examined 2--28 years later. Three patients with local affection of tendon sheaths, treated by excision, were all free of symptoms at follow-up. Nineteen patients all with unilateral knee joint affection were divided into two groups according to peroperative findings, 6 localized PVS and 13 diffuse PVS. The 6 patients with localized PVS all had normal knee movement at follow-up, whereas the 13 with diffuse involvement had varying impaired knee mobility.
cAMP was measured in plasma and synovial fluid from 11 patients suffering from rheumatoid arthritis with a specific protein-binding assay. Plasma and synovial fluid values were 17.0 +/- 6.8 pmol/ml and 8.3 +/- 3.7 pmol/ml, range 5-28 pmol/ml and 5-16 pmol/ml, respectively. No correlation could be established between plasma and synovial fluid levels, plasma and disease activity, or synovial fluid and disease activity, as judged by Lansbury's index. It is concluded that it seems unlikely that synovial fluid cAMP is derived solely from plasma and that no simple relation exists between cAMP in plasma and synovial fluid and total disease activity.
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