Sharad Lakhanpal

Transient Regional Osteoporosis: A Study of 56 Cases and Review of the Literature

We describe the clinical features and course of disease in 56 patients (33 men and 23 women) with transient regional osteoporosis. The median age at hospitalization was 48 years. All patients had monoarticular or oligoarticular joint pain that was aggravated by weight bearing. Eighteen also had pain at rest in the involved joints and 6 had nocturnal pain. The joints of the lower extremities were affected in 54 patients; the hip was the most commonly affected joint. There was little evidence of synovitis. Osteoporosis was diagnosed on the basis of characteristic clinical findings and the results of roentgenograms and bone scans. The osteoporosis resolved spontaneously over several months. Treatment consisted of joint protection, initiation of gradual ambulation, and administration of nonsteroidal anti-inflammatory agents. Although its cause is unknown, osteoporosis appears to be a regional rather than a systemic process.

A flow cytofluorometric double staining technique for simultaneous determination of human mononuclear cell surface phenotype and cell cycle phase

A double staining technique for the simultaneous determination by flow cytofluorometry of cell surface phenotype and cell cycle phase is described. Peripheral blood mononuclear cells were stained with fluorescein-conjugated monoclonal antibodies for cell surface phenotype, fixed serially with 2% paraformaldehyde and 71.25% ethanol, and stained with propidium iodide to label cellular DNA. The cells were then analyzed by flow cytofluorometry for both green and red fluorescence. A variety of cells, including T cells and their subsets, B cells, NK cells and monocyte/macrophages, can be identified by this technique with simultaneous determination of cell cycle phase.

Clinical and Prognostic Significance of Vasculitis as an Early Manifestation of Connective Tissue Disease Syndromes

The courses of 18 patients with arthritis and vasculitis in the first 2 years after onset of disease (mean follow-up, 54 months) were studied. The patients were categorized as having rheumatoid vasculitis, systemic vasculitis, and undifferentiated connective tissue syndrome. These patients cannot be distinguished on basis of organ involvement by vasculitis or histopathologic findings on biopsy, but can be separated clinically by the extent of joint involvement and the presence or absence of rheumatoid factor and antinuclear antibody. Early onset of vasculitis is associated with a poor outcome, especially in patients with rheumatoid arthritis, with rapid progression to vasculitic involvement of the viscera, resulting in death. On the basis of the 54-month follow-up period involving this selected series, the prognosis of patients with systemic vasculitis and undifferentiated connective tissue syndrome appears more favorable than that of patients with rheumatoid vasculitis.

Stimulation of resting normal human peripheral blood mononuclear cells by fetal calf sera. Activation to an interleukin-2 responsive state.

Normal adult human peripheral blood mononuclear cells which are negative for interleukin-2 (IL-2) receptors as assessed by flow cytofluorometry, acquire IL-2 receptors and IL-2 responsiveness after culture in media supplemented with fetal calf sera. Thus, in the absence of any known external stimuli, fetal calf sera used to supplement culture media can induce the transformation of resting (G0) peripheral blood mononuclear cells to an activated (G1) state. The activated (G1) cells are able to progress through the rest of the cell cycle (S, G2, M) in the presence of IL-2. As a result, studies of human peripheral blood mononuclear cells in fetal calf serum-supplemented culture media should be interpreted with appropriate caution.