Sixteen patients with osteoarthritis (13 knees and 3 hips), 3 patients with rheumatoid arthritis (RA) and 4 cadaver were studied for evidence of immune complex in the destroyed articular cartilage tissues. Frozen sect...Sixteen patients with osteoarthritis (13 knees and 3 hips), 3 patients with rheumatoid arthritis (RA) and 4 cadaver were studied for evidence of immune complex in the destroyed articular cartilage tissues. Frozen sections of the articular cartilage from arthroplasty were stained with fluoresceinated antibodies to human immunoglobulins IgG, IgA, IgM and complement C3. The results showed: 1. There were immune complexes linear deposited in the surface of the irregular articular cartilage tissues and on some chondro- cytes remained in most patients with osteoarthritis (14/16). The patterns of immune complexes are IgA, complement C3, IgG and IgM, their percentage is 81. 25%, 75%, 75% and 50% respectively. 2. In all of 3 patients with RA, the surfaces of articular tissues were seen with patchy diffusely positive areas for IgA, IgG, IgM (excepting negative in I case) and complement C3. 3. There were no immune complexes deposited in the surfaces of 4 cases of normal articular tissues. The presence of immune complexes in the cartilages suggested that an autoimmune reaction participated in the pathological process of osteoarthritis and that the autoimmunity may be responsible for the continuous degeneration of the osteoarthritis.展开更多
Tuberculosis （TB） occurring after a closed bone fracture in the patient with no history of TB and no evidence of TB infection at the time of initial fracture is a rare entity. We report one such case of a 48-year-ol...Tuberculosis （TB） occurring after a closed bone fracture in the patient with no history of TB and no evidence of TB infection at the time of initial fracture is a rare entity. We report one such case of a 48-year-old female, who presented in the emergency department with an olecranon fracture which was open reduced and inter- nally fixed with tension band wiring. Patient presented in the outpatient department with serosanguineous discharge at 3 weeks after surgery. The discharge was sent for culture and sensitivity tests, and the patient was managed by anti- biotics and daily dressings. There was wound dehiscence and the underlying implant was exposed, which was removed at 12 weeks after surgery. Repeat debridements and dressings continued for 6 months, but the discharge from the wound site continued. X-rays of the elbow performed at 6 months raised the suspicion of TB, which was confirmed by Ziel-Neelsen staining and histopathological examination of the debrided tissue. Following the confirmation, patient was put on antitubercular drugs. The patient responded to anti- tubercular drug therapy （ATT）, the purulent discharge from the wound ceased, and eventually the wound healed after 2 months of starting ATT.展开更多
文摘Sixteen patients with osteoarthritis (13 knees and 3 hips), 3 patients with rheumatoid arthritis (RA) and 4 cadaver were studied for evidence of immune complex in the destroyed articular cartilage tissues. Frozen sections of the articular cartilage from arthroplasty were stained with fluoresceinated antibodies to human immunoglobulins IgG, IgA, IgM and complement C3. The results showed: 1. There were immune complexes linear deposited in the surface of the irregular articular cartilage tissues and on some chondro- cytes remained in most patients with osteoarthritis (14/16). The patterns of immune complexes are IgA, complement C3, IgG and IgM, their percentage is 81. 25%, 75%, 75% and 50% respectively. 2. In all of 3 patients with RA, the surfaces of articular tissues were seen with patchy diffusely positive areas for IgA, IgG, IgM (excepting negative in I case) and complement C3. 3. There were no immune complexes deposited in the surfaces of 4 cases of normal articular tissues. The presence of immune complexes in the cartilages suggested that an autoimmune reaction participated in the pathological process of osteoarthritis and that the autoimmunity may be responsible for the continuous degeneration of the osteoarthritis.
文摘Tuberculosis （TB） occurring after a closed bone fracture in the patient with no history of TB and no evidence of TB infection at the time of initial fracture is a rare entity. We report one such case of a 48-year-old female, who presented in the emergency department with an olecranon fracture which was open reduced and inter- nally fixed with tension band wiring. Patient presented in the outpatient department with serosanguineous discharge at 3 weeks after surgery. The discharge was sent for culture and sensitivity tests, and the patient was managed by anti- biotics and daily dressings. There was wound dehiscence and the underlying implant was exposed, which was removed at 12 weeks after surgery. Repeat debridements and dressings continued for 6 months, but the discharge from the wound site continued. X-rays of the elbow performed at 6 months raised the suspicion of TB, which was confirmed by Ziel-Neelsen staining and histopathological examination of the debrided tissue. Following the confirmation, patient was put on antitubercular drugs. The patient responded to anti- tubercular drug therapy （ATT）, the purulent discharge from the wound ceased, and eventually the wound healed after 2 months of starting ATT.
