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In 30 patients with rheumatoid arthritis, the activity of beta-glucuronidase and the content of sulfated and non-sulfated glycosaminoglycans (GAG) were measured in synovial fluid (SF) and in the cells of SF. It has been established that as the local inflammation increases, the activity of the enzyme and the content of sulfated GAG in SF also rise. This is accompanied by simultaneous reduction of beta-glucuronidase activity in the cells and by the drop of the hyaluronic acid content in SF.

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Content of glycosaminoglycans and beta-glucuronidase activity were measured in leukocytes, blood serum and urine of patients with rheumatoid arthritis. Concentration of glycosaminoglycans was increased in blood serum and urine of the patients. The most distinct increase as compared with healthy persons in content of these substances was found in leukocytes of the patients with joint form of rheumatoid arthritis. Activity of beta-glucuronidase was also elevated in cells of peripheral blood, whereas content of protein was decreased in these cells. The enzymatic activity was reduced in the fraction of polymorphonuclear leukocytes of the patients as shown by estimation of the activity per 10(6) cells after fractionation using the Ficoll-verografin procedure. Deficiency of beta-glucuronidase activity in polymorphonuclear leukocytes appears to be among the factors responsible for excess of glycosaminoglycans in blood serum and urine of the patients as well as for chronic inflammation under conditions of rheumatoid arthritis.

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A comparative study of the synovial fluid (SF) composition was conducted in 72 patients with rheumatoid arthritis (RA) with relation to the presence of the rheumatoid factor (RF) and clinical manifestations of this disease. A statistically significant difference in the SF composition (the number of leukocytes, neutrophils and ragocytes) was shown in seropositive and seronegative RA. The content of total protein and glucose in SF did not practically differ in both cases. In the common group of the RA patients correlation was established between the number of neutrophils, the level of total protein, percentage of ragocytes, the level of complement in SF and a degree of general inflammatory activity of disease. A subgroup of RA patients (32%) was identified with the prevalence of lymphocytes, a slight rise of the level of total protein, a low percentage of ragocytes and rather a high level of complement. In 87% of the above patients noticeable osteochondrous destruction (III-IV roentgenological stage) was noted against a background of low inflammatory activity. The data obtained confirmed an important role of SF investigation for the elucidation of the mechanisms of pathogenesis, differential diagnosis and prognosis.

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Of 116 persons who developed rheumatoid arthritis (RA) as teen-agers, 56 were seronegative for RF a long period of time. Clinicolaboratory and x-ray manifestations in this group of patients were analyzed. Adolescents with seronegative RA presented a heterogeneous group requiring further investigation.

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Ultrasonography of the knee joints in 55 patients with rheumatoid arthritis permitted diagnosing of popliteal cysts in 14 of them including 7 patients without any clinical symptoms. The method permitted measurements of cyst size and assessment of cysts before and after therapy. Ultrasonic B-scanning is a non-invasive, informative and reliable technique for the detection and assessment of popliteal cysts.

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Patients with proved rheumatoid arthritis (RA) demonstrated changes in the activity of beta-glucuronidase and the concentration of glycosaminoglycans (GAG) in the blood formed elements and biological fluids showing correlation with peculiarities of the RA course. The content of beta-glucuronidase and GAG in biological fluids well reflected the activity of an inflammatory process. Significant differences in the level of beta-glucuronidase and GAG in blood cells of patients with the articular type of RA and systemic manifestations of disease were revealed.

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A study of pirprofen (rengasil) combined with small doses of corticosteroids in 93 patients with rheumatoid arthritis during a double blind multicentre testing showed good and satisfactory therapeutic results in 60%. A decrease in morning rigidity, pains in the joints especially at night, the joint index and in the number of inflammed joints was noted. Rengasil tolerance was good, side effects were few. The new nonsteroid antiinflammatory drug rengasil combined with maintenance doses of corticosteroids can be recommended for a prolonged treatment of patients with rheumatoid arthritis.

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Levels of cAMP were decreased and cGMP increased in progressive systemic sclerosis (PSS) fibroblasts compared with normal fibroblasts. PSS cells took up unusually large quantities of Ca++. The epinephrine-induced increases in cAMP were diminished sixfold and epinephrine-induced Ca++ uptake was abnormal in PSS cells. Considerable heterogeneity was observed in rheumatoid arthritis fibroblasts. Membrane-bound abnormalities in (PSS) cells may be of importance in the defective control of collagen production in progressive systemic sclerosis.

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