Antibodies to citrullinated peptides are not associated with the rate of joint destruction in patients with a well-established diagnosis of rheumatoid arthritis

Antibodies to citrullinated peptides are highly specific for rheumatoid arthritis (RA) and represent a significant risk factor for undifferentiated polyarthritis. This prognostic ability may be related to the very diagnostic performance of these autoantibodies, since RA is a more erosive disease than other forms of arthritis. The present study evaluated an association of antibodies to citrullinated peptides and the rate of joint destruction in patients with a well-established diagnosis of RA. Seventy-one patients with RA were evaluated in 1994 and again in 2002 (functional class, joint count, Health Assessment Questionnaire score, hands X-ray). Autoantibodies (rheumatoid factor (RF), anti-perinuclear factor, anti-cyclic citrullinated peptide (CCP) antibodies) and Sharp's index were analyzed blindly. Delta Sharp was calculated as the difference in Sharp's index obtained in 1994 and 2002. During the follow-up the Health Assessment Questionnaire score increased from 0.91 ± 0.74 to 1.39 ± 0.72 (P < 0.001). Similarly, the number of swollen joints increased from 4.6 ± 5.71 to 6.4 ± 4.1 (P = 0.002). The frequency of autoantibodies and anti-CCP titer remained stable; however, serum RF concentration increased from 202.8 ± 357.6 to 416.6 ± 636.5 IU/mL (P = 0.003). Sharp's index increased from 56.7 ± 62.1 to 92.4 ± 80.9 (P < 0.001). No correlation was observed between Delta Sharp and the presence of RF, anti-perinuclear factor, and anti-CCP antibodies at baseline. Antibodies to citrullinated epitopes are specific and early markers for the diagnosis of RA but do not seem to be associated with the rate of joint destruction in patients with a well-established diagnosis of RA.

Wrist ultrasound analysis of patients with early rheumatoid arthritis

In the present study, we evaluated 42 wrists using the semi-quantitative scales power Doppler ultrasound (PDUS) and gray scale ultrasound (GSUS) with scores ranging from 0 to 3 and correlated the results with clinical, laboratory and radiographic data. Twenty-one patients (17 women and 4 men) with rheumatoid arthritis according to criteria of the American College of Rheumatology were enrolled in the study from September 2008 to July 2009 at Universidade Estadual de Campinas (UNICAMP). The average disease duration was 14 months. The patients were 66.6% Caucasians and 33.3% non-Caucasians, with a mean age of 42 and 41 years, respectively. A dorsal longitudinal scan was performed by ultrasound on the radiocarpal and midcarpal joints using GE LOGIQ XP-linear ultrasound and a high frequency (8-10 MHz) transducer. All patients were X-rayed, and the Larsen score was determined for the joints, with grades ranging from 0 to V. This study showed significant correlations between clinical, sonographic and laboratory data: GSUS and swollen right wrist (r = 0.546), GSUS of right wrist and swelling of left wrist (r = 0.511), PDUS of right wrist and pain in left wrist (r = 0.436), PDUS of right wrist and C-reactive protein (r = 0.466). Ultrasound can be considered a useful tool in the diagnosis of synovitis in early rheumatoid arthritis mainly when the anti-cyclic citrullinated peptide and rheumatoid factor are negative, and can lead to an early change in the therapeutic decision.

Experimental model of heterotopic ossification in Wistar rats

Heterotopic ossification (HO) is a metaplastic biological process in which there is newly formed bone in soft tissues adjacent to large joints, resulting in joint mobility deficit. In order to determine which treatment techniques are more appropriate for such condition, experimental models of induced heterotopic bone formation have been proposed using heterologous demineralized bone matrix implants and bone morphogenetic protein and other tissues. The objective of the present experimental study was to identify a reliable protocol to induce HO in Wistar rats, based on autologous bone marrow (BM) implantation, comparing 3 different BM volumes and based on literature evidence of this HO induction model in larger laboratory animals. Twelve male Wistar albino rats weighing 350/390 g were used. The animals were anesthetized for blood sampling before HO induction in order to quantify serum alkaline phosphatase (ALP). HO was induced by BM implantation in both quadriceps muscles of these animals, experimental group (EG). Thirty-five days after the induction, another blood sample was collected for ALP determination. The results showed a weight gain in the EG and no significant difference in ALP levels when comparing the periods before and after induction. Qualitative histological analysis confirmed the occurrence of heterotopic ossification in all 12 EG rats. In conclusion, the HO induction model was effective when 0.35 mL autologous BM was applied to the quadriceps of Wistar rats.

Three-dimensional kinematic analysis of upper and lower limb motion during gait of post-stroke patients

The aim of this study was to analyze the alterations of arm and leg movements of patients during stroke gait. Joint angles of upper and lower limbs and spatiotemporal variables were evaluated in two groups: hemiparetic group (HG, 14 hemiparetic men, 53 ± 10 years) and control group (CG, 7 able-bodied men, 50 ± 4 years). The statistical analysis was based on the following comparisons (P ≤ 0.05): 1) right versus left sides of CG; 2) affected (AF) versus unaffected (UF) sides of HG; 3) CG versus both the affected and unaffected sides of HG, and 4) an intracycle comparison of the kinematic continuous angular variables between HG and CG. This study showed that the affected upper limb motion in stroke gait was characterized by a decreased range of motion of the glenohumeral (HG: 6.3 ± 4.5, CG: 20.1 ± 8.2) and elbow joints (AF: 8.4 ± 4.4, UF: 15.6 ± 7.6) on the sagittal plane and elbow joint flexion throughout the cycle (AF: 68.2 ± 0.4, CG: 46.8 ± 2.7). The glenohumeral joint presented a higher abduction angle (AF: 14.2 ± 1.6, CG: 11.5 ± 4.0) and a lower external rotation throughout the cycle (AF: 4.6 ± 1.2, CG: 22.0 ± 3.0). The lower limbs showed typical alterations of the stroke gait patterns. Thus, the changes in upper and lower limb motion of stroke gait were identified. The description of upper limb motion in stroke gait is new and complements gait analysis.

An interleukin-33/ST2 signaling deficiency reduces overt pain-like behaviors in mice

Interleukin (IL)-33, the most recent member of the IL family of cytokines, signals through the ST2 receptor. IL-33/ST2 signaling mediates antigen challenge-induced mechanical hyperalgesia in the joints and cutaneous tissues of immunized mice. The present study asked whether IL-33/ST2 signaling is relevant to overt pain-like behaviors in mice. Acetic acid and phenyl-p-benzoquinone induced significant writhing responses in wild-type (WT) mice; this overt nociceptive behavior was reduced in ST2-deficient mice. In an antigen-challenge model, ST2-deficient immunized mice had reduced induced flinch and licking overt pain-like behaviors. In the formalin test, ST2-deficient mice also presented reduced flinch and licking responses, compared with WT mice. Naive WT and ST2-deficient mice presented similar responses in the rota-rod, hot plate, and electronic von Frey tests, indicating no impairment of motor function or alteration in basal nociceptive responses. The results demonstrate that IL-33/ST2 signaling is important in the development of overt pain-like behaviors.

Expression of MMP-2 and MMP-9 in the rat trigeminal ganglion during the development of temporomandibular joint inflammation

Orofacial pain is a prevalent symptom in modern society. Some musculoskeletal orofacial pain is caused by temporomandibular disorders (TMDs). This condition has a multi-factorial etiology, including emotional factors and alteration of the masticator muscle and temporomandibular joints (TMJs). TMJ inflammation is considered to be a cause of pain in patients with TMD. Extracellular proteolytic enzymes, specifically the matrix metalloproteinases (MMPs), have been shown to modulate inflammation and pain. The purpose of this investigation was to determine whether the expression and level of gelatinolytic activity of MMP-2 and MMP-9 in the trigeminal ganglion are altered during different stages of temporomandibular inflammation, as determined by gelatin zymography. This study also evaluated whether mechanical allodynia and orofacial hyperalgesia, induced by the injection of complete Freund's adjuvant into the TMJ capsule, were altered by an MMP inhibitor (doxycycline, DOX). TMJ inflammation was measured by plasma extravasation in the periarticular tissue (Evans blue test) and infiltration of polymorphonuclear neutrophils into the synovial fluid (myeloperoxidase enzyme quantification). MMP expression in the trigeminal ganglion was shown to vary during the phases of the inflammatory process. MMP-9 regulated the early phase and MMP-2 participated in the late phase of this process. Furthermore, increases in plasma extravasation in periarticular tissue and myeloperoxidase activity in the joint tissue, which occurred throughout the inflammation process, were diminished by treatment with DOX, a nonspecific MMP inhibitor. Additionally, the increases of mechanical allodynia and orofacial hyperalgesia were attenuated by the same treatment.

Effects of immobilization and remobilization on the ankle joint in Wistar rats

A sprained ankle is a common musculoskeletal sports injury and it is often treated by immobilization of the joint. Despite the beneficial effects of this therapeutic measure, the high prevalence of residual symptoms affects the quality of life, and remobilization of the joint can reverse this situation. The aim of this study was to analyze the effects of immobilization and remobilization on the ankle joint of Wistar rats. Eighteen male rats had their right hindlimb immobilized for 15 days, and were divided into the following groups: G1, immobilized; G2, remobilized freely for 14 days; and G3, remobilized by swimming and jumping in water for 14 days, performed on alternate days, with progression of time and a series of exercises. The contralateral limb was the control. After the experimental period, the ankle joints were processed for microscopic analysis. Histomorphometry did not show any significant differences between the control and immobilized/remobilized groups and members, in terms of number of chondrocytes and thickness of the articular cartilage of the tibia and talus. Morphological analysis of animals from G1 showed significant degenerative lesions in the talus, such as exposure of the subchondral bone, flocculation, and cracks between the anterior and mid-regions of the articular cartilage and the synovial membrane. Remobilization by therapeutic exercise in water led to recovery in the articular cartilage and synovial membrane of the ankle joint when compared with free remobilization, and it was shown to be an effective therapeutic measure in the recovery of the ankle joint.

Elementtikoon vaikutus väsymismenetelmien tarkkuuteen

Kandidaatintyössä tutkittiin kolmen hitsatun palstalevyliitoksen väsymiskestävyyttä äärellisten elementtien menetelmällä. Tutkimuksen pääpaino oli 2D-mallin antamien tulosten suppenevuudessa kolmella eri elementtikoolla ja kolmessa eri mittasuhdetapauksessa. Tutkimustuloksissa havaittiin noin 5 % muutos harvimman ja tiheimmän elementtiverkon tulosten välillä. Tutkimuksessa havaittiin myös että muutos harvimman ja tiheimmän elementtiverkon tuloksissa pieneni hiukan mitä suurempia kappaleet ja niiden hitsausliitokset olivat.

Simulation and material calibration of ultra high strength steel (UHSS) S960 welded joint under static tensile test utilizing finite element method (FEM)

The aim of this work was to calibrate the material properties including strength and strain values for different material zones of ultra-high strength steel (UHSS) welded joints under monotonic static loading. The UHSS is heat sensitive and softens by heat due to welding, the affected zone is heat affected zone (HAZ). In this regard, cylindrical specimens were cut out from welded joints of Strenx® 960 MC and Strenx® Tube 960 MH, were examined by tensile test. The hardness values of specimens’ cross section were measured. Using correlations between hardness and strength, initial material properties were obtained. The same size specimen with different zones of material same as real specimen were created and defined in finite element method (FEM) software with commercial brand Abaqus 6.14-1. The loading and boundary conditions were defined considering tensile test values. Using initial material properties made of hardness-strength correlations (true stress-strain values) as Abaqus main input, FEM is utilized to simulate the tensile test process. By comparing FEM Abaqus results with measured results of tensile test, initial material properties will be revised and reused as software input to be fully calibrated in such a way that FEM results and tensile test results deviate minimum. Two type of different S960 were used including 960 MC plates, and structural hollow section 960 MH X-joint. The joint is welded by BöhlerTM X96 filler material. In welded joints, typically the following zones appear: Weld (WEL), Heat affected zone (HAZ) coarse grained (HCG) and fine grained (HFG), annealed zone, and base material (BaM). Results showed that: The HAZ zone is softened due to heat input while welding. For all the specimens, the softened zone’s strength is decreased and makes it a weakest zone where fracture happens while loading. Stress concentration of a notched specimen can represent the properties of notched zone. The load-displacement diagram from FEM modeling matches with the experiments by the calibrated material properties by compromising two correlations of hardness and strength.

Modifioidun MAG-kaarihitsausprosessin hyödyntäminen railotilavuuden pienentämisessä mekanisoidussa orbitaalihitsauksessa.

Länsimaisen työn hinta luo jatkuvan paineen hitsauksen tuottavuuden parantamiseen. MIG/MAG-hitsauksen tuottavuutta voidaan parantaa tehostamalla hitsausprosessia, vähentämällä hitsien lukumäärää ja pienentämällä hitsiaineen tarvetta. Eri virtalähdevalmistajat tuovat markkinoille hitsausprosesseja hitsauksen tehostamiseen, joilla pystytään korvata vähemmän tuottavia hitsaustyövaiheita. Hitsien lukumäärän vähentäminen on rakenteen suunnitteluun liittyvä tekijä ja hitsiaineen tarpeen pienentäminen voidaan toteuttaa railogeometrian muutoksilla tai tuotteen sopivalla suunnittelulla. Diplomityössä on tutkittu 30 mm paksujen S355 rakenneteräsputkien hitsauksen tuottavuuden kasvattamista käyttäen nykyaikaisia modifioituja kaarihitsausprosesseja ja railotilavuutta pienentämällä. Työssä vertailtiin 30o ja 60o railokulmalla tehtyjä liitoksia. Railogeometrian muutoksen lisäksi diplomityössä vertailtiin eri menetelmien tehokkuutta putken pohjapalon hitsauksessa.

Underwater Remote Welding Technology for Offshore Structures

The construction of offshore structures, equipment and devices requires a high level of mechanical reliability in terms of strength, toughness and ductility. One major site for mechanical failure, the weld joint region, needs particularly careful examination, and weld joint quality has become a major focus of research in recent times. Underwater welding carried out offshore faces specific challenges affecting the mechanical reliability of constructions completed underwater. The focus of this thesis is on improvement of weld quality of underwater welding using control theory. This research work identifies ways of optimizing the welding process parameters of flux cored arc welding (FCAW) during underwater welding so as to achieve desired weld bead geometry when welding in a water environment. The weld bead geometry has no known linear relationship with the welding process parameters, which makes it difficult to determine a satisfactory weld quality. However, good weld bead geometry is achievable by controlling the welding process parameters. The doctoral dissertation comprises two sections. The first part introduces the topic of the research, discusses the mechanisms of underwater welding and examines the effect of the water environment on the weld quality of wet welding. The second part comprises four research papers examining different aspects of underwater wet welding and its control and optimization. Issues considered include the effects of welding process parameters on weld bead geometry, optimization of FCAW process parameters, and design of a control system for the purpose of achieving a desired bead geometry that can ensure a high level of mechanical reliability in welded joints of offshore structures. Artificial neural network systems and a fuzzy logic controller, which are incorporated in the control system design, and a hybrid of fuzzy and PID controllers are the major control dynamics used. This study contributes to knowledge of possible solutions for achieving similar high weld quality in underwater wet welding as found with welding in air. The study shows that carefully selected steels with very low carbon equivalent and proper control of the welding process parameters are essential in achieving good weld quality. The study provides a platform for further research in underwater welding. It promotes increased awareness of the need to improve the quality of underwater welding for offshore industries and thus minimize the risk of structural defects resulting from poor weld quality.

Hitsatun alumiinirakenteen suunnittelu

Alumiiniseosten käyttö konstruktiomateriaalina lisääntyy johtuen sen lukuisista variaatioista lujuuden ja muovattavuuden suhteen. Alumiinin keveys on merkittävä kilpailuetu teräkseen nähden. Alumiiniseosten hitsattavuus on parantunut hitsausmenetelmien kehittyessä. Uusilla menetelmillä lämmöntuontia hallitaan paremmin, kuten myös alumiinin huokoisuutta sekä lujuuden laskua hitsauksen yhteydessä. Tässä diplomityössä tutkitaan alumiinin metallurgiaa, hitsausmenetelmiä, sekä alumiinin ja teräksen sekaliitoksen toteutusta. Tutkimuksella pyritään tekemään hitsatun alumiinirakenteen suunnittelua ymmärrettävämmäksi. SFS-EN standardit antavat perustuksen alumiinirakenteen suunnittelulle. Tässä diplomityössä tehdään suunnitteluesimerkki hitsatun alumiinirakenteen hitsien suunnittelusta. Suunnitteluesimerkissä tutkitaan alumiiniseoksen lujuuden laskua hitsattaessa, ja etsitään standardien antamia ratkaisuja toimivan hitsatun rakenteen toteuttamiseksi.

Orbitaali-TIG-hitsauksen kehittäminen compoundputkien hitsaamisessa

Tässä työssä tutkittiin orbitaali-TIG-hitsauksen hyödyntämistä paineenalaisten compoundputkien jatkohitsien hitsaamiseen. Tutkimus tehtiin Warkaus Works Oy:n omistamalle konepajalle. Tutkimuksen tavoitteena oli laatia standardin SFS-EN ISO 15613 mukaan hyväksytty hitsausmenetelmä. Työn kirjallisuuskatsauksessa esiteltiin orbitaalihitsauksessa käytettävät hitsausprosessit ja laitteistot eri liitosmuodoille. Työssä esiteltiin myös kuumavedettyjen compoundputkien valmistusprosessia ja rakennetta. Tämän lisäksi kerrottiin putkien hitsattavuudesta ja hitsauksen esivalmisteluista, sekä käyttökohteista voimalaitoskattilassa. Ennen menetelmäkokeen hitsausta suoritettiin suuri määrä koehitsauksia yrityksen orbitaali-TIG-laitteistolla. Onnistuneiden koehitsausten perusteella laadittiin hitsausohjelma, jolla hitsattiin testiputket menetelmäkokeeseen. Hitsausmenetelmää varten valittiin Sandvikin valmistama compoundputki. Testihitseille suoritettiin rikkomattomia ja rikkovia tarkastuksia. Hyväksyttyjen tarkastusten pohjalta laadittiin hitsausmenetelmän hyväksymispöytäkirjan. Lisäksi diplomityössä verrattiin mekanisoidun hitsauksen hitsausaikaa käsinhitsauksen hitsausaikaa. Orbitaali-TIG-hitsauksen käyttäminen edellyttää hitsattavalta railolta aina mahdollisimman samanlaisen lähtötilanteen, jotta sen suoritusvarmuus saadaan mahdollisimman korkeaksi. Railon valmistamisen tarkkuudella on mahdollista saada riittävän tarkkoja railoja hitsien laadukkaaseen hitsaukseen. Hitsaus edellyttää laitteiston langansyötön ja elektrodin tarkkoja asetuksia, jotta hitsaus on laadukasta. Lisäaineen jähmeä sula ja hitsin tunkeumavaatimus hankaloittavat orbitaalihitsausta.

Ultralujan teräksen kaarijuotto

Tässä diplomityössä tutkitaan ultralujan rakenneteräksen kaarijuotolla valmistettujen liitosten väsymiskestävyyttä. Tutkittavat liitokset ovat kuormaa kantamattomia X-liitoksia. Tutkinnassa vertaillaan puhtaasti juottamalla valmistettua liitosta hitsauksen ja juoton kombinaatioliitokseen, jossa pohjapalkona toimivan hitsin rajaviivalle on juotettu lisäpalko. Kaarijuottoa esitellään yleisesti liittämismenetelmänä. Ultralujaa rakenneterästä esitellään yleisesti ja tarkastellaan sen metallurgista käyttäytymistä sekä juotettaessa, että hitsattaessa. Tutkimuksessa tehtiin kaikkiaan 21 väsytystestiä. Väsytystestit muodostuivat kolmesta eri koekappalesarjasta. Ensimmäisen ja toisen sarjan koekappaleet tehtiin juottamalla, eri lisäaineilla. 3. sarjassa pienat hitsattiin, jonka jälkeen hitsin rajaviivalle tehtiin juotto. Kappaleiden geometriat mitattiin ennen testejä, ja osasta kappaleista mitattiin jäännösjännitykset. Kappaleista otettiin hieitä, joista tehtiin kovuusmittaukset ja suoritettiin makro- ja mikrotason tarkastelua liitosprosessin lämmöntuonnin vaikutuksesta. Väsytyskokeiden perusteella kappaleille määritettiin nimelliset ja rakenteelliset väsymisluokat. Tuloksista piirrettiin S-N –käyrät. Liitoksista tehtiin FEA-mallit, joista määritettiin liitoksen rajaviivalle muodostuva jännitys ja 2. sarjan koekappaleiden laskennalliset kestoiät. 1. sarjan juotoksissa oli ongelmana juotoksen tarttuvuus teräksen pintaan. 2. sarjan koetulokset olivat kaikkein parhaita. 3. sarjan kombinaatioliitokset ylsivät kohtalaisiin väsymisluokkiin. 2. sarjan koetulosten perusteella kaarijuotossa on potentiaalia ultralujan rakenneteräksen liittämismenetelmänä. Jatkotutkimuksen tarve on kuitenkin laaja. Tämä työ osoitti, että kaarijuottaminen voi olla vaativa liittämisprosessi, sillä toimiakseen se vaatii varsin tarkat parametrit, ja lisäksi prosessi on melko herkkä olosuhdemuutoksille.

Instruction [de l'Assemblée générale de la régie des droits rétablis] pour la régie de la caisse de crédit établie pour le commerce des vins à Paris, en conformité de l'arrest du conseil du 27 Septembre 1723, vu les trois modèles de soumission, de certificat de remboursement et de congé d'enlèvement...

[Acte. 1723-11-10. Paris]