Collagen is the major structural protein in the human body, especially in connective tissues. There are more than 13 types of collagen. Among them, type II collagen is a main component of articular cartilage structure. Altered immunological conditions against type II collagen may be closely related to the pathologic conditions of joint, especially arthritis. Since 1977, animal model for collageninduced arthritis(CIA) has been developed and used in the investigation of arthritis. In those animals, high titers of anti-type II collagen antibody were noticed. Pathologic findings were similar to rheumatoid arthritis of human, which suggested that rheumatoid arthritis might be one of the autoimmune diseases. There had been many reports about elevation of serum and synovial level of anti-type II collagen antibody in rheumatoid arthritis patients. But majority of them did not discriminate the antibody titers according to the type of immunoglobulin(i.e. IgG, IgM). And the question whether the elevated antibody titers are cause or effect of the arthritis is still in controversy. In this study, the serum levels of anti-type II collagen antibody were determined in 82 persons(35 degenerative arthritis patients, 24 rheumatoid arthritis patients and 22 normal controls without any joint problem) via ELISA method. In each person the serum IgG, IgM and IgG+M+A antibody levels against bovine type IIcollagen and chicken typeII collagen were determined individually. Statistical evaluation of these data among degenerative arthritis group, rheumatoid arthritis group and normal control group was performed. The results were as follows; 1. Degenerative arthritis group revealed significant elevation of anti-type II collagen antibody(IgG, IgG+M+A) compared to normal control(p < 0.05). 2. Rheumatoid arthritis group showed significant elvation of IgM and IgG+M+A compared to normal control. 3. Between degenerative arthritis and rheumatoid arthritis group, no sigificant difference was noticed. 4. Rheumatoid arthritis group showed significant increase of IgM antibody level compared to normal control. 5. Female rheumatoid arthritis group showed significant increase of IgM level compared to female degenerative arthritis group. These findings suggested that the elevation of anti-type II collagen antibody titer is not specific for rheumatoid arthritis and related with general pathologies destroying articular cartilage. And it is suggested that anti-type II collagen antibody associated with rheumatoid arthritis is mainly IgM proportion, especially in female patients. So further investigation of anti-type II collagen antibody associated with rheumatoid arthritis is needed to target IgM antibody.
Animals ; Arthritis ; Arthritis, Rheumatoid ; Autoimmune Diseases ; Cartilage, Articular ; Chickens ; Collagen ; Collagen Type II ; Connective Tissue ; Enzyme-Linked Immunosorbent Assay ; Female ; Human Body ; Humans ; Immunoglobulin G ; Immunoglobulin M ; Joints ; Methods ; Models, Animal ; Osteoarthritis ; Pathology

Intramedullary nailing has become the most popular fixation method in the treatment of the shaft fractures of long bones especially of tibia and femur because it affords most rigid fixation of fracture via closed method which makes early rehabilitation possible. Nowadays intramedullary nailing of the humeral shaft is being performed by many surgeons with good results. Newer implants and better surgical techniques are being developed, which suggests application of this method can be widened. Purpose of this study was aimed to define whether intramedullary nailing could be an effective method or not in the treatment of humeral shaft fractures by documenting the practical points in the application of intramedullary nailing of humerus, effectiveness in fracture healing, any complications or obstacles. We managed thirteen humeral shaft fractures with closed locked intramedullary nailing with distal fanning devices(Seidel nail) from March 1993 to April 1994. Average follow-up period was 14 months(12 months-18 months). The results were as follows; 1, Union of the fracture was obtained at average 12.9 weeks(9 weeks-20 weeks) postoperatively except one case of nonunion, in which case, union was obtained at postoperative 10 months finally. 2. Among the 13 cases, painful limitation of shoulder motion remained in 6 cases. This complication was more common in the cases with protruded proximal end of the nail. Above results suggest that locked intramedullary nailing seemed to be one of the useful method in the treatment of the humeral shaft fractures. However, destruction and irritation of shoulder by the nail was found to be a grave problem, and we found that further investigations should solve this problem.
Femur ; Follow-Up Studies ; Fracture Fixation, Intramedullary ; Fracture Healing ; Humerus ; Methods ; Rehabilitation ; Shoulder ; Surgeons ; Tibia