Itzhak Rosner - Academia.edu (original) (raw)
Papers by Itzhak Rosner
Clinical rheumatology, Jan 10, 2015
The objective of this study is to review the data on entheseal involvement in systemic disorders.... more The objective of this study is to review the data on entheseal involvement in systemic disorders. A Pubmed search utilizing the indexing terms "enthesis" and "enthesitis" was conducted and the data pertinent to the aim of the review was extracted and organized in accordance with the preplanned structure of the manuscript. A number of cadaver-based studies, as well as studies using ultrasonography and magnetic resonance imaging, have detailed new distinct aspects of enthesis physiology and pathology in a variety of rheumatic and non-rheumatic systemic disorders. Major progress has been done in characterization of separate components of the enthesis organ, imaging of entheses, elaboration of the role and features of entheseal disease in spondyloarthropathies, juvenile idiopathic arthritis, osteoarthritis, familial Mediterranean fever, hyperuricemia, and other systemic conditions. The knowledge acquired and summarized herein shows that entheses can be affected in va...
World journal of orthopedics, Jan 18, 2015
To quantify the wrist cartilage cross-sectional area in humans from a 3D magnetic resonance imagi... more To quantify the wrist cartilage cross-sectional area in humans from a 3D magnetic resonance imaging (MRI) dataset and to assess the corresponding reproducibility. The study was conducted in 14 healthy volunteers (6 females and 8 males) between 30 and 58 years old and devoid of articular pain. Subjects were asked to lie down in the supine position with the right hand positioned above the pelvic region on top of a home-built rigid platform attached to the scanner bed. The wrist was wrapped with a flexible surface coil. MRI investigations were performed at 3T (Verio-Siemens) using volume interpolated breath hold examination (VIBE) and dual echo steady state (DESS) MRI sequences. Cartilage cross sectional area (CSA) was measured on a slice of interest selected from a 3D dataset of the entire carpus and metacarpal-phalangeal areas on the basis of anatomical criteria using conventional image processing radiology software. Cartilage cross-sectional areas between opposite bones in the carpa...
International journal of rheumatic diseases, Jan 25, 2015
To evaluate the usefulness of computed tomography (CT)-measured aortic wall thickness (AWT) as a ... more To evaluate the usefulness of computed tomography (CT)-measured aortic wall thickness (AWT) as a sole imaging finding for the confirmation of clinically suspected aortitis. CT scans of 20 patients with the diagnosis of aortitis, endorsed by the abnormally thickened aortic wall, as a single imaging finding, and 250 patients without known aortitis were reviewed and AWT manually measured at the levels of thoracic descending aorta, upper abdominal aorta and infrarenal aorta, as well as the level of maximal AWT in patients with diagnosed aortitis. Patients' charts were analyzed and demographic data and data on co-morbidities extracted. Correlations of measured AWT with patients' demographic data and co-morbidities were calculated for the control patients. Age-dependent upper 97.5 percentile points for AWT were calculated for different age groups as a reference. AWT of patients, diagnosed with aortitis, was compared with these reference values. AWT had significant positive correla...
Joint, bone, spine : revue du rhumatisme, Jan 6, 2015
Clinical Orthopaedics and Related Research
Tamoxifen, an estradiol antagonist, and estradiol were separately evaluated in a rabbit experimen... more Tamoxifen, an estradiol antagonist, and estradiol were separately evaluated in a rabbit experimental osteoarthritis. Cartilage from anatomically defined regions of individual rabbit knees was assayed for sulfate and thymidine incorporation. Tamoxifen reduced erosive osteoarthritic pathology, while estradiol worsened it. There was no effect on the incidence of osteophytes. Metabolic studies in organ culture showed no changes relating to treatment. The results suggest that specific medical therapy for osteoarthritis is within the realm of possibility.
Clinical and experimental rheumatology
We confirm previous observations that MMPs and TIMPs may play an important role in various rheuma... more We confirm previous observations that MMPs and TIMPs may play an important role in various rheumatic diseases. Whereas serum increase of MMP-3 corre l ated with RA seve ri t y, S S c severity was more characterized by the increase of both MMP-1 and TIMP-1. This suggests that the MMPs and TIMPs invo l ved in SSc are diffe re n t than those playing a role in RA, which may indicate that in SSc they are produced in different locations than in RA.
Medicine
The authors propose to encompass under the designation of "fasciitis-panniculitis syndro... more The authors propose to encompass under the designation of "fasciitis-panniculitis syndromes" (FPS) a group of disorders characterized by induration of the skin due to chronic inflammation and fibrosis of the subcutaneous septa and muscular fascia. The prototype of the FPS is eosinophilic fasciitis. Thirty-two consecutive patients with FPS were cared for at the author's hospital during a 10-year period. The association of the FPS with other diseases, clinical presentations, histologic features, and response to treatment were analyzed. Idiopathic FPS, that is, eosinophilic fasciitis, was diagnosed in 14 patients. In the remaining 18 cases, the FPS were ascribed to vascular disorders (n = 6), infections (n = 6), and neoplastic disorders (n = 3), while trauma, insect bites, and Sweet syndrome antedated the FPS in 1 patient each. The lesions had a sleeve-like distribution in 20 patients, plaque-like distribution in 7, and a combined pattern in 5. Skin biopsies revealed lesions in the deep subcutaneous layers with the pathologic triad of septal and fascial fibrosis, chronic inflammatory infiltration, and small-vessel vasculopathy. Spontaneous improvement occurred in 4 cases. Following cimetidine monotherapy, complete remission was achieved in an additional 3 of 5 patients. The concept of the FPS serves to advance our understanding on several fronts: emphasizing the clinical and etiologic diversity; recognizing a stereotypic tissue reaction pattern; highlighting the panniculitis in addition to the fasciitic component; and describing a similar response to drug therapy in different clinical settings. Based on the results of the present series, cimetidine may be recommended as first-line treatment.
Journal of Clinical Gastroenterology
ABSTRACT
The Israel Medical Association journal: IMAJ
Annals of The Rheumatic Diseases, 1990
Three patients presented with septal fasciitis and panniculitis, associated with clinical and lab... more Three patients presented with septal fasciitis and panniculitis, associated with clinical and laboratory features which precluded straight-forward classification into eosinophilic fasciitis, localised scleroderma, or lupus erythematosus profundus. Treatment with cimetidine caused the remission of cutaneous manifestations and the extracutaneous abnormalities, such as nailfold capillary disturbances and the presence of antithyroid antibodies, improved. It is concluded that features of eosinophilic fasciitis
The American Journal of the Medical Sciences
Lymph node enlargement in patients with eosinophilic fasciitis is a rare occurrence and its clini... more Lymph node enlargement in patients with eosinophilic fasciitis is a rare occurrence and its clinical significance is unknown. The literature and authors' registries were searched for eosinophilic fasciitis associated with lymphadenopathy. Clinical data, time sequence of appearance of either disorder, and pathological diagnoses were analyzed. Six patients presenting with eosinophilic fasciitis had a lymph-node-based lymphoma and 4 patients had a reactive lymphadenopathy. The patients with lymphoma were elderly and the subcutaneous induration preceded the lymphadenopathy by 2 to 36 months. The patients with eosinophilic fasciitis and reactive lymphadenopathy were young and the onset of subcutaneous induration and lymph node enlargement coincided with one another. Favorable response of the eosinophilic fasciitis to prednisone therapy was attained in 3 of 3 patients with reactive lymphadenopathy and in 4 of the 6 cases with lymphoma. Eosinophilic fasciitis is rarely associated with ...
The Journal of Rheumatology
To compare the hemodynamic responses to autonomic challenge evoked by upright tilt table testing ... more To compare the hemodynamic responses to autonomic challenge evoked by upright tilt table testing in patients with familial Mediterranean fever (FMF). Forty consecutive patients with FMF and 25 age and sex matched healthy controls were evaluated using the head-up tilt test (HUTT). The main outcome measures were the values of blood pressure (BP) and heart rate (HR) recorded during recumbence and tilt. The endpoints of vasodepressor and cardioinhibitory reactions, orthostatic tachycardia, and postural tachycardia syndrome were recorded. Patients with FMF exhibited significantly higher diastolic BP during supine and tilt measurements (p = 0.003 and 0.04, respectively). In response to tilt, patients showed significant increases in HR compared to healthy subjects (p = 0.02). Pathological endpoints on tilt were observed in the FMF group in 7 patients (17%) and in no controls. FMF severity, genotype, duration of illness, response to therapy, and associated amyloidosis did not correlate with...
Annals of the Rheumatic Diseases
Background Thickening of the aortic wall, probably the earliest computed tomography (CT)-seen sig... more Background Thickening of the aortic wall, probably the earliest computed tomography (CT)-seen sign of aortitis, is frequently missed as there are no accepted criteria for normal aortic wall thickness (AWT). As aortitis can affect patients in a wide range of ages and with different co-morbidities, information on the normal values for AWT for various age groups, as well as for the presence of co-morbid background, may be essential. Objectives The present study was conducted to assess the relationship of CT-measured AWT with patient-related and disease-related variables in a large cohort of patients without aortitis. Methods CT scans of 250 consecutive patients without known aortitis, hospitalized at Bnai Zion Medical Center were reviewed and AWT manually measured at three levels: 1. thoracic descending aorta at the level of the bifurcation of the pulmonary artery; 2. abdominal aorta at the level of celiac artery origin; 3. abdominal aorta one slice below the level of the origin of ren...
Background / Purpose: B cells are important in the process of autoimmunity. Recently, B regulator... more Background / Purpose: B cells are important in the process of autoimmunity. Recently, B regulatory cells were found to be important in suppressing autoimmunity. Targeting B cells becomes important when treating autoimmune diseases is the issue. Main conclusion: In this study we found preliminary data showing that Actemra (anti-IL-6 receptor) shifts B cells towards a B regulatory phenotype suggesting that this treatment could, in addition to the many other beneficial effects, improve B regulatory function.
The Israel Medical Association journal: IMAJ
Clinical and experimental rheumatology
The Israel Medical Association journal: IMAJ
Pamidronate, along with other bisphosphonates, has been used for treatment of bone pain secondary... more Pamidronate, along with other bisphosphonates, has been used for treatment of bone pain secondary to malignant involvement or metastatic disease for years.
Rheumatology International, 2015
expression of semaphorin 3A on regulatory T cells was also lower in SSc compared to healthy contr... more expression of semaphorin 3A on regulatory T cells was also lower in SSc compared to healthy controls 61.7 ± 15.7 versus 88.7 ± 3. 7 % (p < 0.0001). Semaphorin 3A serum level inversely correlated with the duration of disease: r = −0.4, p = 0.036 and with low C4 level r = 0.66, p = 0.026. SCL-70 antibody positivity was associated with a lower semaphorin 3A level (difference in mean of 3.44, p = 0.06). Sema3A expression is low in SSc serum and more specifically on regulatory T cells. This may help explain the reduced activation of regulatory T cells in SSc.
Revue du Rhumatisme, 2013
Revue du Rhumatisme, 2009
Fait clinique Paralysie du nerf hypoglosse secondaire à une atteinte du rachis cervical dans la p... more Fait clinique Paralysie du nerf hypoglosse secondaire à une atteinte du rachis cervical dans la polyarthrite rhumatoïde : caractéristiques cliniques et radiologiques ଝ
Clinical rheumatology, Jan 10, 2015
The objective of this study is to review the data on entheseal involvement in systemic disorders.... more The objective of this study is to review the data on entheseal involvement in systemic disorders. A Pubmed search utilizing the indexing terms "enthesis" and "enthesitis" was conducted and the data pertinent to the aim of the review was extracted and organized in accordance with the preplanned structure of the manuscript. A number of cadaver-based studies, as well as studies using ultrasonography and magnetic resonance imaging, have detailed new distinct aspects of enthesis physiology and pathology in a variety of rheumatic and non-rheumatic systemic disorders. Major progress has been done in characterization of separate components of the enthesis organ, imaging of entheses, elaboration of the role and features of entheseal disease in spondyloarthropathies, juvenile idiopathic arthritis, osteoarthritis, familial Mediterranean fever, hyperuricemia, and other systemic conditions. The knowledge acquired and summarized herein shows that entheses can be affected in va...
World journal of orthopedics, Jan 18, 2015
To quantify the wrist cartilage cross-sectional area in humans from a 3D magnetic resonance imagi... more To quantify the wrist cartilage cross-sectional area in humans from a 3D magnetic resonance imaging (MRI) dataset and to assess the corresponding reproducibility. The study was conducted in 14 healthy volunteers (6 females and 8 males) between 30 and 58 years old and devoid of articular pain. Subjects were asked to lie down in the supine position with the right hand positioned above the pelvic region on top of a home-built rigid platform attached to the scanner bed. The wrist was wrapped with a flexible surface coil. MRI investigations were performed at 3T (Verio-Siemens) using volume interpolated breath hold examination (VIBE) and dual echo steady state (DESS) MRI sequences. Cartilage cross sectional area (CSA) was measured on a slice of interest selected from a 3D dataset of the entire carpus and metacarpal-phalangeal areas on the basis of anatomical criteria using conventional image processing radiology software. Cartilage cross-sectional areas between opposite bones in the carpa...
International journal of rheumatic diseases, Jan 25, 2015
To evaluate the usefulness of computed tomography (CT)-measured aortic wall thickness (AWT) as a ... more To evaluate the usefulness of computed tomography (CT)-measured aortic wall thickness (AWT) as a sole imaging finding for the confirmation of clinically suspected aortitis. CT scans of 20 patients with the diagnosis of aortitis, endorsed by the abnormally thickened aortic wall, as a single imaging finding, and 250 patients without known aortitis were reviewed and AWT manually measured at the levels of thoracic descending aorta, upper abdominal aorta and infrarenal aorta, as well as the level of maximal AWT in patients with diagnosed aortitis. Patients' charts were analyzed and demographic data and data on co-morbidities extracted. Correlations of measured AWT with patients' demographic data and co-morbidities were calculated for the control patients. Age-dependent upper 97.5 percentile points for AWT were calculated for different age groups as a reference. AWT of patients, diagnosed with aortitis, was compared with these reference values. AWT had significant positive correla...
Joint, bone, spine : revue du rhumatisme, Jan 6, 2015
Clinical Orthopaedics and Related Research
Tamoxifen, an estradiol antagonist, and estradiol were separately evaluated in a rabbit experimen... more Tamoxifen, an estradiol antagonist, and estradiol were separately evaluated in a rabbit experimental osteoarthritis. Cartilage from anatomically defined regions of individual rabbit knees was assayed for sulfate and thymidine incorporation. Tamoxifen reduced erosive osteoarthritic pathology, while estradiol worsened it. There was no effect on the incidence of osteophytes. Metabolic studies in organ culture showed no changes relating to treatment. The results suggest that specific medical therapy for osteoarthritis is within the realm of possibility.
Clinical and experimental rheumatology
We confirm previous observations that MMPs and TIMPs may play an important role in various rheuma... more We confirm previous observations that MMPs and TIMPs may play an important role in various rheumatic diseases. Whereas serum increase of MMP-3 corre l ated with RA seve ri t y, S S c severity was more characterized by the increase of both MMP-1 and TIMP-1. This suggests that the MMPs and TIMPs invo l ved in SSc are diffe re n t than those playing a role in RA, which may indicate that in SSc they are produced in different locations than in RA.
Medicine
The authors propose to encompass under the designation of "fasciitis-panniculitis syndro... more The authors propose to encompass under the designation of "fasciitis-panniculitis syndromes" (FPS) a group of disorders characterized by induration of the skin due to chronic inflammation and fibrosis of the subcutaneous septa and muscular fascia. The prototype of the FPS is eosinophilic fasciitis. Thirty-two consecutive patients with FPS were cared for at the author's hospital during a 10-year period. The association of the FPS with other diseases, clinical presentations, histologic features, and response to treatment were analyzed. Idiopathic FPS, that is, eosinophilic fasciitis, was diagnosed in 14 patients. In the remaining 18 cases, the FPS were ascribed to vascular disorders (n = 6), infections (n = 6), and neoplastic disorders (n = 3), while trauma, insect bites, and Sweet syndrome antedated the FPS in 1 patient each. The lesions had a sleeve-like distribution in 20 patients, plaque-like distribution in 7, and a combined pattern in 5. Skin biopsies revealed lesions in the deep subcutaneous layers with the pathologic triad of septal and fascial fibrosis, chronic inflammatory infiltration, and small-vessel vasculopathy. Spontaneous improvement occurred in 4 cases. Following cimetidine monotherapy, complete remission was achieved in an additional 3 of 5 patients. The concept of the FPS serves to advance our understanding on several fronts: emphasizing the clinical and etiologic diversity; recognizing a stereotypic tissue reaction pattern; highlighting the panniculitis in addition to the fasciitic component; and describing a similar response to drug therapy in different clinical settings. Based on the results of the present series, cimetidine may be recommended as first-line treatment.
Journal of Clinical Gastroenterology
ABSTRACT
The Israel Medical Association journal: IMAJ
Annals of The Rheumatic Diseases, 1990
Three patients presented with septal fasciitis and panniculitis, associated with clinical and lab... more Three patients presented with septal fasciitis and panniculitis, associated with clinical and laboratory features which precluded straight-forward classification into eosinophilic fasciitis, localised scleroderma, or lupus erythematosus profundus. Treatment with cimetidine caused the remission of cutaneous manifestations and the extracutaneous abnormalities, such as nailfold capillary disturbances and the presence of antithyroid antibodies, improved. It is concluded that features of eosinophilic fasciitis
The American Journal of the Medical Sciences
Lymph node enlargement in patients with eosinophilic fasciitis is a rare occurrence and its clini... more Lymph node enlargement in patients with eosinophilic fasciitis is a rare occurrence and its clinical significance is unknown. The literature and authors' registries were searched for eosinophilic fasciitis associated with lymphadenopathy. Clinical data, time sequence of appearance of either disorder, and pathological diagnoses were analyzed. Six patients presenting with eosinophilic fasciitis had a lymph-node-based lymphoma and 4 patients had a reactive lymphadenopathy. The patients with lymphoma were elderly and the subcutaneous induration preceded the lymphadenopathy by 2 to 36 months. The patients with eosinophilic fasciitis and reactive lymphadenopathy were young and the onset of subcutaneous induration and lymph node enlargement coincided with one another. Favorable response of the eosinophilic fasciitis to prednisone therapy was attained in 3 of 3 patients with reactive lymphadenopathy and in 4 of the 6 cases with lymphoma. Eosinophilic fasciitis is rarely associated with ...
The Journal of Rheumatology
To compare the hemodynamic responses to autonomic challenge evoked by upright tilt table testing ... more To compare the hemodynamic responses to autonomic challenge evoked by upright tilt table testing in patients with familial Mediterranean fever (FMF). Forty consecutive patients with FMF and 25 age and sex matched healthy controls were evaluated using the head-up tilt test (HUTT). The main outcome measures were the values of blood pressure (BP) and heart rate (HR) recorded during recumbence and tilt. The endpoints of vasodepressor and cardioinhibitory reactions, orthostatic tachycardia, and postural tachycardia syndrome were recorded. Patients with FMF exhibited significantly higher diastolic BP during supine and tilt measurements (p = 0.003 and 0.04, respectively). In response to tilt, patients showed significant increases in HR compared to healthy subjects (p = 0.02). Pathological endpoints on tilt were observed in the FMF group in 7 patients (17%) and in no controls. FMF severity, genotype, duration of illness, response to therapy, and associated amyloidosis did not correlate with...
Annals of the Rheumatic Diseases
Background Thickening of the aortic wall, probably the earliest computed tomography (CT)-seen sig... more Background Thickening of the aortic wall, probably the earliest computed tomography (CT)-seen sign of aortitis, is frequently missed as there are no accepted criteria for normal aortic wall thickness (AWT). As aortitis can affect patients in a wide range of ages and with different co-morbidities, information on the normal values for AWT for various age groups, as well as for the presence of co-morbid background, may be essential. Objectives The present study was conducted to assess the relationship of CT-measured AWT with patient-related and disease-related variables in a large cohort of patients without aortitis. Methods CT scans of 250 consecutive patients without known aortitis, hospitalized at Bnai Zion Medical Center were reviewed and AWT manually measured at three levels: 1. thoracic descending aorta at the level of the bifurcation of the pulmonary artery; 2. abdominal aorta at the level of celiac artery origin; 3. abdominal aorta one slice below the level of the origin of ren...
Background / Purpose: B cells are important in the process of autoimmunity. Recently, B regulator... more Background / Purpose: B cells are important in the process of autoimmunity. Recently, B regulatory cells were found to be important in suppressing autoimmunity. Targeting B cells becomes important when treating autoimmune diseases is the issue. Main conclusion: In this study we found preliminary data showing that Actemra (anti-IL-6 receptor) shifts B cells towards a B regulatory phenotype suggesting that this treatment could, in addition to the many other beneficial effects, improve B regulatory function.
The Israel Medical Association journal: IMAJ
Clinical and experimental rheumatology
The Israel Medical Association journal: IMAJ
Pamidronate, along with other bisphosphonates, has been used for treatment of bone pain secondary... more Pamidronate, along with other bisphosphonates, has been used for treatment of bone pain secondary to malignant involvement or metastatic disease for years.
Rheumatology International, 2015
expression of semaphorin 3A on regulatory T cells was also lower in SSc compared to healthy contr... more expression of semaphorin 3A on regulatory T cells was also lower in SSc compared to healthy controls 61.7 ± 15.7 versus 88.7 ± 3. 7 % (p < 0.0001). Semaphorin 3A serum level inversely correlated with the duration of disease: r = −0.4, p = 0.036 and with low C4 level r = 0.66, p = 0.026. SCL-70 antibody positivity was associated with a lower semaphorin 3A level (difference in mean of 3.44, p = 0.06). Sema3A expression is low in SSc serum and more specifically on regulatory T cells. This may help explain the reduced activation of regulatory T cells in SSc.
Revue du Rhumatisme, 2013
Revue du Rhumatisme, 2009
Fait clinique Paralysie du nerf hypoglosse secondaire à une atteinte du rachis cervical dans la p... more Fait clinique Paralysie du nerf hypoglosse secondaire à une atteinte du rachis cervical dans la polyarthrite rhumatoïde : caractéristiques cliniques et radiologiques ଝ