Tapani Helve - Academia.edu (original) (raw)

Papers by Tapani Helve

Scandinavian Journal of Rheumatology, 1985

Nationwide prevalence and mortality rates in systemic lupus erythematosus (SLE) were estimated us... more Nationwide prevalence and mortality rates in systemic lupus erythematosus (SLE) were estimated using a computer file of all hospital discharge records and cause of death statistics from 1972 to 1978. Age-specific and sex-specific prevalence rates obtained from 1976 to 1978 and mortality rates from 1972 to 1978. In December 1978 the prevalence of SLE was 28:100 000. The overall mortality rate was 4.7 per million person-years in 1972-78. Active lupus nephritis, vascular events and infections were the most frequent causes of death in SLE patients.

Scandinavian Journal of Rheumatology, 1978

DNA-synthesizing cells from the rheumatoid arthritis synovial tissue of 7 patients and from 5 pat... more DNA-synthesizing cells from the rheumatoid arthritis synovial tissue of 7 patients and from 5 patients with traumatic and degenerative joint lesions were studied by incubating fresh synovial tissue samples with tritiated thymidine. Labelled cells were identified using autoradiography. The tissue sections were stained with methyl green pyronine. It was found that 0.66% (range 0.38-1.4) of the cells were labelled with 3H-thymidine whereas in control materials the percentage was 0.17 (range 0-0.38). Approximately half of the labelled subsynovial cells in rheumatoid patients (range 37-67%) were small lymphocytes, according to morphological criteria. About one-tenth of the labelled cells (range 0-17%) looked like medium-sized lymphocytes, while the rest had the characteristics of fibroblasts or were unidentifiable.

Scandinavian Journal of Rheumatology, 1977

Gold treatment was initiated in 98 patients suffering from early-stage rheumatoid arthritis. In 3... more Gold treatment was initiated in 98 patients suffering from early-stage rheumatoid arthritis. In 30 patients side effects due to gold therapy were seen during the first follow-up year: proteinuria in 6, allergic symptoms in 23, and thrombocytopaenia in one patient. The serum IgM level was higher in patients with side effects. None of the 33 other parameters studied showed any significant differences between patients with or without side effects.

Scandinavian Journal of Immunology, 1990

Mouse monoclonal antibodies against ED sequence-containing cellular fibronectin (cFn) were used t... more Mouse monoclonal antibodies against ED sequence-containing cellular fibronectin (cFn) were used to show ihat Fn in the inflamed synovium is distinct from the major form of plasma Fn (pFn), An accumulation of cFn was seen at siles of hyperplasia of the rhcumaloid synovial membrane and in the walls of small vessels in Ihe synovium by immunolluorescence microscopy. cFn was also found in rheumatoid synovial fluid by immunoblotlmg. Appro.ximately one-fifth of the T lymphocytes from rheumatoid synovial fluid bound to Fn, The binding of synovial fluid T cells was always higher than that from peripheral blood. These results have two implications-On the one hand, ihe cellular type of Fn may be an indicator of synovial inflammation. On the other hand, the deposition of Fn may be a factor contributing to ihc infillralion ol mononuclear cells inlo the synovium,

Rheumatology International, 1982

Serum fi2-microglobulin (/?~m), sialic acid and C-reactive protein (CRP) were studied in 58 patie... more Serum fi2-microglobulin (/?~m), sialic acid and C-reactive protein (CRP) were studied in 58 patients with systemic lupus erythematosus (SLE) on 186 occasions. Serum /?2m was significantly higher in SLE patients than in control subjects. Increased serum fi2m levels were seen in 68% of the patients with only extrarenal manifestations of SLE, in 75% of the patients with renal manifestations but normal glomerular filtration rate, and in 100% of the patients with renal failure. Serum /?2m levels in 12 SLE patients with associated Sj6gren's syndrome were similar to those in patients without that syndrome. Serum sialic acid was also significantly increased in the SLE patients. Sixty-one (33%) of the 186 sera were positive for CRP (>/5 rag/l). The CRP elevation was not accompanied by recognized intercurrent infection or other superimposed cause of tissue injury and inflammation in 37 instances (61%). Under such conditions CRP was only moderately increased.

Scandinavian Journal of Infectious Diseases, Feb 1, 2008

Sindbis virus (SINV) emerges as large human outbreaks in northern Europe every 7 years. Similar t... more Sindbis virus (SINV) emerges as large human outbreaks in northern Europe every 7 years. Similar to many other alphaviruses, SINV is a mosquito-borne causative agent of a rash-arthritis. Previous reports suggest that in many alphavirus infections joint symptoms might persist for years. A prospective cohort of 49 patients was physically examined 3 y after verified acute SINV infection to reveal persistent joint symptoms. We carefully searched for a temporal association between the infection and current symptoms, and took into account other medical conditions. Sera were collected and analysed with enzyme immunoassays. Arthritis (swelling and tenderness on physical examination) was diagnosed in 4.1% (2/49) of the patients. Tenderness on palpation or in movement of a joint was found in 14.3% of the patients in the rheumatological examination, and an additional 10.2% complained of persisting arthralgia at the interview. Thus, 24.5% of the patients had joint manifestations attributable to the infection 3 y earlier. A positive IgM antibody response persisted in 3/49 of the patients; both patients with arthritis were in this group. As one-quarter of the patients were symptomatic 3 y after infection, it seems that persistent symptoms of SINV infection have considerable public health implications in areas with high seroprevalence.

A cohort of 66 patients with SLE that were thoroughly studied, both clinically and serologically ... more A cohort of 66 patients with SLE that were thoroughly studied, both clinically and serologically in 1980-81, when they had a mean disease duration of eight years, were evaluated seven years later in order to assess the long-range outcome of the disease. Five patients were lost from follow-up and 12 (20%) died during the follow-up. The estimated 10-year survival was 91%. A total of 30 patients (45%), showed no signs of nephritis at any stage, and in only eight an active nephritis was found during the follow-up. The previous antibody determinations, provided no predictive information regarding the behaviour of the renal manifestations. Arthralgia was the main clinical symptom during the follow-up. Hypertension developed in 23%. At the end of the follow-up the disease was regarded as active in 13% of the patients.

The Journal of Rheumatology, Mar 1, 1986

Autoantibodies against neuronal antigens occur in sera of patients with systemic lupus erythemato... more Autoantibodies against neuronal antigens occur in sera of patients with systemic lupus erythematosus (SLE). These antibodies may have significance in the pathogenesis of neurological complications of SLE. However, the neuronal structures containing the corresponding autoantigens are poorly known. In our study we assayed circulating antibodies against defined neuronal components--neurofilaments--by an enzyme-linked immunosorbent assay (ELISA) using purified neurofilament polypeptides as targets. Circulating neurofilament antibodies (anti-NF) of IgG class were detected in 21% of 28 patients with SLE and in 6% of 17 patients with rheumatoid arthritis and in none of the 14 patients with primary sicca syndrome and 40 blood donors. The presence of anti-NF could also be confirmed by the indirect immunofluorescence technique using frozen sections of rat spinal cord. In one serum, anti-NF cross reacted with vimentin type of intermediate filaments. The antibodies bound both to the 70 kilodalton and the 200 kilodalton polypeptides of neurofilaments as judged by the immunoblotting technique. Two of 6 anti-NF positive patients had neurological complications.

The Journal of Rheumatology, Sep 1, 1983

Antibodies to 2 types of cytoplasmic intermediate filaments (IMF)--vimentin and cytokeratin filam... more Antibodies to 2 types of cytoplasmic intermediate filaments (IMF)--vimentin and cytokeratin filaments--were assayed in sera from various rheumatic diseases by indirect immunofluorescence using cultured human embryonic fibroblasts and an epithelial cell line, PtK 2, as substrates. These antibodies belonged mainly to the IgM class and were detected in most of the sera. Vimentin filament antibodies of IgG or IgA class were frequent in Sjögren's syndrome (43%). Antibodies to another type of IMF, cytokeratin filaments, were also more prevalent in Sjögren's syndrome (64%) than in systemic lupus erythematosus (50%), rheumatoid arthritis (46%) and other hospital patients (8%). Our results show that intermediate filaments are a major target for autoantibodies in rheumatic diseases, especially in Sjögren's syndrome. The presence of intermediate filament IgA antibodies suggest that the stimulus for their production lies at epithelial surfaces.

Nephron, 1984

This case report describes a patient who initially had a pleuritis and arthalgias. During the fol... more This case report describes a patient who initially had a pleuritis and arthalgias. During the follow-up he developed first a membranous glomerulonephritis with nephrotic syndrome and subsequently a crescentic, rapidly progressive glomerulonephritis with glomerular basement membrane antibodies (anti-GBM). An analysis of the serum samples obtained during the follow-up revealed no infections at the onset of renal failure. However, anti-GBM could be demonstrated in the serum samples obtained 2 months before the deterioration of the renal function. The anti-GBM did not react with alveolar BM and the patient had no signs of pulmonary hemorrhage. The etiology and the sequence of the pathological events of rapidly progressive glomerulonephritis is discussed in the light of these observations.

Scandinavian Journal of Rheumatology, 1984

Hydrostatic parotid sialography was performed in 46 rheumatological patients, 17 of whom were SLE... more Hydrostatic parotid sialography was performed in 46 rheumatological patients, 17 of whom were SLE patients. Signs of atrophy of the parotid gland were noted more often in the SLE group (53%) than in the series as a whole (29%). Strictures in the duct and ductuli were also more common in the SLE group (67%) than in the whole series (50%). Sialectasis was only slightly more common (40%) in the SLE group than in the series as a whole (38%). Two contrast media, Amipaque (metrizamide, 170 mgI/ml) and Urographin 60% (sodium amidotrizoate + meglumin amidotrizoate 10:66, 290 mgI/ml) were used, of which Amipaque proved to be clearly better tolerated. This difference is probably due to the low osmolarity of Amipaque.

Rheumatology International, 1986

Sera obtained from 53 patients with systemic lupus erythematosus (SLE) were investigated for the ... more Sera obtained from 53 patients with systemic lupus erythematosus (SLE) were investigated for the presence of immunoglobulin class-specific antibodies against native (ds)DNA and denatured (ss)DNA. The methods employed were the Crithidia luciliae test and an enzymelinked immunosorbent assay (ELISA), respectively. Anti-dsDNA antibodies of IgG class were seen in 42%, IgManti-dsDNA antibodies in 43%, and IgA-anti-dsDNA antibodies in 30% of the patients. There was an association between the presence of both IgG-and IgA anti-dsDNA antibodies and the activity of the disease. Patients with active nephritis also had anti-dsDNA antibodies of IgG and IgA class significantly more often than patients with inactive nephritis or without renal disease. IgG-anti-ssDNA antibodies were seen in 89%, IgM-anti-ssDNA antibodies in 51%, and IgA-anti-ssDNA antibodies in 66% of the patients. Patients with nephritis had low levels of antibodies to ssDNA of IgM class. We suggest that immunoglobulin class-specific anti-DNA antibodies should de determined in the diagnosis and monitoring of SLE.

Journal of Clinical Virology, 2006

European Journal of Internal Medicine, 2009

Wegener's granulomatosis (WG) is a rare granulomatous necrotizing vasculitis of small vessels, af... more Wegener's granulomatosis (WG) is a rare granulomatous necrotizing vasculitis of small vessels, affecting vascular structures having predilection for upper airways. If untreated WG can be lethal. WG is also known to cause oral mucosal lesions. We report a case of WG that was first diagnosed on oral gingival mucosa. A 51-year old woman was referred to a specialized dentist because of consistent irritative buccal gingival hyperplasia that did not react to conservative and microbial treatment. The lesion was biopsied and the diagnosis was suggestive for WG. Patient was further referred to the Department of Rheumatology and the diagnose of WG was confirmed and treated. The oral lesions cured totally. This case emphasizes the importance to recognize the oral manifestation of WG to get proper medication as soon as possible and avoid serious systemic tissue damage.

Scandinavian Journal of Rheumatology, Feb 1, 1995

We compared the effects of intramuscular gold and sulphasalazine on early, active rheumatoid arth... more We compared the effects of intramuscular gold and sulphasalazine on early, active rheumatoid arthritis in 128 consecutive patients. Intramuscular gold was started in the first 70 consecutive patients and sulphasalazine in the subsequent 58 patients. The patient groups were comparable with regard to clinical characteristics. In both groups clinical and laboratory parameters improved, but there was no significant difference between the two groups. The clinical improvement was most pronounced during the first three months. However, despite the clinical improvement a clear progression in radiological changes was observed in both groups, 40% of the patients taking gold and 48% of patients taking sulphasalazine discontinued the treatment because of adverse drug reactions or inefficacy during the one year follow-up. Adverse drug reactions were the main reason in both groups. These findings suggest that intramuscular gold and sulphasalazine seem to have an equal, positive effect on symptoms and clinical variables, but that radiological progression does occur in most patients none the less.

Scandinavian Journal of Rheumatology, Feb 1, 1993

The prognostic significance of HLA DR4 and B27 antigens was investigated in a 3-year follow-up of... more The prognostic significance of HLA DR4 and B27 antigens was investigated in a 3-year follow-up of 87 patients with early rheumatoid arthritis (RA). The frequencies of DR1, DR4 and also of B27 were increased and the frequencies of DR2, DR3 and DR7 decreased compared with the normal Finnish population. During the follow-up with antirheumatic treatment, a similar improvement in clinical variables and laboratory measure assessing disease activity was found in both DR4-positive and DR4-negative RA patients. Despite clinical improvement a fast radiological progression in peripheral joints was observed but the presence of DR4 or B27 had no impact on the progression of joint damage. In some patients cervical changes developed early in the course of RA but were not related to DR4 or B27 positivity. The earlier observation of increased prevalence of HLA B27 in the Finnish RA patients was confirmed but the presence of B27 did not modify the clinical picture of RA.

Scandinavian Journal of Rheumatology, Jul 11, 2009

This special year in the history of the Scandinavian Journal of Rheumatology is coming to an end.... more This special year in the history of the Scandinavian Journal of Rheumatology is coming to an end. In the very first issue, published 40 years ago under the name Acta Rheumatologica Scandinavica, the Editor, Professor Gunnar Edstrom, stated in his Preface:“It is to be ...

Evidence-Based Medicine Guidelines, 2005

Scandinavian Journal of Rheumatology, 1988

A total of 218 samples obtained during a follow-up study of 36 patients with systemic lupus eryth... more A total of 218 samples obtained during a follow-up study of 36 patients with systemic lupus erythematosus (SLE) were tested for the presence of cryoglobulins. Cold-insoluble precipitates were found in 81% for the patients (29 patients, 114 samples). The protein concentration of the cryoglobulins correlated significantly with the disease activity. Autoantibody activity was determined in the dissolved cryoglobulins and in corresponding serum samples by enzyme-linked immunosorbent assays (ELISA). IgM-RF could be demonstrated more often in the cryoglobulins than in the sera (75% vs. 14%), whereas IgA-RF were seen in 28% of both cryoglobulins and sera. Anti-ssDNA and anti-poly(A) antibodies of both IgG and IgM classes were found more often in the sera than in the corresponding cryoprecipitates. In 7 samples from 5 patients an increase in the IgG-anti-ssDNA activity was seen after DNase digestion of the cryoglobulins. Patients with Raynaud's syndrome had a significantly higher level of cryoprecipitating IgM class rheumatoid factors than other patients. There was also an association between the IgG-anti-poly(A) antibody levels in the cryoglobulins and the activity of the disease. There was no difference with regard to the composition of the cryoglobulins, between patients with nephritis and those without an overt renal disease. Thus, the presence of cryoglobulins in SLE indicates active disease, but not necessarily renal involvement. IgM rheumatoid factors may play a role in the pathogenesis of Raynaud's syndrome of SLE patients.