How portraits turned their eyes upon us: Visual preferences and demographic change in cultural evolution

It has often been suggested that innate features of the human mind could make some cultural forms more successful than others. This paper presents a case study consistent with this “cognitive attraction” hypothesis. Numerous studies show that direct eye-gaze catches the attention of adults and newborns. Adults find it more attractive. We explore one possible cultural consequence of this cognitive appeal. Among XVIth century European portraits, direct-gaze paintings are more likely to be featured in today's art books. In Renaissance Europe, the proportion of paintings that stare at the viewer grows gradually, strongly, and remains prevalent for centuries. A demographic analysis of this shift shows that it was due to the arrival of new generations of painters. Those artists show a preference for direct-gaze portraits as soon as they start painting, suggesting that they acquired the new style in the years of their apprenticeship. The preferences of those painters and of contemporary art critics seem consistent with the innate attentional bias that favours direct-gaze faces. The structure of the “Renaissance gaze shift” bears evidence for the importance of demographic turn-over in cultural change.     

On the History of Vegetable Gardens in North-west Europe

Summary

The early history of vegetable gardens is little documented. Only a few references to and depictions of mediaeval vegetable gardens are available. The possible reason is that they were too common, too vulgar, to record and to write about, and to paint or to draw. From the 16th century onwards much information is available on the history of gardens, but information on vegetable gardens is still quite limited. Many of the Flemish and Dutch paintings of the 16th to 18th centuries show vegetable stalls on markets. These paintings show us the vegetables and their variation at the time the paintings were made. More data on the history of vegetable gardens will become available as a result of archaeobotanical research.     

Rheumatoid arthritis and Dupuytren's contracture

Of four patients with rheumatoid arthritis and Dupuytren's contracture, two were not aware of the presence of Dupuytren's contracture. When both diseases coexist, the presence of rheumatoid hand deformities, especially flexion and ulnar deviation of the metacarpophalangeal joints, may mask the flexion deformity caused by Dupuytren's contracture. Careful clinical examination should rule out the presence of a pathologic fascial cord. When reconstructive surgery is indicated for the rheumatoid hand in the presence of advanced Dupuytren's contracture, staged surgery would be appropriate and reconstruction of Dupuytren's contracture should precede other surgery.     

Rheumatoid arthritis "in the buff": erosive arthritis in defleshed bones

Examination of isolated bones from patients with unequivocal rheumatoid arthritis provides only a glimpse of the disease but has been the only "gold standard" for recognition of osseous lesions as compatible with the diagnosis of rheumatoid arthritis. Documentation of skeletal pathologic changes in confidently diagnosed individuals has been a major missing link in the transition from clinical to skeletal analysis. Availability of appropriate skeletal material from two patients with long-standing, well-documented rheumatoid arthritis provided the opportunity for acquiring such information. The osseous appearance, skeletal distribution, and distinguishing features of rheumatoid arthritis "in the buff" were delineated in two contemporary patients and in a skeletal population of 2,906 individuals. The preconceived notion of anticipated severity of disease has hereby been tested and found wanting. Severe lesions are not recognizable or distinguishable from artifact in relatively fragile rheumatoid arthritis-affected bones, whether freshly prepared or remotely sampled. Characterization of the nature and epidemiology of osseous alterations in two contemporary skeletal populations permitted the development of a standard for recognition of the disease in skeletal populations.     

HDAC inhibition in rheumatoid arthritis and juvenile idiopathic arthritis

Rheumatoid arthritis (RA) and juvenile idiopathic arthritis (JIA) are heterogeneous autoimmune diseases characterized by chronic joint inflammation. Methotrexate is used as the gold standard to treat rheumatoid arthritis, yet there are many patients in whom the disease cannot be controlled or who experience unacceptable intolerance. Most of the biologics currently used are effective, but mostly if combined with methotrexate. Long-term possible side effects, such as impaired host defense mechanisms against infection and lymphoma, are distinct disadvantages and a major concern of anticytokine therapies. Parenteral administration is a problem, particularly in children. Thus, there is a need to explore new treatment options. Here we review the properties of histone deacetylase inhibitors (HDACi) as they apply to rheumatoid arthritis by looking at effects on cytokine production, T-cell differentiation and the function of macrophages, dendritic cells, osteoblasts, osteoclasts and synovial fibroblasts. We also review the safety and efficacy of givinostat (ITF 2357) in the treatment of systemic onset juvenile idiopathic arthritis (SOJIA) and its influence on the cytokine networks in SOJIA. Givinostat is an orally active HDACi which was given to children with SOJIA. After 12 wk of treatment, there were significant benefits, particularly in reducing the pain and arthritic component of the disease and decreasing the neutrophilia. CD40L, IL-1α and IFNγ in whole blood lysates decreased at wks 2 and 4 compared with baseline levels. The clinical data are consistent with those from animal models of rheumatoid arthritis and suggest that trials with HDACi are promising as a safe oral alternative to anticytokines and methotrexate.     

Familial clustering of rheumatoid arthritis with other autoimmune diseases

Previous studies have shown that rheumatoid arthritis aggregates within families. However, no formal genetic analysis of rheumatoid arthritis in pedigrees together with other autoimmune diseases has been reported. We hypothesized that there are genetic factors in common in rheumatoid arthritis and other autoimmune diseases. Results of odds-ratio regression and complex segregation analysis in a sample of 43 Caucasian pedigrees ascertained through a rheumatoid arthritis proband or matched control proband, revealed a very strong genetic influence on the occurrence of both rheumatoid arthritis and other autoimmune diseases. In an analysis of rheumatoid arthritis alone, only one inter-class measure, parent–sibling, resulted in positive evidence of aggregation. However, three inter-class measures (parent–sibling, sibling–offspring, and parent–offspring pairs) showed significant evidence of familial aggregation with odds-ratio regression analysis of rheumatoid arthritis together with all other autoimmune diseases. Segregation analysis of rheumatoid arthritis alone revealed that the mixed model, including both polygenic and major gene components, was the most parsimonious. Similarly, segregation analysis of rheumatoid arthritis together with other autoimmune diseases revealed that a mixed model fitted the data significantly better than either major gene or polygenic models. These results were consistent with a previous study which concluded that several genes, including one with a major effect, is responsible for rheumatoid arthritis in families. Our data showed that this conclusion also held when the phenotype was defined as rheumatoid arthritis and/or other autoimmune diseases, suggesting that several major autoimmune diseases result from pleiotropic effects of a single major gene on a polygenic background. Received: 12 January 1998 / Accepted: 10 June 1998     

Recent developments in the immunobiology of rheumatoid arthritis

Progress into the understanding of immunopathology in rheumatoid arthritis is reviewed in the present article with regard to pro-inflammatory cytokine production, cell activation and recruitment, and osteoclastogenesis. Studies highlight the potential importance of T helper 17 cells and regulatory T cells in driving and suppressing inflammation in rheumatoid arthritis, respectively, and highlight other potential T-cell therapeutic targets. The genetic associations of the HLA shared epitope alleles with antibodies to citrullinated peptides in rheumatoid arthritis patients indicate that T cells are providing help to B cells to produce autoantibodies, and there is increasing evidence that these autoantibodies are pathogenic in rheumatoid arthritis.     

Possible case of rheumatoid arthritis from Sudanese Nubia

Due to its apparent absence in archaeologically derived skeletons, rheumatoid arthritis (RA) has generally been believed to be of fairly recent origin. A growing body of evidence now demonstrates that erosive lesions typical of RA are present in archaeological populations and that the antiquity of RA may be greater than previously expected. In support of this argument, a case of erosive arthritis is reported in a skeleton from Kulubnarti, Republic of the Sudan (c. 700-1450 A.D.). Lytic, erosive lesions and subchondral cysts are present bilaterally in the carpal and metacarpal joints of a female skeleton with an estimated age at death of 50+ years. These lesions are typical of those seen in clinically diagnosed rheumatoid patients. While their expression and distribution are highly suggestive of RA, interpretation must be made with due consideration for problems of differential diagnosis of this disease in archaeological material.     

Gene therapy for osteoarticular disorders

Osteoarticular disorders are the major cause of disability in Europe and North America. It is estimated that rheumatoid arthritis affects 1 % of the population and that more than two third of people over age 55 develop osteoarthritis. Because there are no satisfactory treatments, gene therapy offers a new therapeutic approach. The delivery of cDNA encoding anti-arthritic proteins to articular cells has shown therapeutic efficacy in numerous animal models in vivo. Through the development and the experimental progresses that have been made for both rheumatoid arthritis and osteoarthritis, this review discusses the different gene therapy strategies available today and the safety issues with which they may be associated. Among the different vectors available today, adeno-associated virus seems the best candidate for a direct in vivo gene delivery approach for the treatment of joint disorders.     

Pathogenesis of rheumatoid arthritis: how early is early?

Studies of cytokine expression in rheumatoid arthritis have provided key insights into the pathogenesis of disease and have offered clues for effective therapy. Patterns of T-cell products in chronic rheumatoid synovitis suggest that T helper type 1 cells contribute to the perpetuation of disease. However, there is no guarantee that the mechanisms of late disease are identical to very early rheumatoid arthritis. Evaluation of the cytokine profile at the earliest time points after onset of symptoms could identify novel targets that prevent progression to chronic arthritis.     

PRESIDENT'S PAGE

Once the deformities of rheumatoid arthritis of the hand begin to develop, conservative management will not prevent their further development. The ulnar drift of the fingers can be improved considerably by a surgical operation, especially if performed early. Experience has shown that an operation performed during the active stage of the disease does not cause exacerbation of symptoms. The results of operations have been encouraging with regard to return of function, decrease in pain and improved appearance of the hand.     

RHEUMATOID ARTHRITIS-Operations on the Hand for Improvement of Function

Once the deformities of rheumatoid arthritis of the hand begin to develop, conservative management will not prevent their further development. The ulnar drift of the fingers can be improved considerably by a surgical operation, especially if performed early. Experience has shown that an operation performed during the active stage of the disease does not cause exacerbation of symptoms. The results of operations have been encouraging with regard to return of function, decrease in pain and improved appearance of the hand.     

Retinal vasculitis in rheumatoid arthritis.

A woman with exacerbation of severe rheumatoid arthritis developed lesions compatible with retinal vasculitis. Laboratory studies confirmed the diagnosis, and the rapid clinical improvement that accompanied a fall in circulating immune complexes suggested that the vasculitis was a direct consequence of the rheumatoid disease. From these observations retinal vasculitis should probably be sought in any patient with rheumatoid disease and the vasculitis added to the list of ocular complications of rheumatoid arthritis.     

NONSPECIFIC ANTI-INFLAMMATORY AGENTS—Some Notes on Their Practical Application,Especially in Rheumatic Disorders

A number of acute and chronic inflammatory disorders are amenable to varying degrees of therapeutic control with the administration of nonspecific anti-inflammatory drugs. An evaluation of these suppressive agents in the field of rheumatic diseases and practical suggestions regarding their administration are presented.Eight synthetically modified corticosteroid compounds are available commercially. Each of them exhibits qualitative differences in one or several physiologic actions, each has certain advantages and disadvantages in therapy, and each shares the major deterrent features of corticosteroids. Prednisone, prednisolone, methylprednisolone, fluprednisolone and paramethasone have similar therapeutic indices, and there is little choice between them for the usual rheumatoid patient requiring steroid therapy. Conversely, the therapeutic indices of dexamethasone, betamethasone and triamcinolone are lower than that of prednisolone; they are less desirable for routine use and should be reserved for specially selected cases.Salicylates are preferred to adrenocortical steroids in the treatment of the ordinary patient with acute rheumatic fever. Steroid therapy should be reserved for resistant cases and for those with significant carditis. Salicylates are mainstays for pain relief in rheumatoid arthritis, but with the analgesic doses usually employed their anti-inflammatory action is slight.Phenylbutazone is a highly useful anti-inflammatory agent, especially in management of acute gouty arthritis and ankylosing (rheumatoid) spondylitis; its metabolite, oxyphenylbutazone, does not exhibit clear-cut advantages.Colchicine specifically suppresses acute gouty arthritis. Its analogues, desacetylcolchicine and desacetylthiocolchicine, produce fewer unpleasant gastrointestinal symptoms, but may promote agranulocytosis and alopecia.A number of indole preparations with anti-inflammatory activity have been tested clinically. One of them, indomethacin, has received extensive therapeutic trial; with dosages that can be tolerated the drug is fairly effective in the symptomatic control of ankylosing (rheumatoid) spondylitis but it is of questionable value in peripheral rheumatoid arthritis.     

Physical criteria of pathological processes. III. Structure of the correlation between the level of steady brain potential with serum complement proteins in rheumatic diseases]

The activity of serum complement proteins and the level of steady brain potential in patients with systemic lupus erythematosus and rheumatoid arthritis were determined. The statistical analysis indicated that there is a correlation between the parameters of the complement system and neurophysiological characteristics. The differences between rheumatoid arthritis and systemic lupus erythematosus are observed in the mean values of activity of complement proteins and the steady potential, their dispersions, and the structure of correlations between immunological and neurophysiological parameters.     

Does a positive anti-CCP test identify a distinct arthritis entity?

The introduction of tests recognizing 'anti-citrullinated protein antibodies' (ACPA) has caused a revolution in rheumatology. Immunization against citrullinated proteins is a feature almost unique for rheumatoid arthritis, although ACPA may occur long before the onset of symptoms. Even if the presence of ACPA does not seem to reveal a distinct arthritis phenotype at symptom onset, it predicts an aggressive disease course with unfavourable outcome. Despite the very high diagnostic specificity for rheumatoid arthritis, ACPA-positivity does not always accord with a traditional diagnosis of rheumatoid arthritis at clinical presentation. However, even when these patients are judged to suffer from mild undifferentiated arthritis, they call for follow-up and special attention by rheumatologists.     

Radioimmunoassay of IgG and IgM rheumatoid factors reacting with human IgG.

Although IgG rheumatoid factor may play a central role in the pathogenesis of rheumatoid arthritis, previously there have been no precise methods for its specific measurement in serum and synovial fluid. This paper describes a solid phase radioimmunoassay for the independent quantification of IgM and IgG rheumatoid factor reacting with the Fc fragment of human IgG. As measured by this assay, serum IgG rheumatoid factor levels differed significantly between patients with seropositive and seronegative rheumatoid arthritis and normal control subjects. In addition, several sera and joint fluids from patients with seropositive rheumatoid arthritis, even without vasculitis, were shown by gel chromatography to have acid-dissociable complexes of IgG rheumatoid factor suggestive of IgG-IgG dimer or trimer formation.     

Follow-up study of lipid peroxides, superoxide dismutase and glutathione peroxidase in the synovial membrane, serum and liver of young and old mice with collagen-induced arthritis

Because reactive oxygen species (ROS) are generally believed to play an important role in tissue injury in rheumatoid arthritis, we examined the levels of lipid peroxides, superoxide dismutase (SOD), and glutathione peroxidase (GSH-Px) in the synovial membrane, serum and liver of young (8 wk) and old (12 mo) mice with collagen-induced arthritis. In the synovial membrane, serum and liver, lipid peroxide levels of both young and old mice were increased beginning on the 3rd day after the onset of arthritis. SOD activity, which scavenges O2- and inhibits lipid peroxidation, rose markedly in the synovial membrane of young mice in parallel with the increase in lipid peroxide levels, but not so markedly in old mice. Liver GSH-Px activity, which metabolizes already formed lipid peroxides, also rose in young arthritic mice to a greater degree than in old mice. This study suggests that in inflammatory synovial lesions, lipid peroxides are generated due to an increase in ROS concentration, with resultant cytotoxicity, and that younger animals or humans can prevent this unfavorable reaction more effectively than aged ones by enzyme induction. The hypothesis that lipid peroxides formed in the oxidative lesions of the primary organ are released into the serum, trapped by the liver and metabolized there is further supported by the present study.     

Are biologics more effective than classical disease-modifying antirheumatic drugs?

Major achievements have been reached in the treatment of rheumatoid arthritis during past decades due to the recognition of methotrexate as an anchor drug for treatment of rheumatoid arthritis, due to the notion of a treatment window of opportunity in patients with recent-onset rheumatoid arthritis necessitating early aggressive therapy, due to the development of biologics and due to remission as a treatment target. Most biologics have a much faster onset of action than synthetic disease-modifying anti-rheumatic drugs, but presently there is no convincing evidence that biologic drugs have a superior clinical efficacy in comparison with the synthetic drugs. Biologics are, however, accompanied by less radiological deterioration.     

Antigen-specific T cells transduced with IL-10 ameliorate experimentally induced arthritis without impairing the systemic immune response to the antigen

For the treatment of rheumatoid arthritis, efficient drug delivery methods to the inflamed joints need to be developed. Because T cells expressing an appropriate autoantigen-specific receptor can migrate to inflamed lesions, it has been reasoned that they can be employed to deliver therapeutic agents. To examine the ability and efficiency of such T cells as a vehicle, we employed an experimentally induced model of arthritis. Splenic T cells from DO11.10 TCR transgenic mice specific for OVA were transduced with murine IL-10. Adoptive transfer of the IL-10-transduced DO11.10 splenocytes ameliorated OVA-induced arthritis despite the presence of around 95% nontransduced cells. Using green fluorescent protein as a marker for selection, the number of transferred cells needed to ameliorate the disease was able to be reduced to 10(4). Preferential accumulation of the transferred T cells was observed in the inflamed joint, and the improvement in the disease was not accompanied by impairment of the systemic immune response to the Ag, suggesting that the transferred T cells exert their anti-inflammatory task locally, mainly in the joints where the Ag exists. In addition, IL-10-transduced DO11.10 T cells ameliorated methylated BSA-induced arthritis when the arthritic joint was coinjected with OVA in addition to methylated BSA. These results suggest that T cells specific for a joint-specific Ag would be useful as a therapeutic vehicle in rheumatoid arthritis for which the arthritic autoantigen is still unknown.