1633various vehicles or given vehicle alone, all preparations except physiologic saline caused changes in the tissues at the injection site: necrotic muscle tissue, foreign-body reaction, and eventual scar tissue (5). Studies in rabbits demonstrated that the volume of the injection was the major factor in muscle damage (6,7). Damage caused by all aqueous preparations was ameliorated to various degrees by different oil vehicles.From the results of these animal studies, more frequent problems than are seen in practice might be expected. The 2 patients described herein had received large cumulative volumes of ATG in a small area of muscle. Varying the site of injection in large muscle groups results in a low risk of developing oily abscess. Although magnetic resonance imaging would be a sensitive tool for demonstrating an oily abscess, it is much more expensive than a good ultrasound study. Moreover, in the absence of clinical indications, screening seems unnecessary. James M. Sowa, MD, FACR St. Joseph Hospital Towson, MD 1.
2.3.
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6.7.
Bacterial antibodies in HLA-B27+ healthy individualsThe mechanisms that cause susceptibility to ankylosing spondylitis and reactive arthritis in HLA-B27 + individuals remain unknown. Several theories have been proposed, including molecular mimicry and involvement of genes closely linked to the HLA-B locus (1). However, none of these, nor the identification of self peptides bound to purified HLA-B27 molecules, has shed any decisive light on the question (2). If HLA-B27 functions as an immune response gene in the pathogenesis of spondylatihropathies, the effect should be apparent in the immune response. Thus far, no clear evidence for this has been found (3). The most obvious targets for such an immune response are the microbes identified as etiologic agents for reactive arthritis. These microbes can be readily investigated by available methods. Therefore, we studied HLA-B27+ healthy blood donors for the occurrence of antibodies against various serotypes of Yersinia enterocolitica and Yersinia pseudotuberculosis as well as against Salmonella and Campylobacter jejuni, all known to cause reactive arthritis (4). Klebsiella pneumoniae was also included, due to its potential association in the pathogenesis of ankylosing spondylitis (5). Proteus mirabilis and Escherichia coli, which have no known connection to HLA-BU-associated diseases, were used as control antigens.The occurrence of the serum antibodies was studied in 927 healthy blood donors typed for the HLA class I antigens Al, 2, 3, 9, 10, 11, 19, and 28; B5, 7, 8, 12, 13, 14, 15, 16, 17, 18, 21, 22, 27, 35, 37, 40, 41, and 47; and Cwl-Cw8. Enzyme immunoassay for IgM-, IgG-, and IgAclass antibodies specific for the various microbes was carried out as described earlier (6). Bacterial strains used for antigen preparation, and the sources from which they were obtained, were as follows: Y enterocolitica 0:3 (strain MY 0; S. Winblad , and E coli (strain 8330; a clinical isolate, Turku). For yersiniae, K pneumoniae, P mirabilis, and E...