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Disorders of connective tissue. Vol. XI No. 6 1975. Birth DefectsOriginal Article Series. Edited by Daniel Bergsma. New York Stratton Intercontinental Medical Book Corporation 1975. 379 pages. Price16.95

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Current State of the Journal
During the past year several changes in the organization and publication policies of A &R have taken
place. It seems appropriate a t this time to review for
readers of the Journal the changes that have been introduced, as well as additional ones that are planned.
From July 1975 through June 1976 the number of
manuscripts submitted for publication increased by
more than 25% over the preceding year. This increased
volume, coupled with the fact that A&R is a bimonthly
journal, has resulted in an inordinately long lag period
between the time an article is submitted and its publication date. Generally, this interval approaches 10
months. The Editorial Board feels that this long delay in
publication may discourage investigators from submitting articles of greatest importance, significance, and
current interest. It had been our hope that increasing the
size of the Journal from 96 to 144 text pages would be
sufficient to clear up a very large backlog of manuscripts
awaiting publication and also speed up the current editorial process. Although this measure has been somewhat effective, it might take as much as one to two more
years before we could achieve a more reasonable turnaround time. Upon the recommendation of the Editorial
Board and the Committee for the Publication A&R, the
Executive Committee of the American Rheumatism Association has approved an increase to eight 144-page
issues in 1977. It is our hope that this increased frequency will have a major impact in enhancing the speed
of review and publication. We anticipate that the overall
quality of the Journal will continue to improve as a
As an editorial policy, we have made an effort to
decrease the number of case reports and single observation reports that are presented as full-length articles. To
this end, we have encouraged the publication of letters
to the editor. We hope that the letters section, which is
indexed in both A &R and Index Medicus. will become a
forum for discussion of problems and controversy.
The increased number of manuscripts submitted
to A&R for review has also necessitated an expansion of
the Editorial Board. The Committee for the Publication
of A &R has recommended that the size of the Editorial
Board be essentially doubled, with new members being
given two-year appointments. A rotating period of service will be established so that the opportunity exists for
more people to become involved at one time or another
in the efforts of A&R. Participation by more members of
Arthritis and Rheumatism, Vol. 19, No. 5 (September-October 1976)
the American Rheumatism Association should give the
Journal a wider perspective.
The five Associate Editors in Birmingham have
been an important help in making rapid decisions on
revised manuscripts and in handling minor revisions.
The cooperative effort of the Associate Editors also
helps to shorten the time of review, and hence the overall time required for publication.
The changes that have been described are made
in the hopes of 1 ) decreasing the time required for
publication, 2) increasing the quality of research reports, and 3) increasing the participation of members of
the profession in the publication of the Journal.
At all times the Editor, the Editorial Board, and
the Committee for the Publication of A &R are open to
suggestions from any concerned reader. We look forward to working with all members of our profession to
make the Journal the best possible professional publication, and to see continuing improvement through the
coming years.
Editor, A rthritis & Rheumatism
Birmingham, Alabama
Disorders of Connective Tissue. Vol. XI, No. 6 ,
1975. Birth Defects: Original Article Series.
Edited by Daniel Bergsma. New York, Stratton
Intercontinental Medical Book Corporation,
1975. 379 pages. Price: $16.95.
Forty-seven papers presented during the 1974
Birth Defects Conference at Newport Beach, California,
constitute the major portion of this symposium. The
quality of editing is variable, and brief participant discussions have been appended to some presentations. As
a symposium of original papers dealing almost exclusively with selected aspects of heritable connective tissue
disorders, the book is intended for reference and not
cover-to-cover reading, as was attempted-with considerable difficulty-for this review. The experience, however, is generally interesting and instructive.
The first part of the symposium titled “Connective Tissue Diseases” opens with some helpful comments
on classification of the disorders of fibrous components
by Dr. Victor McKusick. However the second paper, “The
Molecular Bases of Certain Inherited Diseases of Con-
96 1
nective Tissue Involving Collagen,” fails to produce the
information implied in the title, probably because of
over-editing. Although also over-edited, papers dealing
with abnormal collagens and lysyl oxidase deficiency in
Ehlers-Danlos Type V are more informative. The remainder of the papers in this section and those in the
second section, “Epiphyseal Dysplasias,” are primarily
descriptive, focusing on new syndromes, phenotypes,
pedigrees, and in some cases, descriptive histology.
These papers are generally difficult to read, but would be
useful references for those associated with this area of
medicine as clinicians or investigators. A discussion of
the problems of classification of epiphyseal dysplasias is
The final section of the symposium, “Mucolipidoses,” provides more interesting reading. An opening
paper on classification is particularly helpful. More fascinating, however, is the biochemical detective work
leading to an increased understanding of the pathogenesis of these disorders, but this work is unevenly presented in the subsequent papers. Only one paper is concerned with the “pure” mucopolysaccharidoses,
presumably because their nature has already been relatively completely elucidated.
The index to the symposium is grossly incomplete, and hence not very useful. The quality of the
photographic reproductions is excellent, but the clarity
of the legends is variable. As expected of a symposium
of this type, there is considerable variation in the apparent quality of research presented, but in some cases
editing may have adversely affected the presentation.
This symposium would be useful primarily for reference
by the pediatrician, rheumatologist, orthopedist, medical geneticist, and connective tissue biochemist.
JR., M.D.
University of Alabama
Birmingham, Alabama
Conference on Articular Cartilage-Biomechanics Unit of the Imperial College of Science and Technology. Edited by G.E. Kempson,
A . Maroudas, and B. Weightman. London, England, Annals of the Rheumatic Diseases, Volume
34, Supplement 2, December 1975.
bolism, and enzymology, as well as mechanical functions of articular cartilage. A second section deals with
the pathogenesis of osteoarthritis (-osis). Ten papers
concern anatomic structure, twelve biochemical aspects
of cartilage constituents, eight cartilage metabolism, ten
cartilage enzymes with special reference to degradation,
sixteen mechanical functional properties, and sixteen
osteoarthritis. There are three to five substantial reports
within each of the above categories and the rest are
presented as short communications.
Among the highlights of the conference are two
independent studies that show age-related worsening of
articular cartilage in respect t o parameters of resistance
to mechanical wear. It is also clear from other studies
that it is virtually routine to encounter in an autopsy
population apparently nonprogressive shallow cartilaginous ulcerations in femoral heads in non-weight-bearing sites. Theories are advanced on the role of various
factors in production of osteoarthritis, such as growth
and developmental defects, maldistributed physical
forces, impact loading and stiffening of subchondral
bone, altered congruity of joint surfaces, metabolic deficiencies in the matrix, and production of degradative
enzymes. Also of interest is the finding of a striking
storage of calcium in normal articular cartilage, a finding that might have bearing on the development of
chondrocalcinosis. Biochemical nature and importance
of proteoglycan aggregates comprised of subunits,
hyaluronic acid, and glycoprotein as the major form of
proteoglycans in normal cartilage are further clarified.
Fluid transport in cartilage and lubrication mechanisms are discussed. In a dog model of osteoarthritis,
evidence of increased synthesis of proteoglycans and
collagen is reported to be present from an early stage of
induced disease.
This symposium fills a pressing need for a compilation of research going on in the major laboratories
interested in cartilage pathophysiology and osteoarthritis. Although the audience for this symposium is
clearly composed of scientists and students involved in
cartilage research, the documentations are clear and for
most of the presentations there is much of interest to
clinical rheumatologists, who would find this a useful
of the art.y9
reference to the
N o major criticisms of the conference seem warranted, except possibly for an over-abundance of the
short communications.
I n the first section of the Conference on Articular
Cartilage one finds a comprehensive series of research
papers on the biological structure, biochemistry, meta-
University of Miami
Miami, Florida
Arthritis and Rheumatism, Vol. 19, No. 5 (September-October 1976)
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