[Is endocarditis of a membraneous septal aneurysm detected in a rheumatological milieu?].
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Biomedical subjects
Publications and source records attributed to A Gaucher.
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Free and total ketoprofen levels in serum and synovial fluid were determined in 37 patients after a single intramuscular injection of ketoprofen, 100 mg. Free drug was separated by equilibrium dialysis. Ketoprofen was assayed by HPLC. Ketoprofen penetrated into the joints rapidly and significant concentrations were found at 15 minutes. The equilibrium time was about 3 1/2 hours. The AUC for total ketoprofen was greater in serum than in synovial fluid. On the other hand, the free fraction AUC in the serum and synovial fluid were quite similar. The mean residence time in the joint was about three times that in the systemic circulation. Ketoprofen was strongly bound to proteins and the percentage of free ketoprofen was not significantly different between serum and synovial fluid. These results provide a possible explanation for duration of the therapeutic effect of ketoprofen despite the short elimination half-life from the serum.
Ossifying enthesites present an undeniable diagnostic value in every chronic inflammatory rheumatism at an early stage, not only in adults but also in children. Bony scintigraphy discovers them in most localizations at a preradiological stage, as soon as they cause pain. The scanner examination enables to follow the anatomical evolution of the ossifications. It is perfectly suitable for the study of sacro-iliac and interapophyseal joints. Ossifying enthesites, the evolution of which spreads over several years, often depend on mechanical, professional or athletic constraints. Ossifying enthesitis is a common characteristics of "classic" spondylo-arthropathies which are all ossifying polyenthesites: ankylosing spondylarthritis, psoriasic rheumatism, rheumatism of enteropathies, Fiessinger-Leroy-Reiter syndrome and juvenile spondylo-arthropathies.
The term sternocostoclavicular hyperostosis groups affections of different pathogenicity. These result from an ossifying enthesiopathy, either inflammatory, isolated to the thoracic wall anteriorly or combined with a spondylarthropathy, particularly ankylosing spondylitis, or degenerative, the anterior thoracic hyperostosis usually being part of an ensheathing vertebral hyperostosis. A differential diagnosis is anterior thoracic hyperostosis due to an inflammatory osteopathy occurring in young patients and often associated with other bone lesions of pelvis and spine or long bones.
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Articular chondrocalcinosis is a well-defined radiological entity with or without clinical manifestations. A familial form was described by Sitaj and Zitnan in 1957. Attention has mostly been paid to chondrocalcinosis associated with metabolic diseases and to "sporadic" chondrocalcinosis, usually due to ageing of the joint. Familial chondrocalcinosis, of which more and more cases are reported, is increasingly under study and is used as a model for pathogenic research. It already appears that familial chondrocalcinosis, of dominant autosomal transmission, is a new metabolic disease.
There are two kinds of stress fracture. One is fatigue fracture of a healthy bone during unusual mechanical overloading. This kind is seen particularly in young persons, such as soldiers and athletes, and most often affects the metatarsals, calcaneum, tibia, and fibula. The second kind is insufficiency fracture, in which the bone has become fragile because of age, metabolic disorder, static disorder of a leg, or prior orthopedic surgery, and cannot withstand even moderate stress. This type of fracture particularly affects the elderly, and is by far most frequent in the pelvis. Bone imaging is very helpful in early diagnosis of stress fractures, because as soon as there are clinical signs it reveals some degree of very localized uptake.
Non specific immunity in human rheumatoid synovium: histochemical and immunohistological analysis. Enzymatic activities and monocyte-specific membrane antigens were looked for on frozen sections from 25 synovial membrane samples from patients with rheumatoid arthritis. Classical histochemical reactions were used to identify non specific esterases, alkaline and acid phosphatases, ATPase and peroxidase. Indirect immunofluorescence was performed with a series of monoclonal antibodies to monocyte membrane antigens and HLA class II molecules. Technical pitfalls were successfully overcome, and specific labelings demonstrated the variety and heterogeneity of these markers among synovial cells and vascular endothelia. Reported data indicated that such a panel of investigations is useful to better define the non-specific immunological phenomenons which take place in this active pathological tissue. They suggest that numerous metabolic activities concur to sustain chronic inflammation.
The authors have developed a technique of CT arthroscan which, by the use of a gas or opaque contrast medium, is able to demonstrate the synovial structures of the knee, the shoulder and the hip. Among the essential indications, they include the demonstration of neoplasia of the synovium and the evaluation of the pannus in rheumatoid arthritis. Their secondary indications include the demonstration of fluid effusions in the hip, the precise evaluation of hyperostotic lesions in the same joint, the detection of ossification phenomena in the capsule of the inter-apophyseal joints in ankylosing spondylitis and, in some cases, following negative or doubtful arthrography for the detection of synovial plica. They also recall the usefulness or the arthroscan in the diagnosis of lesions of the labrum glenoidale.
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