Search PubMed⌕ Search

Biomedical subjects

B Duquesnoy

Publications and source records attributed to B Duquesnoy.

At least 109 records · Page 6Linked to original sources
PubMed1992

Measurement of elastase and cysteine proteinases in synovial fluid of patients with rheumatoid arthritis, sero-negative spondylarthropathies, and osteoarthritis.

Synovial fluid samples were collected from 45 patients with rheumatoid arthritis, spondylarthropathy, or osteoarthritis, to study their content of elastase (EC 3.4.21.37) and of cysteine proteinases (EC 3.4.22.1, 3.4.22.15). We measured both elastase complexed with alpha 1-proteinase inhibitor and elastase activity toward the substrate L-pyroglutamyl-L-prolyl-L-valine-p-nitroanilide. Cysteine proteinase activities were measured with the substrates N-benzyloxycarbonyl-L-phenylalanyl-L-arginine-7-amido-4-methylcoumarin (Z-Phe-Arg-AMC) and Z-Arg-Arg-AMC and the inhibitor E-64 [L-trans-epoxysuccinyl-leucyl-amido-(4-guanidino)-butane]. In all these enzyme assays, higher median values were obtained in inflammatory arthropathies than in osteoarthritis. The concentration of the elastase-alpha 1-proteinase inhibitor complex and of elastase and cysteine proteinase activities were statistically higher in patients with rheumatoid arthritis than in patients with osteoarthritis. The difference in results between patients with spondylarthropathy and patients with osteoarthritis was statistically significant only for the elastase-alpha 1-proteinase inhibitor complex. The median values of the complex and of both enzyme activities were higher in patients with rheumatoid arthritis than in patients with spondylarthropathy; however, the difference was statistically significant only for the cysteine proteinase activity measured with Z-Arg-Arg-AMC substrate. These results suggest that both elastase and cysteine proteinases, which are increased in patients with inflammatory arthritis, are involved in cartilage degradation in these arthropathies.

Adolescent↗
PubMed1991

[Root arthrosis of the thumb].

Root arthrosis of the thumb results from a degenerative lesion of the trapezometacarpal joint. It is particularly frequent in menopausal women. The often prolonged pain it produces sometimes raises therapeutic problems. Treatment is always medical at first, but when it fails several surgical operations will ensure permanent painlessness.

Female↗
PubMed1991

Henoch-Schönlein purpura.

Henoch-Schönlein purpura probably results from a reaction in a host sensitized by an infective stimulus. This stimulus leads to the synthesis of IgA antibody, the presence of circulating immune complexes and a leukoclastic vasculitis involving IgA resulting in renal and dermatological manifestations. The risk factors, the causal organism and the reason for the association with IgA nephropathy remain unknown.

Gastrointestinal Diseases↗
PubMed1991

Increased TNF-alpha secretion by alveolar macrophages from patients with rheumatoid arthritis.

Tumor necrosis factor alpha (TNF) and interleukin-1 (IL-1) production by alveolar macrophages (AM) was evaluated in 17 rheumatoid arthritis (RA) patients without interstitial lung disease (ILD, Group 1) and 14 RA patients with clinical ILD (Group 2) in comparison with 10 control subjects. AM after recovery by bronchoalveolar lavage were selected by adherence, and then supernatants were collected after 3 or 24 h of culture. Results showed no modification of IL-1 synthesis in either group of RA patients. Spontaneous TNF production was significantly increased in Group 2 (2.5 +/- 0.5 ng/ml) as well as in Group 1 (2.4 +/- 0.4 ng/ml) compared with control subjects (0.43 +/- 0.1 ng/ml, p less than 0.001). In addition, AM from patients untreated or treated exclusively by nonsteroidal antiinflammatory drugs produced similar levels of TNF, whereas those receiving corticosteroids, second-line drugs (such as sulfasalazine, aurothiomalate, and methotrexate), or the combination of both therapy regimens released significantly less TNF. Interestingly, TNF was not different in both groups, but Group 2 had a markedly increased ratio of local immune complex to albumin in bronchoalveolar lavage fluid (0.47 +/- 0.12 versus 0.07 +/- 0.02 in Group 1; p less than 0.002). TNF thus appears an additional component of RA subclinical alveolitis in RA, but its prognostic value and its precise role in lung damage remain to be determined. Development of ILD requires certainly complex interactions of synergistic factors, possibly including local immune complexes detected in BAL fluids.

Antigen-Antibody Complex↗
PubMed1991

[Role of iatrogenic spondylodiscitis among pyogenic spondylodiscitis. 136 cases observed between 1980 and 1989].

The authors report 136 cases of spondylodiscitis due to ordinary organisms seen between 1980 and 1989 and note the increasing incidence of iatrogenic forms which during the past three years accounted for 50 per cent of cases. 60 per cent of these cases of iatrogenic spondylodiscitis complicated a medical of surgical procedure involving the spine (form by direct inoculation). In 40 per cent of cases, the organism came from a site of infection located at a distance (from by blood-borne spread). The clinical picture in cases of primary spondylodiscitis and of iatrogenic disease by blood-borne spread is essentially similar. That of iatrogenic forms by direct inoculation is different: most often young subjects, virtually exclusive involvement of the lumbar spine, fever and inflammatory syndrome less common. Escherichia coli and Staphylococcus aureus were the organisms most often responsible for primary spondylodiscitis (23 and 21.7 per cent of case respectively). Streptococci were in third position only (15.6 per cent of cases). Staphylococcus aureus remained predominant in iatrogenic spondylodiscitis (34 per cent of cases), while Escherichia coli and streptococci were significantly rarer than in primary forms and there was the appearance of Pseudomonas aeruginosa and Staphylococcus albus. No organism was found in 23 per cent of cases of primary spondylodiscitis. This figure reached 44% of iatrogenic forms by direct inoculation. Because of their increasing incidence, these cases of apparently aseptic spondylodiscitis, frequently complicating a procedure involving the spine, are modifying the picture of infectious spondylodiscitis. No doubt worthy of separate identification, they raise the problem of the significance of the concept of aseptic spondylodiscitis.

Adolescent↗
PubMed1991

[Chronic sciatalgia caused by sensitive deafferentiation following surgery for lumbar disk hernia: clinical and therapeutic aspects. Apropos of 110 patients].

Sensitive deafferentation is a well recognized entity which has changed the therapeutic approach of some kinds of chronic post operative sciatalgia. It mainly occurs related with a long story of radicular pain and the responsibility of so-called epidural fibrosis has to be discussed. The case records of 110 consecutive patients with deafferentation sciatalgia were reviewed and the clinical data precised: chronic and lasting burning pain with acute nightly paroxysms and sensitive alterations at objective examination. Neuroradiological explorations eliminated the possibility of recurrent disc herniation and neurophysiological tests assessed the chronic radicular suffering and the degree of lemniscal degeneration. After medical treatment (analgesic drugs with central tropism), a strict clinical assessment of pain intensity allowed optimal choice of the technique of neurostimulation: transcutaneous electrical stimulation (51 patients) and/or spinal cord stimulation (59 patients). The efficacy of transcutaneous stimulation (40 excellent and good results) was most often related to its continuous utilisation with a short post-effect. Its side-effects and the frequency of multiradicular involvement lead to spinal cord stimulation. With a mean follow-up period of 37 months, the pain relief was considered as excellent in 51.5%, good in 38% and poor in 8.5% of the patients. One patient had a negative test and was not definitively implanted. Another case failed to respond to stimulation. The clinical and technical complication of the method are reported.

Adult↗
PubMed1991

[Thiol-proteolytic activity in rheumatoid polyarthritis. Assay by spectrofluorimetry].

Joint and bone damage in rheumatoid arthritis is thought to be caused primarily by an imbalance between proteolytic proteinases and their specific inhibitors. Matrix destruction can in part result from the activity of lysosomal cystein proteinases such as cathepsin B and L. Cathepsins usually are determined by enzyme immuno-assay. The aim of this study was the direct determination of synovial thiol-proteolytic activity by spectrofluorimetry using a synthetic substrate (Z-Phe-Arg-NMec) and a cystein proteinase specific inhibitor (E64 = L-trans-epoxy-succinyl-leucylamino-(4 guanidino)-butane). 18 rheumatoid synovial fluids were tested compared to 10 osteoarthritic synovial fluids. Thiol-proteolytic activity appeared higher in rheumatoid arthritis compared to osteo-arthrosis (mean value = 1,311 mU/l vs 156 mU/l, p less than 0.01). Synovial thiol-proteolytic activity is well correlated with synovial elastase-alpha1-proteinase-inhibitor complex. The authors found no correlation with synovial polymorphonuclear count (p = 0.38) nor with clinical and biological parameters of disease evolution. The highest values were observed in patient with radiological signs of joint destruction. Synovial thiol-proteolytic activity might represent the potential destructive evolution of rheumatoid arthritis.

Arthritis, Rheumatoid↗
PubMed1991

[Association of lumbar canal stenosis and ankylosing vertebral hyperostosis. Results of a multicenter study].

The authors report data collected in a study of the association of narrow lumbar canal and vertebral hyperostosis. Five centres (Montpellier, Toulouse, Lille, Lyons and Paris) participated in this cooperative study which was both retrospective and prospective. Grid case forms were sent to homogenise the date provided. Two hundred and sixty nine cases of symptomatic lumbar canal stenosis were collected; 89 (33 per cent) had hyperostosis. Hyperostosis was definite in 74 cases and probable in 15 other cases. Certain radiological and/or CT scan morphological factors seen frequently in the hyperostosis patients group led us to undertake a second study in 2 of the 5 centres (Montpellier and Toulouse) in order to identify their specificity. Twenty eight items were adopted and studied by 3 different evaluators (2 rheumatologists and one radiologist) in the X-ray films and CT scan documents of 100 patients with acquired lumbar canal stenosis with or without hyperostosis (46 and 54 cases respectively). The most discriminative appearances, which we suggest as diagnostic criteria of narrow lumbar canal with hyperostosis concern anterior and/or posterolateral marginal somatic bone proliferations on the non-articular surfaces of the posterior apophyses and ossifications of the posterior joint capsule and of the ligaments (ligamentum flavum--posterior longitudinal ligament--supraspinous ligament). Four of these 6 criteria are necessary to make the diagnosis of lumbar stenosis with hyperostosis. The radiological and CT scan appearances of lumbar hyperostosis appear to differ from ordinary degenerative changes of osteoarthrosis and hyperostosis may be held responsible for compression of the dural cul-de-sac.

Humans↗
PubMed1991

[Action of non-steroidal anti-inflammatory agents on the immune system].

It is widely admitted that the non steroidal anti-inflammatory drugs (NSAID) inhibits the synthesis of prostaglandins by blocking the membrane cyclo-oxygenase. The anti-inflammatory activity of these molecules is partly explained by the vaso-dilatational action of PG2 in particular. However this effect alone cannot account for all the properties of NSAID. The latter have an inhibitory action at the level of the various functions of neurophil leucocytes and to a lesser degree at the level of macrophages. For immune system itself, it seems the NSAID have a rather immunostimulant effect due to a major action on T lymphocytes. In the course of rheumatoid arthritis (RA), the NSAID are unable to modify the ratio CD4/CD8. Yet they may decrease the production of the rheumatoid factor (RF). This ability is related to a loss of the normal suppressive T cells inhibition exerted by PG. Besides the NSAID seem unable to modify the natural killer function (NK). Finally, the impact on the synthesis of interleukins (IL) notably 1 and 2 does not seem clear. Indeed several research papers give us contradictory results between animals and men and between physiological or pathological situations.

Anti-Inflammatory Agents, Non-Steroidal↗
PubMed1990

Septic Streptococcus milleri spondylodiscitis.

We describe 2 patients presenting lumbar spondylitis due to Streptococcus milleri. In both cases origin was related to preexistent intestinal pathology. Surgical drainage of a collection of pus was necessary in one case. Longterm antibiotic therapy led to full recovery. Despite confused nomenclature Streptococcus milleri must be considered a serious pathogen mainly associated with purulent infection with osteoarticular affinity.

Abscess↗
PubMed1989

Osteomesopyknosis. Report of two new cases.

Two inherited cases of osteomesopyknosis are reported. This is an autosomal dominant osteosclerosis described by Maroteaux in 1980; its radiological abnormalities consist of increased density of the vertebral plates, pelvis, and sometimes of the upper part of the femur. Osteomesopyknosis, usually discovered incidentally on radiographic examination, is a mild form of familial osteosclerosis and must be distinguished from osteopetrosis which carries a worse prognosis.

Adolescent↗
PubMed1989

Cholestasis and pneumonitis induced by gold therapy.

The authors describe the association of gold salt-induced cholestasis and lymphocytic alveolitis proved by liver biopsy and broncho-alveolar lavage. To our knowledge this is the third case report on the combination of liver disease and pulmonary infiltration induced by gold compounds.

Aged↗