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Biomedical subjects

E Lejeune

Publications and source records attributed to E Lejeune.

At least 73 records · Page 4Linked to original sources

[Osteoid osteoma of the foot. Apropos of 4 personal cases].

On the basis of four personal cases of osteoid osteomas of the foot, the authors study their frequency, their localization, and their clinical and radiological manifestations. They insist on the special difficulties of diagnosing this condition due to its atypical and uncertain radiological outline, and also on methods of further investigation : arteriography and especially isotopic scintigraphy.

Adolescent↗

[The treatment of Paget's disease using salmon thyrocalcitonin. 8 cases (author's transl)].

An open trial of synthetic salmon thyrocalcitonin was carried out in 8 cases of progressive and multifocal Paget's disease over a period of three months and at a dose of 80 MRC.U twice daily. A clinical improvement was seen in half the cases. The action was also marked upon laboratory parameters with, in particular, an average decrease in alkaline phosphatase of 51% and in urinary hydroxyproline levels of 29.4%.

Alkaline Phosphatase↗

[Our experience with the determination of serum anti-alphastaphylolysins and antigammastaphylolysins during infectious osteoarthritis. A personal series of 53 staphylococcal osteoarthritis cases, 14 cases of osteoarthritis from various germs, 47 extra-articular staphylococcal infections and 500 control subjects].

The difficulty of directly isolating the casual agent (by obtaining specimens in situ or if necessary by hemoculture), during infectious osteo-arthritis and mainly during those deeply located such as spondylodiscitis and sacro-iliac infections, has led authors to investigate the field of serologic examinations. In staphylococcosis, which is quite frequent, they report results of serum anti-alphastaphylolysin dosage (AASTL) in 500 controls, 100 patients in whom a staphylococcus was recovered and 14 patients with other germs. In the first group, 10 subjects out of 500 ad a level greater than 2 IU whereas in the second group an elevation of the level of AASTL was observed in 66% of cases of staphylococcal osteo-arthritis (35 out of 53) and in 54% of cases of staphylococcosis without esteoarticular localization (25 out of 47), a total of 60% of staphylococcosis with various localizations (60 cases out of 100). Despite the elevation AASTL serum in 4 of the 14 cases of the third group, this study confirms the great diagnositc value of this dosage mainly when the levels are higher than 4 IU or are still rising. The recent study of the serum antigammastaphylolysins represent an additional factor of interest because of its reliability and its frequent positive result during staphylococcosis (in 19 cases of osteo-arthritis out of 27, and in 10 cases of staphylococcosis without osteo-articular localization out of 16: a total of 29 cases in a series of 43 staphylococcosis). The dosage of both AASTL and AGSTL, however, seems more valuable since out of 40 cases of staphylococcosis, we have observed a simultaneous elevation of AASTL and AGSTL in 22 cases (55%), a sole elevation of AASTL in 8 cases and AGSTL in 5 cases (12.5%). Therefore, in this series, at least one of the enzymes was elevated in 15 cases out of 40 (87.5%) which represents an increase of 12.5% when compared with the study of the sole AASTL and an increase of 20% when compared to the study of AGSTL.

Animals↗

[Nontuberculous infectious osteoarthritis in adults (excluding spondylodiscitis) in rheumatology].

Analysis of twenty five personal observations of septic osteoarthritis compared with information from the literature led the authors to the following conclusions: 1) Diagnosis of septic osteo-arthritis must be considered when confronted with a picture of acute or subacute arthritis generally inflamed with variable fever, raised sedimentation rates and frequently polymorph neutrophilia, above all especially if there are particular antecedents (local trauma or intra-articular injection, conditions which favor infections: diabetes, alcoholism, impaired immunity, corticosteroid therapy or various therapeutic immuno-suppresives). 2) It may be established on absolute criteria (isolation of the organism at the site of the lesions) or, in the absence of direct bacteriological evidence, by a body of evidence amongst which 4 arguments are of particular value: identification of a pathogenic organism in one or more blood cultures and/or at the site of a closed infection, postive serology and particularly elevation of the antistaphylolysine titres, rapid-onset radiological changes of destruction and/or reconstruction. plus hypercellularity of the fluid greater than 100,000 cells/mm3. 3) Medical treatment sometimes includes local treatment (joint aspiration, local injection of antibiotics) and in all cases immobilisation during the acute phase and systemic antibiotics. The latter will vary according to the organism responsible and its sensitivity. It seems useful to continue this for twelve weeks at the minimum in the normal form, initially making use of the combination of 2 antibiotics and preferably using continuous perfusion and/or intramuscular routes during the first half of treatment. 4) The consistently good results of such medical treatment seem to limit considerably the place of surgery for which the indications have become rare during the acute phase and even more so at later stages.

Adolescent↗

[Fatigue fractures of the femoral neck and pubic rami. Analytical and critical study apropos of 97 case reports from the literature and 5 personal cases].

This investigation involved a study of fatigue fractures of the neck of the femur and of the pubic branches based on the one hand on 97 cases from the literature, which were diagnosed mainly on radio-clinical criteria, and on the other hand on 5 personal cases for which a quantitative histological analysis was undertaken by needle biopsy of the bone of the iliac wing. After describing these fatigue fractures in an unusual site, the authors undertake a critical study taking account of the histological information that was available. They show that only a histological study makes it possible to differentiate clearly fatigue fractures from insufficiency fractures, particularly when the later occur concurrently with a clinically and radiologically latent osteoporosis.

Adult↗

[Osteonecrosis of the femoral condyles in adults. Apropos of 30 personal cases].

On the basis of a series of 30 personal cases, the authors describe the circumstances in which osteonecrosis of the femoral condyles occurs, the clinical and radiological characteristics, the evolution of the disease, and some of the associated therapeutic problems. They emphasize particularly the difference between the primary forms, which are the prerogative of women over 50 years of age and are of a limited character, and the secondary forms that are essentially linked to prolonged corticotherapy. The secondary forms are found in persons of both sexes between the ages of 20 and 40 years and consist of diffuse lesions (frequent extensive epiphyseal reorganization, bilaterality, and associations with other sites). As the evolution of the disorder under simple medical treatment is usually fairly favourable, the authors consider that indications for surgery should be restricted to the infrequent forms (10 to 15% of cases) that progress rapidly towards arthrosis.

Adolescent↗