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Biomedical subjects

E Veys

Publications and source records attributed to E Veys.

At least 37 records · Page 2Linked to original sources
PubMed1991

Occipito-cervical fusion in rheumatoid arthritis.

Between 1977 and 1988 twenty-five patients with rheumatoid arthritis involving the cervical spine were treated by an occipito-cervical fusion. Twenty-two patients are included in this study. The main indications for surgery were intractable pain and progressive neural impairment. The operative procedure consisted of an H-bone graft fixed with steel wire in 19 cases, fusion of occiput-C2 six times and of occiput-C3 thirteen times. A Hartshill-Ransford (5, 12) loop was used in three cases: occiput-C3 twice and occiput-C7 once. The mean duration of follow-up was 3 years 8 months in 17 patients. Improvement of symptoms and signs was achieved in 88%. There were 2 post-operative deaths. The high rate of pseudarthrosis in our series was confirmed by several authors. The loop technique provides a more stable fixation and will be our technique of choice in the future.

Adult↗
PubMed1990

Major histocompatibility complex class II antigen (HLA-DR) expression by ileal epithelial cells in patients with seronegative spondylarthropathy.

Major histocompatibility complex molecules act as non-specific receptors for antigenic proteins and present them to T-cells. Presented antigen together with class II molecules activates antigen specific T-helper cells and may trigger a cellular immune response. The expression of HLA-DR antigens by epithelial cells was examined with an indirect peroxidase technique in ileal biopsies from 38 patients with seronegative spondylarthropathy and features of acute or chronic gut inflammation on biopsy, 14 patients with chronic inflammatory bowel disease, 10 rheumatic and 10 non-rheumatic controls. In acute ileitis, there was more HLA-DR expression in villous and crypt epithelial cells than in non-inflamed controls (p less than 0.01). In chronic inflammation and in chronic inflammatory bowel disease, class II antigens were more expressed in villus (p less than 0.02) and crypt epithelium (p less than 0.01). Strong HLA-DR expression in crypt epithelial cells was connected with active inflammation (p less than 0.02). These findings suggest binding of unknown enterobacterial or nutritional luminal antigens to HLA-DR antigens normally present in enterocytes. The enterocytes act as antigen presenting cells causing a local increase of targets for activated T-cells and trigger the gut inflammation responsible for the clinical symptoms of the seronegative spondylarthropathy.

Adolescent↗
PubMed1989

Microgel immunoblotting of thymus and nuclear extracts by unidirectional diffusion.

A variant immunoblotting procedure is presented, starting from sodium dodecyl sulfate-containing ultra-thin microgels. The use of these gels allows efficient transfer of proteins to an immobilizing matrix such as nitrocellulose, by simple uni-directional diffusion, without loss of resolution. To this end an assembly was developed, keeping the microgel and the immobilizing matrix in continuous contact. To standardize the technique, two protein extracts (a classical rabbit thymus extract and an original autologous nuclear extract) were used, together with reference antinuclear antisera. The method is fast, easy to perform, and perfectly reproducible. For these reasons, the technique is very suitable for screening a patient's sera on a large scale.

Alkaline Phosphatase↗
PubMed1989

Ileocolonoscopy in seronegative spondylarthropathy.

A prospective endoscopic and histologic study of terminal ileum and colorectum in 211 patients with seronegative spondylarthropathy revealed macroscopic inflammatory lesions varying from erythema to superficial erosions in 30% of the patients and microscopic inflammation in 61%. Two types of inflammation were observed: an acute inflammation resembling an infectious enterocolitis and a chronic inflammation. In idiopathic reactive arthritis both types of inflammation were equally present, whereas chronic inflammation predominated in patients with ankylosing spondylitis. In 32% of patients with chronic inflammation, the lesions particularly resembled early Crohn's disease. Repeat ileocolonscopy on 19 patients demonstrated a parallel evolution of joint symptoms and histologic lesions. All patients with acute inflammation went into clinical and histologic remission, whereas lesions persisted in patients with Crohn-like inflammation. In patients with chronic inflammation, remission and persistence were observed equally. This study identified a group of patients with seronegative spondylarthropathy which, even in the absence of gastrointestinal symptoms, showed evidence of gut inflammation, probably inducing an increased gut permeability with transgression of the oral tolerance and absorption of provocative antigens into the circulation. It is also possible that both diseases reflect a common underlying process.

Arthritis↗
PubMed1988

Immunoglobulin containing cells in terminal ileum and colorectum of patients with arthritis related gut inflammation.

In 40 distal ileal and 40 colonic biopsies of arthritic patients mostly without gastrointestinal symptoms, but with histological evidence of acute or chronic inflammation of the gut, the number of immunoglobulin (Ig) containing plasma cells was studied morphometrically using a peroxidase antiperoxidase technique. Compared with controls, the ileal mucosal biopsies showed an increase of IgA and IgG in acute ileitis. In chronic ileitis there was an increase of IgA, IgG, and IgM similar to Crohn's disease. In colonic biopsies there was a significant increase of all immunoglobulin classes in acute inflammation. In chronic inflamed mucosa there was also an increase of all three Ig classes. The Ig distribution, however, was significantly different in acute and chronic colitis. These findings give immunohistochemical evidence of the existence of two different types of inflammation related to reactive arthritis or the peripheral joint involvement of ankylosing spondylitis. The Ig pattern in acute colitis is similar to that found in infectious colitis, suggesting an enterobacterial origin of the arthritis in this group of patients although bacteriological and serological investigations were negative. In the chronic type of arthritis related ileocolitis, the pattern of Ig containing cells is similar to that found in Crohn's disease but different from infectious and ulcerative colitis, which makes the hypothesis that a great number of these arthritis patients suffer from asymptomatic or subclinical Crohn's disease acceptable.

Adolescent↗
PubMed1987

[Treatment of rheumatoid arthritis. Comparative study of the effect of immunoglobulins G eluted from the placenta and of venoglobulins].

A double-blind multicenter study comparing the effect of placenta eluted IgG and venoglobulins in the treatment of rheumatoid arthritis was conducted in 113 hospitalized patients. Rheumatoid arthritis was severe, classical (92 cases) or definite (21 cases), seropositive in 87 cases, with nodules in 32 cases; the mean duration of the disease was 10 years. The majority of patients had previously received numerous slow-acting drugs without result or with side-effects. A statistically significant decrease of all the quantitative indices but one (grip strength) was obtained with both products on the 8th day of treatment; the effect of placenta eluted IgG was statistically superior for the number of swollen joints (P less than 0.025), Ritchie's index (P less than 0.0005) and some extra-articular manifestations. There was no significant decrease in associated treatments and biological parameters (erythrocyte sedimentation rate, rheumatoid factor). Tolerance was excellent; some cases of benign venulitis were observed; treatment was never discontinued on account of side-effects. Further placebo-controlled of each of these immunoglobulins of placental origin are needed for firm conclusions to be drawn.

Arthritis, Rheumatoid↗
PubMed1987

Histopathology of intestinal inflammation related to reactive arthritis.

This study has identified a group of patients with inflammatory chronic, or relapsing acute arthritis who even in the absence of gastrointestinal symptoms have histological evidence of ileocolitis. At colonoscopy simultaneous biopsies of the terminal ileum and colon were taken from 108 patients with reactive arthritis (n = 55) or ankylosing spondylitis (n = 53), 47 patients with other rheumatic diseases and 19 control patients suffering from colonic polyps, adenocarcinoma, or chronic constipation. All control patients and all but one patient with rheumatoid arthritis, juvenile chronic arthritis, systemic lupus erythematosus, lumbar back ache, and psoriatic arthritis did not have histological evidence of acute or chronic inflammatory bowel disease. In contrast, in 30 of 35 (56.6%) patients with ankylosing spondylitis, and in 37 of 55 (67%) patients with reactive arthritis, regardless of HLA B27 phenotype, there was histological evidence of inflammatory bowel disease with features either of acute enterocolitis, or early Crohn's disease. Only 18 of 67 (27%) of the patients with histological gut inflammation, however, had intestinal symptoms.

Adolescent↗
PubMed1982

Long-term functional results of the non-surgical treatment of common bacterial infections of joints.

Thirty patients with acute bacterial infection of a peripheral joint were treated with intravenous antibiotics, daily closed needle aspiration and early mobilization therapy. Joint mobility, expressed as a percentage of normal mobility, was evaluated at the end of the reconvalescence period and again after 42 to 65 months (mean: 50 months). The functional outcome was excellent and joint mobility normal in 2/3 of the cases as revealed by the short- and long-term evaluation results. Factors that affected joint mobility were: delayed treatment, joint disorders prior to treatment, and ease of access to the joint for needle aspiration. Poor results were found in the presence of hip infections. In the long term, deterioration of joint mobility can occur in the same aggravating conditions. Treatment of septic arthritis with daily needle aspiration and early mobilization gave very good functional results.

Anti-Bacterial Agents↗
PubMed1978

Adverse reactions to levamisole.

The adverse reactions mentioned in 267 reports on levamisole are analyzed. Significant adverse reactions are agranulocytosis, skin rash, and febrile illness. They occur in a small subpopulation of patients only, predominantly those with rheumatoid arthritis. Other side effects rarely necessitate discontinuation of treatment. Levamisole did not appear to cause renal or liver toxicity. By means of a questionnaire, cases of blood dyscrasia were analyzed in detail. Agranulocytosis (less than 20% neutrophils) occurs most frequently in patients with rheumatic diseases, in women, and in HLA B27 genotypes. It is spontaneously reversible when treatment is discontinued. The bone marrow is not damaged. Thrombocytopenia has a course similar to that of agranulocytosis but it is very rare. Leukopenia (less than 3000 cells/mm3 but greater than 20% neutrophils) seems to differ from agranulocytosis in a number of ways and is not an indication to discontinue treatment. It is concluded that, if used under the close supervision of a physician, for those clinical situations in which levamisole has proven efficacy, the potential benefit to the patient outweighs the hazards and justifies its use.

Agranulocytosis↗
PubMed1975

Clinical survey of and pathogenic approach to para-articular ossifications in long-term coma.

1. Thirteen patients with para-articular ossification complicating long-term coma are presented. In a series of 26 patients with long-term coma following cerebral traumatic lesions, seven cases were found with para-articular ossification. 2. The high frequency of elbow involvement is emphasized, and in all these cases posterior ossifications were present. 3. In five patients, ossifications were observed in limbs which were not paralytic and in which integrity of the efferent nerve tracts could be demonstrated. 4. The importance of functional or paralytical immobility and of a completely bedridden condition in the patients is emphasized. 5. The aetiopathogenesis of para-articular ossifications still remains unknown, but a prolonged complete immobilization possibly induces vasomotor, metabolic and trophic disorders, which can give rise to metaplasia.

Adolescent↗
PubMedDate not supplied

Multicenter validation of recombinant, natural and synthetic antigens used in a single multiparameter assay for the detection of specific anti-nuclear autoantibodies in connective tissue disorders.

OBJECTIVES: We investigated the feasibility of using a single multi-parameter test based mainly on recombinant autoantigens for the detection of anti-nuclear autoantibodies, and analyzed the agreement between this test format and conventional techniques. METHODS: The presence of autoantibodies was determined by a line immunoassay (LIA) in 755 sera derived from patients with different autoimmune connective tissue disorders. All sera were previously tested by standard assays that are routinely used at the 8 participating European centers. RESULTS: The overall sensitivity and specificity of autoantibody detection by LIA was similar or higher as compared to combined conventional techniques (CCT). In particular, the detection of anti-Ro52 in systemic lupus erythematosus (SLE) sera (P = 0.004) and anti-LA in both SLE (P < 0.0009) and in Sjögren's syndrome (P < 0.0009) sera was significantly more sensitive when using LIA compared to CCT. By contrast, CCT was never more sensitive than LIA for any of the markers. CONCLUSION: The LIA is a reliable alternative to a combination of conventional techniques for the detection of specific anti-nuclear autoantibodies. The multi-parameter test also reveals autoantibody reactivities that may not be detected when only a limited number of conventional techniques are applied.

Antibodies, Antinuclear↗
PubMedDate not supplied

Immune-mediated pathology following hepatitis B vaccination. Two cases of polyarteritis nodosa and one case of pityriasis rosea-like drug eruption.

The association of hepatitis B virus infection and vasculitis or other immune-mediated manifestations is well documented. Reports on such manifestations in relation to hepatitis B vaccination are scarce, however. We report 2 patients who developed polyarteritis nodosa following vaccination against hepatitis B. In one patient this resulted in an ischemic and necrotic digital ulcus, necessitating surgical amputation. The other patient presented with typical cutaneous polyarteritis nodosa which responded well to corticosteroid treatment. A third patient developed a severe pityrias rosea-like eruption. He was treated with topical steroids with healing of the lesions, leaving only post-inflammatory hyperpigmentation. The literature on these associations is reviewed.

Adrenal Cortex Hormones↗