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Biomedical subjects

F Blotman

Publications and source records attributed to F Blotman.

At least 55 records · Page 3Linked to original sources
PubMed1992

Lumbar posterior marginal node (LPMN) in adults. Report of fifteen cases.

This report concerns 15 adults (nine men and six women) who experienced lumbar and sciatic pain associated with an unusual defect of the edges of the vertebral bodies together with a small bony ridge protruding into the spinal canal. This lesion was well demonstrated by computed tomography and easily differentiated from the posterior longitudinal ligament or herniated disc calcifications, as well as from posterior degenerative ridge osteophytes. This lesion looked like the so-called lumbar posterior marginal node. First described in adolescents, this entity was considered as a traumatic fracture of the posterior ring apophysis. Recently, identical cases were noted in young adults in the absence of previous trauma, which were a particular type of marginal cartilaginous node. In the cases reported here, the computed tomographic scans suggested several mechanisms of formation of the vertebral lesion: a variant of marginal cartilaginous nodes; traumatic avulsion; avulsion related to disc herniation; and fusion of the avulsed bony fragment with the vertebral body.

Adult↗
PubMed1992

Effects of a single dose of methotrexate on 5- and 12-lipoxygenase products in patients with rheumatoid arthritis.

The inhibition of 5-lipoxygenase could be involved in the mechanism of action of methotrexate (MTX). We studied 8 patients with active rheumatoid arthritis (RA) immediately before and the day after the first dose of MTX (10 mg intramuscularly). Leukotriene B4 (LTB4) formation by polymorphonuclear leukocytes was significantly decreased (32%, p less than 0.01). This essentially involved released LTB4. A slight decrease was also obtained in omega-oxidation products. Similar results were obtained for plasma LTB4 (30%, p less than 0.02). A non-significant decrease in 5-HETE was noted. Conversely, 12-HETE was not modified. Our results suggest MTX has an effect on the 5-lipoxygenase pathway, particularly at the LTA4 epoxide hydrolase step, since 5-HETE and 6-trans-LTB4 isomers are not involved.

12-Hydroxy-5,8,10,14-eicosatetraenoic Acid↗
PubMed1992

[Effects of methotrexate on leukotriene and derivated lipoxygenase synthesis in polynuclear neutrophils in rheumatoid polyarthritis].

Methotrexate (MTX) has been proved to be effective in rheumatoid arthritis (RA). The mechanism of action of MTX in this disease remains unelucidated but may involve inhibition of the enzyme 5-lipoxygenase. Arachidonic acid metabolites were studied in eight patients with active RA immediately prior to and 24 hours after the first intramuscular injection of 10 mg MTX. None of the patients were taking corticosteroids. Nonsteroidal antiinflammatory drugs were withdrawn four days before the study. Reverse phase high-performance liquid chromatography was used to quantitate metabolites produced by 5-lipoxygenase (5-LO) and 12-LO in plasma (full spectrum of blood cells) and purified neutrophils (PN) after stimulation with calcium ionophore A 21387 (50 microM for 30 minutes and 5 microM for 5 minutes, respectively). LTB4 production by PNs was significantly decreased (-32%, p < 0.01) 24 hours after MTX administration. A moderate (-17%), nonsignificant (NS) fall in LTB4 omega-oxidation products (wP) was seen. Production of 5-HETE was also slightly decreased (-15%, NS). Findings in plasma were comparable, with a significant decrease in total LTB4 (-29.8%, p < 0.01) and moderate falls in wP (-18.8%, NS) and in 5-HETE production (-17%, NS). Production of 12-HETE was unchanged. These findings suggest that MTX in a single dose is responsible for a decrease in the synthesis of LTB4 and 5-LO products in neutrophils and other blood cells in RA patients but does not affect 12-LO activity.

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

[Evaluation of the Amor criteria for spondylarthropathies and European Spondylarthropathy Study Group (ESSG). A cross-sectional analysis of 2,228 patients].

Two sets of criteria have been proposed to discriminate spondylarthropathies (SA) from other rheumatic diseases. To evaluate their performance, we conducted a cross-sectional study in the patients observed during one week in 28 French Departments of Rheumatology by 91 staff-teaching physicians. The physicians had to apply these criteria to all their patients and had to classify them as definite SA, definite other rheumatic disease or possible SA. The analysis performed on the 2,088 patients with a definite diagnosis (124 SA and 1,964 controls) showed the following results: (table; see text) Of the 140 patients with possible SA, 37 fulfilled both sets of criteria, 22 the ESSG criteria alone and 12 the Amor criteria alone. These data suggest that a) the overall performance of these two sets of criteria is similar; b) this performance is better in the group of patients with a definite diagnosis; c) the patients without a definite diagnosis require a longer follow-up to assess the clinical relevance of these two sets of criteria.

Cross-Sectional Studies↗
PubMed1990

[Cutaneous lesions in POEMS syndrome. Apropos of 3 case reports and a review of the literature].

We present three new cases of POEMS syndrome with the most common cutaneous signs of this entity. The syndrome is a multivisceral complex, mostly described in Japanese patients, which includes polyneuropathy, organomegaly, endocrine disorders, monoclonal gammopathy and skin changes. The latter are constant but sometimes reduced to one type of lesion. The most frequent are hyperpigmentation sparing the mucosae, hypertrichosis, scleroderma-like skin thickening and capillary angiomas. The other signs are much less common, as shown in table I. Histological findings are seldom reported and usually have little specificity. None of these abnormalities is pathognomonic, but their predominance at the extremities may be suggestive and leads to a search for other elements of the syndrome, notably gammopathy. The main differential diagnostic problem is with scleroderma, sometimes circumscribed and often systemic. Some cases are very ambiguous. The relationship between the two diseases would suggest the existence of one or several common pathogenic factors. The overall physiopathology of POEMS syndrome is obscure. The role of endocrine disorders in the genesis of the cutaneous signs is subject to discussion: hyperoestrogenism may explain some of these signs, but hypertrichosis is incompatible with the frequent finding of low androgen secretion. The role of one or several "toxic" substances secreted by plasmocytes is highly hypothetical. In some cases, the skin abnormalities have regressed after treatment of gammopathy, and in rare patients the recurrence of gammopathy was followed by that of skin lesions. In a few cases, a "paraneoplastic" character may be suspected.

Adult↗
PubMed1988

Rheumatoid nodulosis: report of two new cases and discussion of diagnostic criteria.

Two patients with typical rheumatoid nodulosis are described and compared with 24 reported cases. Rheumatoid nodulosis is a particular variant of rheumatoid arthritis associated with palindromic rheumatism, subcutaneous rheumatoid nodules, mild or no systemic manifestation and a benign clinical course. Positive rheumatoid factor and radiologic subchondral bone cysts are usual, but their absence should not eliminate the diagnosis of rheumatoid nodulosis, particularly at the onset of the disease.

Adult↗
PubMed1987

Correlation in inflammatory fibroblasts between the number of glucocorticoid receptors and PGE2 release.

The anti-inflammatory effects of glucocorticoids are mediated through steroid receptor occupancy and there is a significant correlation between the extent of receptor saturation and the extent of the biological effects. In a previously published study, we found that the number of these receptors was higher in inflammatory fibroblasts than in quiescent ones. PGE2 release, measured at the same time as the number of steroid receptors, was higher when the cells were from inflammatory tissue. Our aim, in the present study, was to determine whether the PGE2 released by cells during inflammatory processes could participate in increasing the number of steroid receptors. Fibroblasts obtained from rat quiescent subcutaneous connective tissue and granulomas were subcultured in monolayers. The specific binding of [3H]dexamethasone was assessed and analyzed by a method described by Kalimi et al. After a freeze-thaw cycle, we observed a decrease in the number of receptors in inflammatory fibroblasts. When the frozen and thawed fibroblasts were subcultured in the presence of PGE2 (10(-8) M), the number of receptors was enhanced in fibroblasts from inflammatory tissue. Cycloheximide (3 X 10(-7) M) prevented this increase. The release of PGE2 decreased after freezing and then increased simultaneously with the number of receptors in inflammatory cells. These findings suggest that PGE2 may play a role in regulating steroid effects on fibroblast function.

Animals↗
PubMed1987

Calcium absorption in corticoid treated subjects effects of a single oral dose of calcitriol.

We compared the fractional absorption of calcium (FACa, 6 h, % TD) and the radiocalcium transit (% TD per min) in seven glucocorticoid-treated patients (10-25 mg prednisolone per day) and in seven normal subjects, in the basal state and 12 h after an oral dose of synthetic 1,25-(OH)2D (3 micrograms). In the basal state, the radiocalcium transit was significantly decreased (P less than 0.02) at 15 min in patients treated with prednisolone, but FACa at 6 h was not significantly decreased (51 +/- 5 vs. 60 +/- 5% TD). 12 h after an oral dose of 1,25-(OH)2D which resulted in supraphysiologic plasma levels, FACa increased significantly (P less than 0.02) in both groups but the peak absorption rate of Ca remained lower in the corticoid-treated patients than in controls (P less than 0.02). The results suggest that glucocorticoids decrease the 1,25-(OH)2D-dependent transport of calcium across the proximal small intestine.

Aged↗
PubMed1986

Glucocorticoid receptors in fibroblasts from synovial tissue. Changes during the inflammatory process. Preliminary results.

There is known to be a significant correlation between the number of glucocorticoid receptors in tissues and their anti-inflammatory effect. In this work, the specific binding of glucocorticoids was studied in inflammatory fibroblasts. Human fibroblasts were obtained from the knee joint of a rheumatoid patient undergoing surgery; experimental fibroblasts were from rat granulomas. The same study was carried out in quiescent synovial fibroblasts from a healthy subject (post-traumatic amputation) and from rat subcutaneous conjunctive tissue. Fibroblasts were obtained by explant cultures and subcultures in monolayers. The stimulation state of cells was evaluated by the amounts of PGE2 and PGF2 alpha released into the culture media. Analysis of the proportions of steroid bound to whole cells showed evidence of specific glucocorticoid receptors in all fibroblasts. Their number was three times higher in cells from inflammatory tissues than from controls. This increased number of receptors in inflammatory cells could be the result of the action of one or more mediators that promote their biosynthesis.

Animals↗