[Study of a series of 38 cases of hemiplegia in diabetics].
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Biomedical subjects
Publications and source records attributed to H Roux.
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In Caucasian populations, rheumatoid arthritis (RA) is generally associated with serologic HLA-DR4 specificity. In order to refine this correlation in the HLA-D region, we used six different probes pertaining to this locus: DR beta, DQ beta, DQ alpha, DO beta, DP beta and DP alpha. In this step, pooled RA and control DNA were hybridized with DR beta and DQ beta probes after digestion with 12 different endonucleases. Some bands appeared specific in the RA pool. In fact, with genomic DNA from 13 unrelated typed RA patients and 12 matched or partially matched control cells, these bands were revealed to be related to DR4 and/or DR1, with DR beta and DQ beta probes hybridizing BamHI, EcoRV, PvuII and StuI digests. With other probes, no differences could be related to RA disease. The polymorphism detected by these probes was suggestive of a gradient of decreasing complexity from DR beta to DO beta through DQ beta and DP beta, which could reflect discrete functions of each subregion.
The authors report the case of a 46-year old woman who, 7 years after bilateral implantation of a silicone breast prosthesis, presented with a seropositive rheumatoid arthritis involving the shoulders, wrists, metacarpophalangeal and interphalangeal joints of both hands, as well as the knees and ankles. Six months after the onset of the arthritis, she developed a Raynaud's syndrome and a lacrymal and salivary dry syndrome with unilateral axillary lymphadenopathy. No regression followed the removal of the breast prostheses, one of which was found broken.
Pigmented Villonodular Synovitis (PVNS) in an infrequent tumoral like disease and there are only a few MRI studies published. Concerning our series of five cases compared with the literature, the readers attention is drawn to the etiologies still under debate and to the respective contribution of the different imaging methods. MRI known for its high sensibility, but also for its low specificity in tumoral pathology, has turned out to be, in the case of PVNS, quite remarkable in both regards. The RMI aspect is quite well correlated to the histological structure of this synovial hyperplasia and to its evolution: highly vascular mass at the beginning and then low cellular density stroma, fibrous, with deposition of hemosiderin. In our five cases, as in almost all those previously reported in the literature, MR imaging shows heterogeneous areas of decreased signal intensity on T2 weighted sequences and on two of our cases after administration of gadolinium. Still the same MR aspects can be found in rheumatoid, hemophilic arthritis, as well as synovial chondromatosis, and therefore the clinical background and findings as well as plain films become essential. MR imaging should be the first examination to be undertaken after plain films, leading in most cases to a precise local preoperative assessment.
It is fairly frequent to encounter hyperlipemia on a rheumatic unit. Firstly the symptoms of certain idiopathic hyperlipemias sometimes include rheumatic changes. The latter include firstly, arthritis and tendinitis, above all observed in Type II hyperlipoproteinemia but also mentionned in Type IV, and secondly, exceptional bony lesions (generally of xanthoma type) which seem to occur exclusively in severe hyperglyceridemia. A few bone and joint diseases, such as gout or aseptic necrosis, frequently coexist with dyslipemia. Furthermore, various diseases may be simultaneously responsible for secondary hyperlipemia and involvement of the locomotor apparatus. Finally, the iatrogenic manifestations of the locomotor system appear mainly due to hypolipemic drugs, e.g. the muscle disorders seen in a few patients treated with clofibrate.
The authors have studied 58 cases of primitive aseptic osteonecrosis of the hips, 35 cases of coxarthrosis, 12 algodystrophies and 11 cases of coxitis, using numerical scintigraphy with Technetium 99m pyrophosphate. They have studied the ration of uptake by the femoral head over the uptake by the soft issues. The values obtained are compared to those observed in the study of normal hips. The result is that the technique offers the possibility of establishing, in a more differential manner, a diagnosis of lesion of the hips at an infraradiologic stage.
An open clinical study of treatment of severe rheumatoid arthritis (7 cases) with liposomal bovine copper superoxide dismutase is described. The drug was administered by intramuscular injection twice a week for three months and was well tolerated. Of the seven cases five showed good or very good results with significant amelioration. The absence of toxicity indicates that liposomal superoxide dismutase may be used in future trials with a greater number of patients.
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The authors report the results obtained in a series of 20 multiple myelomas by an association Vincristin-Melphalan with a maximum therapeutic survival of 65 months. The median of survival is established at 27 months. The differences are a function of the initial values of the calcemia, the level of hemoglobin, the percentage of medullary plasmocytosis, but the essential factors appear to be the delay in the treatment, the stage of development established according to Salmon and Durie and particularly the presence or absence of a renal involvement. We have seen important fluctuations of certain immune parameters, particularly level of sheep rosettes and B cells detected by immunofluorescence.
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