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Biomedical subjects

R M Flipo

Publications and source records attributed to R M Flipo.

At least 109 records · Page 6Linked to original sources
PubMed1993

[Is the expression of TNF-alpha and cell adhesion molecules a marker of development of rheumatoid vasculitis?].

TNF-alpha, ICAM1, VCAM1, ELAM, CD44 and DR expression were studied (indirect immunoperoxydase methods) on labial salivary gland sections in 5 patients with proven rheumatoid vasculitis (before and after treatment), 5 patients with RA and 5 normal controls. TNF-alpha and cell adhesion molecules were particularly expressed in vasculitic areas of patients with systemic vasculitis and only before the onset of the treatment.

Biomarkers↗
PubMed1993

[Neurologic paraosteoarthropathy of the hand. Apropos of 2 cases].

The frequency of heterotopic ossification in neurological conditions averages 20-25% with variations according to the type of neurological disease and presence or absence of coma. The most common sites are the hips, knees, shoulders, and elbows. Involvement of the hands is an exceedingly rare event of which two instances are reported herein. In both patients evidence of inflammation developed four months after a deep, prolonged coma. Swanneck deformity of the fingers occurred in one case. Juxta-articular ossifications were seen on roentgenograms two months after the onset of symptoms. Both patients had heterotopic ossifications around the shoulders. Erythrocyte sedimentation rate and serum alkaline levels were elevated. Local injections effectively relieved pain in one patient.

Adult↗
PubMed1993

[Rheumatoid arthritis and multiple myeloma. Apropos of 22 cases. Results of a multicenter national survey].

Although studies of patients with rheumatoid arthritis have found no increases in overall cancer rates, significant elevations in rates of lymphoma and myeloma have been reported, suggesting a causal relationship between autoimmune disorders and lymphoid malignancies. Nevertheless, only 22 cases of concomitant rheumatoid arthritis and multiple myeloma were identified during a retrospective national multicenter study carried out in France. Neither disease exhibited unusual features. In every case, rheumatoid arthritis preceded multiple myeloma. Monoclonal gammopathy preceded multiple myeloma in two patients, by 3 and 7 years respectively. No patient had amyloid arthritis. Analysis of data from the cancer registry of the Somme district in northern France did not suggest a significantly increased risk of multiple myeloma in rheumatoid arthritis patients (relative risk 2.3). Use of interferon alpha to treat myeloma has been reported to exacerbate concomitant autoimmune disorders.

Adult↗
PubMed1993

[Aspergillus spondylodiscitis. Apropos of 5 cases].

Five cases of Aspergillus discitis in male patients are reported. Three patients had impaired immune responses as a result of immunosuppressive therapy following a heart transplant (two cases) or hairy cell leukemia (one case). Two patients had a recent history of mycobacterial infection. All five patients were hospitalized for severe spinal pain suggestive of an inflammatory disease with no neurological abnormalities. Erythrocyte sedimentation rate was elevated in every case. The diagnosis of discitis was suspected on spinal roentgenograms and established by computed tomography and/or magnetic resonance imaging. In three patients the spine was the only site of Aspergillus infection (lumbar discitis in two cases and thoracic discitis in one case). One patient developed Aspergillus infection of several disks (L1-L2, L2-L3, and L4-L5) after Aspergillus endocarditis with embolization to the left lower limb. Another patient developed discitis after an Aspergillus lung infection. In every case, Aspergillus fumigatus was recovered in cultures of specimens harvested by a percutaneous needle biopsy of the intervertebral disk. All five patients were treated by itraconazole which was given as single drug therapy in one case and in combination with 5-flucytosine and amphotericin B in four cases. Recovery was achieved in every case after four to six months of this drug therapy. In contrast to most previously reported cases, none of the five patients reported herein required surgical treatment. Efficacy of conservative treatment in this study may be related to the use of itraconazole in every case.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1992

Antibodies in rheumatoid synovial fluids bind to a restricted series of protein antigens in rheumatoid synovial tissue.

OBJECTIVE: By searching the synovial fluid of patients with rheumatoid arthritis (RA) for antibodies that react to protein antigens in synovial tissue, we sought to identify putative antigens present in RA synovial tissue that might drive the pathologic immune response believed to be responsible for the joint inflammation. METHODS: Synovial tissue was homogenized in sodium dodecyl sulfate polyacrylamide gel buffer, electrophoresed, and analyzed by immunoblotting. RESULTS: Antibodies from synovial fluids of patients with RA bound to several proteins in rheumatoid synovial tissues, including a series of low (27.5-, 29-, and 30-kd), middle (43- and 53-kd), and high (140-, 164-, and 182-kd) molecular weight proteins. Most of these antigens were also detected in normal synovial tissue, and the high molecular weight proteins were also present in normal dermal, muscle, and liver tissues. The low and middle molecular weight proteins were detected in some, but not all, of the other normal tissues and in Jurkat cell lysates. Antibodies to the low and high series of proteins were present in all rheumatoid synovial fluids tested, but were generally absent from synovial fluids from patients with other arthritic diseases. CONCLUSION: These results show that antibodies in synovial fluids consistently react to several proteins in RA and normal synovial tissues. These antigens are possibly the same antigens provoking the T cell response in RA; therefore, understanding the mechanism of the immune response against these proteins will likely lead to important insight into the etiology of RA.

Antibodies↗
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

[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

[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↗
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↗