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Biomedical subjects

T Appelboom

Publications and source records attributed to T Appelboom.

At least 55 records · Page 3Linked to original sources
PubMed1994

Chronic interstitial cystitis occurring during the shift between rheumatoid arthritis and lupus.

This case reports documents the progressive development of chronic interstitial cystitis during the overlapping process from rheumatoid arthritis to lupus. Concomitantly high titer antinuclear antibody with an anti-68 KD RNP pattern and other biological markers of lupus were observed in the blood. The symptoms dramatically improved under methotrexate therapy. The pathogenic mechanism is discussed.

Arthritis, Rheumatoid↗
PubMed1994

Effect of an antidiencephalon immune serum on pain and sleep in primary fibromyalgia.

The results of a double-blind, randomized, therapeutical trial with SER282, an antidiencephalon immune serum (Serolab, Lausanne, Switzerland), in 36 women, aged 24-56 years, with primary fibromyalgia are presented. Treatment was ambulatory and consisted of either SER282 (20 mg/ml) or amitryptiline (AMI, 50 mg) or placebo (PL) over an 8-week treatment course. Clinical and sleep EEG polygraphic data were obtained at baseline and after 4 and/or 8 weeks of therapy. Compared to an important PL response and moderate analgesia with AMI, pain and associated symptoms improved moderately with SER282. In contrast, polysomnographic recordings showed that SER282 tended to promote stage 4 sleep, while AMI and PL had few--if any--effect on sleep. These results are discussed together with the clinical characteristics of the patients and the relations between pain, associated symptoms, and sleep parameters in our patient population.

Adult↗
PubMed1993

Antibodies to the constitutive 73-kd heat shock protein: a new marker of mixed connective tissue disease?

PURPOSE, PATIENTS, AND METHODS: This report documents the finding of an elevated titer of IgG reacting with the constitutive bovine 73-kd heat shock protein (HSP) in the serum of patients with rheumatoid arthritis, scleroderma, and mixed connective tissue disease (MCTD). RESULTS AND CONCLUSIONS: Further characterization of antibodies from patients with MCTD showed that the antibodies also recognize the human constitutive 73-kd HSP, but not the inducible 72-kd isoform. Very high levels of antibodies appeared to be specific for MCTD; the differences between levels in patients with MCTD and those in healthy subjects (blood donors) were highly significant (p < 10(-8)), with no values in this group of patients overlapping with those in the controls. This parameter might therefore represent a new diagnostic marker for this disease.

Biomarkers↗
PubMed1993

[Polyarthritis in 4 patients treated with intravesical BCG-therapy for carcinoma of the bladder].

Intravesical administration of Calmette-Guérin bacillus (BCG) is effective in the treatment of superficial bladder carcinoma. Transient arthritis or migratory arthralgia has been reported in 0.5% of cases. The authors report on four men (mean age 65 years), who developed an oligoarthritis in three cases after the 2nd, 5th, and 6th weekly instillation of Pasteur BCG, respectively, and symmetrical polyarthritis in one after 48 BCG instillations over a three-year period. Joints involved were the knees (3/4), ankles (3/4), shoulders (1/4), wrists, and hands (1/4). Features included morning stiffness and local evidence of inflammation. All four patients had an elevated erythrocyte sedimentation rate and negative tests for rheumatoid factor. Neutrophils were the main cell type in synovial fluid. Synovial biopsy performed in two cases revealed non-specific inflammation. Erosions of the metatarsophalangeal joints were observed in one patient. Locoregional or systemic symptoms included transient fever (3/4), cystitis (4/4), urethritis (1/4), epididymoorchitis (2/4), conjunctivitis (1/4), and pleural effusion with pericarditis (1/4). The BCG was recovered from an epididymal specimen in one patient. Two patients were positive for the HLA B27 antigen. Outcome was favorable in every case (range: 15 days-6 months) after discontinuation of BCG therapy and administration of isoniazid, rifampin, and prednisone (3 patients) or NSAID (1 patient). Various pathogenic hypotheses for BCG-induced arthritis are discussed, including infection, immune responses to heat shock proteins, and reactive arthritis.

Administration, Intravesical↗
PubMed1992

Relationship between magnetic resonance imaging and histologic findings by bone biopsy in nontraumatic osteonecrosis of the femoral head.

To attest the validity of magnetic resonance imaging (MRI) to evaluate the pathophysiology in nontraumatic osteonecrosis (ON) of the femoral head, we attempted to correlate the different MRI patterns with the histology in cases of early stages. We used not only the T1 and T2 pulse sequences, but also the T1 sequence after gadolinium-DTPA to demonstrate the presence of vascularization. Studying 24 core biopsies from 16 hips (9 patients), we explored the MRI presentations that corresponded to the main histologic findings of the different trabecular bone and bone marrow conditions. Histologic findings including trabecular bone necrosis and bone marrow necrosis represented by amorphous eosinophilic debris presented a low T1 signal intensity without enhancement after intravenous gadolinium injection and a low T2 signal intensity. Trabecular bone necrosis associated with mummified fat cells presented a normal T1 and T2 signal intensity. Trabecular bone necrosis with fibrosis filling the intertrabecular spaces had a low T1 signal intensity that was enhanced by gadolinium and had an intermediate T2 signal intensity. Bands of fibrosis without trabecular bone as seen in fracture zones showed a low T1 signal intensity that was enhanced by gadolinium with a high T2 signal intensity. Thickened trabecular bone with fibrosis as found in creeping substitution areas had also a low T1 signal enhanced by gadolinium, but the T2 signal intensity was low. Farther from the necrotic area, despite normal trabecular bone, we found some patchy necrosis of the bone marrow without any modification of the normal T1 and T2 MRI patterns.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1991

Enkephalinase: a physiologic neuroimmunomodulator detected in the synovial fluid.

Enkephalinase (endopeptidase 24.11) is a metallopeptidase that is able to cleave not only neuropeptides and hormones but also immune mediators. The enzyme was quantified in synovial fluid obtained from 36 swollen joints. Its concentration correlated with the synovial fluid cell count, mainly the polymorphonuclear cells and lymphocytes, and with the erythrocyte sedimentation rate. No statistically significant difference in enkephalinase levels was demonstrated between the groups of patients with rheumatoid arthritis, seronegative spondylarthropathy, microcrystalline arthritis, or osteoarthritis. The presence of enkephalinase in the synovial fluid could reflect the intensity of the inflammatory process, or it could represent a physiologic regulator of inflammation and pain within the joint.

Arthritis↗
PubMed1991

Medullary impairment at early stage of non-traumatic osteonecrosis of the femoral head.

We found that a painful hip without radiological changes presented a modification of the magnetic resonance image of the femoral head and neck with diffuse low T1 weighted and high T2 weighted signal. Core biopsy showed that the bone marrow was replaced from the neck to the head of the femur by fibroblastic tissue and edema without detectable trabecular bone impairment. Classical radiographic, CT, and MRI abnormalities of osteonecrosis of the femoral head were present 14 months later. This report suggested that diffuse femoral head and neck medullary impairment with fat cell replacement by fibroblastic tissue without evidence of trabecular bone necrosis can be found at the early stages of idiopathic osteonecrosis.

Biopsy↗
PubMed1991

Polymorphonuclear neutrophils enhance anti-CD3-induced T cell activation: the role of polymorphonuclear FC-receptors.

We investigated the effect of polymorphonuclear neutrophils (PMN) on anti-CD3 mAb (OKT3 and anti-Leu4)-mediated T cell activation. In the absence of monocytes, purified E-rosette-positive cells (further referred to as "T cells") require either solid-phase bound anti-CD3 or the combination of both a high concentration of soluble anti-CD3 and exogenous recombinant interleukin 2 (rIL-2) to proliferate. PMN cannot sustain T cell proliferation with soluble anti-CD3, but they markedly boost proliferation in the presence of soluble anti-CD3 and rIL-2. When PMN were added to T cell cultures stimulated with anti-CD3, this resulted in IL-2 receptor (IL-2R) expression and CD3 modulation. The mechanism of enhancement of anti-CD3-induced IL-2-responsiveness by PMN was further analyzed. A cellular T cell-PMN interaction was found to play a critical role and this was mediated through PMN Fc receptors (FcR). PMN bear two types of low-affinity FcR (FcRII and FcRIII). FcRII is known to bind mIgG1 (e.g., anti-Leu4) and FcRIII binds mIgG2a (e.g., OKT3). FcR involvement was demonstrated by two observations. Anti-FcRII mAb IV.3 inhibited the PMN signal for T cell activation with anti-Leu4. PMN bearing the second variant of FcRII which is unable to bind mIgG1 failed to promote anti-Leu4/IL-2-mediated T cell proliferation. Thus, PMN potentiate T cell responsiveness to IL-2 in the presence of anti-CD3 mAb and this potentiation by PMN requires interaction of anti-CD3 with PMN-FcR.

Animals↗
PubMed1991

[Consumption of coca in history].

The first consumers of coca were the Aymara Indians of the Andes mountains. At the beginning, the consumption of coca-leaves was reserved to princes and priests during religious ceremonies. This habit was later extended to the common people. The Spanish invaders judged that this practice was the expression of a "pagan cult" and therefore banned the cultivation of the coca-plant. In the XIXth century, coca and cocaine were used once more in Europe. Freud made self-experiments with cocaine, but he was promptly discouraged by reading about the cases of cocaine mania reported in the American scientific literature. In 1870 Angelo Mariani brought on the market a kind of wine, based on coca extract, which enjoyed a great success in Europe. Hereafter Pemberton produced, in the USA, a competitive drink under the name "Vin français cola", wherein he replaced the wine by a cola extract and where from he finally vanished cocaine. The medical use of cocaine for the treatment of hayfever and asthma (Dr. Tücker's elixir) had in between officially been agreed by the famous scientific societies in America. This treatment was finally abandoned.

Ceremonial Behavior↗
PubMed1991

Study of magnetic resonance imaging in transient osteoporosis of the hip.

To better define the magnetic resonance imaging (MRI) features during transient osteoporosis of the hip, we carried out sequential MRI of 8 patients with transient osteoporosis of the hip showing the typical radiographic pattern of diffuse osteoporosis of the femoral head. These cases displayed the same MRI changes in the femoral head and neck characterized by low signal intensity on the T1 weighted images and high signal intensity on the T2 weighted images. The MRI signal became normal within 11 months, but surprisingly, migration of the MRI abnormalities was observed during the course of the disease in 5 cases: abnormal MRI signals were first observed in the anterior area, then migrated to the posterior part, while a normal MRI signal reappeared in the anterior part. We conclude that MRI seems to show some particular features in transient osteoporosis of the hip, which normalize after a few months of evolution; this could represent a migration of MRI abnormalities. Such findings could help in the differential diagnosis of hip diseases such as aseptic bone necrosis.

Adult↗
PubMed1990

Chronic acquired immunodeficiency syndrome-associated arthritis: a synovial ultrastructural study.

We describe a patient who developed acquired immunodeficiency syndrome-related complex, complicated by chronic, symmetric polyarthritis. Synovial biopsy showed large areas of plasma cell infiltration subjacent to the synovial lining. Ultrastructural study demonstrated tubuloreticular structures within endothelial cells, crystal-like inclusions in plasma cells, and virus-like particles located around synoviocyte fragments. Although immunologic and morphologic studies did not permit classification of these virus-like structures, the role of these possible virions in the pathogenesis of the observed synovitis remains to be determined. Surprisingly, the patient's chronic arthritis resolved with anti-retroviral treatment (azidothymidine: AZT).

AIDS-Related Complex↗
PubMed1990

High bone turnover in fibromyalgia.

This paper seeks to determine if patients with a fibromyalgic syndrome have specific abnormalities of skeletal homeostasis. Radioisotopic evaluation of skeletal remodeling showed higher Fogelman index and increased 24-hour pyrophosphate retention in the group of fibromyalgics (n = 28) when compared to the control group (n = 16). Bone density (lumbar vertebrae and femoral neck) was not significantly different from control subjects. These data might suggest an accelerated bone metabolism in these patients.

Adult↗
PubMed1990

Art and spine.

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Art↗
PubMed1990

Macroscopic and microscopic gut lesions in seronegative spondyloarthropathies.

A retrospective study by ileocolonoscopy and multiple biopsies was performed on 96 patients with seronegative spondylarthropathy, 17 patients with osteoarthritis (OA) and 19 patients with chronic abdominal discomfort. Under these conditions, inflammatory gut lesions were detected in 66.7% of the patients with spondyloarthropathy, 12.5% with OA and 15.8% with chronic abdominal discomfort. In 10 patients treated by sulfasalazine (Salazopyrine), pathologic lesions disappeared simultaneously with an improvement of the rheumatic conditions. comparison between patients treated and untreated with nonsteroidal inflammatory drugs (NSAID) demonstrated that NSAID did not enter into the etiopathology of the intestinal lesions. Our study therefore confirms the high incidence of inflammatory gut lesions among patients with spondylarthropathy which seems not to be related to NSAID therapy.

Abdominal Pain↗
PubMed1990

How ancient is temporal arteritis?

Realism is one of the characteristics of Amarnian art; some details of The Harpist represented in the tomb of Pa-Aton-Em-Heb (1350 BC, 18th Dynasty) might gives clues to a diagnosis: the eyes are closed with swollen lids, and the harpist appears to stare into space; he is round shouldered with a very wasted face, his temporal ara is heightened and hollowed by a broken line joining the extremity of the eyebrow with the corner of the eye. These details are not found elsewhere. Did the harpist's blindness result from temporal arteritis associated to polymyalgia rheumatica?

Giant Cell Arteritis↗