Avascular necrosis of the femoral head in HIV-infected patients.
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Biomedical subjects
Publications and source records attributed to X Chevalier.
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Plasma levels of cholesterol, triglyceride, HDL-cholesterol, and apolipoproteins A1 and B were assayed in ninety patients (sixty-four male and twenty-six female) with reflex sympathetic dystrophy and in ninety controls matched for age, sex, and body mass index (BMI). No significant differences were found between the two groups for the proportions of patients with increased plasma cholesterol levels (6.6% versus 4.4%) or increased plasma triglyceride levels (40% versus 30%), as defined by Turpin's age and sex-specific criteria, or for mean values of these parameters. In the 38 patients with reflex sympathetic dystrophy of less than 3.5 months duration, plasma triglyceride levels were significantly higher than in the 38 matched controls (1.24 + 0.57 g/l versus 1.02 +/- 0.91; p = 0.04). In patients (n = 52) with disease of more than four months duration (range 4-39), plasma triglyceride levels were similar in the two groups. Lipidemia was similar in patients and controls regardless of age, sex, topography of the disease, clinical manifestations, and whether or not the disease was due to an injury. This study, in contrast to previous reports, failed to disclose an association between reflex sympathetic dystrophy and hyperlipidemia. Transient hypertriglyceridemia may occur during the first 3 1/2 months of the disease as a result of initial immobilization.
The authors report a case of multiple myeloma involving the temporal bone and responsible for a vestibular syndrome associated with hypoacusis. The lesion was best visualised by magnetic resonance imaging.
To appreciate hyperlipidaemia as a contributing factor to reflex sympathetic dystrophy (RSD), we have evaluated basal lipidic values (cholesterol, HDL-cholesterol, triglycerides, apolipoproteins A1, B) and frequency of hypertriglyceridaemia (Turpin's diagnosis criteria) in 75 cases of RSD and in 75 paired controls. No difference exists in both groups with regard to frequency of hypertriglyceridaemia or basal lipidic values. These values seem independent of age, sex, duration of localization or etiology (traumatic or nontraumatic) of RSD. Hyperlipidaemia does not seem a contributing factor to RSD.
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The various subsets of serum IgA were determined in 43 patients with ankylosing spondylitis to investigate the putative mucosal origin of increased IgA concentrations in this disease. Total IgA was shown to be increased and weakly correlated with the erythrocyte sedimentation rate (ESR). In contrast, although the mean concentration (but not the median) of secretory IgA (SIgA) was slightly increased, no correlation was found with total IgA nor the ESR. Moreover, molecular sieving of nine serum samples selected for their high concentrations of total IgA, and absorption with insoluble jacalin showed these immunoglobulins to be essentially monomers of the IgA1 subclass. These results are consistent with a non-secretory origin of the increase of serum IgA, which must be ascribed to the central immune system.
The case is reported of a 41 year old white woman who developed systemic lupus erythematosus (SLE) seven years after primary Sjögren's syndrome and four years after the association of Sjögren's syndrome with Jaccoud's arthritis. The SLE was detected by a benign intracranial hypertension, which is a rare neuro-ophthalmic presentation of lupus. No associated conditions linked to benign intracranial hypertension syndrome were seen in this patient and the hypertension syndrome recurred one year later.
The biosynthesis of fibronectin was determined in explants from normal and osteoarthritic human cartilage after metabolic labeling and immunoprecipitation. Each sample of osteoarthritic cartilage was divided into three regions taken at different distances from the eburnated bone area. Only full depth cartilage samples were taken into consideration. We could detect a low level of fibronectin biosynthesis in normal cartilage. In osteoarthritic cartilage increased synthesis of fibronectin was demonstrated, the most important in the region close to the eburnated area. Increased synthesis, although to a lower extent, was also demonstrated in the two other regions at increasing distances from the eburnated areas. Immuno-histological examinations performed on tissue samples and similar studies on articular chondrocyte cell cultures confirmed the accumulation of newly synthesized fibronectin in pathological conditions.
Only 3 cases of isolated septic arthritis of a lumbar facet joint have been reported, all due to Staphylococcus aureus. We describe a case of Klebsiella pneumoniae septic arthritis of a lumbar facet joint in an HLA-B27 positive patient.
In this retrospective study twelve histologically confirmed cases of spinal chordoma have been reviewed. Plain radiographs were performed in all cases, and CT scans in 11 patients. Four patients had post-myelography CT. Five patients were explored by MRI, and two had a post-DOTA-gadolinium MR study. Ten patients underwent spinal arteriography. Cervical spine chordomas (3 cases) were osteolytic, developed laterally to the vertebral body and involved one of more adjacent vertebrae. Thoracic and lumbar chordomas (9 cases) were usually centrally located in the vertebral body with no adjacent involvement and presented as osteo-sclerotic or mixed osteolytic-osteosclerotic lesions. CT scans provide a good view of the extravertebral component of the tumour, but MRI is the best imaging method to evaluate tumoral extension. Intravenous gadolinium injection seems to produce a better delineation of the epidural extent of the tumour at cervical level. Angiography remains useful for presurgical evaluation.
We describe a 74-year-old woman who presented with referred thigh pain associated with multiple osteonecroses of the T12, L1 and L2 vertebrae. Magnetic resonance imaging was found to be a valuable diagnostic aid, revealing signs of spinal cord and nerve root compression related to the collapsed vertebrae. Biopsy of T12 confirmed the benign nature of the vertebral compression fracture. Our patient also showed histologically documented osteoporosis.
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We describe an unusual case of peripheral T cell lymphoma, occurring 4 years after the diagnosis of primary Sjögren's syndrome. Immunologic and genotypic studies demonstrated the T cell origin of this lymphoma.
Pasteurella multocida is frequently responsible for infections in man due to wounds inflicted by animals (generally cats or dogs). However, the development of septic arthritis is a rare complication. We report 4 cases of Pasteurella multocida septic arthritis with demonstration of the organism in the joint in each case. Two cases presented with monoarthritis (sternoclavicular joint and wrist) and 2 cases had polyarticular involvement from the outset.
It could be demonstrated that plasma and tissue fibronectin (FN) increase with age. Some age dependent diseases as diabetes, osteoarthritis and Werner syndrome produce also an increase of tissue fibronectin biosynthesis. Plasma fibronectin decreases in diabetes and in breast cancer. Alternative splicing of the FN gene appears also to vary with age and in some related pathologies. Nutritional status and UV light also influence FN biosynthesis. It appears therefore that the determination of plasma FN and its isoforms as well as the study of tissue FN may be of interest for the study of chronological aging and related pathologies.