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Biomedical subjects

A J Crisp

Publications and source records attributed to A J Crisp.

At least 19 recordsLinked to original sources
PubMed1992

Giant cell tumours in mandible and spine: a rare complication of Paget's disease of bone.

The case of a man who was diagnosed as having polyostotic Paget's disease at the age of 52 years is described. He developed a rare neoplastic complication of Paget's disease--a giant cell tumour in his mandible, which was excised. Nine years after the diagnosis of this tumour he developed a new giant cell tumour arising from the L3 vertebral body. He was born in Avellino in Italy, from where five other cases of giant cell tumours arising from Pagetic bone disease have been reported. No family relationship between our patient and the other cases was established. His Paget's disease was particularly aggressive and resistant to treatment with two single high dose infusions of pamidronate almost two years apart.

Aged↗
PubMed1992

Differential involvement of the dorsal and lumbar spine in osteoporosis.

The presence of normal bone density values in the lumbar spine is often assumed to exclude osteoporosis. Eleven cases are reported in which normal lumbar spine bone density and radiology were associated with one or more dorsal spine fractures; the diagnosis was postmenopausal osteoporosis in eight patients and corticosteroid induced osteoporosis in three. These findings suggest that spinal osteoporosis may sometimes be a focal disorder and emphasise the need for dorsal spine radiology in addition to bone densitometry in patients with strong risk factors for osteoporosis or with clinical evidence of the dorsal spine being affected.

Absorptiometry, Photon↗
PubMed1992

Localized scleroderma and hemiatrophy in association with antibodies to double-stranded DNA.

Localized scleroderma involves primarily skin but also muscle, bone and synovium. Further associations and transitional forms have been reported. We report here two cases showing associations between localized scleroderma and vasculitis, mononeuritis multiplex, juvenile chronic arthritis and hemiatrophy. In particular our cases both possess antibodies to double-stranded DNA, a finding not previously reported.

Adolescent↗
PubMed1992

Comparison of the effect of different reference data on Lunar DPX and Hologic QDR-1000 dual-energy X-ray absorptiometers.

We have investigated whether the Lunar DPX (software 3.4) and Hologic QDR-1000 dual-energy X-ray absorptiometers have comparable normal reference databases for the spine and femur of white UK and USA subjects. After conversion for systematic differences in absolute bone density values between the two systems, the reference databases were very similar for the spine in young subjects, but there were clear differences in the femur databases of young females and males of all ages. These differences were confirmed by comparing the percent age-matched and young values determined by the two systems for subjects scanned on both systems. Thus the diagnosis and management of a patient could differ, depending on the system used for the bone density measurements.

Absorptiometry, Photon↗
PubMed1991

Clinical profile of acute vertebral compression fractures in osteoporosis.

Thirty patients with acute, painful vertebral compression fracture were studied. Certain vertebrae, namely T8, T12, L1 and L4, were more likely to fracture. The majority occurred spontaneously (46%) or after trivial strain (36%). Of the former, 30% occurred whilst in bed. Radiation to the flanks and anteriorly was common (66%) but leg radiation was uncommon (6%). Associated symptoms noted were: nausea (26%), abdominal pain (20%), chest pain (13%). Straining exacerbated pain in only 60%. The position of comfort was lying flat (43%) or sitting (36%) but 16% found standing or walking most comfortable. The correct diagnosis was made at the first visit in only 43% of patients. In the remainder there was a mean delay of 4.5 days before diagnosis. This poor diagnostic rate may be improved if other clinical features of osteoporosis such as kyphosis and a previous history of wrist and hip fractures are recorded, particularly when acute back pain occurs in bed. Full thoracic and lumbar X-rays may be required because pain and site of pathology may not coincide. Bone scanning may be necessary if immediate X-rays are normal. In early management the position of most comfort may be preferable to complete bed rest.

Acute Disease↗
PubMed1991

Comparative performance in vitro and in vivo of Lunar DPX and Hologic QDR-1000 dual energy X-ray absorptiometers.

The measured absolute bone mineral density values of spine and femur and their precision were compared on two dual energy X-ray absorptiometers, the Lunar DPX and the Hologic QDR-1000. There were systematic differences between the two systems, the Lunar DPX always giving a higher bone density value. The ratio of the mean Lunar DPX/Hologic QDR-1000 bone density measurements obtained in vivo was 1.13 g/cm2 for spine (L2-L4) and 1.20-1.43 g/cm2 for femur measurements. For both systems, short- and long-term precision (coefficient of variation) was below 0.5% for spine in vitro measurements and below 1.5% for neck of femur in vitro measurements. Precision of in vivo measurements was less good, especially for femur measurements. The coefficient of variation of spine measurements was dependent on bone density and deteriorated with decreased bone mineral density and increased body thickness.

Absorptiometry, Photon↗
PubMed1991

Astemizole, an H1 antagonist, has no additional therapeutic effect in rheumatoid arthritis.

Mast cells are found in increased numbers in the synovium of patients with rheumatoid arthritis (RA) and may play a role in synovitis. They produce proinflammatory substances including histamine. A double blind placebo controlled study was undertaken in 60 patients with active RA using the H1 receptor blocker, astemizole, as an adjuvant to usual therapies. After 3 months of treatment there were no significant differences in clinical and laboratory variables between the groups. We conclude that H1 antagonist treatment with astemizole has no additional therapeutic effect in RA.

Aged↗
PubMed1990

Clinical conundrum.

Recent publicity about osteoporosis has stimulated an enormous number of enquiries about treatment and prompted a surge of referrals to rheumatologists. In what circumstances should osteoporosis be considered a disease, how is it best monitored, what treatment would you advocate and for how long?

Aged↗
PubMed1989

1H nuclear magnetic resonance investigation of synovial fluid components in osteoarthritis, rheumatoid arthritis and traumatic effusions.

The levels of a range of components were measured by 1H nuclear magnetic resonance (1H NMR) in samples of synovial fluid taken from three groups of patients: 10 with osteoarthritis (OA), 18 with rheumatoid arthritis (RA), and 11 with traumatic effusions. A large number of low molecular weight species were measured simultaneously in addition to triglycerides and glycoproteins. Large variations were found between individuals in any one disease group, and there was no measurable correlation between disease state and levels of any low molecular weight component. However, patients with traumatic effusions had high levels of saturated triglycerides, while those with OA had low levels. The chain length of the triglycerides found in OA synovial fluid appears to be shorter than that for the other groups. In RA the composition of triglycerides appears normal, while the overall level is slightly above normal. In a separate study, serial samples of synovial fluid drawn from the knees of two arthritic patients were examined, and the concentrations of glycoprotein, triglycerides and creatinine were found to show a reasonable correlation with each other and with systemic measures of disease activity. These data suggest the potential of synovial fluid triglycerides and creatinine as inflammatory markers.

Arthritis, Rheumatoid↗
PubMed1989

The effects of changes in left ventricular pressure on respiratory activity in anaesthetized dogs.

This study was undertaken to determine whether moderate increases in left ventricular systolic pressure in anaesthetized dogs result in changes in respiratory activity. Left ventricular systolic pressure was changed using a preparation in which the applied pressure did not distend the aortic arch and in which left atrial and carotid sinus pressures were held constant. The systemic circulation was perfused at constant flow and respiratory activity was assessed from the phrenic electroneurogram. Increases in aortic root and left ventricular systolic pressures resulted in a decrease in arterial perfusion pressure, no significant change in heart rate and a decrease in phrenic nerve activity. These responses differed from those to changes in carotid sinus pressure, which were decreases in perfusion pressure and heart rate but no significant steady-state change in phrenic activity. Responses to changes in ventricular pressure were obtained to each small step between 16 and 28 kPa (120 and 210 mmHg). Following cervical vagotomy, changes in ventricular pressure resulted in neither respiratory nor vascular responses. These results indicate that left ventricular receptors may play a role in the control of respiration.

Anesthesia↗
PubMed1989

The influence of left ventricular pressure on the vascular responses to changes in carotid sinus pressure in anaesthetized dogs.

The aim of this study was to determine whether the degree of stimulation of left ventricular receptors influenced the sensitivity of the carotid sinus baroreceptor reflex. In anaesthetized dogs, the stimulus to left ventricular receptors was changed by changing aortic root and hence ventricular systolic pressure, using a preparation in which the applied pressure did not distend the aortic arch and in which left atrial pressure was controlled. A large step increase in either carotid or left ventricular pressure resulted in vasodilatation both in a perfused hindlimb and in the remainder of the systemic circulation and resulted in a reduction in the response to a change in pressure in the other area. The stimulus-response curves, relating limb and systemic perfusion pressures to small step changes in carotid sinus pressure, were displaced downwards at high left ventricular pressures. However, the curves remained parallel indicating the absence of an interactive effect. These results indicate that the vascular responses to changes in carotid and ventricular pressures show simple additive summation.

Animals↗
PubMed1987

Algodystrophy: a common unrecognized cause of chronic knee pain.

Thirty-three patients with undiagnosed chronic knee pain had features of autonomic disturbance. Thermography is a useful imaging technique for demonstrating this abnormality. The patients lacked the thermographic symmetry observed in 16 normal controls but this returned with resolution of the pain. Recognized radiological and scintigraphic features of algodystrophy were found. The long duration of symptoms, high proportion of young females and the severity of the associated disability were notable. It is suggested that algodystrophy is a more frequent cause of chronic knee pain than previously recognized. Autonomic abnormalities may be less intense in disease at this site, particularly in young females and may be overlooked. This characteristic of algodystrophy of the knee may contribute to chronicity and subsequent disability.

Adolescent↗