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Biomedical subjects

C J Menkes

Publications and source records attributed to C J Menkes.

At least 19 recordsLinked to original sources
PubMed1995

[Pubic symphysitis secondary to fistula. Physiopathological hypothesis].

Symphysitis of the pubis due to Streptococcus occurred after endoscopic resection of the prostate in a 69-year-old man. Despite a well conducted antibiotic regimen, signs persisted one year later and required arthrography that showed a prostato-symphysis fistula. This procedure might be used to find an explanation of certain persistent cases of symphysitis. Fistulization between the prostate and the pubic symphysis would be a new pathogenic hypothesis for symphysitis of the pubis.

Adenoma↗
PubMed1995

Jacques Forestier.

Explore the source record for details and available documents.

Arthritis, Rheumatoid↗
PubMed1995

Treatment of carrageenan induced arthritis by the platelet activating factor antagonist BN 50730.

OBJECTIVE: To evaluate the role of platelet activating factor (PAF) in the early stage of arthritis. METHODS: Arthritis was induced in rabbits by weekly intra-articular injections of carrageenan. A PAF receptor antagonist, BN 50730, was used as a preventive or curative agent. RESULTS: BN 50730 was able partially to prevent the development of arthritis, and was also active on established arthritis. The joint arthritis scores of BN treated animals were significantly lower than those of the non-treated animals. The blood concentrations of PAF, PAF bound to lipoproteins (lipo-PAF), and its precursor, lyso-PAF, were not correlated with clinical variations. CONCLUSIONS: The present data demonstrate a therapeutic action of a PAF antagonist in experimental arthritis and suggest a critical role for PAF during the early stage of arthritis.

Animals↗
PubMed1995

Appearance of systemic lupus erythematosus after thymectomy: four case reports and review of the literature.

The appearance of systemic lupus erythematosus (SLE) after thymectomy (or thymomectomy) is presented in four patients together with a comparative review of additional reports found in a Medline search for the years 1966-94 in the English and French literature. Fourteen women and two men of average age of 39 years (range 11-66 years) at presentation, developed SLE after thymectomy (11 patients) or thymomectomy (five patients). Half developed SLE within 3 years after surgery (range 3 months to 18 years). The most common SLE manifestation was polyarthritis occurring in 15 of 16 patients either at presentation or during the first year. Other frequent manifestations included skin rashes, fever, cytopenias and pleuritis. Two rare manifestations of SLE, optic neuritis and transverse myelitis, were reported in two patients. Thymic hormone activity was measured in one patient and was undetectable compared with normal controls. HLA studies in eight patients showed the combination of A1, B8 in four. In conclusion, the appearance of SLE after thymectomy or thymomectomy appears to be more than a coincidence. It may provide insights into the pathogenesis of SLE.

Adolescent↗
PubMed1995

Correlations between PAF-acether and tumor necrosis factor in rheumatoid arthritis. Influence of parenteral corticosteroids.

The aim of this study was to evaluate the presence of PAF-acether (PAF), its specific degrading enzyme acetylhydrolase, and tumor necrosis factor (TNF) concentrations in blood and synovial fluid (SF) from patients with active RA. The variations of the mediators were also evaluated after corticosteroid perfusions in 7 patients. Lipo-PAF (PAF complexed to lipoproteins) was the main form of PAF detected both in blood and in SF, whereas unbound PAF was uncommon. Acetylhydrolase activity was also present in SF, with a strong correlation between serum and SF levels. TNF was detected in most of the samples, and TNF and acetylhydrolase levels were strongly correlated both in blood and in SF. Despite dramatic clinical improvement, corticosteroid treatment was not accompanied by a significant reduction of the concentration of blood mediators, suggesting that these molecules should not be considered as markers of disease activity.

1-Alkyl-2-acetylglycerophosphocholine Esterase↗
PubMed1995

High levels of antibodies to annexins V and VI in patients with rheumatoid arthritis.

OBJECTIVE: Glucocorticoids are powerful antiinflammatory agents widely used for the treatment of rheumatoid arthritis (RA). Synthesis and/or secretion of annexin I (A-I) is induced by these steroids. Annexins V and VI are also found extracellularly but are not induced by glucocorticoids. Annexins may be potent antagonists of phospholipase A2 (PLA2). Since autoantibodies to A-I have been reported in patients with RA, we studied the reactivity of sera from patients with RA to A-V and A-VI. METHODS: Sera from 26 patients with RA were assessed for anti-A-V and anti-A-VI antibodies and compared with sera from 26 sex/age matched healthy subjects. IgG and IgM antibodies were analyzed in an ELISA: A correlation study with disease activity and corticosteroid treatment schedule was performed. RESULTS: Sera from patients with RA contained significantly higher levels of IgG [anti-A-V and anti-A-VI] autoantibodies than control sera, both being correlated. This rise in antiannexin antibody titers was correlated with the RA activity score, and negatively correlated with the daily dose of corticosteroids. CONCLUSION: High levels of IgG (anti-A-V and anti-A-VI) antibodies were found in sera from patients with RA. We suggest that antiannexin autoantibodies may play a role in the clinical course of RA by impairing the anti-PLA2 effect of annexins.

Adult↗
PubMed1995

Type II procollagen gene (COL2A1) mutation in exon 11 associated with spondyloepiphyseal dysplasia, tall stature and precocious osteoarthritis.

OBJECTIVE: To define the clinical, pathological and molecular genetic characteristics of a family with mild spondyloepiphyseal dysplasia (SED) and precocious osteoarthritis. METHODS: The proband was a 46-year-old man with precocious generalized OA, tall stature, mild chondrodysplasia and moderate deafness. His daughter, aged 21, showed similar clinical features. Electron microscopic (EM) analysis of collagen from an affected joint of the proband was performed. DNA was extracted from whole blood on the proband, his affected daughter, unaffected wife and second daughter, to look for a mutation in exons 31 or 11, sites where point mutations have been previously described in mild forms of SED. After finding no mutation in exon 31, exon 11 of COL2A1 was further analyzed. Exon 11 was amplified using polymerase chain reaction (PCR), and screening for the mutation was undertaken using a restriction enzyme digestion, the recognition sequence of which is altered by this point mutation. Sequence analysis was then performed. RESULTS: Electron microscopic (EM) analysis of cartilage from the proband showed thin appearing collagen fibrils organized into parallel lamellar structures. DNA studies revealed a single base change in one allele of exon 11 which produced an arginine to cysteine mutation at position 75 of the triple helix of type II collagen in the proband and his affected daughter. CONCLUSION: This is the 2nd example of an Arginine75-Cysteine mutation associated with SED; in our case, however, contrasting clinical features were present. Recurrent mutations at a few specific sites of COL2A1 suggest the possibility of susceptibility "hot spots" for mutational events.

Adult↗
PubMed1995

Are classification criteria for spondylarthropathy useful as diagnostic criteria?

The authors used data from a study conducted under the auspices of the Société Française de Rhumatologie to evaluate the sensitivity and specificity of the individual items of two sets of criteria for spondylarthropathy. The study included 124 patients with spondylarthropathy and 1,964 controls. They found that the spondylarthropathy criteria with the highest sensitivities and specificities were useful not only for classifying patients but also for assisting in the diagnosis of spondylarthropathy.

Humans↗
PubMed1994

Guidelines for testing slow acting drugs in osteoarthritis.

New compounds appear to improve symptoms of osteoarthritis (OA), and others are putative chondroprotective agents. We suggest experimental designs for studying the effects of these agents in subjects with hip and knee OA. The course of the articular cartilage lesion is the primary outcome measure to be assessed in putative chondroprotective agent trials. Serial radiographic studies suggest that the annual rate of joint space narrowing in patients with hip or knee OA is about 0.25 mm. Other approaches to quantitation of cartilage loss, e.g., radiographic measurement of the area of joint space, ultrasonography, magnetic resonance imaging and fiberoptic arthroscopy (for knee OA) are under investigation.

Antirheumatic Agents↗
PubMed1994

Intraarticular treatment of osteoarthritis and guidelines to its assessment.

Intraarticular treatment has been considered for osteoarthritis since the first attempts at local injection of steroid derivatives. To assess the effectiveness of intraarticular drugs, in view of the variability of the disease and the remarkable placebo response, a control group of patients is necessary. The main outcome measures are pain and joint effusion when using symptomatic slow acting drugs. If a chondroprotective effect is to be demonstrated the main criterion is measurement on standardized radiography of the knee medial femorotibial joint space.

Clinical Trials as Topic↗
PubMed1993

Effects of disease-modifying anti-rheumatic drugs, steroids and non-steroidal anti-inflammatory drugs on acute-phase proteins in rheumatoid arthritis.

Elevated serum concentrations of acute-phase proteins (APPs) are a characteristic finding of rheumatic diseases, including RA. CRP is the most useful measure of disease activity and is frequently assessed in clinical trials to determine systemic improvement. The effects of different therapies for RA on CRP have been assessed in many studies. The DMARDs such as gold salts, D-penicillamine, sulphasalazine and azathioprine have been shown to reduce serum CRP concentrations significantly in patients with RA. CRP serum concentration is also reduced by the corticosteroids such as prednisone, but addition of pulse therapy with i.v. methylprednisolone had no additive effect compared with DMARDs alone. Many studies have shown that serum CRP concentrations are not reduced by NSAIDs; however, one recent study has demonstrated that CRP concentration was reduced by the NSAIDs flurbiprofen and sustained-release ibuprofen in a subgroup of patients.

Acute-Phase Proteins↗
PubMed1993

Complement component C4 deficiencies and gene alterations in patients with systemic lupus erythematosus.

Deficiency of complement component C4 is considered playing a role in the genetic predisposition for systemic lupus erythematosus (SLE). The purpose of this study was to characterize the genomic alterations of the C4 and CYP21 genes in 40 caucasoid patients with SLE by C4 allotyping and by RFLP analysis. Nineteen patients (47.5%) carried C4A null alleles and eight patients (20.0%) C4B null alleles. SLE patients had more frequent C4A null alleles (47.5%) than healthy individuals (20%) (chi 2 = 10.75; P < 0.005). The commonest molecular alteration in the patients with C4A null alleles was a large gene deletion affecting both C4A and CYP21A genes. However, among the patients with C4A null alleles, 16.7% persons had no detectable C4A deletion. The non-expression of C4A gene might be due to defects at various levels of gene expression (i.e. transcription and translation). Among the patients with C4B null alleles, 62.5% persons had no detectable gene lesion, whereas 37.5% showed a C4B deletion including both C4B/CYP21A or C4B/CYP21B genes. Duplication of the C4B gene was not rare in SLE patients, as we found 15.0% of the patients with a heterozygous C4B/CY21A gene duplication. The patients typed as having C4B gene homoduplication (B1,1) demonstrated two long C4B loci, whereas heteroduplication (B1,2) displayed two short loci, therefore the type of C4B gene duplication may be related to the gene length. In conclusion, C4 deficiencies observed in 26 of the 40 SLE patients studied were very heterogeneous. In every case, the gene alteration affected both C4 and CYP21 genes.

Alleles↗
PubMed1993

Substance P levels in the synovium and synovial fluid from patients with rheumatoid arthritis and osteoarthritis.

Experimental results suggest that substance P (SP) may play an important role in pain and inflammation in rheumatic diseases. Measurements of SP-like immunoreactivity (SPLI) were performed in synovial fluid (SF) and synovial tissue from 40 patients with rheumatoid arthritis (RA) or osteoarthritis (OA). High levels of SPLI were found in the SF of patients with RA compared with OA. Conversely, SPLI content in synovial tissue was higher in OA than in RA, suggesting that there is an active secretory process of SPLI into the SF in RA, thus depleting SPLI stores in the synovium. Our data support the involvement of SP in the perpetuation and exacerbation of inflammation in RA, and may also explain some clinical features of this disease.

Adult↗
PubMed1993

Sarcoid-like forms of Whipple's disease. Report of 2 cases.

Whipple's disease is a worrying disease because of its protean manifestations. It may sometimes take on the appearance of sarcoidosis with polyvisceral granulomatous dissemination. We describe 2 cases of sarcoid-like Whipple's disease including one with synovial granulomatous involvement. It therefore appears to be essential, in view of the therapeutic possibilities, to perform periodic acid Schiff stain on all granulomas and duodenal fibroscopy with biopsies, even in the absence of any gastrointestinal symptoms, before concluding that the diagnosis is sarcoidosis.

Aged↗
PubMed1993

Acute arthritis and human immunodeficiency virus infection in Rwanda.

OBJECTIVE: To determine the etiology of acute arthritis observed in adults and to define its relationship with human immunodeficiency virus 1 (HIV-1) infection in Kigali, capital city of Rwanda. METHODS: From September 1, 1989 until March 31, 1990 we conducted a study of all new patients admitted with acute arthritis to the outpatient and inpatient services of the Department of Internal Medicine at the Centre Hospitalier de Kigali, in Kigali, Rwanda, a city highly endemic for HIV infection. RESULTS: Thirty-six patients (27 men 9 women; mean age: 31 years, range 18-65) were included in the study. Twenty-six (72%) were HIV seropositive. Two main diagnostic categories emerged, both strongly associated with HIV infection: (1) aseptic arthritis: 16 (44.5%) patients including 12 (33.5%) patients with spondyloarthropathy of whom 10 (83%) were HIV seropositive, and 4 (11%) patients with HIV related arthritis, (2) septic arthritis: 11 (30%) patients of whom 9 (82%) were HIV seropositive, including 4 with gonococcal, 2 with staphylococcal, 1 with Salmonella B and 2 with tuberculous arthritis. CONCLUSION: In an area highly endemic for HIV, acute arthritis should be considered a possible manifestation of HIV infection and should prompt HIV testing.

Acquired Immunodeficiency Syndrome↗