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Biomedical subjects

E Lejeune

Publications and source records attributed to E Lejeune.

At least 19 recordsLinked to original sources

Cerebrospinal fluid dynamics in the tardive cauda equina syndrome of ankylosing spondylitis.

Typical cauda equina syndrome secondary to long-standing ankylosing spondylitis is reported in a 63-year-old man. Radionuclide cisternography demonstrated a resorption defect of cerebrospinal fluid in the enlarged lumbosacral dural sac. After transient symptomatic improvement with acetazolamide, a lumboperitoneal shunt was placed. The rate of cerebrospinal fluid, isotope resorption became normal. In the 5 years of follow-up, partial remission has been observed.

Cauda Equina

The rheumatoid heel: its relationship to other disorders in the rheumatoid foot.

Four-hundred and eight rheumatoid feet are studied. The percentage of talalgia is 3.7%; for inferior exostosis it is 29.6%, and 30.8% for posterior exostosis. Posterior demineralisation is present in 12%, whereas for bony erosion it is 8.1%. Plantar spurs are very closely associated to flattened feet (p less than 0.0001). Likewise a very noticeable statistical association is noted between postero-superior calcaneitis and tarsal arthritis (p less than 0.0001), and calcaneitis was more frequent among marked valgus (p less than 0.001). These results are compared with findings of other works. Therapeutic consequences are evoked.

Achilles Tendon

Compared effects of isoxicam and indomethacin on the urinary excretion of prostaglandins in degenerative articular diseases.

The effects of a 7 day-treatment with isoxicam (200 mg/24 h) on the urinary excretion of prostaglandins (PG) were compared to those of indomethacin (150 mg/24 h) in a double-blind randomized study conducted in 18 patients with degenerative arthritic disease and normal renal function. Indomethacin decreased the urinary excretion of PGF2 alpha by about 70% and 6-keto-PGF1 alpha and thromboxane (Tx)B2, the stable break-down products of prostacyclin and TxA2 respectively, by about 40%. Isoxicam effects on urinary PG did not significantly differ from those of indomethacin. During both treatments, urinary gamma-glutamyl transferase and N- acetyl-glucosaminidase remained stable and none of the changes in the urinary excretion of PGs could be related to either plasma or urinary drug concentrations. In conclusion, chronic administration of isoxicam inhibited the renal PG biosynthesis to a similar extent than indomethacin which suggests that non steroidal anti-inflammatory drugs of the oxicam group ought also be used cautiously in patients with renal impairment.

6-Ketoprostaglandin F1 alpha

[Enlarged transfacial approach in the surgery of tumors of the ethmoid].

Cancers and tumours of the ethmoid bone are characterized by the possibility of extension towards the lamina cribrosa and within the cranium. Removal via a combined neurosurgical and paralateronasal route would appear to provide a more favourable prognosis for the patient. It is, however, a particularly cumbersome approach, and the neurosurgical follow up may be difficult. This is why we recommend a direct approach to both the ethmoid bone and the anterior part of the base of the cranium via a transfacial route, thus permitting complete removal of the tumour and of any intracranial extension through the lamina cribrosa. A number of points of technique are important: the line of the skin incision and the flap of cranial periosteum, operative examination and exploration of the upper part of the tumour, the reconstruction of the meningeal barrier and, if necessary the base of the cranium. The price to be paid for this approach route is the scar which is, however, always of minimum size and well tolerated by patients. Operative follow up is simple--which is the major advantage of the technique--and the carcinological prognosis appears to be as satisfactory as for the combined route.

Ethmoid Sinus

Deformation of the adult rheumatoid rearfoot. A radiographic study.

Three hundred ninety-seven adult rheumatoid feet were examined. Those in whom pain had been present since the onset of the disease were compared radiographically with the painless feet in standing position: examination of the talar angle and of the internal arch showed flattening on the affected feet. The calcaneal angle, on the other hand, showed no difference between the two groups, but this latter parameter is little affected by the valgus pronation deformity of the hindfoot most often seen in patients who had experienced foot pain.

Adult

IgM rheumatoid factor (RF), IgA RF, IgE RF, and IgG RF detected by ELISA in rheumatoid arthritis.

One hundred patients with rheumatoid arthritis (RA), of whom 73 were seropositive by latex or Waaler-Rose (WR) assays, or both, 100 healthy subjects, and 102 diseased controls (22 patients with systemic lupus erythematosus (SLE) and 80 with bronchial asthma) were evaluated for the presence of IgM rheumatoid factor (RF), IgA RF, IgE RF, and IgG RF by an enzyme linked immunosorbent assay (ELISA). Ninety two per cent, 65%, 68%, and 66% of the patients with RA were found to be positive for IgM, IgA, IgE, and IgG respectively. A positive correlation existed between the levels of IgM RF and IgA RF on the one hand and disease activity on the other, and the levels of IgM RF and IgA RF correlated with the levels of circulating immune complexes as measured by a C1q binding assay. The presence of extra-articular features also correlated positively with the levels of IgA RF and IgE RF. Five out of six patients with Sjögren's syndrome had very high levels of IgA RF. Of 47 patients typed for HLA-DR, DR1 and DR2 were significantly more frequent in those with the highest levels of IgM RF. Conversely, DR3 was associated with low levels or absence of IgA RF and IgE RF. These results suggest that immune response genes may regulate the level of different RF isotypes. The frequencies of IgM, IgA, IgE, and IgG RF were 59%, 36%, 9%, and 27% respectively in SLE and 25%, 2.5%, 70%, and 59% in bronchial asthma.

Adult

Flattening of the rheumatoid foot in tarsal arthritis on X-ray.

222 consecutive and unselected patients suffering form classical or definite rheumatoid arthritis wee studied. 397 of their feet were examined. Talonavicular arthritis was the commonest finding (31.5% of all patients), followed by sub-talar (23.3%), cuneo-navicular (20.4%) cuneo-metatarsal (14.9%) and tibio-tarsal arthritis (12.6%). Rheumatoid disease of the tarsus becomes commoner as the disease progresses. The incidences of involvement of the talo-navicular and sub-talar joints show a similar pattern, with a leap of 25% between 5 years of duration of the disease and 10 years. The same is seen with involvement of the cuneo-navicular and cuneo-metatarsal joints, between a duration of 10 years of the disease and 15 years. The percentage of flat foot is greater in feet with tarsal arthritis (p less than 0.001). The authors observed a relationship between tarsal arthritis, the length of history of rheumatoid arthritis, and flat foot. The method of investigation is discussed, and theories about evolution of the rheumatoid foot are considered.

Adult